DETOX LAW MEETS A REAL NEED

I'm writing in response to an April 26 Leader-Post article entitled
"Youth detox law trashed" by James Wood, wherein he cites comment
from Children's Advocate Marvin Bernstein pertaining to his
(Bernstein's) "scathing report" on the Youth Drug Detoxification and
Stabilization Act, and from Gary Dickson (information and privacy
commissioner) both of whom are critical of the act respecting
violation of human and privacy rights issues.

Wood also cites Healthy Living Services Minister Graham Addley and
opposition MLA Ted Merriman who both support the law.

As a health services professional who is thoroughly experienced in
working with substance abuse, chemical dependency, and addiction
within families, and both youth and adult populations, I strongly
support the act as ". . . enlightened and principled legislation . .
." contrary to Bernstein's and Dickson's point of view.

Bernstein is concerned: 1) that parental and children's rights are
being violated as drug-addicted children may be "locked up"
involuntarily for detox; 2) that five out of six successful
applications under the act since instatement (April 1) suggests
misappropriation of the act as a "last resort"; 3) that ". . . it's
going to create unintended negative consequences for young people and
their families"; 4) that a judge "assess" a youth ". . . to determine
whether they need involuntary care to stabilize their health . . .";
5) that meddling and vengeful individuals might initiate the legal
process and this invites "potential for mischief"; 6) that the way
youth are treated under the act would not be acceptable to adults (no
one to respond on behalf of the youth, find out after the fact that
there is a warrant to apprehend); 7) that confinement is to occur at
the Paul Dojack Centre and transportation from northern parts of the
province pose major issues.

Most of the concerns listed fall within two primary concerns which
bear upon rights issues (involuntary "lock up" and youth treatment
under the act as not commensurate with adult treatment) and
misappropriation of the act as a "last resort" (judge "assessing"
youth, meddling individuals, and potential for mischief). These
primary concerns ("rights" and "last resort") fall away when
considered against the facts of substance dependence as a disease
process, the harm suffered by families when a defiant adolescent is
out of control due to substance involvements, and the prior efforts
undertaken to intervene in the problem.

Substance dependence is regarded as a "disease" process and, as other
diseases such as cancer and diabetes, is characterized by "morbidity"
(gets worse without assessment, intervention, treatment,) and
"visible signs and symptoms". Unlike other diseases, substance
dependence is also characterized by "denial" (rationalizing,
minimizing, defiance) which must be broken before recovery is possible.

It is my experience that parents are willing to go to considerable
effort to intervene in the painful reality of an out-of-control youth
and will utilize whatever services (ADS, school counselors, trained
psychologists, social services) are available to them. However, all
too often, efforts at intervention prove unsuccessful and available
services inadequate to break denial. "Tough love" (locking-out),
which is also the subject of ethical and moral concern, was often the
"last resort" prior to the youth drug legislation. "Lock-up" (safety
and whereabouts known) is quite preferable to "lock-out" (safety and
whereabouts unknown).

Further, involuntary "lock-up" ("committing") has long been accepted
under the Mental Health Act as appropriate when an individual is
judged at risk to himself or others.

As untreated the situation progresses with increasing severity of
consequence, the substance abuser may well pose a risk to himself,
others and society at large.

Under such circumstances "lock-up" is not only appropriate, but often
necessary.

Adults are not treated as youth under the act precisely because the
act is directed towards the needs of substance-dependent youths and
the need of the parent to intervene and provide service towards recovery.

As such, there is no infringement of human rights as the parent is
responsible for the health and wellbeing of their child.

The act allows parents to exercise their rights in providing
responsibly for the health needs of their child. The act is not
intended to in any way be punitive: it is a step in the intervention process.

Should other forms of intervention fail to be effective in breaking
denial, a legal intervention is both moral and ethical and supersedes
the rights of the suffering individual and allows the parent (as
previously mentioned) to exercise the right to get their child the help needed.

Negative consequences to youth and family associated with the
progression of the disease and the consequential negative behaviour
prior to the legal intervention are likely to be significantly
greater than problems which maybe occur after the instatement of the
act. Should a youth move into recovery, such concerns will be non-existent.

It is fair to say that "last resort" must be established as a last
resort only after other forms of intervention (private counselling,
school counselling, social services, alcohol and drug services, prior
drug assessments) have failed.

The progressive development of the case (interventions, services,
assessments) and severity of consequence would be required in writing
as a part of the application process.

It should be obvious to the judge reviewing application under the act
that a last resort is the "last resort"; that other interventions
have been unsuccessful; and, that the consequences are increasing in
severity (ruling out mischief, meddling individuals).

The judge's job is to assess the applications, not the substance abuser.

If facts warrant youth drug assessment, the matter (as Addley
indicated) is forwarded to the people who can provide a clinical
assessment for probability of substance abuse.

The concern that five of six applicants have been successful under
the act points not to problems associated with misappropriation of
the act under "last resort", but rather to Addley's comment of
"pent-up need". Further, it is my opinion, that the province-wide six
applicants is a low number for the 26-day period since it became law.
The law is new and the process of application under the law is not
well known by health-service providers and the public at large.

I expect applications will increase over time and that we will find
the initiative is under-manned (inadequate resources) producing
wait-list problems.

Bernstein's concerns related to lock-up and detox at Dojack
(correction facility), and to distance travel are real concerns, but
have nothing to do with the act itself.

These concerns are related to a need for facilities (as is the
problem of wait-listing "at risk" youth for treatment) and
appropriate services to expedite the purpose of the act

Bernstein makes a final comment suggesting that more "soul searching"
should have occurred before the act became law. Suffering families
need action, not soul searching.

In fact, when the need for action is established in research and
societal outcry, "soul searching" could be construed as a form of
societal enabling.

The Youth Drug Detoxification and Stabilization Act represents an
enlightened response to an emphatic need and allows families in
desperate circumstances to have hope.

Rod Rossmo

Regina