Families and advocates for young drug users are divided on whether minors should be forced into so-called safe care to stabilize them before longer-term voluntary treatment can be provided.
Laws vary across Canada for what amounts to involuntary detox for minors who are sometimes detained by the emergency department following an overdose.
Angie Hamilton, executive director of Families for Addiction Recovery based in Scarborough, Ont., said many young people with a co-occurring mental health condition lack the capacity, at least temporarily, to consent to initial care, but parents cannot intervene on their behalf.
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It creates a deeper crisis for families prevented from making potentially life-saving decisions for those who reject treatment, Hamilton said.
“You have to sit and watch them self-harm, possibly to death.”
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Hamilton said even short-term protection through safe care would help young people before they have a chance to receive treatment at home that could save them from a deadly overdose of increasingly toxic illicit drugs. .
“I don’t think most Canadian parents understand that if their child, regardless of age, has lost control of their substance use, you can’t intervene,” she said.
“They cannot legally buy cannabis or alcohol. But somehow, if they’re addicted to substances, it’s their right to be stuck like that.
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Hamilton said safe or involuntary care should be provided nationwide as part of society’s duty to protect minors who might be assessed before further treatment. But that’s often not available when it’s needed, she added.
British Columbia declared a permanent public health emergency on April 14, 2016, in response to a growing number of overdose deaths, many of which are linked to the opioid fentanyl.
Nearly 26,700 people died across the country from overdoses of apparently illicit drugs between January 2016 and September 2021, according to the latest data from Health Canada. British Columbia had the highest number of deaths per capita, followed by Alberta, and both provinces hit record high fatalities last year.
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Figures from the BC Coroners Service show that 115 young people under the age of 19 have died of overdoses since April 2016. For those aged 19 to 29, that number rose to 1,311 deaths.
British Columbia suspended a bill nearly two years ago that would have allowed young people to be detained for up to seven days after an overdose so they could be connected to community supports.
It faced strong opposition from groups such as the BC Civil Liberties Association, several First Nations, drug addicts and the province’s representative for children and youth.
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Leslie McBain, co-founder of B.C.-based advocacy group Moms Stop the Harm, said forced intervention was not the right approach, and any kind of treatment should be voluntary and long enough to address multiple issues. related to drug use, such as mental illness. , childhood trauma and poverty.
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“There is a loss of trust when you place a child in safe care, unintentionally,” she said.
Young people may also become suspicious of the health care system if they are held against their will and become more vulnerable to the supply of toxic drugs due to their reduced tolerance while waiting for a treatment bed, if they choose this path, said McBain, whose 25-year-old son died in 2014 from opioid addiction.
Grant Charles, an associate professor at the University of British Columbia’s school of social work, said that all provinces except British Columbia, Prince Edward Island, Newfoundland and Labrador and the territories have laws governing the use of secure care, which is done through residential treatment centers, not hospitals, in most cases.
Alberta, Manitoba, Ontario, Quebec, Nova Scotia and New Brunswick have provisions in their child protection legislation, while Saskatchewan and Manitoba have separate laws , Charles said.
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He said even the term safe care, which is not limited to substance use issues, creates confusion related to so-called safe treatment when it comes to discussions of legislation and intervention.
This, combined with ideological differences, has led to inadequate action during an overdose crisis that has a major impact on young people whose addiction and mental health issues are often treated separately, he said.
“We have ideological arguments on abstract issues when we should be trying to keep young people alive.”
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In Alberta, for example, a parent or guardian of a youth under 18 can apply for a court order for 10 days of drug treatment at a designated facility, said Eric Engler, spokesman for the associate minister of health. Mental Health and Dependencies of this province. A request for an extension of stay for an additional five days can be made, he added.
The goal is to protect children while providing rights to parents or guardians, Engler said.
Dr Tony George, a clinician scientist at the Center for Addiction and Mental Health, said safe care offers a window of hope for young people whose developing brains are altered by substance use to the point that they cannot make rational choices.
“I certainly respect the rights, but unfortunately some of these people, if we let them choose, that’s the way, the one-way ticket, to death or a really bad outcome,” George said.
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The center has brought together a group of experts, including an ethicist, from across Canada to meet regularly and discuss whether there is enough evidence to suggest that safe care might be a viable option “to save these children from themselves.” same,” he said.
The goal is to develop guidelines that could be used nationally in accordance with various mental health laws across the country while encouraging more research, he said.
Rachel Staples, who found her 15-year-old son Elliott Eurchuk unconscious in his bedroom on April 20, 2018, after he became addicted to prescription opioids due to sports injuries, said she hopes the government of British Columbia would reintroduce legislation to allow safe, secure care for young people.
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“I have a dead son. Would I have liked to force my child into care without his consent? No, I would have liked his consent. But I would like him alive too. So I would have taken any opportunity so we can sit with him and someone who specializes in addiction care.
Staples said the emergency care that would be allowed by the legislation must be supported by more home treatment beds, which was also recommended by a jury at a coroner’s inquest into her son’s death.
The British Columbia Ministry of Mental Health and Addictions said there are 142 youth drug beds in the province.
However, only 67 of the beds are for residential treatment and the health authorities do not have a central register of waiting times.
“We know that data is a critical component to understanding how people access treatment and recovery services across the province,” the ministry said in a written statement, adding that it is working to collect data to “formulate a system to better capture waiting times”.
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