Shyanne Dougherty questions the goal and the likely effectiveness of the Alberta UCP government’s supposed “recovery-based” approach to the opioid crisis.

__________________________________________

Alberta saw a record-breaking number of overdoses in April 2023, demonstrating the rapid escalation of the opioid crisis in the province.. The United Conservative Party (UCP) provincial government’s response to this crisis does not seem to embody the principles and values that healthcare should be built upon, including respect for individual autonomy and saving lives. The UCP government opposes a harm reduction approach. Harm reduction approaches have been implemented internationally and have yielded incredible success in reducing drug overdoses, decreasing crime, and lowering the spread of communicable diseases. But the Alberta government instead endorses a “recovery-based approach”. The leader of the UCP government says that “recovery is not only possible, but it’s also actually the most common outcome.” This statement is confusing as it is being used to explain why a recover-based approach is better than a harm reduction approach, but harm reduction approaches include access to resources to promote recovery, and recovery is an observed outcome from harm-reduction. Further comparison between harm reduction and their proposed recovery-based approach suggests an incomplete understanding of addiction.

One aspect of harm reduction is safe supply. Where so many drug overdoses occur due to the toxicity of illegal street drugs, the premise of safe supply is to reduce overdoses by supplying drug users with prescription drugs as a replacement for the risky street drugs their addiction demands. This aspect of harm reduction has been implemented in British Colombia and has seen excellent results. Users of the safe supply program in B.C. report having more time to be productive members of society, feeling more stable, having a new and more positive outlook on life, and being better able to seek addiction treatment. One reason given for rejecting the implementation of this program in Alberta is that “We don’t give up on people. We don’t believe that enabling people in serious opioid addiction is the pathway.” However, safe supply programs do not give up on people or enable addicts. Instead, such programs provide them with protection from the risks associated with their disease and connect them with the resources they need when they are ready to go into recovery.

Photo Credit: Keith Seiffert/Wikimedia Commons. Image Description: Scattered pills and a syringe on a black surface.

Addiction is a disease – a multi-faceted and complicated disease. The same treatment that is successful in one individual may not be successful in another, and addictions specialists are still learning how best to approach the treatment of this disease. Thus, we need to ask ourselves what our goal should be on the issue right now. Should our goal be to save lives? Or should our goal be to end addiction? Harm reduction does save lives while also having success in ending addiction. Not everyone who uses harm reduction resources uses them to treat their addiction, but many do. Thus, with the harm reduction approach, the goal of saving lives is foremost while also having some success in treating addiction. The UCP government seems to be prioritizing recovery, arguing that it is not only possible but the most common outcome with their approach. However, only individuals in the headspace conducive to recovery will be reached with the recovery-based approach. Individuals not ready to seek recovery will still be at risk daily, and lives will still be lost tragically and unnecessarily with this approach. Thus, this recovery-based approach not only fails to prioritize saving lives, but also seems to fail at the goal of recovery.

The resources the UCP government is putting into recovery efforts across the province is a positive step. But many experts are doubtful that this alone will be effective. According to the National Institute of Drug Abuse, 85% of people relapse into drug use after a year of treatment, with two-thirds of individuals relapsing within a few weeks into the treatment process. Even addicts who have been in recovery for many years say it is a daily fight to stay in recovery. If an individual is not in the right mind space and does not have the right support system, they can’t be expected to win this daily fight, even if they receive top-level treatment at a rehab facility. If the UCP government truly believes that forcing an individual into treatment is enough to accomplish recovery, then they clearly do not understand the nature of addiction.

When the UCP government is asked why they won’t take a two-pronged approach, with harm reduction strategies and recovery-based strategies, which have been researched, trialed, and proven to be effective at saving lives, their response is that the government is looking into a legislative framework to be able to order people into treatment. First, this does not answer the question as to why they won’t use a two-pronged approach. Second, there is evidence that forcing an individual into treatment is unlikely to be effective. Furthermore, this plan is a clear infringement on an individual’s autonomy. Although infringement on autonomy can be ethically justified in many cases, when the outcome of the infringement is unlikely to be successful it cannot be justified.

Harm reduction approaches effectively reduce overdoses, decrease crime, and lessen the spread of communicable diseases, thus benefiting society overall. For people with addictions, these approaches, including safe supply, decrease the risks associated with the disease, increase their health and safety, and help them feel less persecuted and judged. Achieving these goals should be the priority and should inform government policy, which is not the case with the Alberta government’s current plan on the opioid crisis.

__________________________________________

Shyanne Dougherty is a Master of Health Ethics student at Memorial University.