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zmason@medicinehatnews.com<\/a>\nStarting this summer, police will be able to detain intoxicated people in a facility located inside Edmonton\u2019s police headquarters in a new initiative under the province\u2019s Alberta Recovery Model.
\nLast week, the Alberta government announced $30 million for addiction and mental health supports in Edmonton. The city has been the epicentre of Alberta\u2019s opioid crisis, representing more than half of all opioid-related deaths and two thirds of opioid-related health emergencies.
\n\u201cThe trends in Edmonton are deeply concerning and cannot be ignored,\u201d reads a statement from Mental Health and Addiction Minister Rick Wilson last week. \u201cWhile most communities have seen opioid deaths return to pre-pandemic levels, Edmonton remains the exception. These investments are about strengthening Edmonton\u2019s entire system of care so more people can get the help they need.\u201d
\nAmong initiatives receiving funding through the investment is the Integrated Stabilization Centre. A joint initiative between the Edmonton Police Service and Recovery Alberta, the ISC is a temporary detention facility located inside police headquarters. It is scheduled to come online this summer.
\n\u201cThe Integrated Stabilization Centre is designed to address the significant rise in opioid overdoses, mental health concerns and substance-use challenges contributing to increased public safety issues and social disorder,\u201d said a spokesperson for the Edmonton Police Service in a statement to the News.
\nThe ISC will operate under the authority granted by the Gaming, Liquor and Cannabis Act to take an intoxicated person into custody and detention for up to 24 hours.
\nThe Ministry of Mental Health and Addiction says individuals at the ISC will receive clinical care addressing both addiction and mental health needs, delivered by a multidisciplinary team that includes physicians, nurses, social workers and recovery coaches.
\nEPS media relations unit supervisor Nancy Carlson says the focus is not specifically on individuals causing a public disturbance. The net police will cast is wider.
\n\u201cThe key consideration is whether the individual is publicly intoxicated and at risk of harm, and would benefit from a safe, clinically supervised environment for stabilization,\u201d said Carlson in a statement to the News.
\nCarlson says the criteria for determining risk of harm will involve medical and behavioural assessments and will focus on immediate safety, physician and mental health status, environmental risks and connection to appropriate services. Those assessments will take place by police officers in the field.
\nDr. Ginetta Salvalaggio, a University of Alberta professor of medicine who studies approaches to care for individuals using drugs, is concerned personnel won\u2019t have the capacity to make that assessment.
\n\u201cIf you\u2019re taking people\u2019s rights away, even for 24 hours, you need to do a very clear assessment of benefit versus risk before you make that call.\u201d
\nShe\u2019s not convinced the framework will contribute much to the long-term improvement of an individual\u2019s health.
\n\u201cOne, it\u2019s a very short time frame. Two, it\u2019s involuntary, and we know that involuntary approaches are most certainly last resort and actually carry the potential for harm.\u201d
\nLast spring, the UCP government passed legislation that will expand the capacity for third-party requests of an involuntary treatment order on an individual dealing with substance use or addiction. Peace and police officers are among those authorized to order treatment.
\nExperts agree that involuntary treatment is proven to yield lower long-term success rates and increase the likelihood of death by overdose following release by lowering an individual\u2019s tolerance.
\nIn only 24 hours, Salvalaggio says there is a risk that an intoxicated individual enters a medically complex withdrawal before being discharged.
\nAddictions specialist and physician Dr. Monty Ghosh says there is potential for the ISC to improve the safety of both detainees and the public, so long as they are adequately staffed with medical professionals.
\n\u201cPsychosis management, that could be a valid reason to take people out of the streets. That\u2019s something we need to do more of. It could be potentially beneficial, if they\u2019re in a stabilization unit and it\u2019s in a quiet environment where there\u2019s no external stimuli, where they can safely come back to normalcy.\u201d
\nMainly, he says the success of the initiative will depend on the kinds of pathways that lead from the ISC, and whether the next steps \u2013 hospitals, social services \u2013 can be sufficiently resourced.
\nSalvalaggio is concerned the potential positive impact of introducing an individual to that system is undermined by the loss of trust in the system that involuntary detainment can produce.
\n\u201cIt ruptures the relationships and the trust with the health community. If people are worried about getting detained, they are going to be a lot more wary about reaching out to health-care and other professionals for any sort of support.\u201d
\nWhat works better, she says, is lower barrier to entry, like supervised consumption sites, where vulnerable people can build relationships with health professionals and social services that can lead to a broader network of social supports.
\n\u201cSobering spaces are important, especially from opioids,\u201d agreed Ghosh. \u201cSupervised consumption sites can be very helpful for this. They\u2019re a space where people can use and, if they\u2019re sophisticated, can stay for a while. So if they\u2019re nodding off, it\u2019s a safe space for them go, rather them someone finding them in the street.\u201d
\nThe UCP government shut down a supervised consumption site in Red Deer last year, and two more in Calgary and Lethbridge closed at the end of June.
\nLast week\u2019s announcement includes adding 400 new treatment, housing and stabilization beds in the Edmonton area. While Ghosh supports expanding capacity, she objects to the use of beds as a metric for success.
\n\u201cBeds isn\u2019t care. Space in a facility is not care. It doesn\u2019t by itself create wellness.\u201d
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