An SOS to Ottawa: stop the harm - Scott McKeen Consulting

Let me begin with a thank you for reading this far. Mental illness and addiction are passions of mine. Yes, you might call it a bias, rather than a passion. My lived experience as a user of alcohol left me with strong opinions, which you might not share. Heck, many people in recovery likely don’t share my opinions. Which is why I wanted to provide evidence for my positions in this and recent blog posts. If you haven’t read the others, you can find the first on trauma here, the second on addiction here and the third on the overdose crisis here. I wanted to illustrate that we need not reinvent the wheel; that a more robust health-care response to addiction is at once pragmatic and compassionate.

We have been in the midst of an overdose crisis for years. The Covid-19 pandemic made things more dire. Closed borders fostered an increasingly toxic drug supply. The shuttering of in-person support services resulted in isolation and people using alone, often tragically. In the pandemic’s early months, advocacy groups began warning us of shocking overdose numbers, with grim records being broken month after month.

To its credit, Vancouver approved new guidelines for prescribing safe alternatives to often-lethal, illicit drugs. This strategy is known as safe supply. Later that summer, the Honourable Patty Hajdu, Federal Minister of Health, wrote a letter to all provinces and territories encouraging them to address the alarming rate of death by overdose through a spectrum of options, including access to safe medical alternatives, or simply, safe supply. Since then, more than 20 municipalities across Canada, from Vancouver to Daniel’s Harbour Newfoundland, approved a variety of new approaches. Many of these municipalities, supported the passing of a resolution written by a 2,000-member advocacy group, Mom’s Stop the Harm, that formed out of Edmonton’s Riverdale community.

National advocacy groups like the Canadian Drug Policy Coalition have been at this for ages. The coalition is behind a powerful project called Getting to Tomorrow, featuring Edmonton’s Streetworks program, out of Boyle Street Community Services.

In the last few weeks the Government of Canada made two significant announcements. On February 18, the Department of Justice announced their proposed Bill C-22, which includes amendments to the Controlled Drugs and Substances Act, decriminalizing simple possession of illicit drugs. These amendments received the support of the Canadian Association of Chiefs of Police in a statement the very next day. The Government of Canada also announced $3.5 million in funding to expand the MySafe Society safe supply pilot in 5 cities across Canada.

So why safe supply? Alberta already has a great rapid-access program called Opioid Recovery Alberta. It is presently the best treatment we have for opioid dependence. The complication is that the program is only able to offer non-injectable opioid agonist treatments such as methadone. Opioid agonists block the withdrawal symptoms from opioid dependence, but don’t work in all cases.

Alberta, to its credit, has offered a more intensive program for some time now, known as iOAT. The program, while relatively modest in scope, has generated encouraging results. iOAT is a safe supply program with additional, or wraparound, services and supports. It engages with people whose addiction defied methadone treatments and forced them back to poisonous street drugs like fentanyl. Unfortunately, the Kenney government has spoken against “giving drugs to addicts.” It defunded the program, then defended that decision in court, successfully. The Kenney government’s position flies in the face of expert advice and, I’d argue, common sense. Addiction specialists describe safe supply programs like iOAT as a first-stage treatment, or as a last-resort for some addiction illnesses. It provides breathing room for the most hard-to-treat cases.

As advocates say: Recovery is impossible if you’re already dead.

So then, why decriminalization? I’ll admit, I wasn’t convinced at first. Then I heard a quote from an advocacy group that really hit home: “Criminalization of substance use is the ultimate stigma.” To be clear, decriminalization is targeted at small amounts and personal use. It does not provide a get-out-of-jail card to dealers and gangsters. Arguably, decriminalization is also an act of anti-discrimination and anti-racism as people of colour are disproportionately impacted by a criminal response to substance use. Decriminalization is also the strongest sign a society can send about addiction being an illness, rather than a crime. Cops say it all the time, but it was interesting to see Dr. Theresa Tam, Chief Public Health Officer of Canada repeat the quote: “You cannot arrest your way out of an opioid crisis.”

Given the tragic deaths, the rampant social disorder and crime associated with illicit drug use, Edmonton, I submit, must join the growing list of cities doing things differently.

I’ve been working up to a council motion, talking to experts, advocates and people with lived experience. I intend to make notice of motion at the next City Council meeting on Monday, March 15. It will be debated at a committee meeting of council in the next couple of weeks.

The motion is for all those who have lost loved ones to overdose. It’s for folks who were arrested and incarcerated, when what they really needed was health care. It is for communities and business districts suffering the side effects of the illicit drug trade. It is for the people out there, barely hanging on to jobs and family because of their stigmatized illness.

Here is my motion ….

That the Mayor, on behalf of City Council, write a letter to the Prime Minister asking for the following:

That the Federal Government officially recognize the overdose crisis as a national public health emergency; that the Federal Government fund and accommodate a safe supply pilot program, or programs, in Edmonton; that the principles of decriminalization within the Government of Canada’s proposed amendments to the Canadian Drug and Substances Act, as proposed in Bill C-22, be enacted by parliament.
That Administration engage with the Government of Alberta in regards to Edmonton’s five supportive housing sites to determine their eligibility for designation as therapeutic communities, with addiction treatment that includes pharmaceutical alternatives to illegal street drugs.