FORCED TREATMENT ISN'T ALWAYS THE BEST PLAN, EXPERT SAYS

SASKATOON -- Although forced treatment may be beneficial, a Vancouver
physician promoted flexible treatment for individual users at the
Community Action Against Crystal Meth Conference Tuesday.

Dr. Ian Martin is a physician at Three Bridges Community Health
Centre and Dusk to Dawn, a youth drop-in centre, in Vancouver. He was
unsure whether forced treatment is the appropriate type of action
that is needed.

"I think sometimes people can be forced into treatment. And there's
some evidence that is a benefit, things like drug courts do work,"
Martin said, referring to courts in British Columbia and parts of the
United States where addicts choose between a jail sentence or treatment.

"I think it's up to the individual to some degree to engage in
treatment. Dragging people kicking and screaming into a treatment
centre probably won't work."

Last week, the Saskatchewan government introduced legislation
allowing parents and guardians to ask a judge to grant involuntary
detoxification for youth aged 12 to 17. Judges would determine
whether a youth should be assessed by a physician. If the youth does
not enter detoxification voluntarily after this, they could be
involuntarily entered into treatment for up to five days, with a
possible extension to 15 days, following an assessment from a second physician.

Martin said detox wasn't treatment, though.

"I think detox facilities are an important first step but I think
people probably put on over-emphasis on what they offer," he said.

He said tailoring treatment to suit a specific person is important
because every user is different. In general, though, Martin said
programs should be flexible to accommodate the user, such as drop-in
hours, short wait times and group meetings.

"Unfortunately in addictions, there's not a lot of evidence to give
us strict direction where to go. So as a result you have a variety of
different treatment centres with a variety of different approaches."

In terms of prevention, Martin said he wasn't a fan of the "meth is
death" message. He said acute heroin usage can kill but acute death
from a methamphetamine injection is actually quite rare.

Despite admitting crystal meth is very addictive, Martin said there
was no evidence for a single dose addiction and that people have
walked away from use.

Still, meth is a dangerous drug which affects both mind and body. It
is different from other drugs because of the prevalence in mental
illness it causes, HIV risk particularly in men who have sex with men
and the drug's availability in rural areas.