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Drug decriminalization puts B.C., Alberta at opposite ends of the policy spectrum in Canada

When Lori Hatfield’s son fled to British Columbia in 2018, hoping to escape the shadow of drug-related crimes in his native Alberta, she felt an odd pang of relief.

The mother from Lethbridge, Alta., had watched her son’s struggle with addiction, and while he was moving to what she saw as the “Mecca” of drugs in Canada, he’d also be closer to the supports she hoped would keep him alive.

“He knew he wasn’t gonna go anywhere in Alberta except to jail … (In B.C.,) there’s more services, there’s different types of services. It’s not all ‘Everybody has to fit into one box.’ ”

Canada’s two westernmost provinces have long been on seemingly different paths when it comes to drug policy, but the divide grew deeper this week with news that B.C. will decriminalize small amounts of some hard drugs.

The landmark move has placed the province on a very short list of jurisdictions — mostly other countries — that have taken the step in the hopes of curbing overdose deaths. But it also seems poised to create awkward bedfellows here at home.

The response from Jason Kenney, the soon-to-be former premier of Alberta, was blistering: “Alberta’s Government will never allow our communities to become sanctuaries for cartels and drug traffickers,” he wrote in a statement posted to Twitter.

“This action will likely result in a dramatic increase in drug use, violence, trafficking and addiction. Something that health systems are already over burdened with (sic).”

Indeed, the two provinces now have strikingly different approaches to drug policy.

British Columbia, arguably a longtime innovator in harm reduction, now has a patchwork of supervised consumption sites — mostly scattered around Vancouver Island and the Lower Mainland — and the country’s first prescribed safer supply policy, in addition to the new decriminalization policy, which means adults will no longer be charged for the next three years for carrying small amounts of opioids, methamphetamine, cocaine or ecstasy.

B.C. Premier John Horgan also took to Twitter to address what he called his province’s “historic step forward,” that would “help break down the stigma that stops people from accessing life-saving support.”

Neighbouring Alberta has taken a markedly different approach, by turning away from harm reduction — including closing the supervised consumption site in Lethbridge, which had previously been the busiest in the country, and relocating a downtown facility in Calgary — in favour of an influx of funding for recovery beds.

The line drawn by the Rocky Mountains on the issue is as much about ideology as it is about drugs, observers say, with each side answering a central question differently: Is drug use a public health issue, or a criminal one?

“One is a perspective that regards drug use as some kind of moral failing that needs to be corrected, and if you’re using you need to stop altogether,” says Dr. Thomas Kerr, director of research at the BC Centre on Substance Use, in reference to Alberta.

“I think the B.C. approach is one that recognizes that addiction is a chronic relapsing condition, that even when you make treatment available on demand, you won’t be able to engage everybody.”

It appears the two provinces are also measuring success differently.

In his statement, Kenney pointed a finger at Vancouver, famously home to the country’s first legal supervised consumption site, which he argues has been effectively in a state of drug decriminalization, leading to a spike in disorder, drug use and death.

A panel appointed by Alberta’s United Conservative government released a report in 2020 that said there was a noticeable uptake in crime rates and disorder near Calgary’s downtown supervised consumption site. At the time, then-associate minister of addictions Jason Luan called it a “system of chaos” that he found “deeply troubling.”

Critics were quick to take aim at the report’s methodology, saying the review was specifically instructed to not consider the benefits of the sites and that there is little peer-review evidence so suggest a connection to crime.

Kerr argues that the panel “simply solicited community complaints about the existing safe-injection sites, ignored the scientific evidence and came to the conclusion that these sites create public disorder.”

Drug policy researchers point to federal numbers that suggest that deaths are rising in Alberta — the result of drug overdoses amid the drug-poisoning crisis.

According to Health Canada, the two provinces with the highest rate of opioid toxicity deaths in 2021 were British Columbia and Alberta.

B.C. was highest, with 41.3 deaths per 100,000 people that year, while Alberta had 33 deaths per 100,000 people. That national rate is 19.4.

“If you look at (overdose deaths) over time, Alberta is closing in on B.C.,” says Rebecca Haines-Saah, an associate professor of community health sciences at the University of Calgary.

“So when Kenney says things like, ‘Oh, that’s a B.C. approach,’ or, ‘They have this problem,’ we really have a serious, deep problem here as well.”

Of course, harm-reduction advocates say British Columbia’s approach is not perfect. Many were disappointed by the federal decision to limit the amount of drugs a person could carry to 2.5 grams, arguing that it wasn’t enough to protect many people who are dependant on a regular supply. (The pilot takes effect Jan. 31.)

Meanwhile, Alberta has pushed hard to open new rehab beds. According to the 2019 budget, the province already spent $1 billion on mental health and addictions but was committing to another $20 million for a “recovery-oriented system of care that will offer a co-ordinated network of community based services and supports.”

For Hatfield, who has become an outspoken advocate for harm reduction after watching her son’s struggle with addiction, the news from across the provincial border was bittersweet.

While her son did end up successfully completing treatment and is currently in recovery, she says she wishes Alberta was as progressive in its approach to harm reduction.

“I was elated for B.C. I am just so happy that they are moving forward in this direction.” However, the prompt response from Kenney struck a different note. “I knew as soon as I heard that, before even reading what Kenney’s comments were, that it would be exactly what he would say.

Haines-Saah, with the University of Calgary, points out that Alberta has not always been against harm reduction — the province was among the first to pilot supervised consumption sites and the rollout of Naloxone, used to counteract overdoses, provincewide.

But in addition to things shifting under the Kenney government, which came to power in 2019, she points out that B.C.’s medical officer of health, Dr. Bonnie Henry, has come out in favour of decriminalization, whereas Alberta’s chief medical officer has not.

While it remains to be seen what will come of these two different approaches, side by side, Kerr argues that it will be Alberta that finds itself increasingly diverging from the rest of Canada.

“In some ways, Alberta is on an island. They’re kind of doing their own thing. It’s very ideological. It’s not evidence-based. And it’s out of step with what the leading health authority in Canada is recommending.”

Though he adds that the long-term question may be how each province tackles the underlying issues that have driven the opioid crisis.

“The thing we’re not very good at is dealing with all the social and structural factors that really perpetuate addiction,” Kerr says.

“We can treat people and help them get back on their feet, but there’s always a steady supply of new customers because of things like lack of income, security and unstable housing.”

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