The Alberta Model isn’t a path to recovery – it’s social murder

The “Alberta Model” concocted by the UCP government and the Associate Minister of Mental Health and Addictions (MMHA) Jason Luan to deal with the opioid poisoning crisis is social murder in action. The contempt Premier Jason Kenney and his political elite allies have for Alberta’s poorest and most marginalized people means we will see tragic, preventable death at a scale we’ve never seen before. 

Alberta’s UCP government has abandoned evidence in the face of a public health emergency. They ignore the pleas of advocates and experts alike. The results have been deadly. In Alberta, like the rest of Canada, the compounding effects of a toxic drug supply and a global pandemic have resulted in skyrocketing overdose death tolls across the province. The recent release of Alberta’s 2020 Q2 Overdose Response Report shows that Alberta just experienced its worst quarter on record. 

In the first six months of 2020, the volatility of the drug supply shifted as public health measures brought in to help control the pandemic disrupted the illicit market. Carfentanil deaths surged in Edmonton. Death rates nearly doubled in Red Deer. Lethbridge surpassed its entire 2019 total in the first six months of 2020.

These numbers are devastating, but they should not be surprising. While the UCP neglected to release any formalized reporting of overdose deaths until late September, removing any potential for timely and meaningful responses, advocates have been sounding the alarm for months. On May 5th 2020, Alberta advocacy group Change the Face of Addiction wrote an open letter to Dr. Deena Hinshaw, Alberta’s Chief Medical Officer of Health, highlighting the rising risk and calling for urgent implementation of a safe supply. Rather than receiving any response grounded in evidence or approached through the lens of public health, Associate Minister Luan opted to minimize these concerns and deny considerations for safe supply with an op-ed in the Edmonton Journal.

“Their claim that the illegal hard drug supply is more toxic than it has been in recent years is not grounded in evidence,” Jason Luan, May 26th 2020.

There’s no wonder why the Q2 overdose report was released literally while the federal throne speech was being read with no media availability from Luan. Facing hard truths head on and admitting missteps is not a part of the new Alberta Model for substance use services. Instead, scapegoating the former government and employing harmful rhetoric reign supreme.

Associate Minister Luan’s rhetoric whenever he talks about this issue has become practiced and rehearsed – he always begins by referring to the previous NDP government’s harm reduction approach as a single prong, myopic approach to substance use. Then he’ll say that his government is different, and that his approach is the route to what he calls recovery. This is of course misleading – the previous Alberta government, through the Minister’s Opioid Emergency Response Commission (MOERC), focused on not one but six strategic areas (including treatment), and expanded care for opioid use disorder (OUD) from 4,000 to 11,000 Albertans..

The UCP, Kenney, Luan, and their various sundry issues managers are keen on moralizing about people who use drugs and discrediting harm reduction by perpetuating a false dichotomy — you are either pro-harm reduction or pro-recovery. As recently as July, Kenney referred to harm reduction as facilitating addiction, and claimed that the former government was obsessing with harm reduction at the expense of other facets of care. But that isn’t how what experts refer to as a ‘continuum of care’ works. In fact that isn’t how harm reduction or recovery works.

The Associate Minister is out of his depth. Harm reduction is far more than a series of services and mantras like ‘meeting people where they are at.' Harm reduction is an underpinning philosophy of care that should be integrated into every practice setting. It is about understanding that everyone’s journey in recovery is different and should be tailored according to the needs and priorities of that individual. A recovery-oriented system of care should acknowledge and fully support the vital role harm reduction plays in the continuum of services. Because recovery is not a commodified product, or a standardized end goal for every person who uses drugs. It is a process with peaks and valleys and can only be defined by the person engaging in their own journey.

Photo by Nathaniel Canuel, Canadian Drug Policy Coalition

“The rest of Canada should be watching, as Alberta’s new, improved, and fully funded system unfolds.” These are the words of Carson McPherson, former senior advisor for recovery research at the B.C. Centre on Substance Use in the op-ed where coined the term “Alberta Model” to describe the UCP’s shift in focus for substance use care. McPherson goes on to tout the brilliance of the UCP government. This is probably the first time the UCP has welcomed validation from B.C., and it fit snuggly with the release of the fundamentally flawed Supervised Consumption Service (SCS) Review Committee findings.

McPherson’s sudden endorsement of the Alberta Model likely involves his relationship with the current chief of staff to Associate Minister Luan, Marshall Smith. You see, before he got his gig in Alberta, he was the Director of Cedars at Cobble Hill, a high-end treatment facility for substance use in B.C. Now, McPherson is the Managing Director of Cedars at Cobble Hill. Yes, the guy who first endorsed the Alberta Model is the successor and colleague of the person who has orchestrated the entire thing. They were also both on the B.C. Recovery Council together.

But the personal relationships and financial beneficiaries of recovery-capitalism is a story for another day. One thing is certain, if you are looking at Jason Kenney to endorse ethical and compassionate care for people who use drugs, you may want to look at his own familial track record. But what I want to talk about is the Alberta Model and its role in harm production. I am a registered nurse who has worked in harm reduction in Medicine Hat, Brooks, Calgary, and Edmonton. Unlike Carson, I have deep roots in Alberta and I care about what happens to its people. Like Carson, I now live in B.C. (right down the road from Cedars).

The Alberta Model doesn’t focus on the here and now – it is a model that speaks of grandiose plans to build more and more treatment and detox beds. But it is a system of zero accountability, where the public is not privy to reporting of even basic metrics like: clients served, treatment episodes completed, relapse rates, and overdose deaths following treatment. It is a model that scoffs at concepts like safe supply. It is a model that defunds proven programs like injectable opioid agonist therapy (iOAT) and mothballs virtual overdose prevention services for no apparent reason other than its close association with harm reduction. 

Simply announcing more “beds and spaces” is nothing more than a public relations stunt that placates those unfamiliar with the current state of substance use treatment services. It is worth mentioning that the Alberta Model is not unlike the dominant approach in the United States, where overdose deaths killed more than 136,000 people between 2016 and 2018.

What’s most important though, is that the Alberta Model is not a response to the overdose crisis. While it might be peddled as such, it is clearly a long-term plan consisting of a heavy-handed focus on abstinence. Meaningful and evidence-based responses to the overdose crisis, like take-home naloxone kits are often downplayed, referred to as ‘Band Aid responses’ or even enablers of drug use.

In the week that a well-compensated review committee released a scathing, biased, and methodologically false report on SCS, many of us saw the threat to the future of harm reduction. Threatened by a government that had made its choice well before any evidence could be fabricated to support their choice. A government so callous that it can shut down North America’s busiest SCS to punish a handful of executives for financial misappropriation. Even after the now infamous SCS Review Report was discredited by scientists across Canada, the UCP presses on with their deadly plan. They are sacrificing the lives of Albertans to make a statement. The Alberta Model isn’t new, or revolutionary. It is a rehashing of antiquated strategies and rhetoric. The Alberta Model is harm production.

As I was working on this article, a brave and compassionate group of advocates in Lethbridge formed the Lethbridge Overdose Prevention Site. They set up a tent at the centre of their city’s overdose crisis, and offered care in the face of opposition from their own government. 

When governments fail to act, ordinary people do heroic work. I will be donating my honorarium for writing this article to the Lethbridge Overdose Prevention Site, and I hope that you will make a contribution to them too. It’s clear that our provincial government is not interested in truly addressing this crisis – and so it falls to us. 

The Lethbridge overdose prevention site. Photo supplied

Photo of the setup of the Lethbridge overdose prevention site. Photo supplied. 

Corey Ranger is a registered nurse who has worked in harm reduction in Medicine Hat, Brooks, Calgary and Edmonton. He currently works in the harm reduction field in Victoria, B.C. You can follow him on Twitter at @CoreyRanger