Harm reduction works. After a number of 2018 federal-level policy decisions, the accessibility of harm reduction measures like safe consumption sites (SCS) for people who use drugs (PWUD) markedly affected the years-long opioid crisis.
Yet, despite their effectiveness—backed by a high level of supporting scientific evidence—accessible harm reduction services are dependent on, and ultimately at the whim of, provincial governments.
While Canada reported a decrease in opioid-related mortality between 2018 and 2019, this decline was not realized in all parts of Canada. For example, in Saskatchewan, >rejected requests for funding contributed to 2020 being the province’s worst year on record for opioid deaths. In January 2020, Alberta reported a decline in opioid-related mortality, but by the end of the year, the province set records. Arguably, this is due to government policy failure more than COVID-19.
Despite the effectiveness of supervised consumption sites, since taking office the Government of Alberta has been actively curbing access. That these actions are even possible in such a short period of time, reflects Canada’s “natural” state which considers PWUD as less deserving of life and care than others. This state has been enshrined in policy since the distinction between good drugs and bad drugs was first made in 1908. Federal measures that add to this prohibition legacy ultimately allow provincial governments to scapegoat supervised consumptions sites as detrimental to communities.
The importance of harm reduction services to ending the opioid crisis must consistently be asserted to governments and the wider public. In the past, we’ve seen that without significant and constant attention, governments will disregard the severity of the opioid crisis. In fact, the federal government paid little attention to opioid overdoses, beyond increasing punitive measures, until overdoses grew beyond those populations society and public policy had deeply stigmatized.
At the end of May, the Government of Alberta declared that Safeworks in Calgary would be closed and that SCS operations would be relocated to two other (unnamed) sites, citing disruptions to the community. Isn’t the closure of this site disrupting a community that is being kept alive by harm reduction measures?
Supervised consumption is not the only harm reduction measure provided by Safeworks and other sites. Relocation will also disrupt community-building and solidarity. This closure, like others, is a death sentence for many.
The closure of Safeworks is the latest in a string of similar policy decisions from the beginning of Kenney’s time in the premier’s office. In March 2020, the Government of Alberta released a report condemning the supervised consumption sites in the province. The report was met with swift criticism, but as the then-burgeoning pandemic grew, the report, as well as future actions the report served to justify, fell off the public agenda.
As the pandemic ravaged many parts of the country, deaths from overdose began to creep and reverse the decline. Suffice to say, the curve of again-increasing opioid overdoses was not met with widespread public awareness campaigns around flattening it. Instead, the Government of Alberta harnessed this moment to begin a campaign of dismantling years of harm reduction policy, most recently in the closure of Safeworks, weeks off the quick closure of the Boyle Street SCS in Edmonton, and a year after the shuttering of ARCHES in Lethbridge.
These actions set a dangerous precedent. The swift dismantling of effective harm reduction services for the purpose of resource management could be a signal for other provinces to follow suit.
Considering the oft-cited economic toll of the pandemic, provincial governments may seek out ways of cost-cutting to make the economic toll of the pandemic more bearable before another election rolls around. We’re already seeing targeted clawbacks of other public health measures across Alberta under the guise of “recovery.”
We cannot believe this problem is limited to Alberta. What will stop other provinces from doing the same, seeing supervised consumption sites as an easy target to deny provincial funding and justify closures due to resource shortages?
Of course, supervised consumption sites can be and are operating through grassroots and public fundraising, but this shouldn’t have to be the only way of ensuring these services are provided.
Why is a significant public health crisis relegated to being funded mainly by citizen activists and underresourced organizations? It is only because governments do not consider curbing drug overdoses a worthwhile public health initiative. What’s more, it’s not politically expedient.
Because of the criminalized and stigmatized nature of drug prohibition, governments of any level will be able to decide when certain lives are not worth saving based on little more than political ideology.
If the federal government wants to substantiate its rhetoric with action, it could begin by taking ownership of the problem from its root, end the criminalization of drugs and people who use them, and prioritize proven treatments and harm reduction methods. Lives are at stake.
Megan Aiken is a PhD candidate at the University of Alberta, currently residing in Halifax, Nova Scotia. Megan’s research seeks to understand the harmful legacy of opium prohibition in Canada by studying political elite rhetoric and policy action since 1908.