The government of Alberta, Canada, will force people who use drugs into substance use disorder treatment against their will, under a new plan announced on February 25.
Alberta Premier Danielle Smith said the government is about to table a budget that will earmark $180 million to build two “compassionate intervention centres” with 150 beds each in Edmonton and Calgary. If approved, construction would begin in 2026 to be completed by 2029.
In the meantime, Smith said the government will identify up to 100 beds in existing treatment facilities that can be used to place people into involuntary care.
“In our downtown cores there are visible effects on every street, with individuals who have lost the ability to make healthy decisions, actively putting their lives at risk and causing fear and harm in the broader community,” Smith said. “There is no compassion in leaving people to suffer in the throes of addiction.”
The plan is in line with other blows to harm reduction inflicted by Alberta’s governing United Conservative Party, including effectively banning safe supply and hampering, shutting down or canceling the opening of safe consumption services. The party promotes abstinence-based recovery as the solution to drug issues.
“How do we know that this isn’t going function as just another criteria for incarceration when your only crime is being houseless and living in poverty?”
Drug policy experts and harm reduction advocates say forcing people to be abstinent is an infringement of civil rights and unlikely to stem overdoses in the province.
“It’s really concerning,” Dr. Rebecca Haines-Saah, associate professor in community health sciences at the University of Calgary, told Filter. “How do we know that this isn’t going to de facto function as just another criteria for incarceration when your only crime is being houseless and living in poverty?”
There is no clear evidence supporting the idea that forced treatment is effective, while evidence also indicates it may be harmful. An evaluation of a similar program in Massachusetts, for instance, found that people who were committed involuntarily were twice as likely to die of an overdose as people who completed voluntary treatment. This is because people’s tolerances will drop after abstinence, Haines-Saah explained. That’s liable to be particularly risky for people who didn’t choose to be abstinent in the first place.
“They’ll go back to using the amount or the combinations that they were used to before that period of abstinence and it just puts them at ultra-high risk for overdose death,” she said.
The province has said it will use a commission comprised of lawyers, doctors and members of the public to decide who gets sent into involuntary treatment. The criteria they will use haven’t yet been decided.
Dan Williams, Alberta’s minister of mental health and addiction, told CBC News that approved cases “would meet the absolute highest standard of the most extreme examples of destruction in our society and in one’s life because of the addiction.”
The province can already hospitalize people deemed to be violent or a danger to themselves under Alberta’s Mental Health Act. Advocates fear the increased involuntary-treatment capacity could see the criteria diluted to cast a wider net.
“We don’t know what becomes of those kids when they get out, they might be subjected to that forced withdrawal dozens of times before they reach adulthood.”
Alberta also can force minors into detox programs through its Protection of Children Using Drugs (PChAD) Program, which requires a parent or guardian to petition a court. No medical sign-off is required.
Euan Thomson, an independent drug policy analyst and author of the Drug Data Decoded newsletter, filed a Freedom of Information request that revealed 41 percent of children in the PChAD program identify as Indigenous, when Indigenous children make up around 10 percent of the youth population. The province does not track what happens to those children after they leave involuntary treatment.
“We don’t know what becomes of those kids when they get out, they might be subjected to that forced withdrawal dozens of times before they reach adulthood,” Thomson told Filter.
A report from the Alberta First Nations Information Governance Centre found that First Nations people accounted for 20 percent of all fatal overdoses in the province between 2016 and 2022, despite Indigenous people making up 6.5 percent of the population.
Speaking alongside Premier Smith, Earl Thiessen, executive director of the Oxford House Foundation of Canada which provides sober living homes in the province, said he supported involuntary treatment.
“Is it a compassionate approach to step over people on the street and allow them to die in front of us, turn our heads and ignore the obvious because it’s their right? No, it’s not,” said Thiessen, who is Indigenous and has been in recovery for 17 years.
Alberta has not published any data on the outcomes for people who were cut off from safe supply or supervised consumption services, including after the shuttering of the busiest site in North America, in Lethbridge, in August 2020.
The province suffered record high overdose deaths in 2023 but saw a dramatic fall in 2024—from 45.1 per 100,000 people from January-September 2023 to 29.4 per 100,000 people over the same period in 2024, according to the Globe and Mail. However, overdose deaths are also falling in other provinces with different policies, and in the United States.
Alberta’s announcement comes amid a nationwide crackdown on harm reduction measures. Ontario is closing down supervised consumption sites and British Columbia has gutted its decriminalization pilot by banning public drug use. BC also just announced that it will be removing take-home safe supply, meaning people will only be able to take the medications while witnessed by a pharmacist or health care provider.
Photograph via Rawpixel/Public Domain
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