Addictions
Alberta closing Red Deer’s only overdose prevention site in favor of recovery model
Alberta’s Minister of Mental Health and Addiction, Dan Williams, at the Alberta Legislature in Edmonton on Sept. 11 2024. [Photo credit: Alexandra Keeler]
Alberta’s Minister of Mental Health and Addiction explains the shift from overdose prevention to recovery amid community concerns
On Sept. 23, Alberta announced the city of Red Deer would be closing the community’s only overdose prevention site by spring 2025. The closure will mark the first time an Alberta community completely eliminates its supervised consumption services.
The decision to close the site was taken by the city — not the province. But it aligns with Alberta’s decision to prioritize recovery-focused approaches to addiction and mental health over harm-reduction strategies.
“The whole idea of the Alberta Recovery Model is that unless you create off-ramps [from] addiction, you’re barreling ahead towards a brick wall, and that’s going to be devastating,” Alberta Minister of Mental Health and Addiction Dan Williams told Canadian Affairs in an interview in September.
However, the closure — which parallels similar moves by other provinces — has sparked debate over whether recovery-oriented models adequately meet the needs of at-risk populations.
The Alberta Recovery Model
The Alberta Recovery Model, which was first introduced by Alberta’s UCP government in November 2023, emphasizes prevention, early intervention, treatment and recovery.
It is informed by recommendations from Alberta’s Mental Health and Addiction Advisory Council and research from the Stanford Lancet Commission on the North American Opioid Crisis.
“Alberta, in our continuum of care, has everything from low entry, low barriers, and zero cost [for] detox, to treatment, to virtual opioid dependency, to outreach teams working with shelters,” said Williams.
Williams said that Alberta intends to continue funding safe consumption sites as short-term harm-reduction measures. But it views them as temporary components in the continuum of care.
This is not without controversy.
At the Feb. 15 Red Deer council meeting where councillors voted 5-2 to close the city’s safe consumption site, some councillors noted that safe consumption sites play an essential role in the continuum of care.
“Each individual is at a different stage of addiction … the overdose prevention site does play a role in the treatment spectrum,” said Coun. Dianne Wyntjes, who voted against the closure.
While Red Deer is home to Alberta’s first provincially funded addiction treatment facility, Wyntjes noted there had been reports within the community of the facility lacking capacity to meet demand.
She pointed to Lethbridge’s experience in 2020, where overdose deaths spiked after its consumption site was replaced with mobile services.
The Ontario government’s recent decision to close 10 safe consumption sites located near schools and daycares has prompted similar concerns.
In August, Ontario Health Minister Sylvia Jones told reporters that the province plans to “very quickly” replace the closed sites with Homelessness and Addiction Recovery Treatment (HART) hubs that prioritize community safety, treatment and recovery. But critics — including site workers, NDP MPPs and harm-reduction advocates — have warned these shutdowns will lead to an increase in fatal overdoses.
It is possible that Alberta, Ontario and other jurisdictions will make other moves in tandem in the coming months and years.
In April, Alberta announced it was partnering with Ontario and Saskatchewan to build recovery-focused care systems. The partnerships include sharing of best practices and advocating for recovery-focused policies and investments at the federal level.
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‘Mandatory treatment’
Another controversial component of Alberta — and other provinces’ — recovery-oriented strategy is involuntary care.
The UCP government has said it plans to introduce “compassionate intervention” legislation next year that will enable family members, doctors or police officers to seek court orders mandating treatment for individuals with substance use disorders who pose a risk to themselves or others.
“If someone is a danger to themselves or others in the most extreme circumstances because of their addiction, then we as a society have an obligation to intervene, and that might include mandatory treatment,” said Williams.
Critics have raised concerns about increasing reliance on involuntary care options.
“Over the last two decades, there has been a dramatic increase in reliance on involuntary services [such as psychiatric admissions and treatment orders], while voluntary services have not kept up with demand,” the B.C. division of the Canadian Mental Health Association said in a Sept. 18 statement published on their website.
The statement followed an announcement by B.C. Premier David Eby — who was recently reelected — to expand involuntary care in that province.
Research from Yale University’s School of Public Health indicates involuntary interventions for substance use are generally no more effective than voluntary treatment, and can in some cases cause more harm than good. The research notes that “involuntary centers often serve as venues for abuse.”
A 2023 McMaster University study that synthesized the research on involuntary treatment from international jurisdictions similarly found inconclusive outcomes. It recommended expanding voluntary care options to minimize reliance on involuntary measures.
Williams emphasized that the province’s involuntary care legislation would target “a very small group of people for whom all else has failed … those at the far end of the addiction spectrum with very serious and devastating addictions.”
‘Off-ramps from addiction’
Over the past six years, Alberta has incrementally increased its mental health and addiction budget from an initial $50 million to a cumulative total of $1.5 billion.
The funding boost has enabled Alberta to eliminate a $40 daily user fee for some detox and recovery services, add 10,000 publicly funded addiction treatment spaces, and expand access to its Virtual Opioid Dependency Program, which offers same-day access to life-saving medications.
To support addiction prevention, Williams said Alberta is expanding CASA Classrooms in schools. These offer mental health support and therapy to Grade 4-12 students who have ongoing mental health challenges, and equip school staff and caregivers to support these students.
“Mental health and addiction needs to be as connected to the emergency room as it is to the classroom,” Williams said. “We need to be able to understand low-acuity chronic mental health challenges as they begin to manifest [in the community].”
The province is also in the process of establishing 11 residential recovery communities across the province. These centres provide free, extended treatment averaging four months — which is longer than most recovery programs.
Oct. 23 marked the one-year anniversary of one such centre, the Lethbridge Recovery Community. The $19-million, 50-bed facility served more than 110 clients in its first year and expects to serve about 200 individuals in 2025.
“I’m coming to see that entering treatment is only the start,” said Sean P., a client of Lethbridge Recovery Community, in a government press release celebrating the anniversary.
“With the support of the staff and the community here, I’m beginning to face my past and make real changes. Recovery is giving me the tools I need for this journey, and I’m genuinely excited to keep growing and moving forward with their help.”
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From the Brownstone Institute
Cigarettes kill nearly half a million Americans each year. Everyone knows it, including the Food and Drug Administration. Yet while the most lethal nicotine product remains on sale in every gas station, the FDA continues to block or delay far safer alternatives.
Nicotine pouches—small, smokeless packets tucked under the lip—deliver nicotine without burning tobacco. They eliminate the tar, carbon monoxide, and carcinogens that make cigarettes so deadly. The logic of harm reduction couldn’t be clearer: if smokers can get nicotine without smoke, millions of lives could be saved.
Sweden has already proven the point. Through widespread use of snus and nicotine pouches, the country has cut daily smoking to about 5 percent, the lowest rate in Europe. Lung-cancer deaths are less than half the continental average. This “Swedish Experience” shows that when adults are given safer options, they switch voluntarily—no prohibition required.
In the United States, however, the FDA’s tobacco division has turned this logic on its head. Since Congress gave it sweeping authority in 2009, the agency has demanded that every new product undergo a Premarket Tobacco Product Application, or PMTA, proving it is “appropriate for the protection of public health.” That sounds reasonable until you see how the process works.
Manufacturers must spend millions on speculative modeling about how their products might affect every segment of society—smokers, nonsmokers, youth, and future generations—before they can even reach the market. Unsurprisingly, almost all PMTAs have been denied or shelved. Reduced-risk products sit in limbo while Marlboros and Newports remain untouched.
Only this January did the agency relent slightly, authorizing 20 ZYN nicotine-pouch products made by Swedish Match, now owned by Philip Morris. The FDA admitted the obvious: “The data show that these specific products are appropriate for the protection of public health.” The toxic-chemical levels were far lower than in cigarettes, and adult smokers were more likely to switch than teens were to start.
The decision should have been a turning point. Instead, it exposed the double standard. Other pouch makers—especially smaller firms from Sweden and the US, such as NOAT—remain locked out of the legal market even when their products meet the same technical standards.
The FDA’s inaction has created a black market dominated by unregulated imports, many from China. According to my own research, roughly 85 percent of pouches now sold in convenience stores are technically illegal.
The agency claims that this heavy-handed approach protects kids. But youth pouch use in the US remains very low—about 1.5 percent of high-school students according to the latest National Youth Tobacco Survey—while nearly 30 million American adults still smoke. Denying safer products to millions of addicted adults because a tiny fraction of teens might experiment is the opposite of public-health logic.
There’s a better path. The FDA should base its decisions on science, not fear. If a product dramatically reduces exposure to harmful chemicals, meets strict packaging and marketing standards, and enforces Tobacco 21 age verification, it should be allowed on the market. Population-level effects can be monitored afterward through real-world data on switching and youth use. That’s how drug and vaccine regulation already works.
Sweden’s evidence shows the results of a pragmatic approach: a near-smoke-free society achieved through consumer choice, not coercion. The FDA’s own approval of ZYN proves that such products can meet its legal standard for protecting public health. The next step is consistency—apply the same rules to everyone.
Combustion, not nicotine, is the killer. Until the FDA acts on that simple truth, it will keep protecting the cigarette industry it was supposed to regulate.
Author
By Adam Zivo
Both are shaped by radical LGBTQ activism and questionable evidence.
Over the past decade, North America embraced two disastrous public health movements: pediatric gender medicine and “harm reduction” for drug use. Though seemingly unrelated, these movements are actually ideological siblings. Both were profoundly shaped by extremist LGBTQ activism, and both have produced grievous harms by prioritizing ideology over high-quality scientific evidence.
While harm reductionists are known today for championing interventions that supposedly minimize the negative effects of drug consumption, their movement has always been connected to radical “queer” activism. This alliance began during the 1980s AIDS crisis, when some LGBTQ activists, hoping to reduce HIV infections, partnered with addicts and drug-reform advocates to run underground needle exchanges.
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In the early 2000s, after the North American AIDS epidemic was brought under control, many HIV organizations maintained their relevance (and funding) by pivoting to addiction issues. Despite having no background in addiction medicine, their experience with drug users in the context of infectious diseases helped them position themselves as domain experts.
These organizations tended to conceptualize addiction as an incurable infection—akin to AIDS or Hepatitis C—and as a permanent disability. They were heavily staffed by progressives who, influenced by radical theory, saw addicts as a persecuted minority group. According to them, drug use itself was not the real problem—only society’s “moralizing” norms.
These factors drove many HIV organizations to lobby aggressively for harm reduction at the expense of recovery-oriented care. Their efforts proved highly successful in Canada, where I am based, as HIV researchers were a driving force behind the implementation of supervised consumption sites and “safer supply” (free, government-supplied recreational drugs for addicts).
From the 2010s onward, the association between harm reductionism and queer radicalism only strengthened, thanks to the popularization of “intersectional” social justice activism that emphasized overlapping forms of societal oppression. Progressive advocates demanded that “marginalized” groups, including drug addicts and the LGBTQ community, show enthusiastic solidarity with one another.
These two activist camps sometimes worked on the same issues. For example, the gay community is struggling with a silent epidemic of “chemsex” (a dangerous combination of drugs and anonymous sex), which harm reductionists and queer theorists collaboratively whitewash as a “life-affirming cultural practice” that fosters “belonging.”
For the most part, though, the alliance has been characterized by shared tones and tactics—and bad epistemology. Both groups deploy politicized, low-quality research produced by ideologically driven activist-researchers. The “evidence-base” for pediatric gender medicine, for example, consists of a large number of methodologically weak studies. These often use small, non-representative samples to justify specious claims about positive outcomes. Similarly, harm reduction researchers regularly conduct semi-structured interviews with small groups of drug users. Ignoring obvious limitations, they treat this testimony as objective evidence that pro-drug policies work or are desirable.
Gender clinicians and harm reductionists are also averse to politically inconvenient data. Gender clinicians have failed to track long-term patient outcomes for medically transitioned children. In some cases, they have shunned detransitioners and excluded them from their research. Harm reductionists have conspicuously ignored the input of former addicts, who generally oppose laissez-faire drug policies, and of non-addict community members who live near harm-reduction sites.
Both fields have inflated the benefits of their interventions while concealing grievous harms. Many vulnerable children, whose gender dysphoria otherwise might have resolved naturally, were chemically castrated and given unnecessary surgeries. In parallel, supervised consumption sites and “safer supply” entrenched addiction, normalized public drug use, flooded communities with opioids, and worsened public disorder—all without saving lives.
In both domains, some experts warned about poor research practices and unmeasured harms but were silenced by activists and ideologically captured institutions. In 2015, one of Canada’s leading sexologists, Kenneth Zucker, was fired from the gender clinic he had led for decades because he opposed automatically affirming young trans-identifying patients. Analogously, dozens of Canadian health-care professionals have told me that they feared publicly criticizing aspects of the harm-reduction movement. They thought doing so could invite activist harassment while jeopardizing their jobs and grants.
By bullying critics into silence, radical activists manufactured false consensus around their projects. The harm reductionists insist, against the evidence, that safer supply saves lives. Their idea of “evidence-based policymaking” amounts to giving addicts whatever they ask for. “The science is settled!” shout the supporters of pediatric gender medicine, though several systematic reviews proved it was not.
Both movements have faced a backlash in recent years. Jurisdictions throughout the world are, thankfully, curtailing irreversible medical procedures for gender-confused youth and shifting toward a psychotherapy-based “wait and see” approach. Drug decriminalization and safer supply are mostly dead in North America and have been increasingly disavowed by once-supportive political leaders.
Harm reductionists and queer activists are trying to salvage their broken experiments, occasionally by drawing explicit parallels between their twin movements. A 2025 paper published in the International Journal of Drug Policy, for example, asserts that “efforts to control, repress, and punish drug use and queer and trans existence are rising as right-wing extremism becomes increasingly mainstream.” As such, there is an urgent need to “cultivate shared solidarity and action . . . whether by attending protests, contacting elected officials, or vocally defending these groups in hostile spaces.”
How should critics respond? They should agree with their opponents that these two radical movements are linked—and emphasize that this is, in fact, a bad thing. Large swathes of the public understand that chemically and surgically altering vulnerable children is harmful, and that addicts shouldn’t be allowed to commandeer public spaces. Helping more people grasp why these phenomena arose concurrently could help consolidate public support for reform and facilitate a return to more restrained policies.
Adam Zivo is director of the Canadian Centre for Responsible Drug Policy.
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