Coroner cautions mandatory drug treatment could increase deaths

Chief coroner Lisa Lapointe has publicly criticized the NDP’s new Bill 22, Mental Health Amendment Act.
 
The government contends the legislation, tabled earlier this week, aims to help B.C. “do more and better for young people” who are under 19 and struggling with problematic substance use.
 
Hours after Mental Health and Addictions Minister Judy Darcy intro’d the bill  — which would allow youth to be involuntarily admitted for up to a week of “stabilization care” immediately following an overdose —  Lapointe released a statement cautioning it could have “serious unintended consequences” if it isn’t paired with “a comprehensive, culturally safe system of care and treatment.” 
 
Premier John Horgan said it’s something many families have “asked and appealed” to both the government and opposition parties to do (Liberal MLA Jane Thornthwaite has floated a private member’s bill pushing for involuntary addictions treatment for youth). 
 
Youth under 19 accounted for just one per cent of the more than 6,000 fatal overdoses B.C. has seen since 2015, according to Lapointe.
 
Unintended consequences loom large
The chief coroner credits the mental health and addictions ministry’s “laudable work” to reduce stigma linked to substance use and help get people into treatment but warns those efforts could be “negatively impacted” by Bill 22.

Lapointe is not the only one with concerns about such legislation. A peer-reviewed article published in the Canadian Medical Association Journal in 2018 concluded that forcing youth into treatment can do more harm than good

The article, which specifically references the B.C. debate on mandatory treatment, states “existing evidence suggests that mandatory addiction treatment does not lead to significant improvements in substance use outcomes and can be destabilizing, increasing the risk of subsequent overdose.” 

Horgan said Darcy would talk with Lapointe about her concerns but stopped short of committing to additional funding for treatment programs. 

“I know the minister will engage with the coroner to ensure any of her concerns are addressed going forward, but today is not the day to announce new funding,” Horgan told reporters Wednesday.
 
The government is open to suggestions on how “best to improve the legislation,” the premier said, but approving additional funding is a separate process “that starts with the treasury board and ends with the decision.”

No commitment to decriminalize
In 2019, Dr. Bonnie Henry released a report recommending that the province decriminalize possession of small amounts of drugs by reforming the Police Act.
 
A special parliamentary committee is set to review the act in response to protests against racism and police brutality in the province — but Horgan did not commit to making decriminalization part of the committee’s mandate. 
 
“The house leaders are discussing the configuration, the makeup and the terms of reference for the review,” Horgan said, adding that it will cover “a whole range of issues.”
 
Horgan defended his government’s handling of the province’s overdose crisis —  which was declared a public health emergency in April 2016 under the previous Liberal government — and said he remains “very concerned” about the issue.
 
“We have been making good strides until recently, where we see an unacceptable spike in deaths,” Horgan said. 
 
May saw B.C.’s highest monthly number of overdose deaths with 170 people losing their lives — a figure that is likely to rise as the coroner’s office completes more cause of death investigations.