Marshall Smith, ex-chief of staff to Alberta Premier Danielle Smith, made a pitch for a B.C. version of the model at a public safety meeting.
The architect of Alberta’s recovery model for addictions treatment is urging B.C. to take a similar approach when it comes to dealing with the toxic drug crisis, pointing to the 38 per cent reduction in deaths that his province saw last year.
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Marshall Smith, who served as Alberta Premier Danielle Smith’s chief of staff until last fall, told a community safety forum in Vancouver on Thursday that Alberta’s success stems from its efforts to aggressively build out treatment beds, including 11 recovery communities.
The B.C. native also said that Alberta has approached harm reduction differently than his home province and given police a role in facilitating health assessments as soon as people are placed into custody. He said this allows for treatment to start right away.
“We’ve added 10,000 new treatment spaces. Our goal is to have excess beds. I will have done my job when there is always a bed available. It’s a lofty goal. Maybe we won’t attain it. Maybe we will, but we’re not going to stop trying to do that,” said Smith, explaining that treatment is also now free for all Alberta residents.
“We’ve gone out and we have indexed every available bed and resource in the province. We have contracted them out publicly. Nobody in Alberta takes their wallet out of their pocket to pay for treatment anymore. No family will ever have to make the difficult decision of mortgaging their house or selling their car to get them the care their loved one needs.”
Nevertheless, Smith took his model to Alberta where it was enthusiastically endorsed by the ruling United Conservative Party in 2019 as part of its 10-year plan to address its own toxic drug crisis.
While the plan has been praised by some for its focus on treatment and success in rapidly expanding recovery options, others have criticized its lack of harm reduction measures as the provincial government has rolled back the number of supervised consumption sites and banned safer supply.
Health Minister Josie Osborne responded to Smith by saying that just as Alberta is taking an approach that works for them, B.C. is developing local solutions to the complex problem of the mental-health crisis.
“We continue to be focused on everything from prevention and harm reduction to treatment and recovery, and then, of course, tackling organized crime and taking action there,” she said, promoting the Road to Recovery program at St. Paul’s Hospital.
“We know that harm reduction works, and so we’re going to continue that. Underneath that, we are investing historic amounts in treatment and recovery, $1 billion invested into mental-health and addictions care in Budget 2023 and then building on that, the following year with another $250 million and that’s to keep all of those mental-health and addiction services going.”
She also said the province continues to work with Dr. Daniel Vigo to develop involuntary care for people with complex addiction and mental-health issues at the Surrey Pretrial Centre and the Alouette Correctional Centre in Maple Ridge.
B.C.’s former provincial health officer, Dr. Perry Kendall, said there is also very little evidence to support Smith’s claim that the Alberta model is responsible for that province’s sharp reduction in drug deaths.
Most provinces are seeing a decline in toxic drug deaths regardless of the policy approach they’re taking to the crisis. B.C., for instance, saw a nine per cent decrease in deaths during the first 10 months of 2024 when compared with the same time in 2023.
“I don’t think the results are out yet. I haven’t seen any data. All the data comes from the recovery community, which has been commissioned by the Alberta Drug and Alcohol Abuse Commission to do the work,” said Kendall.
He also said that while “I don’t think anybody can disagree with treatment,” the Alberta approach is suffering because of its lack of focus on harm reduction in conjunction with treatment.
Many people relapse after going through treatment, said Kendall, and harm reduction is important in keeping them alive while they wait to get back in or pursue other options.
“People are more vulnerable when they relapse, it can be a very dangerous time,” he said. “There are also an awful lot of people who are not at any particular time willing for treatment, ready for treatment, and harm reduction is a proven way of keeping people alive, in contact with primary care, and it actually acts as a very good referral source.”
B.C.’s former top doctor also expressed concern that B.C. is reverting to a more law-and-order approach to treatment and the toxic drug crisis, although he voiced conditional support for the initiative being led by psychiatrist Vigo to provide involuntary treatment for people with severe illness and addiction.
He said the province needs to do more when it comes to building supportive housing, improving primary care and providing more options for mental-health care.
“Addiction is made more problematic by lack of primary care, and access to the treatment that we do have is like for any chronic diseases, it’s imperfect, and it takes time to work, and people relapse, and the homelessness does not help,” said Kendall.
“There aren’t, unfortunately, any simplistic answers. If we put all our eggs in one basket, I think we’ll end up doing more harm than good.”
Conservative mental-health and addictions critic Claire Rattee said the Alberta model is definitely something B.C. can learn from, saying it places an important emphasis on harm prevention as opposed to harm reduction.
“Their overdose deaths are down 38 per cent in 2023 in Alberta, we only went down nine per cent and … that’s kind of the big takeaway for me. Obviously, what they’re doing is working, focusing on recovery, focusing on harm prevention, has been successful,” she said.
“Those that are struggling with substance abuse need to be able to access treatment. They need to be able to access opioid dependency programs. They need access to these things, and it’s just not something that seems to be a focus for this current government.”
She pointed to Terrace, in her riding of Skeena, which she said has the second highest rate of toxic drug deaths outside Vancouver’s Downtown Eastside but few treatment options.