Fentanyl killed her son. This is what she thinks of involuntary treatment
Discussion around forced treatment has ramped up in Ontario in recent weeks
Like many other parents, all Christy Soulliere wanted to do was protect her son Austin Tremblay.
And for years, the Windsor. Ont., mom did everything she could to do just that while also continuing to support him as he struggled with a methamphetamine addiction.
"As a parent watching it, it's excruciating," she said.
"There was times when Austin was homeless because of his addiction and I'd be up all hours of the night, just crying, but knowing I couldn't force him to do something he wasn't ready to do."
That something was going to get treatment.
This month, Ontario's big city mayors called on the provincial and federal governments to provide more tools to tackle the worsening homelessness, mental health and addictions crises. Brampton's mayor specifically called on the provincial government to consider a program that would force people with mental health and addictions issues to get treatment.
In Windsor, city council agreed this week to send a letter to the province expressing interest in any future pilot that involves involuntary care and addresses the worsening crises.
Though the details around what that care is and how long it will last aren't clear, some health experts and advocates are already sounding the alarm.
Mom doesn't think forced treatment works for addiction
Over the course of Tremblay's addiction, Soulliere made the hard decision in three separate instances to call police and have them bring him to a hospital against his will. During these moments, Soulliere knew her son needed to be looked after.
In Ontario, if deemed necessary by a doctor, a person can be temporarily held without their permission if they are considered to be dangerous to themselves or others. There is a process involved that allows the person to challenge the decision.
And while there were multiple times Soulliere wanted Tremblay to get treatment before he wanted it, she knew it wasn't going to stick.
But in July 2022, he was ready.
"He called me from Ottawa and he was devastated. He had just found out his girlfriend had passed from a fentanyl overdose and it was the first time since he was like 16 years old where he reached out and genuinely wanted help," said Soulliere.
While she did everything she could, Tremblay relapsed and died from a fentanyl overdose in November 2022. He was 27 years old.
When it comes to involuntary treatment, Soulliere thinks it's a complex topic. She suggests it might work for people with mental health issues, but doesn't think it will help those in active addiction.
She says if a pilot moves forward, she would want there to be a thorough psychiatric evaluation that determines whether a person is capable of making decisions for themselves.
Ideally, she says the treatment should be about 30 days and be followed with access to housing and continued supports.
"My biggest concern is setting them up for success once they leave the program — that piece has to be there, it's not just scoop them up, send them to treatment and then they're on their way," she said.
She emphasized that with addiction, she believes forcing sobriety on someone who doesn't want it just won't work.
Why is forced care controversial?
According to Dr. David Gratzer, an attending psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, when people talk about involuntary care today it seems they are referring to holding someone for a long period of time and making them get some type of treatment.
The main concerns with forced treatment, Gratzer says, are that it goes against a person's human rights and there isn't enough strong evidence to suggest it works.
And at it's core, people against this idea say that someone in active addiction has to want to make a change, otherwise they will continue to cycle in and out of treatment.
"I have never had much luck in treating people that don't want to be treated," said Dr. Dominique Morisano, a clinical psychologist and adjunct professor at the University of Toronto and University of Ottawa.
"If you're starting out the relationship in a power imbalance, where you're forcing someone into what can be a very scary place ... a person that's struggling is going to go on the ultimate defence mode, ultimate wall up."
Morisano, who works with people who struggle with addiction, says this process is not just about treating the substance use — it's about addressing underlying problems that are likely causing the person to rely on drugs or alcohol.
If you can't get to the root of the problem, she says, "those people are going to keep coming back to their solutions that they know how to do that are accessible and easy for them."
And at the end of the day, the person has to be willing to do the work to get out of that cycle.
"You can lead a horse to water but you can't force the horse to drink, right? So it's like, how [did] we forget that lesson?"
What should be done instead?
What CAMH's Gratzer would like to see instead of involuntary care is more funding and resources put toward social issues, like homelessness, easy access to current evidence-based treatments and filling gaps in the health-care system.
He says the priority should be on improving resources for people who are ready for treatment, but stuck on lengthy waitlists.
"We have many people in Canada today who are interested voluntarily addressing their substance use problems and yet they struggle to get access. Here in Ontario you might wait 10, 12, 15 weeks to get into an evidence-based residential program," said Gratzer.
"I think before we push people into care against their will and re-balance their fundamental rights ... what we ought to do is make it easy for people to get the care they want and need."
For example, Gratzer said there are numerous Rapid Access Addiction Medicine Clinics (RAAM) across Ontario where people with addiction issues can walk in and get counselling or connected to more supports. He says these clinics are "poorly funded and open only a handful of hours," but would be more helpful if open 24.7
And if the province decides to pursue involuntary treatment, both Gratzer and Morisano said that following the care, the priority should be on setting that person up for success by giving them access to affordable housing, along with continued support.
'Stand by your loved one'
As for Soulliere, her best advice to others going through what she did is to "stand by your loved one as best as you can."
She says the stigma around addiction is harmful for those who are going through it.
"When they're constantly made to feel bad about something that is a disease, it discourages them from getting help," she said.
"So just love your child, you brother, sister, whoever it may be. Support them and let them know that you're always there."
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