By Alexandra Keeler

An Ottawa mother, who lost her daughter to addiction, is frustrated by Recovery Care’s failure to help her opioid-addicted son

Masha Krupp has already lost one child to an overdose and fears she could lose another.

In 2020, her 47-year-old daughter Larisa died from methadone toxicity just 12 days into an opioid addiction treatment program. The program is run by Recovery Care, an Ottawa-based harm reduction clinic with five locations across the city, which aims to stabilize drug users and eventually wean them off more potent drugs.

Krupp says she is skeptical about the effectiveness of the support and counseling services that Recovery Care claims to provide and believes the clinic was negligent in her daughter’s case.

On Oct. 22, the Ottawa mother testified before the House of Commons Standing Committee on Health, which is studying Canada’s opioid epidemic.

In her testimony, Krupp said her daughter was prescribed 30mg of methadone — 50 per cent more than the recommended induction dose — and was not given an opiate tolerance test before starting the program. Larisa received treatment at the Bells Corners Recovery Care location.

Krupp’s 30-year-old son, whom Canadian Affairs agreed not to name, has been a patient at Recovery Care’s ByWard Market location since 2021, where he receives a combination of methadone and hydromorphone, another prescription drug administered through the treatment program.

“Three years later, my son is still using fentanyl, crack cocaine and methadone, despite being with Dr. [Charles] Breau and with Recovery Care for over three years,” Krupp testified.

“About four weeks ago, I had to call 9-1-1 because he was overdosing,” Krupp told Canadian Affairs in an interview. “This is on the safer supply program … three years in, I should not be calling 9-1-1.”

Open diversion

Founded in 2018, Recovery Care is a partner in the Safer Supply Ottawa initiative. The initiative, which is led by Ottawa Public Health and managed by the nonprofit Pathways to Recovery, provides prescription pharmaceutical opioids to individuals who are at high risk of overdose.

Pathways to Recovery works with a network of service providers throughout the city — including Recovery Care — to administer safer supply.

Krupp says she supports the concept of safer supply, but believes it needs to be administered differently.

“You can’t give addicts 28 pills and say ‘Oh here you go,’” she said in her testimony. “They sell for three dollars a pop on the street,” she said, referring to the practice of some individuals selling their prescribed medications to fund purchases of more intense street drugs like heroin and fentanyl.

Krupp says she sees her son — and other patients of the program — openly divert their prescribed medications outside of the Recovery Care clinic in ByWard Market, where she parks to wait for him.

“[B]ecause there’s no treatment attached to [my son’s safer supply], it’s just the doctor gives him all these pills, he diverts them, gets the drugs he needs, and he’s still an addict,” Krupp said in her testimony.

Donna Sarrazin, chief executive of Recovery Care, told Canadian Affairs that Recovery Care has measures to address diversion, including security cameras and onsite security staff.

“Patients are educated at intake and ongoing that diversion is not permitted and that they could be removed from the program,” she said in an emailed statement.

“Recovery Care works to understand diversion and has continued to progress programs and actions to address the issues. Concerns expressed by the community and our teams are taken seriously,” she said.

Krupp says she has communicated her concerns about her son reselling his prescribed medications to his doctor, Dr. Charles Breau, both in-person and through faxed letters. “I never hear back from the doctor. Never,” she said.

Krupp also said in her testimony that police have spoken to her son about his diversion.

Breau did not respond to inquiries made to his clinical teams at Recovery Care or Montfort Hospital, a teaching hospital affiliated with the University of Ottawa.

Sarrazin said Breau is not able to comment on patient or family care.

In Krupp’s view, the safer supply program would be more successful if drug users were required to take prescribed medications under supervision.

“If he was receiving his hydromorphone under witnessed dosage and there was a treatment plan attached to it, I believe it would be successful,” she said.

Dr. Eileen de Villa, the City of Toronto’s medical officer of health, reinforced this point at the Oct. 22 Health Committee meeting. She said Toronto Public Health’s injectable opioid agonist therapy program — which combines observed administration with a treatment plan — has seen “incredible results.”

De Villa shared a case of a pregnant client who entered the program. “She went on to have a successful pregnancy, a healthy baby, has actually successfully completed the treatment, and is now housed and has even gained custody of her other children,” she said.

‘An affront to me’

Krupp also says Recovery Care fails to deliver on its promise of supporting patients’ mental health needs. Recovery Care’s website says its clinics offer “mental health programs which are essential to every treatment plan.”

Krupp and her son’s father have both requested a clear treatment plan and consistent counselling for their son. But he was started on safer supply after participating in only one virtual counselling session, she says.

She says Recovery Care has only one mental health counselor who services four of Recovery Care’s clinics. “If you’re getting $2-million-plus a year in funding, you should be able to staff each clinic with one on-site counselor five days a week,” she said.

Instead of personalized assistance, her son received “a sheaf of photocopies” offering generic services like Narcotics Anonymous and crisis helplines. “It’s almost an affront to me, as a taxpayer and a mother of an addict,” Krupp said.

Krupp says that, following her testimony to the parliamentary committee, Breau reached out to offer her son a mental health counseling session for the first time.

Sarrazin told Canadian Affairs that patients are encouraged to request counseling at any time. “Currently there is no wait list and appointments can be booked within 1 week,” she said in her emailed statement.

Class actions

Today, Krupp is considering launching a class-action lawsuit against Health Canada and the Government of Canada, challenging both the enactment of safer supply and the loosening of methadone dispensing requirements in 2017. She believes these changes contributed to her daughter’s death in 2020.

She is also considering joining an existing class-action lawsuit in B.C., which alleges Health Canada failed to monitor the distribution of drugs provided through safer supply programs.

The Pathways to Recovery initiative received $9.69-million in funding from Health Canada from July 2020 to March 2025. In June 2023, Health Canada allocated an additional $1.9 million to expand Ottawa’s safer supply program across five sites and improve access to practitioners, mental health support, housing and other services.

“I want to see that money being put to a recovery based treatment, not simply people going in and out and getting their medications and just creating this new sub-layer of addicts,” Krupp said.

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.

Alberta’s Minister of Mental Health and Addiction, Dan Williams, at the Alberta Legislature in Edmonton on Sept. 11 2024. [Photo credit: Alexandra Keeler]

By Alexandra Keeler

Alberta’s Minister of Mental Health and Addiction explains the shift from overdose prevention to recovery amid community concerns

On Sept. 23, Alberta announced the city of Red Deer would be closing the community’s only overdose prevention site by spring 2025. The closure will mark the first time an Alberta community completely eliminates its supervised consumption services.

The decision to close the site was taken by the city — not the province. But it aligns with Alberta’s decision to prioritize recovery-focused approaches to addiction and mental health over harm-reduction strategies.

“The whole idea of the Alberta Recovery Model is that unless you create off-ramps [from] addiction, you’re barreling ahead towards a brick wall, and that’s going to be devastating,” Alberta Minister of Mental Health and Addiction Dan Williams told Canadian Affairs in an interview in September.

However, the closure — which parallels similar moves by other provinces — has sparked debate over whether recovery-oriented models adequately meet the needs of at-risk populations.

The Alberta Recovery Model

The Alberta Recovery Model, which was first introduced by Alberta’s UCP government in November 2023, emphasizes prevention, early intervention, treatment and recovery.

It is informed by recommendations from Alberta’s Mental Health and Addiction Advisory Council and research from the Stanford Lancet Commission on the North American Opioid Crisis.

“Alberta, in our continuum of care, has everything from low entry, low barriers, and zero cost [for] detox, to treatment, to virtual opioid dependency, to outreach teams working with shelters,” said Williams.

Williams said that Alberta intends to continue funding safe consumption sites as short-term harm-reduction measures. But it views them as temporary components in the continuum of care.

This is not without controversy.

At the Feb. 15 Red Deer council meeting where councillors voted 5-2 to close the city’s safe consumption site, some councillors noted that safe consumption sites play an essential role in the continuum of care.

“Each individual is at a different stage of addiction … the overdose prevention site does play a role in the treatment spectrum,” said Coun. Dianne Wyntjes, who voted against the closure.

While Red Deer is home to Alberta’s first provincially funded addiction treatment facility, Wyntjes noted there had been reports within the community of the facility lacking capacity to meet demand.

She pointed to Lethbridge’s experience in 2020, where overdose deaths spiked after its consumption site was replaced with mobile services.

The Ontario government’s recent decision to close 10 safe consumption sites located near schools and daycares has prompted similar concerns.

In August, Ontario Health Minister Sylvia Jones told reporters that the province plans to “very quickly” replace the closed sites with Homelessness and Addiction Recovery Treatment (HART) hubs that prioritize community safety, treatment and recovery. But critics — including site workers, NDP MPPs and harm-reduction advocates — have warned these shutdowns will lead to an increase in fatal overdoses.

It is possible that Alberta, Ontario and other jurisdictions will make other moves in tandem in the coming months and years.

In April, Alberta announced it was partnering with Ontario and Saskatchewan to build recovery-focused care systems. The partnerships include sharing of best practices and advocating for recovery-focused policies and investments at the federal level.

‘Mandatory treatment’

Another controversial component of Alberta — and other provinces’ —  recovery-oriented strategy is involuntary care.

The UCP government has said it plans to introduce “compassionate intervention” legislation next year that will enable family members, doctors or police officers to seek court orders mandating treatment for individuals with substance use disorders who pose a risk to themselves or others.

“If someone is a danger to themselves or others in the most extreme circumstances because of their addiction, then we as a society have an obligation to intervene, and that might include mandatory treatment,” said Williams.

Critics have raised concerns about increasing reliance on involuntary care options.

“Over the last two decades, there has been a dramatic increase in reliance on involuntary services [such as psychiatric admissions and treatment orders], while voluntary services have not kept up with demand,” the B.C. division of the Canadian Mental Health Association said in a Sept. 18 statement published on their website.

The statement followed an announcement by B.C. Premier David Eby — who was recently reelected — to expand involuntary care in that province.

Research from Yale University’s School of Public Health indicates involuntary interventions for substance use are generally no more effective than voluntary treatment, and can in some cases cause more harm than good. The research notes that “involuntary centers often serve as venues for abuse.”

A 2023 McMaster University study that synthesized the research on involuntary treatment from international jurisdictions similarly found inconclusive outcomes. It recommended expanding voluntary care options to minimize reliance on involuntary measures.

Williams emphasized that the province’s involuntary care legislation would target “a very small group of people for whom all else has failed … those at the far end of the addiction spectrum with very serious and devastating addictions.”

‘Off-ramps from addiction’

Over the past six years, Alberta has incrementally increased its mental health and addiction budget from an initial $50 million to a cumulative total of $1.5 billion.

The funding boost has enabled Alberta to eliminate a $40 daily user fee for some detox and recovery services, add 10,000 publicly funded addiction treatment spaces, and expand access to its Virtual Opioid Dependency Program, which offers same-day access to life-saving medications.

To support addiction prevention, Williams said Alberta is expanding CASA Classrooms in schools. These offer mental health support and therapy to Grade 4-12 students who have ongoing mental health challenges, and equip school staff and caregivers to support these students.

“Mental health and addiction needs to be as connected to the emergency room as it is to the classroom,” Williams said. “We need to be able to understand low-acuity chronic mental health challenges as they begin to manifest [in the community].”

The province is also in the process of establishing 11 residential recovery communities across the province. These centres provide free, extended treatment averaging four months — which is longer than most recovery programs.

Oct. 23 marked the one-year anniversary of one such centre, the Lethbridge Recovery Community. The $19-million, 50-bed facility served more than 110 clients in its first year and expects to serve about 200 individuals in 2025.

“I’m coming to see that entering treatment is only the start,” said Sean P., a client of Lethbridge Recovery Community, in a government press release celebrating the anniversary.

“With the support of the staff and the community here, I’m beginning to face my past and make real changes. Recovery is giving me the tools I need for this journey, and I’m genuinely excited to keep growing and moving forward with their help.”

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