“This isn’t gonna fix your child,” Experiences of parents using involuntary stabilization for a child’s substance use

• Author / Creator

  O'Brien, Daniel

• Background: Evidenced-informed strategies are urgently needed to support families who are struggling with a youth’s substance use disorder. One strategy used in several Canadian provinces is involuntary stabilization programs, which involve the apprehension and confinement of youth whose substance use has resulted in serious harm to themselves or others, and who have declined voluntary treatment. In Alberta, the Protection of Children Abusing Drugs (PChAD) act allows for the confinement of minors for up to 15 days for detoxification, assessment, and discharge planning. Involuntary stabilization programs are controversial. Proponents argue that involuntary stabilization enables parents to rescue youth who are at risk of imminent serious harm and lack the mental capacity to make decisions. However, there is little evidence that compulsory treatment can improve outcomes for substance use in youth or adults. Further, there are serious concerns that involuntary stabilization may cause harm among opioid-dependent by increasing their risk of overdose. Indeed, it is well-documented among adults that rapid withdrawal from opioids poses a significant risk of experiencing an overdose due to loss of opioid tolerance. Finally, some parents who have used involuntary stabilization report that it “backfired” because it angered or distressed the youth and damaged the parent-child relationship.
  Although secure programs for substance use have existed in Canada since 2006, little is known about the experiences of parents using these programs. This qualitative study was designed to explore parents’ experiences with the PChAD program and their perceptions of how PChAD impacted their child. By illuminating parent experiences with PChAD, this study contributes knowledge about the possible benefits and drawbacks of involuntary stabilization and offers insights as to how these programs might better support families.
  Methodology: Semi-structured individual interviews were conducted with 15 parents who used PChAD between 2008 and 2018. Interview transcripts were analyzed using Interpretive Phenomenological Analysis.
  Results: During the application for a PChAD order, parents found the court hearings intimidating, overwhelming, and humiliating, and wanted more support to help them navigate this process. When their child was confined, parents were often frustrated that they were not more involved in their child’s care and felt they did not receive enough guidance or planning for after discharge. Most parents thought the program had little lasting impact on their child’s substance use. While some parents were relieved to simply have their child temporarily safe, others were disappointed because they had hoped PChAD would either improve their child’s substance use or motivate them to seek further treatment. Parents thought that service providers should help parents develop realistic expectations about what involuntary stabilization can accomplish.
  Some parents were frustrated that their child was discharged back into their care without any plan for continuous support or follow-up. They thought that even if their child was unwilling to attend voluntary treatment or reduce their substance use, they still needed guidance, education, and support to care for their child. Many parents thought longer involuntary programs were needed to address their child’s addiction and mental health programs. Parents also identified several risks of using PChAD. They were concerned that police apprehension and confinement traumatized their child and damaged their relationship. Some parents found that their child subsequently worked harder to hide their drug use and avoid their parents because they were afraid of being re-apprehended. Other parents perceived that their child’s substance use escalated following PChAD because they had met other peers who had a negative influence and offered greater opportunities to access substances. Finally, several parents were concerned about the negative impact of detoxification on youth who are opioid dependant.
  Conclusions: By describing parent experiences with the PChAD program, this study provides insight into how involuntary stabilization programs and other services can better serve families. Efforts are needed to increase parent involvement in involuntary stabilization, provide more comprehensive discharge planning, and offer ongoing support and guidance. Additionally, parents who are considering using involuntary stabilization need guidance to understand the possible benefits and drawbacks so that they can make informed decisions. Prior to using involuntary stabilization, parents should understand that involuntary stabilization may have little long-term impact on their child’s substance use. Finally, policy makers should consider the risks associated with involuntary stabilization when implementing these programs and seek ways to mitigate possible harms. Future research is needed to demonstrate the outcomes of involuntary stabilization programs and explore youth experiences and perspectives.

• Subjects / Keywords

  • Substance use
  • Youth
  • Addiction
  • Harm Reduction
  • Involuntary Stabilization
  • Secure Care

• Graduation date

  Fall 2021

• Type of Item

  Thesis

• Degree

  Master of Education

• DOI

  https://doi.org/10.7939/r3-9vm3-7k16

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.