I was a strong proponent of the Harm Reduction strategy until more data has come out about its effectiveness and benefits for society versus other methods. There might be a case for Harm Reduction, but as currently implemented in BC it is a like a 4 legged stool that is missing three legs -harm reduction, law enforcement, prevention and treatment – just focusing on harm reduction and not the other areas is a recipe for social disaster.
The Alberta rehabilitation model has been modestly more successful in dealing with the problems of addictions. Both systems require overlapping programs working together to get people out of the drug abuse loop – whether Alberta has been more successful in coordinating the synergy of anti-addiction programs or that rehabilitation programs are just more effective remains to be seen. Initial data points to the Alberta method being more successful.
The divergent policies and politics of B.C. and Alberta have played a major role in determining the public perception of Canada’s opioid crisis. Left-leaning media outlets have tended to laud B.C.’s harm reduction as being more compassionate, while conservative voices point to Alberta’s focus on treatment as more practical and realistic. What Canada had lacked until recently was an impartial, data-driven assessment of the two competing systems.
Advantage Alberta: The Stanford Network on Addiction Policy’s 2023 report (depicted above) observes that, “Alberta is currently experiencing a reduction in key addiction-related harms,” while “Canada overall, and BC in particular, is not yet showing the progress that the public and those impacted by drug addiction deserve.” At middle, a typical street scene in Vancouver’s Downtown Eastside; at bottom, a therapy session at Alberta’s new Red Deer Recovery Community. (Sources of photos: (middle) Ted McGrath, licensed under CC BY-NC-SA 2.0 DEED; (bottom) EHN Canada)
That problem was partially solved last year with the release of a report from the U.S.-based Stanford Network on Addiction Policy. Entitled Canada’s Health Crisis: Profiling Opioid Addiction in Alberta & British Columbia, the document offers an even-handed review of the differing policies of the two provinces, summarizes the latest available data (which it criticizes as inadequate) and cautiously evaluates the results. B.C., the report notes, emphasizes harm reduction, “safe supply” of illicit drugs, decriminalization of possession and reduction of addiction stigma. Alberta, by contrast, is focusing on “investment in rehabilitation beds and spaces, such as therapeutic communities,” while moving away from “safe supply” of opioids and instead providing addicts with medications.
Using these differences as a natural experiment, the Stanford report comes to a few key conclusions. First, it observes “a lack of policy innovation in BC on the issue of drug addiction.” Obsessive attention to harm reduction appears to have blinded politicians and public health officials to the longer-term consequences of their favoured policy. “Enforcement against drug crime has [been] reduced in recent years,” the report notes, “indicating a general lessening of criminal justice enforcement against drug offences in Canada during the escalating health crisis of opioid addiction.”
Second, “Of the two provinces studied for this report, Alberta is currently experiencing a reduction in key addiction-related harms.” The province’s rate of overdose deaths declined by 17 percent from 2021 to 2022 (B.C.’s remained almost unchanged), although it was still Alberta’s second-worst year on record. Using the most recent data available, the Stanford researchers point to B.C.’s higher death rate as suggestive of the two approaches’ relative effectiveness: “Our research indicates that Canada overall, and BC in particular, is not yet showing the progress that the public and those impacted by drug addiction deserve.”
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