“For me, something just clicked. I thought, ‘I don’t want to fucking live the same way I’m living, I don’t want to feel the same way I’m feeling,’” says one young Calgarian who battled substance use disorder for years.
“I was a chronic alcoholic by the age of 14, give or take. Smoking weed all day every day, snorting Dexedrine,” they said. “Ended up in long-term drug rehab by 16.”
Now sober for over two decades, they have over four years of experience working at a supervised consumption site operated by Alberta Health Services. They believe that their own history helps them better understand the people they now support.
“It was a troubled childhood with a lot of trauma that led me into my stuff and gave me a greater understanding of what people go through,” they said.
When asked how they feel about Bill 53, they answered earnestly, “It’s not going to do anything productive or constructive for that person if they’re feeling forced. Anything forced, specifically with this, is not going to go well.” Given their sensitive role, Article 1 has agreed not to reveal their identity.
Their perspective echoes a growing concern in Alberta as the province enters new territory with the passage of Bill 53, the Compassionate Intervention Act (CIA), on May 15, 2025. It allows “adult family members, guardians, healthcare professionals, police, or peace officers to request a treatment order for those whose addiction or substance use has made them a danger to themselves or others.”
This applies to both adults and youth.
Introduced as a response to Alberta’s worsening drug problem, a crisis mirrored in cities across North America, critics warn the bill’s practice of involuntary treatment opens a Pandora’s box of ethical and legal concerns, potentially violating the Canadian Charter of Rights and Freedoms. There is also the question of whether involuntary rehabilitation is a proven method for substance abuse treatment.
On the other hand, supporters of the bill argue that it’s meant to target a small group of people whose illness has progressed to the point that they can no longer safely take care of themselves. At that point, there’s a discussion that clinicians intervening may be the least harmful option.
Compassionate Intervention Act
Involuntary psychiatric care already exists in Alberta under the Mental Health Act, which raised concerns in the past about limiting certain Charter rights. However, they are under more specific and regulated circumstances. Bill 53, on the other hand, expands on that framework and opens it up to a new clinical population.
Here’s how it works.
Under the CIA, if a commission approves an apprehension order, a police officer has “sufficient authority” to forcibly apprehend the individual and transport them to a compassionate intervention centre. Within 72 hours, a three-person commission, consisting of a lawyer, a physician, and a member of the public (appointed by the Lieutenant Governor in Council), performs a hearing to determine one of three outcomes:
- Admit the person to a secure treatment facility for up to three months
- Refer them to a community recovery centre for up to six months
- Discharge them from the process
Reflecting on their own history with addiction and time working at consumption sites, our AHS work believes the new measures will churn up issues. “They’re going to be so spiteful towards whoever put them there,” they said. “They’re going to be angry and not get anything out of that treatment program.”
When contacted for an interview about the legislation, the Alberta Medical Association provided a written statement.
“The AMA has identified several areas of concern within the legislation, particularly regarding the process for apprehension orders and the potential for administration of medications without patient consent.” It adds, “These require thorough consultation and a robust, high-quality evaluation to inform future policy development and monitor for unintended harms.”
SCREENSHOT: RILEY FONGER
Challenging Section 9
Critics of the CIA say it violates basic rights. Section 9 of the Charter of Rights and Freedoms guarantees that,“Everyone has the right not to be arbitrarily detained or imprisoned.”
Apprehension orders under Bill 53 could raise questions about what constitutes “arbitrary,” defined by Cambridge as being based on chance rather than being planned or based on reason.
Doug King, a criminal justice professor at Mount Royal University, says that courts will always question whether the detention was reasonable rather than arbitrary based on the judgement of an “ordinary, cautious, prudent person.”
“So I may have a belief that what I’m doing is right, but would an ordinary cautious person also support that?” says King.
Under provisions of the law, within 72 hours of apprehension, the hearing process begins. In this, the commission determines the person’s outcome based on whether they pose substantial harm to themselves or others. However, it doesn’t have set indicators or markers for what qualifies as substantial harm. “It would be hard to build those markers into law,” says King.
It considers the following factors:
- Severity and history of drug use
- Medical history in relation to that drug use, including overdoses and hospital visits
- Mental or physical decline as a result of that drug use
- Inability to meet basic human needs as a result of drug use
- Previous CIA admissions
- If the drug use has negatively impacted key aspects of their life, such as health, job, or relationships
- If they’ve engaged in high-risk behaviour
Clients subject to an order have the right to appeal decisions. They may also request legal counsel and representation by a mental health patient advocate during the hearing process. But without clear indicators, decisions lean heavily on subjective judgment, which always poses the worry of potential bias.
“The decision about whether it’s arbitrary or not wouldn’t be made at the front end, [it] is made at the back end after the person has been detained,” says King. “Of all of the [Charter] arguments, the strongest, in my opinion, is [section] nine.”
This isn’t the only part of the legislation that calls for greater clarity. The bill fails to outline how social factors like housing and income will be handled. The Canadian Bar Association also raised concerns about the vague and overly broad language used in the legislation in a letter addressed to Dan Williams (Minister of Mental Health and Addiction at the time). They say the bill refers to “substance use or addiction” but doesn’t clearly define what those terms encompass. Does it include abuse of legalized drugs like marijuana and alcohol or behavioural addictions such as gambling or pornography?
They go on to note that the breadth of the wording “family member,” while well-intended, could potentially allow for vindictive or abusive family members to use the act in malicious ways.
March 2025. INFOGRAPH: RILEY FONGER
Systemic Racism
On the topic of personal misuse, there are deeper worries that this bill could fall into a trap of systemic racism and disproportionately impact Indigenous communities and other marginalized groups across Alberta.
“Who’s going to be using this legislation?” notes King. “I think that will be a real telling hit, because from a social science perspective, that’s going to be a real small subset of people.”
The province of Alberta’s health analytics reported 1,492 substance-related deaths in Alberta in 2024. Opioids are directly responsible for 1,191 of these fatalities. The Government of Canada’s findings on opioid-related deaths echo the same growing concern.
According to the Alberta Opioid Response Surveillance Report (2024), First Nations Peoples make up about 3.4% of Alberta’s population but accounted for 20% of all unintentional opioid poisoning deaths between 2016 and 2022.
This is highlighted because it’s particularly concerning that the new policy could fall into a trap of systemic racism. Further criminalizing and discriminating against minorities under the guise of treatment rather than addressing the root causes of substance use through culturally appropriate and community-led solutions.
“There’s also the reality that many of the people who are substance use challenged are not on the street; they’re in homes, they’re coming to school,” says King. “They’re not likely going to be targeted by this legislation… What it’s really targeting is people around the street, the public image.”
Challenging Section 7
Section 7 of the Charter guarantees that,“Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”
The CIA may challenge this because it deprives a patient of their liberty by keeping them in a facility and preventing them from leaving on their own volition. However, it is worth noting that clients may be granted a leave of absence.
“When I went [to treatment], so many kids ran, got arrested, and came back,” the unnamed AHS worker said. “If they have a chance to bolt, they’re probably going to. But, if somebody’s on the streets, they might not bolt because it’s a place to stay.” They also question what transpires if a person uses drugs during their leave, something they say is common.
Another provision challenging Section 7, clients subject to an order cannot refuse psychiatric or medical treatment once admitted unless they are deemed to have capacity. Defined in the bill as “a person is able to understand the information relevant to a treatment decision and appreciate the consequences of giving or refusing to give consent for a treatment.” According to the CIA, a client who doesn’t have “capacity” can’t refuse the following forms of treatment:
- To be observed, monitored, and assessed by a treatment team
- To be provided with clinical advice
- Subject to regulations, they can’t refuse the administration of Schedule 1 drugs as defined under the Pharmacy and Drug Act or any other drug specified in the regulations.
How the treatment team determines a person’s capacity in practice will be the deciding factor.
“What about when you’re under the age of 16? If I’m 14 and say, ‘I don’t want it,’ is my voice the last one heard?” King says. “The Supreme Court has ruled that it is actually your parents’ voice, your guardian’s voice.”
Refusing medical care is a critical component of a person’s right to manage their own bodily autonomy. In some cases, this is due to religious beliefs. When such a claim is made, it falls under Section 2(a) of the Charter, which guarantees Freedom of Religion.
According to King, the Supreme Court has developed a test to determine whether a claim truly qualifies under this section, stemming from the Syndicat Northcrest v. Amselem case. The test outlines two key criteria for courts to consider.
“One, is the claimant’s belief sincere? So, they’re not trying to be gimmicky,” says King. “The second is, is it consistent with an established religious belief?” If someone can prove both of those, they likely have a case.
To make small talk, the bill grants authorities the power to override an individual’s decisions about their own care. If that power is exercised without clear guidelines or best practices and intentions, it could open the door to legal challenges.
Interestingly enough, however, “A Section 7 violation has never been justified or upheld [by the Supreme Court] under Section 1 of the Charter,” says Meredith Hundert, a student at law.
Which is true.
This hails from the infamous R v Oakes case. Known as the Reasonable Limits clause, Section 1 dictates that there needs to be a balance between the rights of the individual and the interests of society. For example, restrictions on speech to prevent hate crimes or protect public safety. But, since Section 7 rights are considered extremely important and personal, courts seldom accept that a violation of them can be justified under 1.
“Section 7 is as close to being an absolute right as we have,” says King.
In other words, that means if a law is found to breach Section 7, it will almost always be struck down as unconstitutional.
“I wouldn’t be surprised if this bill wasn’t amended or struck in the next 10 years,” says Hundert.
The Research
Though there is limited scientific literature and still an ongoing debate, research casts doubt on the effectiveness of compulsory drug treatment for most people.
A 2025 evidence brief from the Canadian Centre on Substance Use and Addiction found that while some suggest involuntary rehab can help keep people in treatment longer, most do not show significant improvements in substance use. In fact, in certain cases, it poses more of a risk.
“If a treatment is forced, people often can feel traumatized, stigmatized, and distrustful in the system. That can make them less likely to seek help voluntarily,” says Dr. Anees Bahji, an assistant professor in the department of psychology at the University of Calgary.
“There’s also evidence of physical risk, especially overdose,” he said. “After people leave mandatory settings, their tolerance to some substances drops. If their circumstances haven’t changed, returning to use what they were before could be fatal.”
That risk is part of the harm people with addictions pose to themselves. A 2020 study by psychopharmacologists found that many substances are linked to risky decision-making and signs of neurological damage in parts of the brain responsible for decision-making, cognition, and reward.
“Some of our patients are so ill, their addiction is so severe, it impairs their actual ability to keep themselves safe,” says Dr. Bahji. “In those moments, an argument could be made that not intervening is almost as ethically problematic.”
He is the lead author on one of the most up-to-date studies on the effectiveness of involuntary treatment. In 2023, he and his colleagues published a large-scale systematic review in the Canadian Journal of Addiction. It examined 42 studies covering 354,420 participants with substance use disorders across the U.S., Canada, and China.
Of those studies analyzed, 22 directly compared voluntary to involuntary treatment. Only seven showed improved outcomes for involuntary. 10 reported negative outcomes for involuntary, and five reported nonsignificant findings between the two types of treatment. The study concluded that there is insufficient high-quality evidence to support or oppose such treatment and emphasized the need for more research to guide health policy.
“Part of the problem is the evidence gap itself,” says Dr. Bahji.
Because it is uncertain how effective involuntary treatment is, Bill 53 could be moving ahead faster than the science supports. That could make it vulnerable to potential negative repercussions of the practice, such as harsh results, criticism, and worsening effects of substance abuse.
“There’s limited evidence for involuntary treatment, but that doesn’t mean that there isn’t a need for an involuntary pathway in very specific contexts,” says Dr. Bahji.
He emphasizes that the picture is more complex than a simple voluntary-versus-involuntary divide. The real question at hand is, what do we do when someone’s addiction has eroded the very capacities they need to take care of themselves and make use of the care available to them?
Looking forward
Involuntary rehab may not be the most practical answer, but something still needs to be done to address Alberta’s drug crisis.
“If a government wants to pursue an involuntary model, it has to be built with very strict safeguards,” says Dr. Bahji. “But you can’t pretend the bill alone is going to fix the problem.”
The Alberta Medical Association echoed the need for balance, writing in its letter, “Ongoing investment in voluntary treatment services remains critical. This includes reducing the long wait times that currently exist and increasing spaces so people can access treatment on an as-needed basis.”
To that end, the Government of Alberta has significantly stepped up its access to addiction and mental health services. Since committing $140 million in 2019, the province reported over 22,000 detox spaces and 6,700 treatment and recovery spaces as of 2023—an overall increase of more than 55 percent.
That context matters, given there had not been a single fatal overdose at a safe consumption site in all of Canada until one occurred in Ontario in late 2024. Between 2017 and 2024, federally exempted supervised consumption sites responded to more than 60,000 overdose events, with no reported onsite fatalities. The AHS worker in this story also noted some common misconception.
“People don’t actually have to use [substances] to access services there,” they say. Supervised consumption sites will also help people connect to recovery services such as substance use treatment, support mental health care, and even housing. The second misconception is how people with substance use disorders are perceived and treated at these sites.
“Your goal in that environment is to actually develop a relationship with these people and their needs. And, understanding where they’re at [and] what happened in their lives,” they said. “It’s genuinely getting to know somebody at a deeper level.”
This is something Dr. Bahji supports.
“The long-term success of addiction care really depends on things like engagement, trust, and motivation, and those are difficult to build through coercion.”
While legal questions may loom with Bill 53, King says it’s not necessarily a bad thing if it runs into a case with the Charter; it will help inform future policy. “Of all the arguments, the strongest, in my opinion, is [Section] 9, then 7, and then 2(a),” says King.
Moreover, it’s a reminder of why we have the charter: protection from government overreach.
“The real test will be the first court case,” King says.
