A person in distress battling addiction at the back alley of East Hastings Street in Downtown Eastside Vancouver

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Involuntary Care Sparks Controversy in Pre-Election Push

Addiction, Involuntary Care, Opioid Crisis

British Columbia is grappling with a toxic drug crisis that has claimed over 15,000 lives since 2016, sparking fierce political debate as the province approaches its October 19 election. A staggering 1,365 people have died so far in 2024 alone, with fentanyl detected in 83% of those deaths. While policy responses have ranged from safer supply programs to decriminalization efforts, the announcement by NDP Leader David Eby to open “secure facilities” for involuntary care has ignited a fresh round of controversy—uniting B.C.’s major political parties in surprising agreement, yet drawing sharp criticism from drug policy experts and advocates.

Compassion or Misstep?

When Eby introduced plans for involuntary care facilities for people suffering from severe addiction and mental health issues, it marked a significant shift in policy. His rationale: the system is failing those who need help the most. “These are the people we see on our streets, lying face down or involved in incidents where they pose risks to themselves and others,” Eby explained during a press conference, emphasizing the need for urgent action.

B.C. Conservative Leader John Rustad echoed this sentiment, also pledging to implement mandatory treatment. However, Rustad was quick to criticize Eby’s plan, arguing it would divert valuable hospital beds away from other patients. “We need to build capacity, and it’s not going to happen overnight,” Rustad said, underscoring the complexity of the issue. Both leaders claim their policies are grounded in compassion and public safety, but critics aren’t convinced.

Political Motivations Cloud Judgment

For DJ Larkin, executive director of the Canadian Drug Policy Coalition, the embrace of involuntary care smacks of political opportunism. “This shift toward involuntary treatment is a knee-jerk reaction,” Larkin argues. “It’s quite obviously a political move to create a simple solution to a problem that requires multiple interventions.”

The timing of these policy shifts, just ahead of a provincial election, lends weight to this critique. Drug policy has become a central issue in the election, and with B.C. witnessing 6.4 overdose deaths per day, candidates are scrambling to propose solutions that balance public safety with effective care. However, many experts warn that involuntary care is not only impractical given current resource limitations but also potentially dangerous.

Former chief coroner Lisa Lapointe has been particularly vocal, describing the plan for involuntary care as “unrealistic” given that there aren’t enough beds even for people who want treatment. Lapointe points out that there is scant scientific evidence to support compulsory care and cautions that relying on it as a primary solution could be disastrous. A 2022 Swedish study cited by Larkin even found a “very high” risk of death immediately after discharge from involuntary care, raising ethical and safety concerns.

The Struggle for Safe Supply and Decriminalization

The focus on involuntary care also detracts from ongoing harm reduction efforts, which have faced increasing challenges. B.C.’s three-year decriminalization pilot, which allowed adults to carry up to 2.5 grams of opioids, cocaine, methamphetamine, or ecstasy without facing criminal charges, has been a focal point of drug policy. The project, however, has been criticized for inadequate implementation, particularly regarding safe supply programs.

While safer supply aims to provide regulated alternatives to toxic street drugs, these programs have been hindered by logistical issues, primarily a lack of physicians willing or able to prescribe. Only around 2% of the estimated 225,000 people using unregulated substances in B.C. have access to a regulated supply. Lapointe and other advocates, such as Leslie McBain of Moms Stop the Harm, have called for expanded access to these safer alternatives, arguing that decriminalization and safe supply initiatives are being blamed for the province’s ongoing crisis without receiving the necessary support to succeed.

Indeed, data from the BC Coroners Service suggests decriminalization may have had a positive effect. As of July 2024, B.C. saw a 15% decrease in drug-related deaths compared to the previous year, the lowest rate since 2020. Lapointe insists this is no coincidence, claiming that “there is a trend down in fatalities… post-decriminalization.” Despite this, the provincial government recently rolled back aspects of its decriminalization policy, particularly regarding public drug use in parks, public transit, and hospitals—moves widely criticized as politically motivated rather than evidence-based.

Rhetoric vs. Reality

Both the NDP and B.C. Conservatives have framed their push for involuntary care as a compassionate response to a worsening crisis. Yet, critics argue this rhetoric oversimplifies a complex public health issue, scapegoating drug users instead of addressing the broader systemic problems—such as housing shortages and inadequate treatment services—that exacerbate the crisis.

“The issue of homelessness has become conflated with public drug use,” Larkin explains, pointing to the increasing visibility of people using drugs in public spaces due to a lack of housing and safe consumption sites. This has led to a perception that more people are using drugs or that drug use is spiraling out of control, when in reality, the toxic drug supply has become more volatile, leading to prolonged sedation and other visible symptoms.

The Path Forward

As B.C. heads toward its provincial election, the toxic drug crisis looms large. The competing policy proposals—from involuntary care to safer supply expansion—reveal deep divisions over how best to tackle the crisis. The data supports safer supply and decriminalization as effective harm reduction strategies, yet political rhetoric and public safety concerns continue to drive the push for more punitive measures like involuntary treatment.

Meanwhile, advocates like Larkin and McBain continue to push for more comprehensive harm reduction strategies, including expanding access to safe consumption services, building more supportive housing, and increasing the number of physicians able to prescribe safer alternatives to street drugs. The toxic drug crisis, they argue, is far too complex to be solved by a single policy, let alone one driven by political expediency.

Ultimately, the success of B.C.’s drug policy will depend on a multifaceted approach that balances public health with compassion—ensuring that those who need help receive it without being forced into a system ill-equipped to handle their needs. With over 2,500 drug deaths recorded in 2023 and no signs of the crisis abating, the stakes couldn’t be higher.

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Response to “Involuntary Care Sparks Controversy in Pre-Election Push”

  1. […] important to note that the BC Conservatives are not the only party exploring involuntary treatment as a solution to the drug cr…. BC NDP leader David Eby recently announced plans to expand involuntary care through secure […]

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