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Addictions

New organizations for mental health and addictions to provide focused care and take pressure off health system

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Refocusing health care: mental health and addiction

Alberta’s government is creating two new organizations that will support the development of the mental health and addiction system of care.

In November 2023, Alberta’s government announced it would be refocusing health care with the creation of four new organizations that will be responsible for the oversight and delivery of health care services in the province. The four new organizations include acute care, continuing care, primary care and mental health and addiction. The mental health and addiction organization will be the first of these to be established when it becomes an entity later this year.

The new mental health and addiction organization, Recovery Alberta, will be responsible for the delivery of mental health and addiction services currently delivered by Alberta Health Services (AHS). In addition, Alberta’s government is establishing the Canadian Centre of Recovery Excellence (CoRE) to support Alberta’s government in building recovery-oriented systems of care by researching best practices for recovery from around the world, analyzing data and making evidence-based recommendations.

“Refocusing health care enables us to better prioritize the health care and services Albertans need. Giving Albertans living with mental health or addiction challenges an opportunity to pursue recovery and live a contributing life is the responsible and compassionate thing to do. I am so proud of the work we have done to be leaders on recovery, and I am looking forward to seeing both Recovery Alberta and the Canadian Centre of Recovery Excellence continue this work for years to come.”

Danielle Smith, Premier

“Alberta is leading the country with the development of the Alberta Recovery Model to address mental health and addiction challenges. The establishment of these two new organizations will support the delivery of recovery-oriented services to Albertans and will further cement Alberta as a leader in the field. We are proud to establish Recovery Alberta and CoRE as part of the Alberta Recovery Model.”

Dan Williams, Minister of Mental Health and Addiction

“We’re making good progress on refocusing health care in Alberta. Today marks a pivotal milestone towards creating a system that truly serves the needs of Albertans. Through this refocused approach, our aim is to prioritize the needs of individuals and families to find a primary care provider, get urgent care without long waits, access the best continuing care options, and have robust support systems for addiction recovery and mental health treatment.”

Adriana LaGrange, Minister of Health

Recovery Alberta

In August 2023, Alberta’s Ministry of Mental Health and Addiction began the process of consolidating the delivery of mental health and addiction services within AHS, a process that was completed in November 2023 with no disruption to services.

Recovery Alberta will report to the Ministry of Mental Health and Addiction and further support the Ministry’s mandate to provide high-quality, recovery-oriented mental health and addiction services to Albertans. It is anticipated Recovery Alberta will be fully operational by summer 2024 and will operate with an annual budget of $1.13 billion from Alberta’s government. This funding currently supports the delivery of mental health and addiction services through AHS.

The current provincial leadership team for Addiction and Mental Health and Correctional Health Services within AHS will form the leadership team of Recovery Alberta. When Recovery Alberta is fully established, Kerry Bales, the current Chief Program Officer for Addiction and Mental Health and Correctional Health Services within AHS will be appointed as CEO. Dr. Nick Mitchell, Provincial Medical Director, Addiction and Mental Health and Correctional Health Services within AHS, will become the Provincial Medical Director for Recovery Alberta.

“Recovery Alberta will build on the strong foundation of existing mental health and addiction services that staff and clinicians deliver. By working closely with Alberta Mental Health and Addiction and the Canadian Centre of Recovery Excellence, Recovery Alberta will continue to set a high standard of care for mental health and addiction recovery across the province, and beyond.”

Kerry Bales, chief executive officer (incoming), Recovery Alberta

“Albertans deserve patient-centered care when and where they need it. By establishing Recovery Alberta, we have an opportunity to work together in a new way to make that a reality for our patients and our communities.”

Dr. Nicholas Mitchell, provincial medical director (incoming), Recovery Alberta

While timelines are dependent on legislative amendments yet to be introduced, the Ministry of Mental Health and Addiction is aiming to establish the corporate structure of Recovery Alberta by June 3. Following the establishment of the corporate structure and executive team, staff and services would begin operation under the banner of Recovery Alberta on July 1.

Frontline workers and service providers will continue to be essential to care for Albertans. To ensure stability of services to Albertans, there will be no changes to terms and conditions of employment for AHS addiction and mental health staff transitioning to Recovery Alberta. Additionally, there will be no changes to grants or contracts for service providers currently under agreement with AHS upon establishment of Recovery Alberta.

Canadian Centre of Recovery Excellence (CoRE)

Alberta’s government has been leading the country in creating a system focused on recovery by building on evidence-based best practices from around the world. In five years, Alberta has removed user fees for treatment, increased publicly funded treatment capacity by 55 per cent and built two recovery communities with nine more on the way. Alberta’s government has also pioneered new best practices such as making evidence-based treatment medication available same day with no cost and no waitlist across the province through the Virtual Opioid Dependency Program.

To continue the innovative work required to improve the mental health and addiction system, Alberta’s government is creating the Canadian Centre of Recovery Excellence to inform best practices in mental health and addiction, conduct research and program evaluation and support the development of evidence-based policies for mental health and addiction. CoRE will be established as a crown corporation through legislation to be introduced this spring.

Alberta’s government has committed $5 million through Budget 2024 to support the establishment of CoRE. It is anticipated CoRE will be operational by this summer.

The CoRE leadership team will consist of Kym Kaufmann, former Deputy Minister of Mental Health and Community Wellness in Manitoba as the CEO. She will be supported by Dr. Nathaniel Day as Chief Scientific Officer of CoRE. Dr. Day currently serves as the Medical Director of Addiction and Mental Health within AHS.

“There is a need for more scientific evidence on how best to help those impacted by addiction within our society. The Canadian Centre of Recovery Excellence will generate new and expanded evidence on the most effective means to support individuals to start and sustain recovery.”

Kym Kaufmann, chief executive officer (incoming), Canadian Centre of Recovery Excellence

“The Canadian Centre of Recovery Excellence will provide the research and data we need to understand what works best when it comes to recovery. This new expertise and expanded evidence will provide us with further insight into how we can support communities, service providers and frontline staff to effectively help those living with addiction and mental health challenges.”

Dr. Nathaniel Day, chief scientific officer (incoming), Canadian Centre of Recovery Excellence

Quick facts

  • Budget 2024 will invest more than $1.55 billion to continue building the Alberta Recovery Model.
    • This includes a $1.13 billion transfer from Health to Mental Health and Addiction (MHA) for mental health and addiction services currently delivered by Alberta Health Services.
  • Virtual engagement sessions for AHS staff and service providers will be held on April 11, 16, 17 and 22.

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Addictions

‘Our Liberal Government Is Acting Like A Drug Lord’: A Mother’s Testimony

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By Adam Zivo

“As soon as [my son] was put on safe supply, he started diverting his safe supply” Mom tells Parliament safer supply isn’t working

“The whole purpose of the safer supply program was to divert addicts from using harmful street drugs, but that’s not happening,” testified Masha Krupp, an Ottawa-based mother, at the House of Commons Health Committee last week. Exhausted and blunt, she described how her son has, in the past, diverted his “safer supply” drugs to the black market and how she has personally witnessed widespread diversion, by other patients, outside the clinic her son attends.

Safer supply programs distribute free addictive drugs – typically hydromorphone, a heroin-strength opioid – under the belief that this stabilizes addicts and dissuades them from consuming riskier street substances. Addiction experts and police leaders across Canada, however, say that recipients regularly divert these taxpayer-funded drugs to the black market, fueling new addictions and gang profits.

The Liberals and NDP have denied that widespread safer supply diversion is occurring, despite ample evidence to the contrary – but Krupp’s lived experiences underline the folly of their willful blindness.

“As soon as he was put on safe supply, he started diverting his safe supply,” she testified. “You’ve got drug dealers – I know this for a fact through my son; I’ve seen it – they will come to your home, 24/7, you can call two in the morning. They take your hydromorphone pills.”

According to Krupp, her son’s addiction issues have not improved despite him being enrolled in a safer supply program for more than two years. He still uses fentanyl and crack cocaine, which led to yet another overdose just last month, she said, adding that diversion and a lack of recovery-oriented services contribute to his instability.

“The Dilaudid (brand name hydromorphone) is a means of currency for my son to continue using crack cocaine – so it’s not safe, because he’s still using unsafe street drugs,” she said in parliament.

Krupp further explained that, on multiple occasions, she witnessed and photographed patients selling their safer supply in front of the clinic where her son has been a patient since June 2021. The transactions were not subtle: she could see them counting and exchanging white pills.

Over time, Krupp corroborated these observations by acquainting herself with some of these patients, who would admit to selling their safer supply: “I get to know all these people that are diverting and using right in front of the clinic, in front of all the tourists, parents walking by with kids.”

She believes that safer supply could have a role in addiction care if it were better regulated, but feels that the current model, where supervised consumption of these drugs is rarely required, is only “flooding the market, using taxpayers’ dollars, with lethal opiates…”

“It’s unsafe supply, in my view, as a mother with lived experience,” said Krupp. “Our Liberal government, right now, is acting like a drug lord.”

Her testimony was consistent with what was described in a CBC investigative report published last February, wherein Ottawa’s police officers confirmed that safer supply diversion is rampant.

One constable quoted in the story, Paul Stam, said that virtually anytime police would pull up to Rideau and Nelson street, where the clinic Krupp’s son attends is located, “they would observe people openly trafficking in diverted hydromorphone.” The officer further told the CBC that the “street is flooded with this pharmaceutical grade hydromorphone” and that there has been a dramatic, province-wide reduction in the drug’s blackmarket price – from $8-9 per 8-mg pill to just $1-2 today.

Although Krupp gave her parliamentary testimony last week, I interviewed her in July and kept her story private at her request – at the time, she worried that going public could interfere with her son’s attempts at recovery.

In the July interview, Krupp explained that, not only had her son told her that safer supply diversion is ubiquitous, she had also heard this from two acquaintances of his, who were also on the program: “The information that I’ve received is that the drug dealers have operations set up 24/7 across the city, buying legal dillies (the slang term for hydromorphone).”

She explained that she had been able to witness and document safer supply diversion because, on most Friday mornings, she would take her son to his clinic appointments and wait for him outside in her car. As she was often parked just two or three metres away from where many drug deals occurred, she had a line of sight into what was going on: clearly-identifiable dillies being handed over for other drugs.

She estimated that, by that point, she had cumulatively witnessed at least 25 safer supply patients engage in diversion.

“[Safer supply patients] would trade their dillies for fentanyl and/or crack cocaine and smoke or inject it right in front of me. They would just huddle in a corner. It’s all done very openly,” she said. “What I witness, to me, is a human tragedy on the sidewalks of the nation’s capital, with Parliament Hill eight or nine blocks away, and all the politicians sitting there singing praises to safer supply.”

She pushed back on the narrative, popular among Liberal and NDP politicians, that criticism of safer supply is conservative fear mongering and said that she had voted NDP in the past, and had even voted for Trudeau in 2015. Her disgust with safer supply was simply her “speaking from the heart as a mother.”

While harm reduction activists claim that safer supply is a form of compassionate care, Krupp vehemently disagreed: “How is it compassionate to fuel somebody’s addiction? How is it humane to keep a perpetual cycle of drug abuse and dependence?”

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Addictions

New documentary exposes safer supply as gateway to teen drug use

Published on

By: Alexandra Keeler

In a new documentary, Port Coquitlam teens describe how safer supply drugs are diverted to the streets, contributing to youth drug use

Madison was just 15 when she first encountered “dillies” — hydromorphone pills meant for safer supply, but readily available on the streets.

“Multiple people walking up the street, down the street, saying ‘dillies, dillies,’ and that’s how you get them,” Madison said, referring to dealers in Vancouver’s Downtown Eastside.

Madison says she could get pills for $1.25 each, when purchased directly from someone receiving the drugs through safer supply — a provincial program that provides drug users with prescribed opioids. Madison would typically buy a whole bottle to last a week.

But as her tolerance grew, so did her addiction, leading her to try fentanyl.

“The dillies weren’t hitting me anymore … I tried [fentanyl] and instantly I just melted,” she said.

Kamilah Sword, Madison’s best friend, was just 14 when she died of an overdose on Aug. 20, 2022 after taking a hydromorphone pill dispensed through safer supply.

Madison, along with Kamilah’s father, Gregory Sword, are among the Port Coquitlam, B.C., residents featured in a documentary by journalist Adam Zivo. The film uncovers how safer supply drugs — intended as a harm reduction measure — contribute to harm among youth by being highly accessible, addictive and dangerous.

Through emotional interviews with teens and their families, the film links these drugs to overdose deaths and explores how they can act as a gateway to stronger substances like fentanyl.

Some last names are omitted to respect the victims’ desire for privacy.

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‘Not a myth’

Safer supply aims to reduce overdose deaths by providing individuals with substance use disorders access to pharmaceutical-grade alternatives, such as hydromorphone.

But some policy experts, health officials and journalists are concerned these drugs are being diverted onto the streets — particularly hydromorphone, which is often sold under the brand name Dilaudid and nicknamed “dillies.”

Zivo, the film’s director, points out the disinformation surrounding safer supply diversion, highlighting that some drug legalization activists downplay the issue of diversion.

In 2023, B.C.’s then-chief coroner Lisa Lapointe dismissed claims that individuals were collecting their safer supply medications and selling them to youth, thereby creating new opioid dependencies and contributing to overdose deaths. She labeled such claims an “urban myth.”

In the film, Madison describes how teen substance users would occasionally accompany people enrolled in the safer supply program to the pharmacy, where they would fill their prescriptions and then sell the drugs to the teens.

“It’s not a myth, because my best friend died from it,” she says in the film.

Fiona Wilson, deputy chief of the Vancouver Police Department, testified on April 15 to the House of Commons health committee studying Canada’s opioid crisis that about 50 per cent of hydromorphone seizures by police are linked to safer supply.

Deputy Chief of the Vancouver Police Department, Fiona Wilson, testified on April 15 during the House of Commons ‘Opioid Epidemic and Toxic Drug Crisis in Canada’ health committee meeting.

Additionally, Ottawa Police Sergeant Paul Stam previously confirmed to Canadian Affairs that similar reports of diverted safer supply drugs have been observed in Ottawa.

“Hopefully, by giving these victims a platform and bringing their stories to life, the film can impress upon Canadians the urgent need for reform,” Zivo told Canadian Affairs.

‘Creating addicts’

The teens featured in the film share their experiences with the addictive nature of dillies.

“After doing them for like a month, it felt like I needed them everyday,” says Amelie North, one teen featured in the documentary. “I felt like I couldn’t stand being alive without being on dillies.”

Madison explains how tolerance builds quickly. “You just keep doing them until it’s not enough at all.”

Madison started using fentanyl at the age of 12, leading to a near-fatal overdose after just one hit at a SkyTrain station. “It took five Narcan kits to save my life,” she says in the film.

Many of her friends use dillies or have tried fentanyl, she says. She estimates half the students at her school do.

“Government-supplied hydromorphone is a dangerous domino in the cascade of an addict’s downward spiral to ever more risky behaviour,” said Madison’s mother, Beth, to Canadian Affairs.

“The safe drug supply is creating addicts, not helping addicts,” Denise Fenske, North’s mother, told Canadian Affairs.

“I’m not sure when politicians talk about all the beds they have opened up for youth with drug or alcohol problems, where they actually are and how do we access them?”

Sword, Kamilah’s father, expressed his concern in an email to Canadian Affairs. “I want the people [watching the film] to understand how easy this drug is to get for the kids and how many kids it is affecting, the pain it causes the loved ones, [with] no answers or help for them.”

Screenshot: Dr. Matthew Orde reviewing Kamilah Sword’s toxicology report during his interview for the filming of ‘Government Heroin 2: The Invisible Girls’ in March 2024.

Autopsy

Kamilah’s death raises further concerns.

According to Dr. Matthew Orde, a forensic pathologist featured in the film, Kamilah’s toxicology report revealed a mix of depressants and stimulants, including flualprazolam (a benzo), benzoylecgonine (a cocaine byproduct), MDMA and hydromorphone.

Orde criticizes the BC Coroners Service for not following best practices by focusing solely on cardiac arrhythmia caused by cocaine and MDMA, while overlooking the potential role of benzos and hydromorphone.

Orde notes that in complex poly-drug deaths, an autopsy is typically performed to determine the cause more accurately. He says he was shocked that Kamilah’s case did not receive this level of investigation.

B.C. has one of the lowest autopsy rates in Canada.

Zivo told Canadian Affairs he thinks a public inquiry into Kamilah’s case and other youth deaths involving hydromorphone since 2020 is needed to assess if the province is accurately reporting the harms of safer supply.

“That just angers me that our coroners did not do what most of Canada would have done,” Sword told Canadian Affairs.

“It also makes me question why they didn’t do an autopsy, what is our so-called government hiding?”

Government Heroin 2: The Invisible Girls is available for free on YouTube.


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.

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