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Alberta’s recovery-focused addiction agency to address data gap

Published

4 months ago

8 minute read

Break The Needle

By Alexandra Keeler

The launch of Alberta’s Centre of Recovery Excellence comes as Ontario and Saskatchewan also shift to recovery-oriented models

This fall, Alberta will be launching a new agency to lead recovery-focused addiction research and treatment in the province.

The Canadian Centre of Recovery Excellence (CoRE) aims to address a major challenge in Canada’s toxic drug crisis: a shortage of evidence-based, recovery-oriented research.

“[W]e hope to … support individuals on their recovery journey using the best available evidence on what works and what does not work,” the centre’s communications lead Katy Merrifield told Canadian Affairs in a written statement.

“There is also a lack of tangible research centred on the outcomes of recovery-focused policy, which is what CoRE aims to address,” she said.

The move comes at a time when Ontario and Saskatchewan are also shifting their policy responses away from harm-reduction strategies — such as safe consumption sites and needle exchange programs — toward more recovery-oriented models.

Last week, Ontario announced it would be closing 10 safe consumption sites located near daycares and schools and opening 19 recovery hubs. It also plans to prevent municipalities from establishing new consumption sites, requesting the decriminalization of illegal drugs or participating in federal safe supply initiatives, Canadian Affairs reported last week.

Early signs of success

CoRE’s launch is part of Alberta’s broader approach to addiction under the United Conservative Party government. The party, which has been in power since 2019, favours a recovery-oriented approach over a harm-reduction model.

In 2019, Alberta committed $140 million over four years to enhance addiction services, which has increased the number of available treatment spaces from 19,000 to 29,400. The province has eliminated a $40-a-day user fee at publicly funded addiction treatment facilities. And it has authorized police officers to assist detainees in seeking treatment.

The number of opioid-related deaths in the first three months of 2024 was 452, down from a high of 627 deaths in Q1 2023. However, it is still above the 241 deaths registered in the first quarter of 2020, according to the Alberta Substance Use Surveillance System.

Despite these early signs of success, the province would like to see further data to support its recovery-focused policy decisions.

“There is no clear centre of recovery excellence that can advise on what works and does not work when it comes to mental health and addictions,” Alberta’s Minister of Mental Health and Addiction Dan Williams said April 2 when announcing the creation of CoRE.

“One challenge with addiction research, and research in general, is there is often an attempt to look at a very specific intervention over a short period of time,” said Merrified. “[B]roader, long-term research is time consuming and expensive.”

CoRE will investigate the number of Albertans affected by addiction, their recovery journeys and outcomes, such as return to work, access to housing and family reunification.

The agency also plans to integrate global best practices into Alberta’s programs.

“From Portugal’s commission for drug dissuasion combined with their massive scale of recovery spaces to Italy’s use of recovery communities, we look forward to incorporating global lessons where applicable,” said Merrifield.

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Industry funding

Alberta’s 2024 budget committed $5 million in funding to launch CoRE.

Merrifield says CoRE’s funding structure will be a key point of distinction between it and the British Columbia Centre on Substance Use, which is another key player in addiction research and education.

In contrast to CoRE, the B.C. centre prioritizes addiction medicine and harm reduction.

“Our vision is to enable the well-being of people who use substances through evidence-informed, stigma-free policies,” the centre’s website says.

“CoRE has safeguards enshrined in legislation to protect against receiving external funding that could be seen as attempting to bias research results,” said Merrifield, noting the centre will not accept industry funding from pharmaceutical or cannabis companies.

By contrast, the British Columbia Centre on Substance Use does receive funding from the pharmaceutical company Indivior, the pharmacy chain Shoppers Drug Mart and the cannabis companies Tilray and Canopy Growth.

Indivior is the maker of Suboxone, a medication prescribed for opioid dependence. Indivior is currently the subject of at least two class-action lawsuits alleging Indivior failed to disclose Suboxone’s adverse side effects, Canadian Affairs  reported in August.

In 2021, Shoppers Drug Mart offered a $2-million gift to the University of British Columbia to establish a pharmacy fellowship and support the education of pharmacist-focused addiction treatment at the British Columbia Centre on Substance Use.

Asked about the risk that drug industry funding could compromise the objectivity of their research, the B.C. centre referred Canadian Affairs to their website’s funding page. The website states their research is supported by peer-reviewed grants and independent ethical reviews to ensure objectivity.

Similar programs

Kevin Hollett, communications lead for the British Columbia Centre on Substance Use, said the centre is willing to collaborate with CoRE.

“We would welcome opportunities to collaborate and share knowledge with the CoRE team following their operational launch and as they define their research scope,” he said in a written statement.

CoRE was initially slated to be operational this summer, but launch details have not yet been announced.

At a conference on April 4, Minister Williams announced plans for CoRE to collaborate with Ontario and Saskatchewan on recovery-focused treatment systems. Currently, both provinces lack a direct equivalent to CoRE or B.C.’s centre.

“Many jurisdictions are interested in learning from the Alberta Recovery Model and implementing similar programs,” said Merrifield.

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

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Addictions

London Police Chief warns parliament about “safer supply” diversion

Published on December 7, 2024

By

London Police Chief Thai Truong testifies to House of Commons Standing Committee on November 26, 2024.

By Adam Zivo

“Vulnerable individuals are being targeted by criminals who exchange these prescriptions for fentanyl, exacerbating addiction and community harm,” said London Police Chief Thai Truong.

Thai Truong, the police chief of London, Ontario, testified in parliament last week that “safer supply” opioids are “obviously” being widely diverted to the black market, leading to greater profits for organized crime. His insights further illustrate that the safer supply diversion crisis is not disinformation, as many harm reduction advocates have speciously claimed.

Truong’s testimony was given to the House of Commons Standing Committee on Health, which is in the midst of an extended study into the opioid crisis. While the committee has heard from dozens of witnesses, Truong’s participation was particularly notable, as safer supply was first piloted in London in 2016 and the city has, since then, been a hotbed for opioid diversion.

“While the program is well intentioned, we are seeing concerning outcomes related to the diversion of safe supply medications… these diverted drugs are being resold within our community, trafficked to other jurisdictions, and even used as currency to obtain fentanyl, perpetuating the illegal drug trade,” he said in his opening speech. “Vulnerable individuals are being targeted by criminals who exchange these prescriptions for fentanyl, exacerbating addiction and community harm.”

He later clarified to committee members that these vulnerable individuals include women who are being pressured to obtain safer supply opioids for black market resale.

Safer supply programs are supposed to provide pharmaceutical-grade addictive drugs – mostly 8-mg tablets of hydromorphone, an opioid as potent as heroin – as an alternative to riskier street substances. The programs generally supply these drugs at no cost to recipients, with almost no supervised consumption, and have a strong preference for Dilaudid, a brand of hydromorphone that is manufactured by Purdue Pharma.

Addiction experts and police leaders across Canada have reported that safer supply patients regularly divert their hydromorphone to the black market. A recent study by Dr. Brian Conway, director of Vancouver’s Infectious Disease Centre, for example, showed that a quarter of his safer supply patients diverted all of their hydromorphone, and that another large, but unknown, percentage diverted at least some of their pills.

Truong’s parliamentary testimony, which mostly rehashed information he shared in a press conference last July, further corroborated these concerns.

He noted that in 2019, the city’s police force seized 847 hydromorphone pills, of which only 75 were 8-mg Dilaudids. Seizures increased after access to safer supply expanded in 2020, and, by 2023, exploded to over 30,000 pills (a roughly 3,500 per cent increase), of which roughly half were 8-mg Dilaudids. During this period, the number of annual overdose deaths in the city also increased from 73 to 123 (a 68 per cent increase), he said.

Relatedly, Truong noted that the price of hydromorphone in London – $2-5 a pill – is now much lower than in other parts of the province.

As an increasing number of police departments across Canada have publicly acknowledged that they are seeing skyrocketing hydromorphone seizures, some safer supply advocates have claimed, without evidence, that these pills were mostly stolen from pharmacies, and not diverted by safer supply patients. Truong’s parliamentary testimony dispelled this myth: “These increases cannot be attributed to pharmacy thefts, as London has had only one pharmacy robbery since 2019.”

The police chief declined to answer repeated questions about the efficacy of safer supply, or to opine on whether the experimental program should be replaced with alternative interventions with stronger evidence bases. “I’m not here to criticize the safe supply program, but to address the serious challenges associated with its diversion,” he said, noting his own lack of medical expertise.

The chief emphasized that, while more needs to be done to stop safer supply diversion, the addiction crisis is a “complex issue” that cannot be tackled solely through law enforcement. He advocated for a “holistic” approach that integrates prevention, harm reduction and treatment, and acknowledged the importance of London’s community health and social service partners.

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In response to Truong’s testimony, NDP MP Gord Johns, an avid safer supply advocate, downplayed the importance of the diversion crisis by arguing that “people aren’t dying from a safer supply of drugs; they’re dying from fentanyl.”

While it is true that 81 per cent of overdose deaths in 2024 involved fentanyl, addiction physicians across Canada have repeatedly debunked Johns’ argument as misleading. The dangers of diverted hydromorphone is not that it directly kills users, but rather that it easily hooks individuals into addiction, leading many of them to graduate to deadly fentanyl use.

Johns previously faced criticism when, in a September health committee meeting, he seemingly used parliamentary maneuvers to reduce the speaking time of a grieving father, Greg Sword, whose daughter, Kamilah, died of drug-related causes after she and her friends got hooked on diverted hydromorphone.

There is currently no credible evidence that safer supply works. Most supporting studies simply interview safer supply patients and present their opinions as objective fact, despite significant issues with bias and reliability. Data presented in a 2024 study published in the British Medical Journal, which followed over 5,000 drug users in B.C., showed that safer supply led to no statistically significant mortality reductions once confounding factors were fully filtered out.

An impending update to Canada’s National Opioid Use Disorder Guideline, which was recently presented at a conference  organized by the Canadian Society of Addiction Medicine, determined that the evidence base for safer supply is “essentially low-level.” Similarly, B.C’s top doctor acknowledged earlier this year that safer supply is “not fully evidence-based.”

This article was syndicated in The Bureau, an online media publication that investigates foreign interference, organized crime, and the drug trade.

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Addictions

Parliament votes for proposal recommending hard drug decriminalization

Published on November 25, 2024

By

From LifeSiteNews

By Clare Marie Merkowsky

Canadian MPs have voted 210 to 117 in favor of a proposal to decriminalize simple possession of heroin, cocaine and all other illegal drugs across Canada despite the disastrous effects of lax drug policies already observed.

Canada may be one step closer to decriminalizing hard drugs as the majority of MPs voted in favor of a proposal recommending the move.

According to information published November 25 by Blacklock’s Reporter, MPs voted 210 to 117 in favor of a proposal recommending the decriminalizing of the simple possession of heroin, cocaine and all other illegal drugs across Canada. While the proposal is non-binding, it could point to how MPs would vote on a future bill seeking to augment the law.

“Why has it come to this?” Conservative MP Jacques Gourde, who opposes such a move, questioned. “We have reached the end of the road and nothing better lies ahead if we continue down this path.”  

The recommendation, which received a House majority with only Conservative MPs voting against it, suggested “that the Government of Canada decriminalize simple possess of all illicit drugs.”  

Prime Minister Justin Trudeau’s cabinet was noncommittal in their response to the suggestion, saying, “The government recognizes there are increasing calls from a wide range of stakeholders to decriminalize the simple possession of drugs as another tool to reduce stigma that can lead many to hide their drug use and avoid seeking supports including treatment.” 

“The government is exploring policy approaches and a broader framework that would ease the impact of criminal prohibitions in certain circumstances,” the Cabinet continued. 

The Trudeau government’s consideration of nationwide decriminalization comes despite drug-related deaths skyrocketing in the province of British Columbia after decriminalization was implemented there by the Trudeau government in 2023. In fact, the policy was considered so damaging by the left-wing controlled province that it had to ask to have certain aspects of the policy, such as the public use of drugs, rescinded earlier this year.

Other soft-on-drug policies have already been implemented by the Trudeau government, including the much-maligned “safer supply” program.

“Safe supply” is the term used to refer to government-prescribed drugs given to addicts under the assumption that a more controlled batch of narcotics reduces the risk of overdose. Critics of the policy argue that giving addicts drugs only enables their behavior, puts the public at risk, disincentivizes recovery from addiction and has not reduced – and sometimes even increased – overdose deaths when implemented.    

Gunn, who has since become a Conservative Party candidate, previously noted that his film shows clearly the “general societal chaos and explosion of drug use in every major Canadian city” since lax policies were implemented.  

“Overdose deaths are up 1,000 percent in the last 10 years,” he said in his film, adding that “every day in Vancouver four people are randomly attacked.”  

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