Quote:
Originally Posted by Makarov
The goal of treatment is to treat the person's addiction to fentanyl so that they don't use fentanyl (recognizing that relapses and set backs are inevitable and part of the process). Every time someone uses fentanyl, they risk their lives. That is not an overstatement.
And the whole point of involuntary treatment (as opposed to just involuntary detention) is to treat the illness (not just detain the person). I'm no expert in what that treatment looks like or how effective it is (and I certainly appreciate that treating opiate addiction is incredibly difficult), but I come back to... it must be better than doing nothing and just letting people suffer and die on the streets.
I don't know. I don't have the answers. I've spent many, many sleepless nights thinking about this. I know people who have lost children and siblings to this crisis. I've spent hundreds of hours drafting affidavits, cross-examining affiants, cobbling together arguments in facta and in court. I still don't have the answers. But, in this moment, I feel like the status quo is not acceptable.
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I think you're dancing around the question a bit. A goal of therapy is not to treat the illness. That's the therapy. I think you're saying the goal of therapy is to prevent harm to the patient. I think all clinicians share that goal. The goal of therapy should not, therefore, be a specific treatment.
As for its practicality, if you're able to leave, is not involuntary so it is in fact incarceration. You can easily force abstinence via incarceration but I don't know how you change their behavior when they leave incarceration.
I've lost multiple patients to opioids and one of my best friend's brother died downtown Edmonton from exposure because of opioid use disorder. I share the concern. These are real people that simply look less sympathetic to many because they may be homeless or look unwell. But all of them are somebody outside of that illness and it's too easy to ignore that.
There's a reason they often say "First, do no harm". You don't pick a random treatment because others aren't working. We are losing the fight on the supply side. The current therapies are working but the scale of devastation is so great it isn't enough.
I have real concerns, both civil and medical, about choosing one drug over another to incarcerate someone over. Opioids are deadly, but not as deadly as alcohol and yet we don't incarcerate alcohol addicts. Cigarettes are the only legal product that exists that will kill you if used correctly and yet we don't incarcerate cigarette addicts. We've chosen to incarcerate those with opioid addictions because it's yucky and culturally acceptable.