Grant: Project Grant - PA: Patient-Oriented Research - POR equity-focused

Canada's overdose crisis has killed nearly 50,000 people since 2016, with many more experiencing significant negative health and social outcomes. Officials have implemented new harm reduction and treatment services, but these efforts have not achieved sustained reductions in drug-related illness and death. Compounding this crisis, homelessness, encampments, and public drug use are also increasing. In response, multiple provincial governments are looking to expand compulsory drug treatment, arguing that it will improve public safety and put people on a path to recovery. However, studies suggest compulsory treatment has limited benefit and could cause harm. This includes increasing the risk of overdose death following release, and discouraging help-seeking and trust in the healthcare system. Despite these concerns, perspectives of the people targeted by compulsory drug treatment and the healthcare providers who care for them, remain poorly understood. To address this gap, we propose to examine the implementation of Alberta's Compassionate Intervention Act, which expands provincial authority to detain and treat any adult deemed at sufficient risk of harming themselves or others due to drug use. Using a community-engaged research approach, we will conduct qualitative research with marginalized people who use drugs and healthcare providers to: (1) document perspectives on the need for and implementation of expanded compulsory drug treatment; (2) identify potential benefits, harms, ethical tensions, and practical challenges; and (3) develop recommendations for culturally safe and effective drug treatment. Our findings will center patient and provider expertise, inform public understanding, and support policies that promote health, safety, and human rights.