Addictions
New organizations for mental health and addictions to provide focused care and take pressure off health system
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.”
“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.”
“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.”
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.”
“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.”
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.”
“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.”
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.
Related information
Addictions
BC Addictions Expert Questions Ties Between Safer Supply Advocates and For-Profit Companies
By Liam Hunt
Canada’s safer supply programs are “selling people down the river,” says a leading medical expert in British Columbia. Dr. Julian Somers, director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University, says that despite the thin evidence in support of these experimental programs, the BC government has aggressively expanded them—and retaliated against dissenting researchers.
Somers also, controversially, raises questions about doctors and former health officials who appear to have gravitated toward businesses involved in these programs. He notes that these connections warrant closer scrutiny to ensure public policies remain free from undue industry influence.
Safer supply programs claim to reduce overdoses and deaths by distributing free addictive drugs—typically 8-milligram tablets of hydromorphone, an opioid as potent as heroin—to dissuade addicts from accessing riskier street substances. Yet, a growing number of doctors say these programs are deeply misguided—and widely defrauded.
Ultimately, Somers argues, safer supply is exacerbating the country’s addiction crisis.
Somers opposed safer supply at its inception and openly criticized its nationwide expansion in 2020. He believes these programs perpetuate drug use and societal disconnection and fail to encourage users to make the mental and social changes needed to beat addiction. Worse yet, the safer supply movement seems rife with double standards that devalue the lives of poorer drug users. While working professionals are provided generous supports that prioritize recovery, disadvantaged Canadians are given “ineffective yet profitable” interventions, such as safer supply, that “convey no expectation that stopping substance use or overcoming addiction is a desirable or important goal.”
To better understand addiction, Somers created the Inter-Ministry Evaluation Database (IMED) in 2004, which, for the first time in BC’s history, connected disparate information—i.e. hospitalizations, incarceration rates—about vulnerable populations.
Throughout its existence, health experts used IMED’s data to create dozens of research projects and papers. It allowed Somers to conduct a multi-million-dollar randomized control trial (the “Vancouver at Home” study) that showed that scattering vulnerable people into regular apartments throughout the city, rather than warehousing them in a few buildings, leads to better outcomes at no additional cost.
In early 2021, Somers presented recommendations drawn from his analysis of the IMED to several leading officials in the B.C. government. He says that these officials gave a frosty reception to his ideas, which prioritized employment, rehabilitation, and social integration over easy access to drugs. Shortly afterwards, the government ordered him to immediately and permanently delete the IMED’s ministerial data.
Somers describes the order as a “devastating act of retaliation” and says that losing access to the IMED effectively ended his career as a researcher. “My lab can no longer do the research we were doing,” he noted, adding that public funding now goes exclusively toward projects sympathetic to safer supply. The B.C. government has since denied that its order was politically motivated.
In early 2022, the government of Alberta commissioned a team of researchers, led by Somers, to investigate the evidence base behind safer supply. They found that there was no empirical proof that the experiment works, and that harm reduction researchers often advocated for safer supply within their studies even if their data did not support such recommendations.
Somers says that, after these findings were published, his team was subjected to a smear campaign that was partially organized by the British Columbia Centre on Substance Use (BCCSU), a powerful pro-safer supply research organization with close ties to the B.C. government. The BCCSU has been instrumental in the expansion of safer supply and has produced studies and protocols in support of it, sometimes at the behest of the provincial government.
Somers is also concerned about the connections between some of safer supply’s key proponents and for-profit drug companies.
He notes that the BCCSU’s founding executive director, Dr. Evan Wood, became Chief Medical Officer at Numinus Wellness, a publicly traded psychedelic company, in 2020. Similarly, Dr. Perry Kendall, who also served as a BCCSU executive director, went on to found Fair Price Pharma, a now-defunct for-profit company that specializes in providing pharmaceutical heroin to high-risk drug users, the following year.
While these connections are not necessarily unethical, they do raise important questions about whether there is enough industry regulation to minimize potential conflicts of interest, whether they be real or perceived.
The BCCSU was also recently criticized in an editorial by Canadian Affairs, which noted that the organization had received funding from companies such as Shoppers Drug Mart and Tilray (a cannabis company). The editorial argued that influential addiction research organizations should not receive drug industry funding and reported that Alberta founded its own counterpart to the BCCSU in August, known as the Canadian Centre of Recovery Excellence, which is legally prohibited from accepting such sponsorships.
Already, private interests are betting on the likely expansion of safer supply programs. For instance, Safe Supply Streaming Co., a publicly traded venture capital firm, has advertised to potential investors that B.C.’s safer supply system could create a multi-billion-dollar annual market.
Somers believes that Canada needs more transparency regarding how for-profit companies may be directly or indirectly influencing policy makers: “We need to know exactly, to the dollar, how much of [harm reduction researchers’] operating budget is flowing from industry sources.”
Editor’s note: This story is published in syndication with Break The Needle and Western Standard.
The Bureau is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Dr. Julian M. Somers is director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University. He was Director of the UBC Psychology Clinic, and past president of the BC Psychological Association. Liam Hunt is a contributing author to the Centre For Responsible Drug Policy in partnership with the Macdonald-Laurier Institute.
An Ottawa mother, who lost her daughter to addiction, is frustrated by Recovery Care’s failure to help her opioid-addicted son
Masha Krupp has already lost one child to an overdose and fears she could lose another.
In 2020, her 47-year-old daughter Larisa died from methadone toxicity just 12 days into an opioid addiction treatment program. The program is run by Recovery Care, an Ottawa-based harm reduction clinic with five locations across the city, which aims to stabilize drug users and eventually wean them off more potent drugs.
Krupp says she is skeptical about the effectiveness of the support and counseling services that Recovery Care claims to provide and believes the clinic was negligent in her daughter’s case.
On Oct. 22, the Ottawa mother testified before the House of Commons Standing Committee on Health, which is studying Canada’s opioid epidemic.
In her testimony, Krupp said her daughter was prescribed 30mg of methadone — 50 per cent more than the recommended induction dose — and was not given an opiate tolerance test before starting the program. Larisa received treatment at the Bells Corners Recovery Care location.
Krupp’s 30-year-old son, whom Canadian Affairs agreed not to name, has been a patient at Recovery Care’s ByWard Market location since 2021, where he receives a combination of methadone and hydromorphone, another prescription drug administered through the treatment program.
“Three years later, my son is still using fentanyl, crack cocaine and methadone, despite being with Dr. [Charles] Breau and with Recovery Care for over three years,” Krupp testified.
“About four weeks ago, I had to call 9-1-1 because he was overdosing,” Krupp told Canadian Affairs in an interview. “This is on the safer supply program … three years in, I should not be calling 9-1-1.”
Open diversion
Founded in 2018, Recovery Care is a partner in the Safer Supply Ottawa initiative. The initiative, which is led by Ottawa Public Health and managed by the nonprofit Pathways to Recovery, provides prescription pharmaceutical opioids to individuals who are at high risk of overdose.
Pathways to Recovery works with a network of service providers throughout the city — including Recovery Care — to administer safer supply.
Krupp says she supports the concept of safer supply, but believes it needs to be administered differently.
“You can’t give addicts 28 pills and say ‘Oh here you go,’” she said in her testimony. “They sell for three dollars a pop on the street,” she said, referring to the practice of some individuals selling their prescribed medications to fund purchases of more intense street drugs like heroin and fentanyl.
Krupp says she sees her son — and other patients of the program — openly divert their prescribed medications outside of the Recovery Care clinic in ByWard Market, where she parks to wait for him.
“[B]ecause there’s no treatment attached to [my son’s safer supply], it’s just the doctor gives him all these pills, he diverts them, gets the drugs he needs, and he’s still an addict,” Krupp said in her testimony.
Donna Sarrazin, chief executive of Recovery Care, told Canadian Affairs that Recovery Care has measures to address diversion, including security cameras and onsite security staff.
“Patients are educated at intake and ongoing that diversion is not permitted and that they could be removed from the program,” she said in an emailed statement.
“Recovery Care works to understand diversion and has continued to progress programs and actions to address the issues. Concerns expressed by the community and our teams are taken seriously,” she said.
Krupp says she has communicated her concerns about her son reselling his prescribed medications to his doctor, Dr. Charles Breau, both in-person and through faxed letters. “I never hear back from the doctor. Never,” she said.
Krupp also said in her testimony that police have spoken to her son about his diversion.
Breau did not respond to inquiries made to his clinical teams at Recovery Care or Montfort Hospital, a teaching hospital affiliated with the University of Ottawa.
Sarrazin said Breau is not able to comment on patient or family care.
In Krupp’s view, the safer supply program would be more successful if drug users were required to take prescribed medications under supervision.
“If he was receiving his hydromorphone under witnessed dosage and there was a treatment plan attached to it, I believe it would be successful,” she said.
Dr. Eileen de Villa, the City of Toronto’s medical officer of health, reinforced this point at the Oct. 22 Health Committee meeting. She said Toronto Public Health’s injectable opioid agonist therapy program — which combines observed administration with a treatment plan — has seen “incredible results.”
De Villa shared a case of a pregnant client who entered the program. “She went on to have a successful pregnancy, a healthy baby, has actually successfully completed the treatment, and is now housed and has even gained custody of her other children,” she said.
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‘An affront to me’
Krupp also says Recovery Care fails to deliver on its promise of supporting patients’ mental health needs. Recovery Care’s website says its clinics offer “mental health programs which are essential to every treatment plan.”
Krupp and her son’s father have both requested a clear treatment plan and consistent counselling for their son. But he was started on safer supply after participating in only one virtual counselling session, she says.
She says Recovery Care has only one mental health counselor who services four of Recovery Care’s clinics. “If you’re getting $2-million-plus a year in funding, you should be able to staff each clinic with one on-site counselor five days a week,” she said.
Instead of personalized assistance, her son received “a sheaf of photocopies” offering generic services like Narcotics Anonymous and crisis helplines. “It’s almost an affront to me, as a taxpayer and a mother of an addict,” Krupp said.
Krupp says that, following her testimony to the parliamentary committee, Breau reached out to offer her son a mental health counseling session for the first time.
Sarrazin told Canadian Affairs that patients are encouraged to request counseling at any time. “Currently there is no wait list and appointments can be booked within 1 week,” she said in her emailed statement.
Class actions
Today, Krupp is considering launching a class-action lawsuit against Health Canada and the Government of Canada, challenging both the enactment of safer supply and the loosening of methadone dispensing requirements in 2017. She believes these changes contributed to her daughter’s death in 2020.
She is also considering joining an existing class-action lawsuit in B.C., which alleges Health Canada failed to monitor the distribution of drugs provided through safer supply programs.
The Pathways to Recovery initiative received $9.69-million in funding from Health Canada from July 2020 to March 2025. In June 2023, Health Canada allocated an additional $1.9 million to expand Ottawa’s safer supply program across five sites and improve access to practitioners, mental health support, housing and other services.
“I want to see that money being put to a recovery based treatment, not simply people going in and out and getting their medications and just creating this new sub-layer of addicts,” Krupp said.
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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