Keith Fitzpatrick’s addiction story begins like so many others: with a prescription for painkillers.
“I didn’t just pick it up around the corner and go see a dealer,” Fitzpatrick said. “It was the doctors who were trying to help me. But in the early 2000s, of course, it wasn’t really understood that these drugs would cause problems.”
Fitzpatrick, now a father and mental health advocate who lives in Labrador City, says it took him years to accept that he was physically and mentally dependent on pills meant to help him overcome trauma.
It would be two full decades and several brushes with death before he was ready to detox.
“It wasn’t enough for me to stop doing it. I’ve been legally dead a couple of times and still using,” he said.
“People have to make the decision to save their own lives. We can’t force it. No one could force me; I had to do it when I was ready.”
Fitzpatrick has agreed to speak to Breaking: about his experience in response to a recent public push for involuntary addiction treatment, a controversial policy that has been attempted in the United States and is now under review by the Alberta government.
About 100 people gathered at a rally in St. John’s on Wednesday to call on the provincial government to implement what organizers call “compassionate involuntary care.”
They want the province to pass laws allowing relatives to send their loved ones to rehab without their consent.
Nathan Wicks Parsons, a 21-year-old in addiction recovery who attended the rally, told Breaking: his mind was so clouded when he used substances that he wasn’t making rational decisions, and those decisions nearly cost him his life.
“When it comes to a disease that makes … victims of the disease not believe they’re actually sick, that’s when we need to step in and say, ‘Hey, somebody else needs to help take care of that person, because they can’t take care of that person. of themselves,'” he said.
“If it wasn’t for my mom, I’d probably be dead.”
At Wednesday’s rally, Health Minister Tom Osborne said his department was “watching closely” that policy to see if it could be applied to Newfoundland and Labrador.
Unintended treatment could kill
But Fitzpatrick says forcing someone into treatment will fail at best and kill them at worst.
“In many cases they force you to go to a rehab center when you don’t want to be there. Your body’s tolerance for drugs [is] it goes down because you’re not using… You go off and pick up where you left off, and then you immediately overdose,” Fitzpatrick said.
“They would have locked me up. And I can tell you right now that if they had locked me up, I probably wouldn’t be alive right now, because I didn’t want to be there. That’s the scary thing about forced treatment. The fact is, there’s no proof that it works.”
Fitzpatrick is referring to a moment of clarity, 20 years into his addiction, when he decided he had had enough. A strong and affordable health care system for addicts, she says, is the only way to help.
“We need a frank and honest debate that yes, there is a problem in this province. People are dying,” he said.
“We need facilities and availability of treatment for people who want it. We need safe supplies, we need safe injection sites, we need naloxone kits.”
Similar laws on involuntary treatment already exist in the United States. In Massachusetts, tens of thousands of people have been forced into treatment since the 1970s by a law known as “Section 35.” This mechanism allows family members, doctors or police officers to request a judge to issue a warrant and arrest the person who uses substances.
The detained person, who has not necessarily broken any laws, then goes to court, where a judge decides whether to send them to jail for detox or rehab.
Research on whether these laws help or harm people with addictions is limited, but there is a 2016 systematic review of studies on compulsory treatment showed that “most studies… failed to detect any significant positive impact on drug use”.
Nick Boyce, a policy expert with the Canadian Coalition on Drug Policy, points out that overdose deaths don’t always occur in people with a substance use problem.
“Not everyone consumes drugs, it’s an addiction,” he said.
“The vast majority of people are actually using [substances] in unproblematic ways. It’s recreational, it’s occasional. And those are actually the people most at risk of overdose, because they tend to have less tolerance.”
Boyce said forced treatment generally violates international conventions on human rights, medical autonomy and ethics, and can lead to higher death rates.
“It might seem like we’re doing the right thing, but if people aren’t prepared for treatment…it can actually increase the chances again that people will die because they weren’t prepared,” he said.
“Why do we need to have laws requiring involuntary treatment when we don’t even have accessible, voluntary treatment to begin with?”
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