Addictions
‘Harm Reduction’ is killing B.C.’s addicts. There’s got to be a better way
From the Frontier Centre for Public Policy
B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy
Fuelled by the deadly manufactured opioid fentanyl, Canada’s national drug overdose rate stood at 19.3 people per 100,000 in 2022, a shockingly high number when compared to the European Union’s rate of just 1.8. But national statistics hide considerable geographic variation. British Columbia and Alberta together account for only a quarter of Canada’s population yet nearly half of all opioid deaths. B.C.’s 2022 death rate of 45.2/100,000 is more than double the national average, with Alberta close behind at 33.3/100,00.
In response to the drug crisis, Canada’s two western-most provinces have taken markedly divergent approaches, and in doing so have created a natural experiment with national implications.
B.C. has emphasized harm reduction, which seeks to eliminate the damaging effects of illicit drugs without actually removing them from the equation. The strategy focuses on creating access to clean drugs and includes such measures as “safe” injection sites, needle exchange programs, crack-pipe giveaways and even drug-dispensing vending machines. The approach goes so far as to distribute drugs like heroin and cocaine free of charge in the hope addicts will no longer be tempted by potentially tainted street drugs and may eventually seek help.
But safe-supply policies create many unexpected consequences. A National Post investigation found, for example, that government-supplied hydromorphone pills handed out to addicts in Vancouver are often re-sold on the street to other addicts. The sellers then use the money to purchase a street drug that provides a better high — namely, fentanyl.
Doubling down on safe supply, B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy — though for now that effort has been stymied by the courts.
According to Vancouver city councillor Brian Montague, “The stats tell us that harm reduction isn’t working.” In an interview, he calls decriminalization “a disaster” and proposes a policy shift that recognizes the connection between mental illness and addiction. The province, he says, needs “massive numbers of beds in treatment facilities that deal with both addictions and long-term mental health problems (plus) access to free counselling and housing.”
In fact, Montague’s wish is coming true — one province east, in Alberta. Since the United Conservative Party was elected in 2019, Alberta has been transforming its drug addiction policy away from harm reduction and towards publicly-funded treatment and recovery efforts.
Instead of offering safe-injection sites and free drugs, Alberta is building a network of 10 therapeutic communities across the province where patients can stay for up to a year, receiving therapy and medical treatment and developing skills that will enable them to build a life outside the drug culture. All for free. The province’s first two new recovery centres opened last year in Lethbridge and Red Deer. There are currently over 29,000 addiction treatment spaces in the province.
This treatment-based strategy is in large part the work of Marshall Smith, current chief of staff to Alberta’s premier and a former addict himself, whose life story is a testament to the importance of treatment and recovery.
The sharply contrasting policies of B.C. and Alberta allow a comparison of what works and what doesn’t. A first, tentative report card on this natural experiment was produced last year in a study from Stanford University’s network on addiction policy (SNAP). Noting “a lack of policy innovation in B.C.,” where harm reduction has become the dominant policy approach, the report argues that in fact “Alberta is currently experiencing a reduction in key addiction-related harms.” But it concludes that “Canada overall, and B.C. in particular, is not yet showing the progress that the public and those impacted by drug addiction deserve.”
The report is admittedly an early analysis of these two contrasting approaches. Most of Alberta’s recovery homes are still under construction, and B.C.’s decriminalization policy is only a year old. And since the report was published, opioid death rates have inched higher in both provinces.
Still, the early returns do seem to favour Alberta’s approach. That should be regarded as good news. Society certainly has an obligation to try to help drug users. But that duty must involve more than offering addicts free drugs. Addicted people need treatment so they can kick their potentially deadly habit and go on to live healthy, meaningful lives. Dignity comes from a life of purpose and self-control, not a government-funded fix.
Susan Martinuk is a senior fellow at the Frontier Centre for Public Policy and author of the 2021 book Patients at Risk: Exposing Canada’s Health Care Crisis. A longer version of this article recently appeared at C2CJournal.ca.
From LifeSiteNews
Nearly 64% of American men now believe online pornography should be more difficult to access, with even higher numbers of women saying the same thing.
A new survey has shown that an increasing number of young men want more restrictions on online pornography.
According to a survey by the American Enterprise Institute’s Survey Center on American Life, nearly 7 in 10 (69 percent) of Americans support the idea of making online pornography less accessible. In 2013, 65 percent expressed support for policies restricting internet pornography.
The most substantial increase in the support for restrictive measures on pornography could be observed in young men (age 18-24). In 2013, about half of young men favored restrictions, while 40 percent actively opposed such policies. In 2025, 64 percent of men believe accessing online pornography should be made more difficult.
The largest support for restriction on internet pornography overall could be measured among older men (65+), where 73 percent favored restrictions. An even larger percentage of women in each age group supported making online pornography less accessible. Seventy-two percent of young women (age 18-24) favored restriction, while 87 percent of women 55 years or older expressed support for less accessibility of internet pornography.
Viewing pornography is highly addictive and can lead to serious health problems. Studies have shown that children often have their first encounter with pornography at around 12 years old, with boys having a lower average age of about 10-11, and some encountering online pornography as young as 8. Studies have also shown that viewing pornography regularly rewires humans brains and that children, adolescents, and younger men are especially at risk for becoming addicted to online pornography.
According to Gary Wilson’s landmark book on the matter, “Your Brain on Porn,” pornography addiction frequently leads to problems like destruction of genuine intimate relationships, difficulty forming and maintaining real bonds in relationship, depression, social anxiety, as well as reduction of gray matter, leading to desensitization and diminished pleasure from everyday activities among many others.
These four personality traits are predictive of addiction. A new program is using this knowledge to prevent addiction from ever developing
In classrooms across Canada, addiction prevention is getting personal.
Instead of warning students about the dangers of drugs, a program called PreVenture teaches students about themselves — and it’s working.
Developed by Canadian clinical psychologist Patricia Conrod, PreVenture helps young people recognize how traits like risk-taking or negative thinking shape their reactions to stress.
“When you intervene around these traits and help people learn new cognitive behavioural strategies to manage these traits, you are able to reduce their substance use,” said Conrod, who is also a professor at the Université de Montréal.
By tailoring addiction prevention strategies to individual personality profiles, the program is changing how we think about addiction — from something we react to, to something we might stop before it starts.
And now, scientists say the potential for early intervention is going even deeper — down to our genes.
Personality and addiction
PreVenture is a personality-targeted prevention program that helps young people understand and manage traits linked to a higher propensity for future substance use.
The program focuses on four core traits — anxiety sensitivity, sensation seeking, impulsivity and hopelessness — that shape how individuals experience the world and respond to stress, social situations and emotional challenges.
“They don’t only predict who’s at risk,” said Conrod in an interview with Canadian Affairs. “They predict what you’re at risk for with quite a lot of specificity.”
Anxiety sensitivity shows up in people who feel overwhelmed by physical symptoms like a racing heart or dizziness. People with this trait may ultimately turn to alcohol, benzodiazepines such as Xanax, or opioids to calm their bodies.
Sensation seeking is characterized by a desire for excitement and novel experiences. This trait is associated with a higher likelihood of being drawn to substances like cannabis, MDMA, psilocybin or other hallucinogens.
“[Cannabis] alters their perceptual experiences, and so makes things feel more novel,” said Conrod.
Sensation seeking is also associated with binge drinking or use of stimulants such as cocaine.
The trait of impulsivity involves difficulty controlling urges and delaying gratification. This trait is associated with a higher likelihood of engaging in risky behaviours and an increased risk of addiction to a broad range of substances.
“Young people with attentional problems and a core difficulty with response inhibition have a hard time putting a stop on a behaviour once they’ve initiated it,” said Conrod.
Finally, the trait of hopelessness is tied to a pessimistic, self-critical mindset. People with this trait often expect rejection or assume others are hostile, so they may use alcohol or opioids to dull emotional pain.
“We call it negative attributional style,” said Conrod. “They have come to believe that the world is against them, and they need to protect themselves.”
These traits also cluster into two broader categories — internalizing and externalizing.
Anxiety sensitivity and hopelessness direct distress inward, while sensation seeking and impulsivity are characterized by outward disinhibition.
“These traits change your perception,” said Conrod. “You see the world differently through these traits.”
Conrod also notes that these traits appear across cultures, making targeted addiction prevention broadly applicable.
Personality-based prevention
Unlike most one-size-fits-all drug prevention programs, PreVenture tailors its prevention strategies for each individual trait category to reduce substance use risk.
The program uses a brief personality assessment tool to identify students’ dominant traits. It then delivers cognitive-behavioural strategies to help users manage stress, emotions and risky behaviours associated with them.
Recreation of the personality assessment tool based on the substance use risk profile scale — a scale measuring traits linked to reinforcement-specific substance use profiles. | Alexandra Keeler
Students learn to recognize how their dominant trait influences their thoughts and reactions — and how to shift those patterns in healthier directions.
“We’re trying to raise awareness to young people about how these traits are influencing their automatic thinking,” said Conrod. “You’re having them be a little more critical of their thoughts.”
Hopelessness is addressed by teaching strategies to challenge depressive thoughts; those high in sensation seeking explore safer ways to satisfy their need for stimulation; anxiety sensitivity is managed through calming techniques; and impulsivity is reduced by practicing pausing before acting.
Crucially, the program emphasizes the strengths of each trait as well.
“We try to present [traits] in a more positive way, not just a negative way,” said Sherry Stewart, a clinical psychologist at Dalhousie University who collaborates with Conrod.
“Your personality gets you into trouble — certainly, we discuss that — but also, what are the strengths of your personality?”
While a main goal of the program is preventing substance use disorders, the program barely discusses substances.
“You don’t really have to talk about substances very much,” said Conrod. “You talk more about how you’re managing the trait, and it has this direct impact on someone’s motivation to use, as well as how severely they experience mental health symptoms.”
The workshops make it clear, however, that while substances may offer temporary relief, they often worsen the very symptoms participants are trying to manage.
The genetic angle
Catherine Brownstein, a Harvard Medical School professor and geneticist at Boston Children’s Hospital, says genetic factors also help explain why some people are more vulnerable to addiction.
“A lot of personality is genetic,” she said in an interview with Canadian Affairs.
Her research has identified 47 locations in human DNA that affect brain development and shape personality traits.
While substance use risk cannot yet be detected genetically, certain gene variants — like SHANK3, NRXN1 and CRY1 — are linked to psychiatric disorders that often co-occur with substance use, including ADHD and schizophrenia.
Brownstein also says genetic variations influence pain perception.
Some variants increase pain sensitivity, while others eliminate it altogether. One such gene, SCN9A, may make individuals more likely to seek opioids for relief.
“If you’re in pain all the time, you want it to stop, and opioids are effective,” said Brownstein.
While we cannot yet predict addiction risk from genetics alone, Brownstein says she thinks genetic screening combined with psychological profiling could one day personalize prevention even further.
Expansion and challenges
Conrod’s personality-targeted intervention program, PreVenture, has proven highly effective.
A five-year study published in January found that students who participated in PreVenture workshops were 23 to 80 per cent less likely to develop substance use disorders by Grade 11.
Stewart says that the concept of PreVenture began with adults with substance use disorders, but research suggests earlier intervention can alter life trajectories. That insight has driven PreVenture’s expansion to younger age groups.
Conrod’s team delivers PreVenture to middle and high school students, UniVenture to university students and OpiVenture to adults in treatment for opioid dependence.
PreVenture has been implemented in schools across the U.S. and Canada, including in B.C., Ontario, Quebec, Nova Scotia and Newfoundland and Labrador. Five Canadian universities are participating in the UniVenture study.
However, currently, Canada’s flagship youth prevention strategy is based on the Icelandic Prevention Model — a 1990s framework that aims to reduce youth substance use by focusing on environmental factors such as family, school and peer influence.
While the Icelandic Prevention Model has shown success in Iceland, it has serious limitations. It lacks a mental health component, does not specifically address opioid use and has demonstrated mixed results by gender.
Despite strong evidence for personality-targeted prevention, programs like PreVenture remain underused.
Conrod says education systems often default to less effective, generic methods like one-off guest speakers. She also cites staffing shortages and burnout in schools, along with insufficient mental health services, as major barriers to implementing a new program.
Still, momentum is building.
B.C. has aligned their prevention services with the PreVenture model. And organizations such as the youth wellness networks Foundry B.C. and Youth Wellness Hubs Ontario are offering the program and expanding its reach.
Conrod believes the power of the program lies in helping young people feel seen and understood.
“It’s really important that a young person is provided with the space and focus to recognize what’s unique about [their] particular trait,” she said.
“Recognize that there are other people in the world that also think this way [and tell them] you’re not going crazy.”
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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