Some countries just execute drug users
Which countries execute drug users, as opposed to drug traffickers? Only one I can think of with low thresholds is Singapore, and apparently Saudi Arabia had one possession case in 2025? Hardly one country out of 190+? I don't think anybody or any country openly advocates for execution of drug
users.
I work for an international research institution that is considered one of the best for mental health research in the world.
Is that just a roundabout way of saying a University with 'Toronto' in its name?
We first discussed this because someone pointed out that there is no legal mechanism for involuntary treatment of addictions in Ontario, only psychiatric conditions. In theory there is overlap, but in practice much less so.
Some homeless in Toronto are drug users. The studies on voluntary treatment vs. involuntary treatment is not as clear-cut as some would make it seem. IMO, evidence is limited and inconclusive. The issue is
highly political so it's normal for conflicting conclusions to show up.
Involuntary treatment may not be as effective as voluntary treatment in many studies, but there are
some studies showing involuntary treatment is better. Ultimately, no treatment is what many, if not most homeless end up with. AFAIK: 1.
there are no peer-reviewed studies comparing involuntary treatment to no treatment for homeless addicts. 2.
There are no studies comparing involuntary treatment to treatment as usual for homeless (cycling through shelters, ERs, jail, little to no treatment depending on TAU definition). 3.
There are no studies directly comparing involuntary treatment to housing first for homeless.
Here's a systematic 'review of reviews':
"The evidence indicates that Housing First does not lead to significant changes in substance use. Evidence regarding housing and other outcomes is mixed."
Background People who experience homelessness and those vulnerably housed experience disproportionately high rates of drug use and associated harms, yet barriers to services and support are common. We undertook a systematic ‘review of reviews’ to investigate the effects of interventions for this...
journals.plos.org
Here's a Ottawa study comparing housing first to standard care in the community:
"Results: Housing First clients moved into housing more quickly, reported a greater proportion of time housed, were more likely to spend the final six months housed, and had longer housing tenure at 24 months. There was a group by time interaction on problematic alcohol use with more rapid improvement for the comparison group; however, both groups improved over time. The comparison group had a greater decrease on problematic drug use by 24 months. There was no change in physical health and only the comparison group had improvements in mental health by 24 months. The groups had similar improvement on community functioning by 24 months. The comparison group had a greater increase in total quality of life. More specifically, the comparison group had an increase in the family relations-related quality of life, whereas the clients did not. [...[ The Housing First clients reported higher levels of satisfaction with living conditions than the comparison group at baseline and 12 months, but not at 24 months."
Adults who are homeless with problematic substance use can successfully be housed using a Housing First approach. However, further targeted services might be required to address other areas of functioning, such as health, substance use, and quality of life.
pubmed.ncbi.nlm.nih.gov
The Fraser Institute (I know many UT people hate that think tank) points out using
public info, that the City of Toronto incurs $51,000 in operating costs on each homeless person per year. Even higher, when considering capital costs. Both numbers would be higher than median after-tax income in Canada. (
https://www.fraserinstitute.org/com...uld-demand-better-citys-homelessness-services
When the City rented out hotels to serve as shelters, the homeless trashed the rooms. The underlying problem was moved from the streets to the hotel.
The goal is to reduce that cost while improving outcomes, and in some cases a
housing first policy may theoretically be better. As opposed to TAU or institutionalization.
I think it's obvious institutionalizing all 15,000 homeless in Toronto would be financially infeasible and not even necessary. Not all homeless are drug addicts, especially given the worsened housing crisis post-COVID. What I advocate for is involuntary treatment of
some homeless addicts, particularly the ones costing more than the typical homeless person. The ones disruptive on transit, frequenting emergency services, hospitals, as well as court and jail. The correctional institutions in Ontario are often overcapacity.
"Most people held in Ontario’s jails are not serving sentences; they are awaiting trial, legally presumed innocent. Many institutions are dangerously overcrowded – some operating at over 150% of their intended capacity – and/or facing chronic staff shortages."
Ombudsman's message - A strong voice for fairness – now more than ever: It is my great pleasure to present my 10th Annual Report as we mark Ombudsman Ontario’s 50th anniversary. It has been an historic year in many respects.
www.ombudsman.on.ca
People forget that part of the later de-institutionalization in the 70s & 80s was due to the government cutting spending due to a weak economy. It's not that those institutions were not effective in getting the mentally ill and addicted off the streets and out of the jail/prison. That was often the point, instead of sending someone to prison, they go to an asylum. Institutions were far from perfect, but I don't see a compelling reason to not revamp that model with modern methods. The provincial jails are averaging over 100% capacity, would you rather build more jails or more mental hospitals?
Many on one side of the political spectrum believe that people will always save themselves (therefore should always be given agency, instead of being forced into treatment). Unfortunately, that's not universally true. As has been pointed out, many homeless people do not seek nor want treatment despite having shelter or permanent housing (first). It's "de facto suicide in slow motion, which is evidently self-harming and which in the process, often pains others."
https://urbantoronto.ca/forum/threads/ttc-other-items-catch-all.20264/post-2367619
Some people likely cannot be saved, much less want to save themselves. Take Anders Behring Breivik, who will likely be imprisoned indefinitely by one of the most liberal justice systems on the planet.
Unfortunately for 'housing first', we're not going to solve the housing crisis for the middle class anytime soon, much less homeless addicts. It's not just unpopular to spend more on homeless than we're already spending, it's also infeasible as there is little to no excess capacity in housing construction. There is a difference between what a politically-motivated study concludes and what is actually economically
and politically feasible.
Ontario mental hospitals admissions are already 3/4ths involuntary. Is it really that big of a conceptual leap to involuntary addiction treatment? Substance use disorder IS a mental disorder under the DSM.
The CMHA doesn't get more funding when people are admitted to mental hospitals instead of attending their community-based programs. Of course they're against involuntary treatment.