Addictions
Alberta and opioids III: You can’t always just stop

Monty Ghosh at Highlevel Diner, May 30. Photo: Paul Wells
By Paul Wells

This is the concluding installment in a series on drugs in Alberta. Previously:
i. “Worse Than I’ve Ever Seen,” June 4
ii. “Alberta’s System Builder,” June 7
To support ambitious reporting on important issues, please consider a paid subscription:
A matter of expectations
Street family
My tour guide for much of my visit to Edmonton was Dr. Monty Ghosh, a clinician who’s on faculty at the University of Calgary and the University of Edmonton. He seems to talk to everybody who works with substance users in Alberta, from his own patients to front-line clinicians to the Alberta government. His relations with the latter go up and down, but he urged me to talk to Marshall Smith, the chief of staff to premier Danielle Smith.
On my first night in Edmonton Ghosh walked me around a neighbourhood that included the George Spady Society supervised-consumption site, the Hope Mission’s Herb Jamieson Centre, and the Royal Alexandra Hospital, which has a supervised-consumption service on its premises.
A lot of people use the services these places provide. Other people don’t. Shelters in particular are tricky: they’re usually for single people who arrive alone. “The Hope, the Herb, the Navigation Centre, offering the world,” one Edmonton Police Service officer told me. “But all these places have one thing in common: rules.” If you have a spouse or a pet, you want to keep your drug supply or you want to stay close to your “street family” — the community spirit in neighbourhoods like this is striking, and might be surprising to people who prefer to stay away — a shelter’s probably not for you.
Several of the places we visited weren’t ready to welcome us when we showed up unannounced. To say the least, they’re busy. That was the case at Radius Community Health and Healing, an institutional building in a more residential part of the neighbourhood. Radius is a drop-in clinic and, as we’ll see, quite a bit more.
On a sunny weekday afternoon, more than a dozen people stood, sat or lay on the building’s front steps and truncated lawn. One lay on his back, shirtless, not moving visibly. Ghosh asked the man whether he was all right, asked again, finally nudged him. The man stirred, looked around. Ghosh apologized mildly for bothering him, then checked in on two other people who also weren’t moving. They turned out to be all right too.
Francesco Mosaico, Radius’s medical director, was on his way home for the day when we arrived, but we made plans to talk the next day. When I returned, I met Mosaico and Radius’s executive director, Tricia Smith, in her office.
I think it’s important to hear them out, because when drug use becomes the object of political debate, it’s natural to talk as though policy decisions are the main thing keeping people from getting well. This can lead to a lot of blame on one hand, and to excessive optimism on the other. In fact the biggest thing that keeps people from getting well is often the entire sum of their lives until now, compounded by the influence of drugs that are more potent than anything earlier generations had to deal with.
The most complex patients
Radius offers primary care to people “experiencing multiple barriers,” Smith said. That can include homelessness, addiction, severe mental health problems, criminal records. The centre’s team includes 12 family physicians and three psychiatrists. They currently see about 3,000 patients.
Radius has Western Canada’s only non-profit dental clinic. The centre runs a respite program for people who are not sick enough to be in acute care but are too sick to be managing independently on their own. It has a program for pregnant women experiencing homelessness. It runs on a harm-reduction model, so they don’t need to be drug-free to go into the program. It has an interdisciplinary Assertive Community Treatment team to help people with mental-health and substance problems find and stay in market apartments, with frequent assistance. There’s a supervised consumption site in the basement.
“In fact,” Smith said, “we actually have an exemption from the College of Physicians and Surgeons of Alberta to filter out and keep the most complex patients. The least complex, we refer elsewhere.” I couldn’t get care in Radius if I tried; they’d politely refer me elsewhere. They’re for the people who need the most help.
After my visit, Smith wrote to me to add another program to the list: Kindred House, which for more than 25 yearss has supported women and Trans women sex workers. “The women we see are from age 18 to 50, predominantly Indigenous, have intergenerational trauma, past/current trauma, substance use issues, often houseless or couch surfing,” Smith wrote.
Smith has been at Radius for three and a half years. While I was there, I asked her how work at Radius is going. “It’s going fabulously, honestly,” she said. She arrived early in the COVID pandemic, after eight years in Alberta government departments — which in turn followed 20 years as a Canadian Forces army nurse, including in combat zones. “I’m in the right place,” she said of Radius. “It felt like coming home.”
How come? “The staff, the team, the work, the dedication. It just feels like family. I missed that. Being in the military was a big thing. This work that this group does is just really amazing. The team is amazing and it’s hard, but it’s good work.”
And how’s the workload evolving? “Unfortunately, for this population, the struggles are only increasing, and the number of individuals that are experiencing those challenges is not getting less,” she said. “The workload isn’t going anywhere. It’s getting more difficult.”
Paul Wells is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
“Especially in the last couple years, I don’t think things have ever been worse for the vulnerable population,” Mosaico, Radius’s medical director, added. The same housing crunch that has made homes less affordable for everyone has put thousands of the most vulnerable on the street. Results: more frequent frostbite or burns from lamps lit to keep from freezing. Body lice. Trauma from watching friends die. And to Mosaico’s astonishment, frequent shigella outbreaks.
“Shigella’s a bacteria that causes torrential bloody diarrhea. It can be treated with a single dose of antibiotics. But if you’re homeless and you don’t have a place to take care of yourself… 70 percent of the cases have had to be hospitalized in the last two years…. I mean, they’re talking about potentially calling it an endemic disease, and it’s a disease of destitution. You see it in refugee camps in developing countries, not in the capital of Alberta, you know?”
Ten thousand times deadlier
Radius also works closely with the Alberta government to integrate its services with the “recovery-oriented system of care” that I told you about last week. There are two Radius staffers working at the Integrated Care Centre the police set up to replace the old, passive holding cells for overnight detention. There are two more at the Navigation Centre, which steers people toward social and government services. If there’s an Alberta model, they’re part of it. So I was fascinated by the response when I asked my hosts the basic question that sent me to Alberta: Why are so many people dying?
“I think it’s the nature of the drugs,” Mosaico said. “You know, people used to overdose and die. But I’ve been here 17 years. I think in the first 10 or 11 years it wasn’t very common to hear about overdoses by opioids. Every once in a while you’d hear about it, but it wasn’t a daily thing. Whereas now with fentanyl and carfentanil, it’s really dangerous.”
Carfentanil is 10,000 times more potent than morphine, 100 times more than fentanyl. The Edmonton Police won’t return stolen cars they recover until they’ve scrubbed them thoroughly, because even trace amounts of these drugs are too dangerous. “We’re finding clients who use methamphetamines and swear up and down they’re not taking opioids,” Mosaico said. “And then we do urine tests and it’s there. We think their dealers are lacing methamphetamine with fentanyl because it increases the addiction.”
The other big thing on his mind, Mosaico said, is that any program to guide users into recovery will bump up against the fact that different people have often lived starkly different lives.
93% 4+
“I don’t know if you’re familiar with Adverse Childhood Experiences — the ACEs study,” Mosaico said. I was, barely, but I needed a refresher.
The original study began in 1985 in San Diego, under Vincent Felitti, who ran an obesity clinic, and Rob Anda from the Centres for Disease Control. (If you want to learn more about the study, this article and this speech on Youtube are good places to start.)
“They surveyed 17,000 people,” Mosaico said. “They found, you know, if people had developmental trauma — so, trauma between the ages of 0 and 18 — and there are 10 different forms of trauma that the study bore out as being detrimental. Things like physical, emotional, sexual abuse; physical, emotional neglect; substance use in the family; untreated mental illness in the family; separation from biological parents; maternal figure being treated violently; and a household member going to jail.
“If those things occurred, you would just tally up the number of types of trauma and you’d get a score out of 10. What they found was, if you scored four or greater, that there seem to be adverse health effects in adulthood. And it wasn’t just the presence of addictions or mental illness. It was lung disease, heart disease, liver disease, certain forms of cancer, diabetes, obesity.” This is almost folk wisdom today, but at the time, Felitti and Anda were amazed at the strength of the correlations between childhood trauma and adult physical and mental health.
The original test has been widely replicated, and it usually finds that the proportion of people in a sample who’ve had four or more adverse childhood experiences is about 12%. So something like every eighth person you meet had a really difficult childhood, and while you can’t predict for individuals from statistical trends, there’s a good chance they’re still living with the fallout.
The team at Radius surveyed a large sample of the population under their care. The prevalence of high-risk ACE scores was about 93 percent, compared to 12 in the general population,” Mosaico said.
“Harvard has a center on the developing child, which has pulled together a lot of the science that explains the neurobiological link between the adverse trauma and the adverse health effects. They talk about limitations in the development of executive function, of decision-making, emotional regulation. Impulse control is underdeveloped, neuroanatomically in the brain. And instead what over-develops is the fight-or-flight response.
“So you’re dealing with a population that, because of their experiences, isn’t the same as the general population . And then that’s compounded by the fact that a high percentage of those clients who have high ACE scores also have traumatic brain injuries from living rough on the street. They also have adult trauma that compounds the childhood trauma. They have [fetal alcohol spectrum disorder], which impairs executive function even further.
“I hear these success stories and I think they’re wonderful, when you hear about people who have a difficult life and then they straighten up. And then, you know, they go back to their jobs and their families and they become leaders in their communities. But this is a population which is over-represented in every aspect of society, negatively as it were. In the prisons and child family welfare services. In the health system, you know, prevalence of HIV, tuberculosis, Hepatitis C, STIs, all that.
“And you look at them and you think, even if they managed to wait, you know, six months to get into an addiction recovery bed, after waiting for weeks to get into detox and they go through the program, what do they go back to? Most of them had to drop out of school. They have criminal records, which makes it hard to get a job. They’re disconnected and estranged from their families. They haven’t learned social skills.
“I had a client who lived in dumpsters for two and a half years. The fact that he just stayed housed — on income support — for the rest of his life was a huge win, right? It was important for his dignity, his quality of life. It’s just a matter of adjusting your expectations of what might actually be realistic.”
Thank you for reading Paul Wells. This post is public so feel free to share it.
Dr. Larson writes
The idea for these stories goes back to February, when it first became clear to me that 2023 would be Alberta’s worst year for overdose fatalities. I asked the communications team at the University of Calgary for names of people to talk to. Many weeks went by, because sometimes it’s ridiculous how hard it is to extract myself from Ottawa routine. After I published the second article in this series, the one where Marshall Smith showed me all the stuff Alberta is building, I received an email from Dr. Bonnie R. Larson, who’s on faculty at the University of Calgary. She thought I should have talked to her, and she thought I was too credulous in reporting the Alberta government’s side. I asked if I could publish part of her email. Here it is.
What cannot be taken for granted is Mr. Smith’s view that his goals are different, somehow nobler, than those of us on the front line. Smith paints a picture that front line providers’ priorities are at odds with his own. His perspective is at once undemocratic, insulting, and arrogant, belittling those who are doing the hard work of keeping people alive every day.
I will not have Smith speak for me in his suggestion that front liners lack system knowledge and that is why we support harm reduction. This ignores the excellent evidence supporting harm reduction interventions at the population level. Smith seems to think he knows from whence I “enter this conversation”. If so, why does he not engage me and my expert colleagues? Where I “enter this conversation” is at 20 years of working with the affected community and 13 years of post-secondary education. The only reason I am what Smith likes to dismiss as a “radical harm reduction activist”, is because the UCP, immediately upon taking office, set out to destroy harm reduction in Alberta. Nobody would have ever needed to fight this soul-destroying battle in the first place if Smith hadn’t put Alberta squarely on its current path of destruction. Yes, we should hope for a better tomorrow but that doesn’t excuse ignoring the past and present.
I would ask you to think about several additional factors that your analysis appears to ignore, including who actually benefits, in power and wealth, from Smiths’ system of so-called care? DId you consider the other ways that the UCP policy direction is moving the entire publicly-funded system steadily towards profit? Gunn (McCullough Centre) was a wonderful non-profit facility that helped many of my patients find their way to recovery from substance use disorders. While I agree that people should not have to pay for treatment, the question remains: in whose pockets do those tax dollars ultimately land?
You report that Smith indicates that they are “monitoring” the entire system. Where is the data from that monitoring? They have had five years now to show some outcomes, but who am I, just a lowly street doctor, to ask for population data? What I do know is that if deaths begin to decline, it is because so many are already gone. You should ask to see the data about which Smith so proudly boasts.
Smith’s entire premise that he is fixing the ‘addiction crisis’ is a fallacy. Addictions are not increasing. Deaths by drug poisonings are, however, and Smith’s circus is only making that worse. Allow me to spell it out for you: harm reduction addresses the drug poisoning crisis that is, no question, taking a horrific toll in Alberta and nationally. Smith’s ROSC, in contrast, addresses a figmentary addictions crisis.
One last tip. Medications used for opioid agonist treatment are not harm reduction, they are treatment. Nobody here is against treatment or recovery. But Marshall Smith is against harm reduction. Why can’t we just have the full spectrum of care??? Polarization is created by politicians to benefit politicians.
I don’t endorse everything Dr. Larson writes here. The data, or a lot of it, seems to me to be publicly available on the province’s impressive dashboard website. Use the tabs at the top of the page to navigate. And indeed, the story the dashboard tells is alarming, which, as I explained in this series’ first instalment, is why I flew west. But Larson’s years of front-line work has earned her, at the very least, a right of rebuttal.
Synthesis
On my last day in Edmonton, I met Monty Ghosh at Highlevel Diner, at the outer edge of the hip Strathcona neighbourhood on the south of the North Saskatchewan River. Highlevel is famous for its cinnamon buns, which, if I’m going to be honest, are noteworthy mostly for being large.
If the Alberta government and its most vociferous critics are thesis and antithesis, Ghosh tries to provide synthesis. He helped design the National Overdose Response Service, or NORS, which provides some of the emergency-response capability supervised consumption sites offer to people who aren’t near such a site or can’t use it for other reasons. He’s been critical of the Alberta government, but both sides keep lines of communication open.
I asked him about diverted safe supply — the idea that pharmaceutical opioids used in safe-supply programs in BC, principally hydromorphone tablets, are being sold or distributed away from their intended use. “I know it happens,” Ghosh said. “We sometimes get clients from British Columbia who come to Alberta to try to escape BC, because they’re looking for a fresh start. They’re looking for support and they’ll tell me themselves that they’ve diverted their safe supply.”
But what are the quantities? Trivial so far, Ghosh maintains. “Have I seen hydromorphone come into our province? Not at all, not yet.” This is the same thing I heard from Warren Driechel, the Edmonton deputy police chief.
Why do people divert their prescribed safe supply anyway? The answer Ghosh gave me was the answer I heard from everyone I asked. “They never used it. It just was not effective. The potency of the hydromorphone that they’re getting was nowhere near touching the fentanyl that they were using. It wasn’t dealing with the cravings, it wasn’t dealing with withdrawals, they felt it was useless. So what did they do? They sold it. They’re incredibly poor, they cannot afford their substance-use concerns and so therefore they supplement with revenue from hydromorphone.”
Before I flew to Edmonton, when Ghosh and I were trying to gauge on the phone what each of us thought of this infernal crisis, he figured out that I was interested in the differences between government policy in British Columbia and Alberta. “I’m not sure you want to hear this,” he said, “but I think it’s going to be bad everywhere.” I said that’s what I think too. Perhaps I surprised him.
I don’t know what happens next. Maybe things just stop getting worse everywhere on their own, for big complex reasons that resist easy analysis. Overdose deaths were lower last year in the United States, the capital of this hellscape, than the year before.
If not… well, we shall see. I wonder what happens in year six or seven of the effort the Alberta government is building. Is there resentment among people in ordinary hospitals and correctional facilities, who don’t have access to bespoke programs and personal attention? Does the ROSC system become bureaucratized after the first generation of administrators moves on?
Or does it start to win converts? David Eby, the NDP premier of British Columbia, has started putting distance between himself and his public-health advisors on legalization and safe supply. A new appointment in BC is being closely watched in Edmonton.
Or, conversely, does the Alberta recovery effort bump up against the limits imposed by the substances involved and by human nature? Reported recovery rates from addiction vary widely, depending in part on how you measure them. This paper puts the rate at less than 30%. If you even manage to double it, that still leaves a large cohort who aren’t getting better. Would their neighbours see them as people who “failed recovery” or “blew their chance?”
I won’t claim to know. I do hope that in the year ahead, more Canadians check their assumptions and stow their cheap certainties. Especially those who aspire to positions of leadership.
For the full experience subscribe to Paul Wells.
Addictions
There’s No Such Thing as a “Safer Supply” of Drugs

By Adam Zivo
Sweden, the U.K., and Canada all experimented with providing opioids to addicts. The results were disastrous.
[This article was originally published in City Journal, a public policy magazine and website published by the Manhattan Institute for Policy Research. We encourage our readers to subscribe to them for high-quality analysis on urban issues]
Last August, Denver’s city council passed a proclamation endorsing radical “harm reduction” strategies to address the drug crisis. Among these was “safer supply,” the idea that the government should give drug users their drug of choice, for free. Safer supply is a popular idea among drug-reform activists. But other countries have already tested this experiment and seen disastrous results, including more addiction, crime, and overdose deaths. It would be foolish to follow their example.
The safer-supply movement maintains that drug-related overdoses, infections, and deaths are driven by the unpredictability of the black market, where drugs are inconsistently dosed and often adulterated with other toxic substances. With ultra-potent opioids like fentanyl, even minor dosing errors can prove fatal. Drug contaminants, which dealers use to provide a stronger high at a lower cost, can be just as deadly and potentially disfiguring.
Because of this, harm-reduction activists sometimes argue that governments should provide a free supply of unadulterated, “safe” drugs to get users to abandon the dangerous street supply. Or they say that such drugs should be sold in a controlled manner, like alcohol or cannabis—an endorsement of partial or total drug legalization.
But “safe” is a relative term: the drugs championed by these activists include pharmaceutical-grade fentanyl, hydromorphone (an opioid as potent as heroin), and prescription meth. Though less risky than their illicit alternatives, these drugs are still profoundly dangerous.
The theory behind safer supply is not entirely unreasonable, but in every country that has tried it, implementation has led to increased suffering and addiction. In Europe, only Sweden and the U.K. have tested safer supply, both in the 1960s. The Swedish model gave more than 100 addicts nearly unlimited access through their doctors to prescriptions for morphine and amphetamines, with no expectations of supervised consumption. Recipients mostly sold their free drugs on the black market, often through a network of “satellite patients” (addicts who purchased prescribed drugs). This led to an explosion of addiction and public disorder.
Most doctors quickly abandoned the experiment, and it was shut down after just two years and several high-profile overdose deaths, including that of a 17-year-old girl. Media coverage portrayed safer supply as a generational medical scandal and noted that the British, after experiencing similar problems, also abandoned their experiment.
While the U.S. has never formally adopted a safer-supply policy, it experienced something functionally similar during the OxyContin crisis of the 2000s. At the time, access to the powerful opioid was virtually unrestricted in many parts of North America. Addicts turned to pharmacies for an easy fix and often sold or traded their extra pills for a quick buck. Unscrupulous “pill mills” handed out prescriptions like candy, flooding communities with OxyContin and similar narcotics. The result was a devastating opioid epidemic—one that rages to this day, at a cumulative cost of hundreds of thousands of American lives. Canada was similarly affected.
The OxyContin crisis explains why many experienced addiction experts were aghast when Canada greatly expanded access to safer supply in 2020, following a four-year pilot project. They worried that the mistakes of the recent past were being made all over again, and that the recently vanquished pill mills had returned under the cloak of “harm reduction.”
Subscribe for free to get BTN’s latest news and analysis – or donate to our investigative journalism fund.
Most Canadian safer-supply prescribers dispense large quantities of hydromorphone with little to no supervised consumption. Patients can receive up to 40 eight-milligram pills per day—despite the fact that just two or three are enough to cause an overdose in someone without opioid tolerance. Some prescribers also provide supplementary fentanyl, oxycodone, or stimulants.
Unfortunately, many safer-supply patients sell or trade a significant portion of these drugs—primarily hydromorphone—in order to purchase more potent illicit substances, such as street fentanyl.
The problems with safer supply entered Canada’s consciousness in mid-2023, through an investigative report I wrote for the National Post. I interviewed 14 addiction physicians from across the country, who testified that safer-supply diversion is ubiquitous; that the street price of hydromorphone collapsed by up to 95 percent in communities where safer supply is available; that youth are consuming and becoming addicted to diverted safer-supply drugs; and that organized crime traffics these drugs.
Facing pushback, I interviewed former drug users, who estimated that roughly 80 percent of the safer-supply drugs flowing through their social circles was getting diverted. I documented dozens of examples of safer-supply trafficking online, representing tens of thousands of pills. I spoke with youth who had developed addictions from diverted safer supply and adults who had purchased thousands of such pills.
After months of public queries, the police department of London, Ontario—where safer supply was first piloted—revealed last summer that annual hydromorphone seizures rose over 3,000 percent between 2019 and 2023. The department later held a press conference warning that gangs clearly traffic safer supply. The police departments of two nearby midsize cities also saw their post-2019 hydromorphone seizures increase more than 1,000 percent.
The Canadian government quietly dropped its support for safer supply last year, cutting funding for many of its pilot programs. The province of British Columbia (the nexus of the harm-reduction movement) finally pulled back support last month, after a leaked presentation confirmed that safer-supply drugs are getting sold internationally and that the government is investigating 60 pharmacies for paying kickbacks to safer-supply patients. For now, all safer-supply drugs dispensed within the province must be consumed under supervision.
Harm-reduction activists have insisted that no hard evidence exists of widespread diversion of safer-supply drugs, but this is only because they refuse to study the issue. Most “studies” supporting safer supply are produced by ideologically driven activist-scholars, who tend to interview a small number of program enrollees. These activists also reject attempts to track diversion as “stigmatizing.”
The experiences of Sweden, the United Kingdom, and Canada offer a clear warning: safer supply is a reliably harmful policy. The outcomes speak for themselves—rising addiction, diversion, and little evidence of long-term benefit.
As the debate unfolds in the United States, policymakers would do well to learn from these failures. Americans should not be made to endure the consequences of a policy already discredited abroad simply because progressive leaders choose to ignore the record. The question now is whether we will repeat others’ mistakes—or chart a more responsible course.
Our content is always free –
but if you want to help us commission more high-quality journalism,
consider getting a voluntary paid subscription.
Addictions
Should fentanyl dealers face manslaughter charges for fatal overdoses?

Tyler Ginn prior to his death from a fentanyl overdose in 2021. [Photo credit: Gayle Fowlie]
By Alexandra Keeler
Police are charging more drug dealers with manslaughter in fentanyl overdose deaths. But the shift is not satisfying everyone
Four years ago, Tyler Ginn died of a fentanyl overdose at the age of 18. Tyler’s father found his son unresponsive in the bedroom of their Brooklin, Ont., home.
For Tyler’s mother, Gayle Fowlie, the pain of his loss remains raw.
“He was my kid that rode his bike to the store to buy me a chocolate bar on my birthday, you know?” she told Canadian Affairs in an interview.
Police charged Jacob Norn, the drug dealer who sold Tyler his final, fatal dose, with manslaughter. More than three years after Tyler’s death, Norn was convicted and sentenced to six years in prison.
“I don’t think you can grasp how difficult going through a trial is,” Fowlie said. “On TV, it’s a less than an hour process. But the pain of it, and going over every detail and then going over every detail again … it provides details you wish you didn’t know.”
But Fowlie is glad Norn was convicted. If anything, she would have liked him to serve a longer sentence. Lawyers have told her Norn is likely to serve only two to four years of his sentence in prison.
“My son’s never coming back [and] his whole family has a life sentence of missing him the rest of our lives,” she said. “So do I think four years is fair? No.”
Norn’s case reflects a growing trend of drug dealers being charged with manslaughter when their drug sales lead to fatal overdoses.
But this shift has not satisfied everyone. Some would like to see drug dealers face harsher or different penalties.
“If we say that it was 50 per cent Tyler’s fault for buying it and 50 per cent Jacob’s fault for selling it … then I think he should have a half-a-life sentence,” said Fowlie.
Others say the legal system’s focus on prosecuting low-level drug dealers misses the broader issues at play.
“[Police] decided, in the Jacob Norn case, they were going to go one stage back,” said Peter Thorning, who was Norn’s defence lawyer.
“What about the person who gave Jacob that substance? What about the person who supplied the substance to [that person]? There was no investigation into where it came from and who was ultimately responsible for the death of that young man.”
Manslaughter charge
At least 50,000 Canadians have died from drug overdoses since 2016. Last year, an average of 21 individuals died each day, with fentanyl accounting for nearly 80 per cent of those deaths.
Fentanyl, a synthetic opioid, is up to 50 times stronger than heroin and 100 times stronger than morphine. A dose as small as a few grains of salt can be lethal.
Given its potency, police and prosecutors have increasingly turned to manslaughter charges when a dealer’s product results in a fatal overdose.
A recent study in the Canadian Journal of Law and Society found that the number of manslaughter charges laid for drug-related deaths in Canada surged from three cases in 2016 to 135 in 2021.
Individuals can be convicted of manslaughter for committing unlawful, reckless or negligent acts that result in death but where there was no intention to kill. Sentences can range from probation (in rare cases) to life.
Murder charges, by contrast, require an intent to kill or cause fatal harm. Drug dealers typically face manslaughter charges in overdose cases, as their intent is to distribute drugs, not to kill those who purchase them.
Joanne Bortoluss, a spokesperson for the Durham Regional Police, which charged Norn, said that each of their investigations follows the same fundamental process.
“Investigators consider the strength of the evidence, the dealer’s level of involvement, and applicable laws when determining whether to pursue charges like manslaughter,” she said.
The Canadian Journal of Law and Society study also found that prosecutions often target low-level dealers, many of whom are drug users themselves and have personal connections to the deceased.
Norn’s case fits this pattern. He struggled with substance abuse, including addiction to fentanyl, Xanax and Percocet. Tyler and Norn were friends, the judge said in the court ruling, although Fowlie disputes this claim.
“[Those words] are repulsive to me,” she said.
The Crown argued Norn demonstrated “a high degree of moral blameworthiness” by warning Ginn of the fentanyl’s potency while still selling it to him. In a call to Ginn, he warned him “not to do a lot of the stuff” because he “didn’t want to be responsible for anything that happened.”
Fowlie’s outrage over Norn’s lenient sentencing is compounded by the fact that Norn was found trafficking fentanyl again after her son’s death.
“So we’ve killed somebody, and we’re still … trafficking? We’re not worried who else we kill?” Fowlie said.

Trafficking
Some legal sources noted that manslaughter charges do not necessarily lead to harsh sentences or deterrence.
“If you look at how diverse and … lenient some sentences are for manslaughter, I don’t think it really pushes things in the direction that [victims’ families] want,” said Kevin Westell, a Vancouver-based trial lawyer and former chair of the Canadian Bar Association.
Westell noted that the term “manslaughter” is misleading. “Manslaughter is a brutal-sounding title, but it encapsulates a very broad span of criminal offences,” he said.
In Westell’s view, consistently charging dealers with drug trafficking could be more effective for deterring the practice.
“What really matters is how long the sentence is, and you’re better off saying, ‘We know fentanyl is dangerous, so we’re setting the sentence quite high,’ rather than making it harder to prove with a manslaughter charge,” he said.
Trafficking is a distinct charge from manslaughter that involves the distribution, sale or delivery of illicit drugs. The sentencing range for fentanyl trafficking is eight to 15 years, Kwame Bonsu, a media relations representative for the Department of Justice, told Canadian Affairs.
“Courts must impose sentences that are proportionate to the gravity of the offence and the degree of responsibility of the offender,” Bonsu said, referencing a 2021 Supreme Court of Canada decision. Bonsu noted that aggravating factors such as lack of remorse or trafficking large quantities can lead to harsher sentences.
‘Head of the snake’
Some legal experts noted the justice system often fails to target those higher up in the drug supply chain.
“We don’t know how many hands that drug goes through,” said Thorning, the defence lawyer.
“Are the police going to prosecute every single person who provides fentanyl to another person? Jacob [Norn] was himself an addict trafficker — what about the person who supplied the substance to him?”
Thorning also questioned whether government agencies bear some responsibility. “Is some government agency’s failure to investigate how that drug came into the country partly responsible for the young man’s death?”
Westell, who has served as both a Crown prosecutor and criminal defence lawyer, acknowledged the difficulty of targeting higher-level traffickers.
“Cutting off the head of the snake does not align very well with the limitations of the international borders,” he said.
“Yes, there are transnational justice measures, but a lot gets lost, and as soon as you cross an international border of any kind, it becomes incredibly difficult to follow the chain in a linear way.”
Bortoluss, of the Durham police, said even prosecuting what appear to be obvious fentanyl-related deaths — such as Tyler Ginn’s — can be challenging. Witnesses can be reluctant to cooperate, fearing legal consequences. It can also be difficult to identify the source of drugs, as “transactions often involve multiple intermediaries and anonymous online sales.”
Another challenge in deterring fentanyl trafficking is the strong financial incentives of the trade.
“Even if [Norn] serves two to four years for killing somebody, but he could make a hundred thousand off of selling drugs, is it worth it?” Fowlie said.
Thorning agreed that the profit incentive can be incredibly powerful, outweighing the risk of a potential sentence.
“The more risky you make the behaviour, the greater the profit for a person who’s willing to break our laws, and the profit is the thing that generates the conduct,” he said.
A blunt instrument
Legal experts also noted the criminal justice system alone cannot solve the fentanyl crisis.
“Most people who have [lost] a loved one [to drug overdose] want to see a direct consequence to the person that’s responsible,” said Westell. “But I think they would also like to see something on a more macro level that helps eliminate the problem more holistically, and that can’t be [achieved through] crime and punishment alone.”
Thorning agrees.
“These are mental health .. [and] medical issues,” he said. “Criminal law is a blunt instrument [that is] not going to deal with these things effectively.”
Even Fowlie sees the problem as bigger than sentencing. Her son struggled with the stigma associated with therapy and medication, which made it difficult for him to seek help.
“We need to normalize seeing a therapist, like we normalize getting your eyes checked every year,” she said.
“Pot isn’t the gateway drug, trauma is a gateway drug.”
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 – or donate to our investigative journalism fund.
-
2025 Federal Election1 day ago
MORE OF THE SAME: Mark Carney Admits He Will Not Repeal the Liberal’s Bill C-69 – The ‘No Pipelines’ Bill
-
2025 Federal Election1 day ago
‘I’m Cautiously Optimistic’: Doug Ford Strongly Recommends Canada ‘Not To Retaliate’ Against Trump’s Tariffs
-
2025 Federal Election1 day ago
‘Coordinated and Alarming’: Allegations of Chinese Voter Suppression in 2021 Race That Flipped Toronto Riding to Liberals and Paul Chiang
-
International2 days ago
Trump’s ‘Golden Dome’ defense shield must be built now, Lt. Gen. warns
-
Business16 hours ago
California planning to double film tax credits amid industry decline
-
Business24 hours ago
Canada may escape the worst as Trump declares America’s economic independence with Liberation Day tariffs
-
Alberta24 hours ago
Big win for Alberta and Canada: Statement from Premier Smith
-
Alberta1 day ago
Energy sector will fuel Alberta economy and Canada’s exports for many years to come