CHANGES COMING TO DRUG ABUSE PROGRAM

Possible revisions would force young addicts into safe houses for 10,
possibly 15 days

By Sheila Pratt, The Edmonton Journal

As the scourge of crystal meth cut across the prairies in 2005-06,
Alberta decided special measures were needed to rescue teenagers from
destructive habits.

Desperate parents were given the right to go to court to force their
teens into detox for five days in a bid to break the grip of ruinous
addictions.

Since July 2006, more than 1,500 court orders have been issued --
about ten every week -- under the Protection of Children Abusing
Drugs Act (PChAD), sending hundreds of teens into five safe houses
around the provinces. Many teens report using multiple drugs,
including alcohol (more than 90 per cent) crystal meth, (18 per
cent), cocaine, marijuana.

The Alberta government is proposing several changes to the program
after a major review expected to be released this month. Among them:
Extending the length of confinement, encouraging more parental
involvement in treatment and a greater role for addiction specialists
from the Alberta Alcohol and Drug Addiction Commission (which runs
the program).

The PChad program is costly -- $13.9 million in the first year. But
parents are adamant their new legal tools are the key to getting
their kids back from the dangerous world of drug addiction.

There are, however, also some questions about whether the program
risks alienating teens and parents.

Saskatchewan and Manitoba also have involuntary confinement
legislation, but Alberta stands out for the significant role PChAD
gives to parents and wider powers it gives to the courts to order
confinement. In Saskatchewan and Manitoba, addictions experts and
doctors, not parents, are the key players in making the decision
about mandatory confinement.

Initially, AADAC took the view that forcing a child into detox should
be "a last resort," explains Diann Tansem, AADAC's executive director
of the PCHAD program. Early intervention and voluntary treatment are
generally preferable, so AADAC didn't necessarily promote the program.

But parents look at the situation differently, says Tansem.

"What we've learned is many parents see this as their only resort,"
she said. "For them, it is a first step to getting their child into AADAC."

"It's not necessarily what we want, but it's the only resort for parents."

When their kids refuse counselling or don't come home night after
night, some parents haven't even had a chance to talk with their
children about drug abuse until a police officer picks them up under
a court order and takes them to one of five safe houses, she said.

The proposed amendments will extend the stay from the current
five-day limit to ten days with an additional five-day extension
where warranted.

Parents, addiction counsellors and some teens agreed that five days
was not long enough for an addicted teen to get the drug out of his
system and make a rational decision about whether to go on for treatment.

Two other changes will slightly increase the role of addictions
experts in determining the child's fate. First, parents will be
required to meet an AADAC counsellor before they head to court. (Now
they go directly to court).

The goal of the meeting is to give parents advice on what's best for
their teen and also give parents tools to deal with their child's
addiction. The parents, however, may proceed to court even if AADAC
advises against at this meeting.

Second, both AADAC and counsellors at the safe house will be given
the right to appeal a confinement order if, after an assessment, they
decide the teen does not meet the criteria of severe addiction that
warrants a compulsory ten-day stay.

(Currently, only the teen has the right to appeal the court order and
in a handful of cases, judges have agreed and released the teenager. )

Currently, PChAD court orders have no expiry date. As a result,
parents keep them on hand for months -- stick them on the fridge or
keep then in the glove box of the car -- and use them as a discipline
tool or a heavy-handed threat; if you don't shape up, I'll send you
to treatment.

"We know that happens and it's unfortunate, but that is not the
intent," says Tansem, adding that the focus of the act is protection,
not punishment.

To reduce the chances of misuse, the court orders would expire after
50 days under the proposed amendments.

There is no limit on the number of times a parent can go to court for
a confinement order. But Tansem said she hopes the court will be more
reluctant to issue repeat orders on the same child, given the
confinement period is now up to 15 days.

Cam Wild, director of the Addiction and Mental Health research lab at
the University of Alberta, says he sympathizes with desperate parents
who seek the help from the courts.

In some ways, he says, involuntary confinement for detox looks like
"an ideal solution" because teens are often so resistant to such help.

But there are some difficult issues. There's a risk of driving a
wedge between the parent and the child by using this heavy-handed
measure, he said.

One of the best protections against drug abuse or risky teen
behaviour is a close relationship between parents and their teens,
says Wild. If the teen becomes even more alienated from his parents
after they send him to a safe house, that could impede recovery in
the long run, says Wild.

Tansem notes that many teens are often angry when they first enter
the safe house. Many are unaware their parents have gone to court
until a police officer shows up to take them away.

But the anger usually subsides after a few days, she said.

Wild also notes it's easy to mistake drug use and experimenting for
abuse and dependence, which are more extreme. It's not necessarily
easy for judges to know the difference when making their decisions.

"This system depends on well-educated, informed parents and judges
understanding the difference," he says.

Not all drug use ends up with full-blown addiction, he added,
especially if there is appropriate intervention early on.

For instance, the vast majority of those who try alcohol don't abuse
it or become dependent. But it is important that parents be vigilant
for "signs of use versus abuse."

"Then they can work first to strengthen the relationship with their
child rather than call in the big guns," he said.

A key question in assessing PChAD's success is looking at how many
teens agree, after their stint of forced confinement, to go into
voluntary treatment and rehabilitation.

About 49 per cent of the teens end up going on to voluntary
treatment, according to a 2007 report.

She says that's a successful ratio.

"Those are kids we wouldn't otherwise get into treatment," she says.

(In Saskatchewan about 71 per cent of the teens go on to voluntary
treatment. In Manitoba, 83 per cent of youth agree to a treatment
plan after leaving detox).

Wild offers a note of caution. When parents resort to a court order
five and six times to confine their kids, which happens in some
cases, you have to ask if forced detox is working as an entry point
to treatment, he says.

Wild says his biggest worry is that this narrowly focused program
will take resources away from the other treatment options.

"There is a real need for a continuum of care and you don't want to
take resources from, say, prevention activities for the court program."

"From top to bottom we need resources," he said. "There is a real
opportunity now that AADAC is moved into the Alberta Health Services
Board to provide more treatment."