In the run-up to Canada’s election on September 20, the Conservative Party of Canada has announced a slew of policies to “address the opioid crisis”—part of a platform that the right-wing party dubs Canada’s Recovery Plan.
The plan states that, if elected, the CPC “will treat the opioid epidemic as the health issue that it is”—and party leader Erin O’Toole has suggested Canada should investigate legalizing poppers. But harm reductionists have expressed concern over what they say amounts to an “abstinence-based approach.”
The CPC, which at publication time narrowly led in national opinion polls, responded to Filter‘s request for an interview with an emailed list of policies from the party’s platform. They include—but are not limited to—pledges to support housing and mental health initiatives as potential tools to “aid in the fight against Canada’s addictions crisis.”
“We will reorient … towards ensuring that everyone suffering from addiction has the opportunity to recover and to lead a drug-free life.”
More pointed policies include investing CA$325 million over three years to create 1,000 residential drug treatment beds, and 50 “recovery community centers” across the country (it’s not clear exactly what those would look like, although some examples exist). Further, Canada’s Recovery Plan says the party believes that “law enforcement should focus on dealers and traffickers.”
Filter sent the CPC an email asking if the party would keep Canada’s safe supply program—which allows pharmacies and other organizations to provide pharmaceutical grade alternatives to street drugs—which the incumbent Liberal Party established. But the CPC did not respond by publication time.
The party’s platform also states that the party will “revise the federal government’s substance abuse policy framework to make recovery its overarching goal.”
“We will reorient the Canadian Drugs and Substances Strategy towards ensuring that everyone suffering from addiction has the opportunity to recover and to lead a drug-free life,” the document reads, “and that all policies that fall under the Strategy have the reduction of harm and promotion of recovery as their objectives.”
Bonnie Larson, assistant clinical professor of family medicine at the University of Calgary, said that this type of policy is similar to that being enacted in Alberta, under the province’s United Conservative Party. As Filter reported last year, the UCP has bet heavily on an abstinence-, or recovery-based approach.
“It’s very troublesome to me because it is exactly the same policy—with the same wording and priorities—as what we’re dealing with here in Alberta, which is not working for the drug-poisoning crisis,” Larson told Filter. “If that’s the problem they’re trying to address, then it is an ineffective solution.”
The number of overdose deaths in Alberta has continued to rise under the UCP’s policies which, more recently, have also included changes to regulations around safe consumption sites. Advocates say the new rules make it harder to run these evidence-based facilities. Meanwhile, each month between May 2020 and April of this year, more than 105 people in Alberta died of drug poisonings, the CBC reports.
Filter also asked the CPC whether it would change any federal rules surrounding SCS, but again, did not hear back by publication time.
“We’re not against increasing treatment capacity, but when you’re doing it with that many conditions applied, it’s being driven by ideology, not evidence or science.”
“It’s really awful here—more than four [deaths] a day, and it continues to climb,” Larson said of the situation in Alberta. “They continue to defund and shut down the harm reduction resources that we do have.”
She added that there’s nothing wrong with providing more addiction treatment beds, as the CPC promises to do, but that a person needs to “survive long enough” first if they’re to use this resource. The CPC’s policies disregard the primary importance of keeping people alive, she said.
Many of these publicly-funded recovery beds would likely end up being in private facilities, which can pick who they admit and might be “abstinence-only,” Larson continued. In these settings, taking buprenorphine, methadone or other opioid agonist treatment might not be allowed, depending on the facility. The same could also be true for other medicines for various disorders such as depression or anxiety.
“We’re not against increasing treatment capacity, but when you’re doing it with that many conditions applied, it’s being driven by ideology, not evidence or science,” Larson said. “And it completely disregards and does not even come close to addressing what people call the ‘opioid crisis’—what actually is a crisis of poisoning … deaths that are preventable.”
Elaine Hyshka, assistant professor in the University of Alberta’s School of Public Health, also called the CPC’s platform “nationalizing Alberta’s policy.”
The UCP and the CPC are both framing Canada’s rising rates of overdose deaths as problems with addiction, rather than with a fundamental shift in the illegal market, Hyshka said. In some Canadian cities, like Vancouver, fentanyl and its analogs are becoming so common that heroin is functionally disappearing. Last year, Canada saw 6,214 opioid-involved deaths.
Hyshka also noted that abstinence-based systems can result in more overdoses. Often, people who use opioids will use a recovery service for a while, but then return to using drugs. If they were abstinent, their tolerance to opioids will have dropped, so if they take the amounts they were using previously, it can increase their risk of death.
The overdose crisis is not seen as the most politically pressing issue in this election, although the related area of health care tops the list, together with climate change and housing. But Hyshka suggested that an ideal drug policy for whatever party ends up in power would involve decriminalization not only possession but also sales of small amounts of drugs. Vancouver is currently advancing with its own decriminalization plan, earning the support of mayors of other cities in British Columbia, although activists have criticized the plan for not going far enough.
But when it comes to the two largest parties in national politics, the CPC does not mention decriminalization in its platform, and—prior to the election—the Liberals have said in the past that they will not decriminalize drugs, and have not issued any statements suggesting this would change.
“We need to be realistic and recognize that the current policy approach has failed.”
The CPC’s platform suggests, however, that law enforcement should not focus on people using drugs, but rather on people selling them. That might reduce criminalization; yet in recent years, drug policy reform advocates have increasingly highlighted that the criminalization of so-called “dealers” is harmful and racist—targeting marginalized and economically vulnerable people who are far from the “kingpins” of popular imagination, and failing to benefit public health.
Among Canada’s other national parties, The New Democratic Party (NDP)—which bills itself as a social democratic party—pledged to “end the criminalization and stigma of drug addiction,” and before the election was called, the Green Party supported decriminalizing opioids and other drugs.
While the CPC seems to be leading the race in terms of voters, the Liberals could still end up with the most seats. Historically they have vied with the NDP, the Greens and in some cases the Bloc Quebecois—a center-left Quebec nationalist party—for similar voters. However, O’Toole is positioning himself as a moderate this election. The Liberals could, in theory, form a coalition government with one or more of the other parties, but that remains to be seen. O’Toole has called the notion of, for example, a Liberal-NDP government a “conspiracy.”
Unlike the United States, Canada has some flagship safe supply programs as well as SCS. But the country needs to look into more innovative ways of connecting people who use drugs with these pharmaceutical-grade alternatives to street drugs, said Hyshka, because they don’t currently reach enough people who are at risk.
“We need to be realistic and recognize that the current policy approach has failed,” she said.
Photograph by Cold, Indrid via Flickr/Creative Commons 2.0