This N.L. man spent 20 years addicted to opiates — and says forced treatment laws would have killed him

Keith Fitzpatrick's addiction story starts like so many others: with a prescription for painkillers.

"I wasn't picking it up around the corner and seeing a dealer," Fitzpatrick said. "It was doctors who were trying to help me. But back in the early 2000s, of course, it really wasn't understood that these drugs would cause problems."

Fitzpatrick, now a father and mental health advocate living in Labrador City, says it took years before he accepted he was physically and mentally dependent on the 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. I was legally dead a couple of times and I still used," he said.

"People have to make the choice to save their own lives. We can't force it. Nobody could force me — I had to do it when I was ready."

Fitzpatrick agreed to speak to CBC News about his experience in response to a recent public push for involuntary addiction treatment, a controversial policy that's 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 ask the provincial government to implement what organizers are calling "compassionate involuntary care."

They want the province to pass laws that would permit 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 CBC News his mind was so clouded when he was using substances, he wasn't making rational decisions — and those decisions nearly cost him his life.

"When you're dealing with an illness that's making … the victims of the illness not believing 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 themselves,'" he said.

"If it wasn't for my mom, I would probably be dead."

At Wednesday's rally, Health Minister Tom Osborne said his department was "looking closely" at that policy to determine whether it could be applied in Newfoundland and Labrador.

Involuntary treatment could kill

But Fitzpatrick says forcing someone into treatment will, at best, fail — and at worst, kill them.

"In a lot of cases you're forced into a rehab centre when you don't want to be there. Your body's tolerance to drugs [is] going down because you're not using.… You leave and you pick right back up where you left off, and then you overdose immediately," Fitzpatrick said.

"I would've been locked up. And I can tell you right now, if I had been locked up, I probably wouldn't be alive now, because I didn't want to be there. That's the scary thing about forced treatment. The fact is there's no proof it works."

Fitzpatrick refers to a moment of clarity, 20 years into his addiction, when he decided he'd had enough. A strong, affordable health-care system for addicted people, he says, is the only way to help.

"We need frank and honest discussion that yes, there's a problem in this province. People are dying," he said.

"We need the facilities and the availability of treatment for people who want it. We need the safe supplies, we need safe injection sites, we need naloxone kits."

Evidence limited

Similar involuntary treatment laws are already in place in the United States. In Massachusetts, tens of thousands of people have been forced into treatment since the 1970s through a law known as "Section 35." That mechanism allows family members, doctors or police officers to petition a judge to issue a warrant and arrest the person using substances.

The detained person — who hasn't necessarily broken any laws — then attends court, where a judge decides whether to send them to detox in jail or in rehab.

Research on whether these laws help people with addictions or harm them is limited, but a 2016 systematic review of studies on compulsory treatment showed "the majority of studies … failed to detect any significant positive impacts on drug use."

Nick Boyce, a senior policy expert with the Canadian Drug Policy Coalition, points out that overdose deaths don't always happen to people with a substance use problem.

"Not everyone's drug use is addiction," he said.

"The vast majority of people actually are using [substances] in non-problematic ways. It's recreational, it's occasional. And those are actually the people at highest risk of overdose, because they tend to have less tolerance."

Boyce said forced treatment typically violates international conventions on human rights, autonomy and medical ethics, and can lead to higher fatality rates.

"It might seem like we're doing the right thing, but if people are not ready for treatment … it actually can again increase the chances of people dying because they were not ready," he said.

"Why do we need to have laws that mandate involuntary treatment when we don't even have voluntary accessible treatment in the first place?"

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