A new commentary suggests the Government of Alberta purposely pushed false narratives around public safety to scale down safe supply in the province.
The commentary, titled Safer supply and political interference in medical practice: Alberta’s Narcotics Transition Services, is published in International Journal of Drug Policy.
The commentary’s statements revolve around the election of the United Conservative Party (UCP) in 2019, and the ensuing policy shift away from harm reduction towards an abstinence-focused, recovery-oriented system of care.
The commentary concludes that the UCP caucus’ strong opposition to all forms of prescribed safe supply has led to the government prioritizing ideology over evidence.
It claims that at various times “prescribers were framed as harmful and requiring increased restrictions,” and “people who use drugs were framed as criminals and a danger to the public.”
The narratives, according to the study, allowed for “political inference in medical decision-making.”
Regulating policy
In October 2022, Alberta effectively banned safe supply in the province by amending the Mental Health Services Protection Regulation.
The changes prohibited prescribing of safer supply in most clinical settings in Alberta,and made it so all dosing had to be witnessed.
The decision was at least partially informed by findings from a handpicked Committee to Examine Safe Supply.
One of the commentary’s authors says the committee wasn’t particularly interested in linked data or science.
“We were seeing a lot of concerns framed around safety, but within the committee’s work, they relied on experts that are not experts on safer supply,” Patty Wilson said. “Many of the experts that this government went out and chose had publicly denounced safer supply before coming to the committee.”
“They leaned more into ideology.”
That accusation — that committee members had predetermined outcomes — has been in the public domain for some time.
When the initial committee report was released, multiple doctors and health experts from across the country voiced their displeasure.
Elsewhere in the report, the authors show how many clinicians were framed by the committee’s work.
“Prescribers of safer supply, usually physicians, were depicted as causing harm, both unintentionally and intentionally,” the report reads.
“Both historical and current prescribing practices were framed as harmful and a reckless approach to care,” and “reckless prescribing was frequently attributed to either the influence of pharmaceutical companies or clinicians adopting a defeatist approach in their practice.”
Alberta’s response
Alberta’s Minister of Mental Health and Addictions Dan Williams calls the commentary “an opinion piece.”
Williams has long insisted safe supply — or “unsafe supply,” as he refers to it — doesn’t work.
“We came to that conclusion through the evidence in a thoughtful policy process, through a committee at the legislature and then built our policy,” he told CTV News. “Unsafe supply isn’t the silver bullet and government-funded heroin is going to make the addiction crisis worse and not better.”
Williams denied that the committee was biased from the beginning, instead stating that its members were taking into conversation not only research, but “what Albertans wanted.”
“I have to look at what’s best for Alberta, and it’s categorical that unsafe supply will damage Albertan lives,” he said. “It will make our communities less safe and facilitate more addiction. We’ve seen this movie before.”
Safe supply
Multiple data sources from other provinces show safe supply decreases both deaths and hospitalizations, “but only when it’s easily accessible,” said Wilson.
She believes the recovery model is also effective, but long waitlists for treatment can oftentimes cause problems.
“(We can’t) frame recovery or treatment in opposition to Harm Reduction interventions,” Wilson said. “We need all of them. And that’s what people deserve, is all of them.”
Registered Nurse and University of Calgary professor Dr. Jennifer Jackson agrees.
“What we have done is narrowed all the range of options essentially to one pathway, and that pathway isn’t up and running yet,” Jackson said, referring to Recovery Alberta treatment sites that are still under construction. “So we’ve left a lot of people stranded who are trying to access services.”
“There could be overdose prevention sites, family doctors prescribing medication that can help manage addiction, nurse practitioners running clinics, there could be more phone-based and virtual services and community drop-in centres that offer supports for people with addictions.”
The number of opioid-related overdose deaths in Alberta is trending in the right direction after the heights of the pandemic, but remain high.
431 deaths were reported between January and May of this year, down from 788 over the same period last year.