Experts have raised serious ethical concerns over Ontario's consideration of mandatory involuntary addiction treatment, particularly for those in the criminal justice system. Many in the addictions and mental health fields emphasize the absence of concrete evidence supporting its effectiveness. Clinical psychologist Sarah Dermody argues that the focus on involuntary treatment lacks empirical support, and can risk exacerbating issues like overdose, especially among opioid users. Studies from Massachusetts indicate heightened overdose risk post-involuntary treatment and a tendency for individuals to relapse, suggesting that such approaches may hinder genuine recovery efforts.
Data from Massachusetts, where there is a legal mandate for involuntary treatment for adults with substance use disorders, published in 2016 found the risk of fatal overdose was twice as likely after involuntary treatment compared to voluntary treatment, according to information compiled by the Canadian Mental Health Association (CMHA).
In some cases, such as with people facing opioid addiction, it could even present risks of overdose if they return to using when their tolerance is lowered, Dermody said. "If someone you know was using a certain dose and then returns to it several weeks later, that could be life-threatening for them."
That type of research really hasn't been done," said Sarah Dermody, a clinical psychologist and professor of psychology at Toronto Metropolitan University. "So we're in a position where people are advocating for involuntary treatment, we have some theoretical concerns and ethical concerns of that approach, and we don't have empirical evidence to suggest that it would be helpful in the short or long term.
Those studies suggest this type of approach can be 'more like sort of holding someone than actually helping and treating someone,' said Dr. Leslie Buckley, chief.
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