Marshall Smith, Alberta’s Chief of Staff, sits in his office at the Alberta Legislature in Edmonton

By Alexandra Keeler

Marshall Smith, on what he has learned as an addict and policy leader and what’s next for him

Alberta Premier Danielle Smith’s chief of staff, Marshall Smith, is leaving his post at the end of October.

Since taking office in 2022, he has been instrumental in shaping Alberta’s drug policies and developing the Alberta Model — a recovery-focused addiction treatment policy that has gained international recognition for enhancing access to mental health and addiction services.

Under his guidance, Alberta has prioritized building recovery communities over harm-reduction programs. Government data show a 53 per cent decrease in opioid-related overdose deaths in June 2024 from the prior year, which may suggest Smith’s initiatives are having an impact.

In a statement on social media, the Premier shared that Smith informed her of his decision to retire earlier this year, after dedicating 32 years to public service. His departure comes just ahead of the United Conservative Party’s leadership review on Nov. 2.

Smith met with reporter Alexandra Keeler on Sept. 10 to discuss his personal journey from addiction to recovery and how it has shaped Alberta’s drug policies. On Oct. 10, they spoke by phone to discuss his recent decision to step down and what lies ahead for him.

AK: What emotional and psychological impact did your addiction have on your sense of self?

MS: It makes you feel powerless. Addiction is an illness of isolation, despair, loneliness and powerlessness. One of the hallmarks of addiction is continuing to use a substance despite a complete lack of control over your using, and over the circumstances that you’re in.

AK: Do you think that sense of powerlessness impacts an individual’s ability to provide informed consent for involuntary treatment?

MS: I think that, over time, if addiction is left unchecked or untreated, or is allowed to progress to its very latter stages, you absolutely lose agency over your ability to make decisions.

I used to get the question a lot: ‘Is it a disease? Is it a choice?’ And I say it’s both. It’s actually a disease of choices, which is to say that it’s a disease or an illness that affects my brain’s ability to make good choices.

AK: Were you the driving force behind Alberta’s shift away from harm reduction towards a recovery-focused approach, or was there a broader change in attitudes within the community?

MS: Certainly I’m not solely responsible. I’m a member of a broad community of people in recovery who have been advocating for these policies for two decades. I think that I have a background [and] certain skills that have found me in positions like this, where I can be most effective helping my community advance these ideas and concepts and actually get them implemented into policy and action.

AK: Obviously your lived experience with addiction brings a valuable perspective to the table. But what data sources are the province using to inform its addiction and recovery policies?

MS: We have a very broad literature base that we use to inform a lot of our policy decisions … Alberta [also] has the most comprehensive data collection and data analytics system in North America, bar none.

A practical example of how that’s useful is … [if] the data shows us that a very high number of people who were in custody — whether that’s corrections or police custody — went on to fatally overdose in a period after their release, that tells us that we need to focus on correctional programs, and we need to focus on policing programs.

And we’ve done that. We have amazing new correctional treatment programs that are second to none. I don’t know of anybody in Canada that’s doing this — we’ve taken [jail units where inmates sleep and live] and turned them into treatment centres, and connected them with our new treatment centres outside of jails. We partnered with police, because police have probably the most amount of contact with people who are using substances, and we gave them the ability to help people get on to opioid-substitution medications.

We’re going to go even further. Minister [of Mental Health and Addiction Dan] Williams has just announced the creation of the Centre of Recovery Excellence (CoRE), which is a first of its kind in Canada. It’s a Crown corporation not beholden to pharmaceutical money, which is a big change for us, and we were very deliberate about that.

[CoRE] will give us the ability to pull in data from across systems in government and have that data analyzed … So we’re entering into a very exciting time in terms of data and analytics around this issue.

AK: Without CoRE fully operational yet, what made you confident the recovery-focused approach would succeed?

MS: I see hundreds of thousands of Canadians every day entering recovery and maintaining their recovery … What I see in the alternative is a lot of drug use, homelessness, despair, disease [and] crime.

We spend a lot of time talking about data and evidence and science, and all of those things are good and necessary … but it’s not the only component of the decision-making process. … The policies that we’re making and the pathways that we take also have to be informed by the values of the community that we serve. … For far too long in Canada, that hasn’t been a consideration.

I think that we are at a place in Canada where the country is saying to us it’s time to revisit the direction that we’ve been going. I think that they’re saying to us, as policymakers, that we gave this a chance. We had become convinced by experts and the media … to give [pro-drug, harm-reduction policies like safer supply] a try …

[A]fter 20 years of that, I think that Canadians are ready to throw in the towel and to say, ‘We’re done with this. We’ve given you enough time to prove out your thesis. It’s not worked, and now we’re looking for fresh ideas.’

So Alberta is here leading that conversation of fresh and different ideas, and we’re happy to have that role.

The remainder of this interview took place on Oct. 10.

AK: Premier Smith announced your retirement at the end of October. What prompted your decision to step down?

MS: My time in Alberta has been a lengthy and intense role of system transformation over two premiers and standing up government twice.

While there’s still a lot of work to be done here, we have a tremendous team in Alberta that is leading that work under Minister Williams. I just felt that it’s time for me to step out of the role and continue to serve in other capacities.

AK: Looking ahead, what aspects of the Alberta Model will you carry with you into your future endeavours?

MS: I would say all aspects of the model need to be expanded across Canada, for jurisdictions that are interested.

Where I can be of the most assistance to other governments is talking to them about how to effectively organize themselves to be successful in this area. I think that governments across the country are struggling to figure out how to do that.

AK: What new opportunities do you hope to pursue that you haven’t been able to explore during your time in this role? Will your focus continue to be in addiction and drug policy?

MS: The majority of my focus will be on addiction and drug policy, but I have other areas of interest.

I’m passionate about the work that we’re doing with Indigenous people … I’m also very passionate about emerging technology and how we’re going to use that to uncover some of the answers that we’re looking for on these models.

I’m looking forward to having a little bit more freedom and focus.

This interview has been edited and condensed for clarity.

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.