This blog is part 2 of my previous post, "Forced Addiction Treatment is ALREADY Failing: An Ex-Addiction Counselor's Point of View." In that post, I discussed the significant challenges and ethical concerns surrounding forced addiction treatment. Now, let’s focus on why forced treatment is not only logistically unfeasible but also fails to uphold the fundamental principles of recovery: choice, voice, and autonomy. For recovery to be truly effective, individuals must be empowered to make their own decisions, have a say in their treatment, and retain control over their journey. Without these core elements, forced treatment not only risks failing to foster long-term recovery but it also undermines the dignity and human rights of those affected. It’s clear that a more holistic, compassionate approach—one that emphasizes personal agency—is essential for lasting recovery.
Human Rights and Ethics
The first part of this blog has already discussed how forced treatment violates ethics and human rights, but it’s worth revisiting this vital point. The main issue with forced treatment is that it overlooks some key parts of recovery: choice and personal control. International guidelines from organizations like the World Health Organization (WHO) and the United Nations (UN) highlight that voluntary, evidence-based care is vital for people dealing with substance use disorders. These guidelines emphasize the importance of respecting people’s autonomy and offering care that is trauma-informed, recognizing that addiction is a complex health issue, not a criminal one.
Even though forced treatment might seem like a quick fix, it doesn’t tackle the deeper issues that contribute to addiction. True recovery happens when someone is ready and motivated to make changes, which simply isn’t possible if they’re being forced into treatment. Research shows that when treatment is coerced, people are more likely to relapse and get caught in a cycle of re-admissions, using up resources without creating lasting change.
Addressing Gaps in Detox and Treatment: Nurse Shortage
For the 2023/2024 fiscal year, the BC government has allocated about $1.4 billion to mental health and only a very small amount of this went towards detox and treatment for substances. This amount does not address the overwhelming demand across the province. In urban areas like Vancouver, wait times for publicly funded detox programs can stretch weeks to months. The closure of the Directions Youth Detox Centre in 2022, which was the only youth-specific detox facility in Vancouver, has further exacerbated this issue. Youth who previously had access to tailored services now have to compete with adults for limited in-patient detox beds. This lack of adequate resources for youth detox highlights a significant gap in mental health and substance use services, particularly for vulnerable populations.
Canada is facing a serious shortage of both healthcare workers and social service workers and the two issues are connected in ways that make things even harder. We’re seeing fewer people going into these fields because of the high costs of tuition, the rising cost of living, and the burnout that many workers are facing. On top of that, experienced staff are leaving due to stress, retirement, or career changes, and this is affecting both the healthcare and mental health sectors.
When it comes to detox and addiction treatment, the lack of healthcare workers is a major hurdle. Detoxing from substances like alcohol, benzodiazepines, and opioids requires 24/7 medical supervision to manage the risks that come with withdrawal. But with Canada projected to need thousands more nurses in the next few years, adding more detox beds or forced treatment programs isn’t realistic—it would put even more pressure on a workforce that’s already stretched too thin. As it stands, fewer people are entering the field and many who are already in it are burning out. Expanding treatment programs without addressing these staffing shortages would only make things worse, and could impact other important areas of healthcare.
Social Service Workers Shortage
The shortage of mental health professionals is just as concerning. Frontline workers in mental health and addiction services are doing emotionally and physically exhausting work, often with little support. They’re managing heavy caseloads, responding to crises, and helping people navigate trauma and recovery—but they’re not paid nearly enough for the complexity of their roles. In British Columbia, for example, addiction workers earn around $20–$25 an hour, and clinical counselors make $30–$40 an hour, despite the education and experience they bring to the table. These wages are just not enough to live on, especially in expensive cities like Vancouver. As a result, many workers are leaving the field due to burnout, and there’s not enough support to keep them in these crucial roles.
Despite the increasing need for mental health and addiction services, funding isn’t keeping up. Only 7% of Canada’s healthcare budget is spent on mental health, and even less goes toward addiction treatment. This gap in funding, combined with the lack of support for workers, means that there aren’t enough resources to meet the growing demand for care. To truly make a difference and address the toxic drug crisis, we need a more sustainable, trauma-informed approach—one that supports both the workers and the people who need these services. Simply adding more treatment beds won’t fix the problem if the system is already stretched too thin.
In contrast, Canada invests significantly more in other sectors. For example, the average salary of a police officer in 2022 was $92,000, according to Statistics Canada. This funding imbalance underscores systemic priorities that undervalue mental health services and the professionals working in them, leaving these essential services underfunded and understaffed. The lack of sufficient support for mental health workers is further exacerbated by a lack of competitive pay and resources, which hinders the ability to address growing demands.
Building Purpose: The Role of Employment in Sustainable Recovery
Skill-building and finding a sense of purpose are essential parts of recovery because they support reintegration into society. For many, this can mean having meaningful work, learning new skills, or even helping others. Programs like the KT6 CREW Peer Harm Reduction initiative show just how powerful Peer-led work can be. When people with lived or living experience take the lead, it builds trust, real connection, and empowerment—especially in communities that often feel left out or overlooked.
Paid Peer work is crucial. It provides an income and gives people in recovery a chance to share their knowledge and make a real difference. Programs like KT6 CREW prove that harm reduction works best when driven by the people who truly get it. While there’s room to grow—like making sure these programs get the funding and support they need—the impact so far has been tremendous.
Expanding access to Peer jobs, along with job training and support, helps people in recovery rebuild their lives. Stable work leads to financial independence, housing stability, pride, and purpose. It also helps break down stigma and create stronger, more understanding communities. When we invest in Peer-led work and recovery-focused employment, we’re not just helping individuals—we’re building a more compassionate society for everyone.
Lack of Supportive and Affordable Housing
The priority should shift to investing in supportive and affordable housing, which is essential for providing individuals with the stability and safety they need to rebuild their lives. People who use substances deserve comprehensive support that includes not only detox and rehab but also secure housing and long-term recovery services. Without stable housing, recovery efforts are often undermined, as individuals are returned to environments that may trigger relapse. Housing-first models, which prioritize secure and supportive housing first, have been shown to improve long-term recovery outcomes, reduce healthcare costs, and create safer communities. This approach, when combined with expanded access to voluntary, trauma-informed care, represents the most compassionate and effective path forward in addressing substance use.
However, there is a critical shortage of transitional and second-stage housing in Canada. People leaving addiction recovery programs are often faced with the devastating reality of having nowhere to go, with long waitlists for supportive housing that can extend from months to over a year, especially in urban centers like Vancouver and Victoria. Without secure housing, individuals exiting detox or treatment programs often return to unstable and unsafe environments that jeopardize their recovery. This gap in support services highlights the urgent need for trauma-informed, long-term housing solutions to provide a stable foundation for recovery. Second-stage or transitional housing is particularly essential for those leaving inpatient treatment, yet its limited availability exacerbates the challenges people face as they transition back into the community.
The housing crisis in Canada makes this situation even more pressing. Many individuals who successfully complete detox or treatment still face the devastating reality of homelessness or the lack of sober living options. When no supportive housing is available, they are often forced to return to environments that fueled their addiction, leading to higher rates of relapse. While transitional spaces like sober living are vital, the long waitlists and limited capacity create a dangerous gap in the recovery process, undermining the hard work done in treatment.
It's important to remember that housing is not a privilege—it’s a fundamental human right. Everyone deserves a safe, dignified place to live, not just those in recovery. By ensuring access to stable housing, we can help individuals regain their footing, reduce stigma, and promote inclusion, ultimately fostering a society where everyone has the opportunity to rebuild and thrive, no matter their struggles. Instead of focusing on forced treatment, we must prioritize building a comprehensive, compassionate system that integrates secure housing and recovery services to help people truly heal.
Increased Demand for Emergency and Law Enforcement Services
Implementing forced treatment would place a heavy burden on emergency responders and law enforcement, who would need to manage and transport individuals who may resist. This would take up more of their time and resources, potentially pulling them away from other essential community needs. First responders are already stretched thin, and adding forced treatment to their workload would make it harder for them to respond to other urgent situations.
Forced treatment will also risk criminalizing people who need mental health support rather than law enforcement, deepening the strain on our already overwhelmed systems. Are people going to get charged if they dodge their treatment order? Instead of addressing the root causes of mental health and addiction, it could end up creating more harm and making it harder for these individuals to get the trauma-informed care they need.
Proven Ineffective
Studies consistently show that individuals forced into addiction treatment often experience higher relapse rates. Successful recovery depends on an individual’s internal motivation, which is largely absent in cases of coerced treatment. Without the willingness to change, many people struggle to benefit from treatment, resulting in a cycle of readmissions that consumes valuable resources without producing long-term success. This cycle undermines the effectiveness of addiction programs and limits their ability to help individuals rebuild their lives sustainably.
Addiction treatment must extend far beyond detox and stabilization. Long-term support systems, including after-care counseling, stable housing, and reintegration programs, are critical for sustainable recovery. Without these foundational supports, relapse rates rise, rendering forced treatment ineffective.
The global history record of forced treatment further illustrates its failure. Countries such as the U.S., China, Vietnam, and Russia have implemented forced treatment programs in hopes of eliminating drug use. Some of these programs include "work therapy," where individuals are compelled to perform labor as part of their recovery. While such programs may show short-term reductions in drug use, they fail to address the deeper emotional and psychological struggles at the root of addiction. Research, such as studies conducted in Boston, demonstrates that individuals forced into treatment often relapse because the underlying causes of their addiction are never truly addressed.
In contrast, holistic harm-reduction approaches, such as the UK’s heroin-assisted treatment (HAT) and Portugal’s decriminalization model, focus on treating substance use as a health issue rather than a criminal one. These strategies prioritize safety and well-being by meeting people where they are at. For example, the UK's HAT provides medical-grade heroin in a controlled setting, reducing reliance on unsafe street drugs and decreasing overdose risks. It also helps to lower drug-related crime while integrating mental health support to address the root causes of substance use.
Similarly, Portugal’s model decriminalizes personal drug use and emphasizes care over punishment, offering social and healthcare support to individuals. Both models create safer, more supportive spaces for people to heal, work through their challenges, and access necessary resources. These person-centered approaches focus on long-term recovery, not short-term fixes, and have proven to foster lasting change while maintaining the dignity of those seeking help.
Conclusion:
Forced treatment for addiction is an impractical and ineffective solution, given the logistical, ethical, and practical challenges it presents. A critical gap in these approaches is secure, stable housing, which is essential for long-term recovery. Throughout both of my blogs, housing has repeatedly emerged as a core issue, underscoring its role as the root of addiction challenges. It is important to recognize that even individuals who do not yet wish to pursue sobriety still deserve dignified, safe housing. Housing-first models prioritize safe, supportive housing as the foundation of treatment and have proven to improve recovery outcomes and reduce healthcare costs by lowering hospitalizations, arrests, and emergency services use. These models promote the principle that everyone deserves stability, regardless of whether or not they are in recovery. Coupled with global evidence showing the failure of forced treatment, it’s clear that the focus should shift to voluntary, person-centered care. To address addiction effectively, we must prioritize trauma-informed, compassionate approaches that include sustained housing support and empowering individuals on their recovery journey while respecting their dignity.
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