BC NDP leadership race: Eby launches involuntary care for severe overdose cases

Experts warn forced care can backfire, Eby said he would consult extensively first


People who repeatedly overdose should be treated rather than discharged from hospital, even if that means involuntary care, says BC NDP leader candidate David Eby.

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The idea, however, worries a leader in addictions. doctor and researcher who said such an approach could do more harm than good.

“When someone overdoses twice in one day and shows up in the ER a second time, a second overdose in the same day, the idea that we release that person back out on the street to overdose a third time and die or have a deep brain injury or just go back to the emergency room, it seems very strange,” Eby told Postmedia News while touring the Okanagan as part of his leadership campaign.

“Currently under our system…intervention can only occur once they themselves have suffered severe brain injury from an overdose. We need to have better interventions and that could and should include involuntary care for people to make sure they at least have a chance.”

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Eby acknowledged gaps in the addiction treatment system, with people trying to get into detox or supportive housing facing long waits.

“But for some people, they’ll just never (seek treatment), so we’re going to have to do everything we can to give them a chance to survive.”

This approach has similarities to the controversial Bill 22, introduced by the NDP in 2020, which would have required young people to undergo seven days of treatment after an overdose.

The plan was scrapped in May after backlash from First Nations groups and the children and youth representative.

Dr. Paxton Bach, co-medical director of the BC Center for Substance Use, said currently involuntary admission is only for those who No to have the ability a do decisions by themselves.

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The addiction specialist doctor who works daily with people with addictions at St. Paul’s Hospital said he doesn’t support involuntary admission because evidence shows it’s ineffective and may do more harm than good.

That is because someone receiving treatment against their will, after being discharged, is at increased risk of overdose if they relapse due to loss of drug tolerance, he said. Involuntarily detaining someone often involves physical coercion that can be traumatizing and deter that person from seeking emergency medical care in the future, Bach said.

“The bottom line is that we cannot force treatment on people. That is not an effective strategy. We have to do the hard work of building a system that provides the care that people are really looking for.”

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Jon Braithwaite, a board member of the Vancouver Area Network of Drug Users or VANDU, has a problem with any treatment where the individual is robbed of their choice.

“One time your beginning down that path, it’s they can get Type of Dark.”

Brittany Graham, executive director of VANDU, said it’s counterintuitive to force people into treatment at an all-time low when we have a system where those who voluntarily seek treatment often face a two- to five-week wait.

Adam Olsen, MLA at BC Green, said any system that includes involuntary care would have to be based on the best research and include extensive consultation.

“We would have to be very sure that the culture of service will not be more stigmatizing and will not lead to further marginalization of people,” said Olsen, who is a member of the Tsartlip First Nation.

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Eby acknowledged that involuntary care is a “very hot topic,” especially considering the colonial legacy of the province’s treatment of indigenous people and its treatment of children in foster care.

“It hasn’t been a great record. Therefore, any type of movement in that direction will have to be undertaken with great care. But fundamentally I do not agree with the idea that it is respectful of someone’s freedom and human rights to leave them on the street to die of an overdose.

There was not enough public consultation on Bill 22 and the involuntary attention, Eby said, something that would change if he became prime minister.

“Part of our solution will have to be involuntary care for people with serious mental health and addiction issues, but I have no interest in repeating the mistakes of the past.”

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BC has lost more than 10,000 lives to illicit drug deaths since the province declared a public health emergency in 2016.

In the first half of 2022, 1,095 British Columbians died from accidental overdoses, the highest number recorded in the first six months of any calendar year. That’s an average of six deaths per day, Chief Coroner Lisa Lapointe said.

Eby, who has resigned as attorney general and housing minister to run to replace Prime Minister John Horgan, is being challenged by climate campaigner Anjali Appadurai. Appadurai did not respond to a request for comment on the overdose issue.

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