Addictions
A conversation with Premier Smith’s outgoing chief of staff, architect of Alberta’s recovery-focused drug policies
Marshall Smith, Alberta’s Chief of Staff, sits in his office at the Alberta Legislature in Edmonton
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.
Subscribe to Break The Needle. Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
From LifeSiteNews
As Canada expands its euthanasia regime, vulnerable individuals like the homeless, obese, and grieving are increasingly offered assisted suicide, countering claims that ‘safeguards’ ensure the protocol remains limited in its scope.
Canada’s suicide activists and euthanasia advocates promised the public that the path to “medical aid in dying” would be a narrow path with high guardrails. They were lying. It is a four-lane highway, and there’s nobody patrolling it.
Not a week goes by without some grim new development, and our government refuses to listen to those hoarsely sounding the alarm.
On October 16, the Associated Press covered the questions euthanasia providers are discussing on their private forums. One story featured a homeless man being killed by lethal injection:
One doctor wrote that although his patient had a serious lung disease, his suffering was “mostly because he is homeless, in debt and cannot tolerate the idea of (long-term care) of any kind.” A respondent questioned whether the fear of living in the nursing home was truly intolerable. Another said the prospect of “looking at the wall or ceiling waiting to be fed … to have diapers changed” was sufficiently painful. The man was eventually euthanized. One provider said any suggestion they should provide patients with better housing options before offering euthanasia “seems simply unrealistic and hence, cruel,” amid a national housing crisis.
Another featured a doctor debating whether obesity made someone eligible for assisted suicide:
One woman with severe obesity described herself as a “useless body taking up space” – she’d lost interest in activities, became socially withdrawn and said she had “no purpose,” according to the doctor who reviewed her case. Another physician reasoned that euthanasia was warranted because obesity is “a medical condition which is indeed grievous and irremediable.”
And perhaps the most chilling story of all is the case of a woman who was consistently pushed into accepting death:
When a health worker inquired whether anyone had euthanized patients for blindness, one provider reported four such cases. In one, they said, an elderly man who saw “only shadows” was his wife’s caregiver when he requested euthanasia; he wanted her to die with him. The couple had several appointments with an assessor before the wife “finally agreed” to be killed, the provider said. She died unexpectedly just days before the scheduled euthanasia.
Read that carefully: the couple had several appointments with the person assessing their eligibility for euthanasia before the wife “finally agreed” – that is, broke down and assented – to be euthanized. Other providers cited examples of people being euthanized for grief. It should be obvious to anyone looking at what is happening in Canada: there are no brakes on this train.
It just keeps getting worse. Linda Maddaford, the newly elected president of the Regina Catholic Women’s League, is sharing her family’s experience this month at the Catholic Health Association of Saskatchewan convention.
After her mother passed away, Maddaford’s family moved their father to a care facility in Saskatoon. “The very day after, we got a blanket email inviting us to come to a presentation in the dining room,” she said. The topic? Accessing euthanasia. Maddaford added that there is a “push from the top-down. That if you don’t – if you aren’t open to the idea; you should be. I worry for the people who feel the pressure of: ‘Well my doctor advised it.’ Or ‘someone with a clipboard came around and kept asking.’”
Another story, covered this month by the Telegraph, relayed the experience of a Canadian woman undergoing life-saving cancer surgery… who was offered assisted suicide by doctors as she was about to enter the operating room for her mastectomy.
None of these stories appear to give euthanasia activists pause. Instead, they are constantly pushing for more.
On October 16, the Financial Post published an editorial by Andrew Roman titled, “You should be able to reserve MAID service: Quebec is going to let people pre-order medical assistance in dying. Ottawa shouldn’t try to stop it. People should have that right.” Anyone still arguing about “rights” as Canadian physicians euthanize patients for grief, obesity, homelessness, disability, and a plethora of other conditions should not be taken seriously. But here’s Roman, arguing that if we don’t permit this, all kinds of elderly people with dementia will not be killed:
As Canada’s population continues to age, demand for MAiD – medical assistance in dying – will only increase. But, with rates of dementia also increasing, the cognitive ability of patients to consent becomes a barrier. The prevalence of dementia more than doubles every five years among seniors, rising from less than one per cent in those aged 65-69 to about 25 per cent among people 85 and older.
Then, revealing a breathtaking ignorance of how Canada’s euthanasia regime has unfolded, Roman writes this:
There is no good reason why, with the numerous safeguards in Ottawa’s and Quebec’s laws, patients should be precluded from making advance requests before their condition renders them incapable of giving consent; and no good reason why their physicians should become criminals for honouring their patients’ duly stipulated advance requests.
No good reason why? Safeguards? What a joke. He concludes:
MAiD is also regulated under provincial law and by the same medical colleges that regulate abortion. Ottawa should amend the Criminal Code to exempt MAiD altogether and, as is the case with abortion, let the medical profession do its work in accordance with provincial regulation and patients’ wishes.
And there you have it: the final goal of the euthanasia activists. Euthanasia on demand; doctors licensed to kill. We don’t have to ask ourselves what will happen if people like Roman get their way. It’s happening already.
Addictions
14-year old Kamilah Sword died after becoming addicted to diverted “safer supply” opioids. Now her loved ones are speaking up.
By Adam Zivo
New documentary exposes suffering caused by Canada’s “safer supply” programs
It has been widely reported that “safer supply” opioids are getting into the hands of youth and causing new addictions and deaths – but this fact, terrible as it is, can feel abstract to many. That’s why I’ve released this new 28-minute documentary, “Government Heroin 2: The Invisible Girls,” to illustrate the terrible harms being inflicted upon families by this failed policy.
The film focuses on the story of Kamilah Sword, a 14-year-old girl from Metro Vancouver who died of drug-related causes in 2022. Before her death, Kamilah and her friends had been using hydromorphone, an opioid as potent as heroin, that originated from government-funded safer supply programs.
These programs claim to reduce overdoses and deaths by providing addicts with pharmaceutical-grade addictive drugs – typically hydromorphone – as an alternative to riskier street substances. In reality, though, most addicts simply divert (sell or trade) their safer supply to the black market to acquire stronger drugs, such as illicit fentanyl. This then floods surrounding communities with hydromorphone, crashing its street price by up to 95 per cent and fueling new addictions.
Kamilah and her friends were victims of this corrupt system.
In 2021, hydromorphone pills suddenly became popular at their school. The pills, which were colloquially called “dillies,” were abundant and cheap and many teenagers did not believe that they were dangerous to experiment with, as they had originally been prescribed by the government and were marketed as “safe.”
The girls did not understand that they were essentially playing with heroin. Not until it was too late. But they were hopelessly addicted by then and as their opioid tolerances grew, so did their appetite for dillies.
Two of Kamilah’s friends – Amelie North and Madison (a pseudonym) – escalated to using fentanyl and eventually went to rehab. But Kamilah herself was not so lucky. She was found dead, curled up in the fetal position in her bed and with foam on the corner of lips, one warm August morning.
It was only after her death that her father, Greg Sword, learned about how safer supply had destroyed the lives of his daughter and her friends. Amelie and Madison explained to him, for example, how they would sometimes travel downtown and purchase dillies directly from safer supply patients, who gave the cheapest prices.
The Trudeau Liberals and BC NDP have spent years aggressively advocating for safer supply and have repeatedly denied that diversion is a serious issue that harms youth. So when Kamilah’s loved ones went public with their story in the summer of 2023, it caused a national scandal.
The situation was further complicated when the BC Coroners Service, after a considerable delay, released Kamilah’s coroner’s report in late December 2023. The report ruled out hydromorphone as a cause of death and claimed that Kamilah had died of a cardiac arrhythmia (irregular heartbeat) caused by cocaine and MDMA.
But when several physicians and forensic pathologists reviewed the report, they noticed some concerning irregularities.
As Kamilah’s body was not sent to autopsy (a scandal in itself), it would’ve been impossible to confidently diagnose an arrhythmia as a cause of death. And in complex polydrug cases such as Kamilah’s, the best practice would have been to list every major death as contributing to mortality – including hydromorphone.
Additionally, the coroner claimed that it was unknown from where the hydromorphone in Kamilah’s body had originated – even though Kamilah’s friends and family had been clear, across several media reports, that the drugs were diverted safer supply. It was impossible that the BC Coroners Service would have been unaware of this, but, strangely enough, no attempt was made by the coroner to interview Kamilah’s loved ones about her death, despite such interviews being regular practice.
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Greg Sword, along with Amelie and her mother, recently launched a class action lawsuit against a wide array of defendants – including the governments of British Columbia and Canada – for irresponsibly marketing and prescribing safer supply, and for their “wilful blindness” to the prevalence and dangers of diversion.
The tragedy of this story cannot be adequately captured with words. The tears of a mourning father need to be seen and heard to be grasped. The sobs of a mother who laments her daughter’s fentanyl addiction has no substitute.
This is why Government Heroin 2: The Invisible Girls exists. To give these families a chance to be properly understood. And to better inform the public, through visceral storytelling, of the outrageous failures of Canada’s institutions and addiction policies.
This film is the second in a series. The first installment – “Government Heroin” – focuses on a 25-year-old student in Ontario who purchased thousands of diverted safer supply films. That 19-minute film provides a slightly more technical overview of the safer supply diversion scandal, so while each film stands on its own, the two also pair together very well (with a brisk total runtime of only 47 minutes).
I implore you to watch this new documentary, and its predecessor, too, if possible. They are sad and challenging, and yet vitally necessary for anyone who is concerned about Canada’s eroding public order and, of course, the predations of organized crime.
Subscribe to Break The Needle. Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
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