Ruth Pollard
January 4, 2007
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* Compulsory treatment for addicts
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PEOPLE with a life-threatening addiction to alcohol or drugs will be forced into short-term involuntary care under a two-year pilot study proposed by the NSW Government.
Part of long-awaited changes to the state's Inebriates Act 1912, the proposal was recommended by a NSW upper house committee after the Alcohol Summit in 2003. But it has come under harsh criticism from drug experts and civil libertarians.
Admitting it would create a "difficult situation", the Health Minister, John Hatzistergos, defended the project, saying it would be "clinically driven and judicially supervised".
The proposed changes to the Inebriates Act would allow a doctor to seek a court order to refer an alcohol- or drug-dependent person for compulsory treatment, he said.
The trial, which will involve up to 28 days of involuntary care in a four-bed secure unit at Nepean Hospital, would be a "circuit-breaker" for the most severely addicted, treating up to 50 patients a year.
"There will be capacity for an earlier discharge if a doctor believes it is appropriate, and there is also capacity to apply for an extension of care," Mr Hatzistergos said.
Once a person was discharged, they would be cared for in the community, and helped with with any problems related to housing, mental health and general physical health, he said.
Experts doubt the effectiveness of coercive programs. Gino Vumbaca, the executive officer of the Australian National Council on Drugs, said there was no evidence compulsory treatment produced good outcomes for people with addictions. "For coerced or compulsory treatment, the outcomes are generally poorer," he said. "Motivation is obviously a key factor in the success of treatment.
"There would have to be a lot of safeguards in there ? to make sure that you are not undermining people's rights."
Andrew Byrne, a GP who treats patients with drug addictions, agreed there was "no evidence to show that locking people up is of any benefit".
"It is a big step for doctors to take away someone's liberty on the basis that they appear to be harming themselves. We see lots of patients who appear to be harming themselves with cigarettes and overeating - where do you draw the line?"
One group that supports the proposal is the Network of Alcohol and Other Drug Agencies, the peak body that represents drug and alcohol services.
Its executive director, Larry Pierce, said the pilot would target only the small group of people who were literally trying to kill themselves with alcohol or drugs.
"The numbers would be very small and represent only the spectacular cases - cases where people who are severely dependent on alcohol to the extent that they are harmful to themselves, their family or the community.
"Twenty-eight days is probably enough time to save their lives - this intervention would interrupt what is clearly a life-threatening situation."
Mr Hatzistergos believed civil liberties fears could be allayed, but he admitted it was "a difficult situation".
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