How refreshing to read about, and at some length and some depth, a government-run program that looks to be serious about ‘getting at’ a social problem of significance. The kind of reporting we need (and the kind of connecting-systems thinking we need more of in Govt). Well done Paul.
Well, darn if you haven't forced me to look at Premier Smith and her government in a more nuanced way as well as recognize something going on in my province that I was completely unaware of but will now try to stay informed about.
I have read the subsequent comments at the time of my writing, so am cautious, but I am honestly gobsmacked that something like this is going on in Alberta. Thank you for your focus on this.
Whether Alberta’s approach is the best is something about which reasonable people can have differing views—at least until more long-term data is available. I am struck, though by your comment about having the right level of attention to a problem to make a difference. In my career in government, I can point to occasions where exactly that happened: progress and change did happen because the right people paid attention to and championed what needed to be done. This isn’t easy though. The urgent regularly usurps the important and people come and go and have different degrees of interest in an issue. Drug addiction is not a technocrat/bureaucrat issue; it does need sustained attention from the political classes. One cannot just wave a magic wand (e.g. decriminalization) and assume the problem has been solved. Extra $ is probably needed, but that is also probably the lesser challenge. Designing the right system, monitoring and measuring it and adjusting as required takes time, energy and constant attention.
I enjoyed reading this informative article, and especially appreciated the free wheeling nature of what Mr. Wells saw and shared. I will look forward to his summations in the next instalment.
Alberta is starting with a baseline acceptance that the current fragmented substance abuse and mental health treatment programs are disjointed and not adequately working for the benefit of those needing care. That’s quite an admission. Government services are supposed to work for the people but often the services are designed to work for the providers. Spending the political capital to admit mistakes and strive for better isn’t normal politics in Canada.
We need more politicians and bureaucrats to admit that many people do not have the skills or time to navigate the maze (obstacle course) that they face. In some cases, the opportunities to reach those with addiction or mental health problems are few, and the system needs to be ready when the chance arises.
Yes, building a system. I admire Marshall Smith tremendously. Most people who work in social services of any type and especially police, are good people who just need a system to follow. Without guidelines, funding gets scattered around throughout a broken network instead of funnelled to a purpose-oriented system.
A great report. I wish we had such programs in Toronto where addiction has become so terribly visible on city streets, streetcars and the subway, leading people to fear for their safety.
Very interesting strategy, and these two pieces certainly shift my view of what Alberta is trying to accomplish, compared to the (former) B.C. approach of harm reduction. What about cost and budget? Apart from the reference to Alberta's wealth, .compared to poorer provides, and the $1,000-a-shot Suboxone treatment, there are no cost figures yet. Maybe in part 3?
I got really stuck at the point when the police officer asks the arrested person, ‘Let's talk about your substance use. Are you an opioid user? We can offer you immediate treatment right now. Right here. Would you like to do that?’
That reads to me as incredibly simplistic. What is the response? "Sure, as long as when I'm done treatment there will be housing, mental health supports, appropriate care to address PTSD and/or intergenerational trauma, etc." While a more complex and financially invested approach is great, the idea that the addiction itself is the issue and not the social causes of addiction is trite.
When I worked for AIDS Vancouver in the early 90s, we identified the lack of support services for addictions. There was one detox facility for women that was 4-6 months, highly successful, but the only one of its kind. It is great to read that in Alberta there are going to be many detox support services with extended timelines. But we are now in the apex (so far anyway) of economic inequity and mental health concerns. I would love to see a really complex approach. Not just 'let's just keep them alive' which was the BC approach and which in Vancouver has turned into a 'f*#k them' approach (thank you Mayor Sim). But let's really look at the complex issues leading to the current magnitude of addiction and despair.
I listened to a great discussion on addictions and the researcher Bohdan Nosyk called it a disease of despair: https://www.sfu.ca/publicsquare/events/2024/bohdan-nosyk.html#video. That seems like a really important issue. I keep thinking, given the rise in mental health issues in young people, we need to address addictions in all its complexity because the next generation is only going to have it worse.
I hope your next instalment of this series does consider the very real limitations of the Alberta approach--for instance, its lack of interest in keeping alive
(1) drug users who are recreational/occasional/non-dependent users but still very much at risk of death from the toxic drug supply, and
(2) substance-dependent users who are not able/willing to commit to OAT therapy or who find it doesn't work for them.
Natalie, I must say that I find your comment quite offensive. You say that we in Alberta are not interested in keeping alive those folks. That is an absolute falsehood.
I respond that here in Alberta we are interested in keeping people alive on an extended basis normal life span basis whereas in some other jurisdictions there is interest only in the next twenty minutes, not on an extended basis; that is, there is no real attention paid to recovery.
I have had my say - as have you - and I, as I presume you, have no interest in a long debate or justification; let us say that we agree to disagree.
Well said. Alberta is always criticized when it seems there are many great things happening there that even their residents don't know about because the MSM does not report them. Maybe that is why so many people are moving there.
I think it is wonderful that a govt has a goal and sustained interest in solving difficult and complex issues. One may hope a graph showing the outcomes for those being arrested to others being helped with recovery programs would show some great difference in recovery.
It looks like both approaches to help addicts are failing. We can keep slugging away, trying to improve these programs but we should devote more resources to the existential reasons why people would take something like Fentanyl in the first place. You feel your life is unpleasant, pointless and hopeless but Fentanyl makes life momentarily less unpleasant. It's also a death wish that makes your other problems worse. Yes, the existential problems are even harder to solve but they could be where the answer lies. Yet it's not even part of the discussion.
Preparing this three part journalistic investigative report you, Paul, must have done considerable research and planning. Once in place you made the trip to Alberta, made contact with those people who were on the ground tackling your subject matter. You asked the right people the right questions, and in the end, you used your writing expertise to prepare a report for your readers. In summary providing your readers with the facts required the energy, mental and physical, financial resources and time of yourself and all those you interviewed.
So it is that dedicated individuals such as Marshall Smith realize and appreciate that more than the harms reduction approach is needed if we as a country hope to adequately address the challenge of Canada's drug overdose crisis. They are planning long term because they are seeking long term results. Whether they will be successful, time will tell; however, they are putting forth the effort, and effort usually provides results. That is life!
I think it's worth noting -- since we're seeing the appearance here of some people who are sticklers for data even though I've never seen them mention any data from any federal auditor-general's report or any provincial authority outside Alberta -- that the Alberta substance-use dashboard is, *by a country mile*, a more complete inventory of public data on drug use than any in the country. Tabs at the top give you detail from more than a dozen classes of information, usually showing monthly trend lines going back eight years. https://healthanalytics.alberta.ca/SASVisualAnalytics/?reportUri=%2Freports%2Freports%2F1bbb695d-14b1-4346-b66e-d401a40f53e6§ionIndex=0&sso_guest=true&reportViewOnly=true&reportContextBar=false&sas-welcome=false
How refreshing to read about, and at some length and some depth, a government-run program that looks to be serious about ‘getting at’ a social problem of significance. The kind of reporting we need (and the kind of connecting-systems thinking we need more of in Govt). Well done Paul.
Well, darn if you haven't forced me to look at Premier Smith and her government in a more nuanced way as well as recognize something going on in my province that I was completely unaware of but will now try to stay informed about.
I have read the subsequent comments at the time of my writing, so am cautious, but I am honestly gobsmacked that something like this is going on in Alberta. Thank you for your focus on this.
Whether Alberta’s approach is the best is something about which reasonable people can have differing views—at least until more long-term data is available. I am struck, though by your comment about having the right level of attention to a problem to make a difference. In my career in government, I can point to occasions where exactly that happened: progress and change did happen because the right people paid attention to and championed what needed to be done. This isn’t easy though. The urgent regularly usurps the important and people come and go and have different degrees of interest in an issue. Drug addiction is not a technocrat/bureaucrat issue; it does need sustained attention from the political classes. One cannot just wave a magic wand (e.g. decriminalization) and assume the problem has been solved. Extra $ is probably needed, but that is also probably the lesser challenge. Designing the right system, monitoring and measuring it and adjusting as required takes time, energy and constant attention.
I enjoyed reading this informative article, and especially appreciated the free wheeling nature of what Mr. Wells saw and shared. I will look forward to his summations in the next instalment.
Alberta is starting with a baseline acceptance that the current fragmented substance abuse and mental health treatment programs are disjointed and not adequately working for the benefit of those needing care. That’s quite an admission. Government services are supposed to work for the people but often the services are designed to work for the providers. Spending the political capital to admit mistakes and strive for better isn’t normal politics in Canada.
We need more politicians and bureaucrats to admit that many people do not have the skills or time to navigate the maze (obstacle course) that they face. In some cases, the opportunities to reach those with addiction or mental health problems are few, and the system needs to be ready when the chance arises.
Yes, building a system. I admire Marshall Smith tremendously. Most people who work in social services of any type and especially police, are good people who just need a system to follow. Without guidelines, funding gets scattered around throughout a broken network instead of funnelled to a purpose-oriented system.
Thank you for writing about this, and for consistently being so humane and serious about the issue.
Let's hope and pray that AB's system s successful. Ottawa could also use it.
A great report. I wish we had such programs in Toronto where addiction has become so terribly visible on city streets, streetcars and the subway, leading people to fear for their safety.
Very interesting strategy, and these two pieces certainly shift my view of what Alberta is trying to accomplish, compared to the (former) B.C. approach of harm reduction. What about cost and budget? Apart from the reference to Alberta's wealth, .compared to poorer provides, and the $1,000-a-shot Suboxone treatment, there are no cost figures yet. Maybe in part 3?
I got really stuck at the point when the police officer asks the arrested person, ‘Let's talk about your substance use. Are you an opioid user? We can offer you immediate treatment right now. Right here. Would you like to do that?’
That reads to me as incredibly simplistic. What is the response? "Sure, as long as when I'm done treatment there will be housing, mental health supports, appropriate care to address PTSD and/or intergenerational trauma, etc." While a more complex and financially invested approach is great, the idea that the addiction itself is the issue and not the social causes of addiction is trite.
When I worked for AIDS Vancouver in the early 90s, we identified the lack of support services for addictions. There was one detox facility for women that was 4-6 months, highly successful, but the only one of its kind. It is great to read that in Alberta there are going to be many detox support services with extended timelines. But we are now in the apex (so far anyway) of economic inequity and mental health concerns. I would love to see a really complex approach. Not just 'let's just keep them alive' which was the BC approach and which in Vancouver has turned into a 'f*#k them' approach (thank you Mayor Sim). But let's really look at the complex issues leading to the current magnitude of addiction and despair.
I listened to a great discussion on addictions and the researcher Bohdan Nosyk called it a disease of despair: https://www.sfu.ca/publicsquare/events/2024/bohdan-nosyk.html#video. That seems like a really important issue. I keep thinking, given the rise in mental health issues in young people, we need to address addictions in all its complexity because the next generation is only going to have it worse.
The third installment, which I’m writing now, gets at a lot of these issues, Maria.
I hope your next instalment of this series does consider the very real limitations of the Alberta approach--for instance, its lack of interest in keeping alive
(1) drug users who are recreational/occasional/non-dependent users but still very much at risk of death from the toxic drug supply, and
(2) substance-dependent users who are not able/willing to commit to OAT therapy or who find it doesn't work for them.
Natalie, I must say that I find your comment quite offensive. You say that we in Alberta are not interested in keeping alive those folks. That is an absolute falsehood.
I respond that here in Alberta we are interested in keeping people alive on an extended basis normal life span basis whereas in some other jurisdictions there is interest only in the next twenty minutes, not on an extended basis; that is, there is no real attention paid to recovery.
I have had my say - as have you - and I, as I presume you, have no interest in a long debate or justification; let us say that we agree to disagree.
Well said. Alberta is always criticized when it seems there are many great things happening there that even their residents don't know about because the MSM does not report them. Maybe that is why so many people are moving there.
I think it is wonderful that a govt has a goal and sustained interest in solving difficult and complex issues. One may hope a graph showing the outcomes for those being arrested to others being helped with recovery programs would show some great difference in recovery.
It looks like both approaches to help addicts are failing. We can keep slugging away, trying to improve these programs but we should devote more resources to the existential reasons why people would take something like Fentanyl in the first place. You feel your life is unpleasant, pointless and hopeless but Fentanyl makes life momentarily less unpleasant. It's also a death wish that makes your other problems worse. Yes, the existential problems are even harder to solve but they could be where the answer lies. Yet it's not even part of the discussion.
Preparing this three part journalistic investigative report you, Paul, must have done considerable research and planning. Once in place you made the trip to Alberta, made contact with those people who were on the ground tackling your subject matter. You asked the right people the right questions, and in the end, you used your writing expertise to prepare a report for your readers. In summary providing your readers with the facts required the energy, mental and physical, financial resources and time of yourself and all those you interviewed.
So it is that dedicated individuals such as Marshall Smith realize and appreciate that more than the harms reduction approach is needed if we as a country hope to adequately address the challenge of Canada's drug overdose crisis. They are planning long term because they are seeking long term results. Whether they will be successful, time will tell; however, they are putting forth the effort, and effort usually provides results. That is life!
Good work Paul!