Secure care: more harm than good
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KEY POINTS Many who overdose on drugs in British Columbia are youth under the age of 19 years,[1][1] and calls for “secure care” legislation have intensified. Secure care legislation would legitimize the detention and forced care of youth who are deemed to be at immediate risk of serious
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Decades of research have failed to provide conclusive and consistent evidence supporting the effectiveness of involuntary treatments for substance use issues.
“This occurs despite the fact that decades of research have failed to provide conclusive and consistent evidence supporting the effectiveness of involuntary treatments for substance use issues [16,17].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [16]
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An Ethicolegal Analysis of Involuntary Treatment for Opioid Use Disorders
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Autonomy and (In)Capacity to Consent in Adolescent Substance Use Treatment and Care
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Self-citationSecure care: a question of capacity, autonomy and the best interests of the child
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Secure care can help youth reduce imminent risk of serious harm and prevent unnecessary death
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The authors respond to comments on the use of secure care in youth
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Self-citationSecure care: more harm than good
(2019) · Canadian Medical Association Journal · doi:10.1503/cmaj.181654 · Cited by 4 · see citing works
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“This occurs despite the fact that decades of research have failed to provide conclusive and consistent evidence supporting the effectiveness of involuntary treatments for substance use issues [16,17].”
Hinderyckx, M., & Neufeld, S. D. (2025) · Sociological Inquiry · doi:10.1111/soin.70000
Goodyear, T., Mneina, M., Schlissel, J., Long, V., Shaffer, B., Russolillo, A., Jenkins, E., Slemon, A., Gagnon, M., & Greer, A. (2026) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2026.105486
- Authors
- Pilarinos, A., Kendall, P., Fast, D., & DeBeck, K.
- Affiliations
- University of British Columbia (CA)
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2018-10-14
- Volume
- 190
- Issue
- 41
- Pages
- E1219-E1220
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC6188950
- OpenAlex
- W2895782395
- Cited by
- 25
- References
- 10
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 3 · 2019: 4
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Summit (Simon Fraser University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Criminal Law and Policy
- Keywords
- juvenile detention, harm reduction, British Columbia
- MeSH terms
- Psychological Trauma, Involuntary Treatment, Adolescent, British Columbia, Canada, Coercion, Delivery of Health Care, Humans, Evidence-Based Medicine, Substance-Related Disorders, Drug Overdose
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