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Alberta

Big boost for energy companies working on emission reduction innovations

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15 minute read

From the Province of Alberta

In October 2019, Emissions Reduction Alberta (ERA) launched the Natural Gas Challenge and invited technology developers to share project concepts for innovation opportunities in Alberta’s natural gas industry.

Alberta’s government is providing $58 million through ERA to support this opportunity to create jobs in the natural gas sector.

Funding recipients include a project that uses artificial intelligence to locate and measure methane emissions, and a project to produce renewable natural gas from biogas at an agricultural facility that will be the first of its kind in Alberta.

The 20 new projects have the potential to reduce a cumulative one million tonnes of emissions by 2030 – the same as taking about 750,000 cars off Alberta’s roads. These projects will also get Albertans back to work by creating more than 750 new jobs when they are needed most.

“Alberta is already a leader when it comes to our environmental footprint, and our ongoing work with Emissions Reduction Alberta will help us become even better.”

Jason Nixon, Minister of Environment and Parks

Projects were selected through ERA’s competitive review process. Experts in science, engineering, business development, commercialization, financing, and greenhouse gas quantification reviewed 117 submissions and chose projects based on the strongest potential for success.

“With Alberta’s 300-year supply of affordable natural gas, a technically skilled workforce and world-class environmentally responsible facilities, there is tremendous opportunity for Alberta to compete with international markets. Funding opportunities like this, in partnership with Emissions Reduction Alberta, are critical to attracting investments that will grow Alberta’s economy by reducing upfront costs, while reducing our province’s share of global emissions.”

Dale Nally, Associate Minister of Natural Gas and Electricity

Government funds ERA through the Technology Innovation and Emissions Reduction (TIER) system. TIER is an improved system to help energy-intensive facilities find innovative ways to reduce emissions and invest in clean technology to stay competitive and save money. Facilities can pay into a TIER Fund, which is used for innovative and cleaner Alberta-based projects like those selected under the Natural Gas Challenge.

ERA’s funding model requires that every dollar committed to an initiative is matched or exceeded by additional investments, which ensures there is a market demand for the technology. Government’s $58-million investment through ERA has been more than doubled by private and public investment to stimulate the economy, lower emissions and create jobs, leading to a total of $155 million in funding.

“Investing in the next wave of technological advancements will help Canada’s natural gas industry achieve new efficiencies, reduce costs, and continue to drive world-leading environmental performance.”

Steve MacDonald, CEO, Emissions Reduction Alberta

A complete list of the successful Natural Gas Challenge projects can be found here.

“We are grateful for ERA’s support to help fund Canadian Natural’s ALT-FEMP project. By working together, we will develop and pilot technologies that can be adopted across the industry to enable early detection of methane emissions through cost-effective methods, ultimately accelerating industry’s reductions in greenhouse gas emissions.”

Joy Romero, vice-president of technology and innovation, Canadian Natural Resources Limited

“This project is an important first step for Alberta, which has all the ingredients to be a leader in the hydrogen economy – including the ability to produce a near zero-emission hydrogen at a lower cost than most jurisdictions in the world.”

George Lidgett, executive vice-president and general manager, Canadian Utilities Inc.

Quick facts

  • In 2018, Alberta produced almost 70 per cent of the marketable natural gas in Canada.
  • ERA works with government, industry and innovators to support technologies that reduce greenhouse gas emissions.
  • Since 2009, ERA has committed $607 million in funds from industrial carbon pricing toward 183 projects worth $4.1 billion that are reducing emissions, keeping industries competitive, and leading to new investment opportunities.
  • These 183 projects are estimated to deliver cumulative reductions of 34.8 million tonnes of emissions by 2030.

If successful, these technology innovations will lead to cumulative GHG reductions of almost one million tonnes of CO2e by 2030—equivalent to the GHG emissions from 750,000 passenger vehicles driven for one year. It is anticipated these projects will also deliver approximately 760 new jobs.

Funding is being sourced from the carbon price paid by Large Final Emitters in Alberta through the Technology Innovation and Emissions Reduction (TIER) fund.

The following projects were selected for funding:

UPSTREAM PROJECTS:

MultiSensor Canada Inc.
Methane Imaging Solution for Continuous Leak Detection and Quantification for Tank Emissions and Facility Monitoring
Total project value: $3,200,000 | ERA commitment: $1,600,000
Permanent installation and demonstration of an infrared camera at 100 well sites to provide continuous leak detection and quantification for tank emissions and facility monitoring.

Qube Technologies
Emissions Reductions Through Artificial Intelligence
Total project value: $16,200,000 | ERA commitment: $4,000,000
Deployment of an industrial device designed to collect large quantities of data to use artificial intelligence and machine learning techniques to better quantify, locate, and classify emissions.

University of Calgary:
Field-Scale Deployment and Acceleration of Made-In-Alberta Technology for Fugitive Emissions Detection and Reduction
Total project value: $3,200,000 | ERA commitment: $1,600,000
Full-scale, field pilot of a new vehicle-based technology designed for equipment-level emissions screening to support effective regulatory leak detection and repair.

Canadian Natural Resources Limited
Fugitive Emissions Study Using Aerial Detection Technology
Total project value: $1,900,000 | ERA commitment: $930,000
Pilot project of both aerial screening technology and ground-based detection at conventional oil and gas facilities to validate technology performance and inform a broader Alternative Fugitive Emissions Management Program (FEMP).

Challenger Technical Services
Multi Component Downhole Injection System
Total project value: $2,600,000 | ERA commitment: $1,000,000
Development, testing, and validation of a multicomponent downhole injection system that uses epoxy resins to rapidly seal leaking oil and gas wells and eliminate surface casing vent flow.

Petroleum Technology Alliance Canada (PTAC)
Affordable Zero-Emission Fail-Safe Electric Dump Valve Actuator (EDVA) Phase 2
Total project value: $2,200,000| ERA commitment: $550,000
Applied research, prototype design and development, and field pilot testing of an electrically-driven valve actuator that is more compact, powerful, and lower maintenance than alternative pneumatic options.

Kinitics Automation Limited
Valve Actuator for Gas Producers
Total project value: $1,100,000 | ERA commitment: $550,000
Testing a novel electric actuator at 15 well sites in Alberta to validate the technology as a cost effective, technically viable alternative to eliminate venting from established pneumatic devices.

Westgen Technologies Inc
Unlocking EPOD Economic Zero Bleed Pneumatic Instrument Air Retrofit Solution
Total project value: $4,000,000 | ERA commitment: $1,300,000
Demonstration of a solar-hybrid power generation system for remote well sites to provide reliable electricity to prevent gas venting from pneumatic devices in a cost-effective manner.

Modern Wellbore Solutions
Demonstration of a Full-Scale Multilateral Junction Assembly
Total project value: $12,100,000 | ERA commitment: $3,500,000
Full-scale deployment of a multilateral junction tool assembly that will allow natural gas operators to drill, complete, and operate multi-branched wells for unconventional reservoirs. The technology reduces emissions by enabling lateral junctions rather than requiring separate wells.

Tourmaline Oil Corp.
Natural Gas Mobile Unit for Drilling Rig Power Generation
Total project value: $8,000,000 | ERA commitment: $3,200,000
Pilot demonstration of a plug and play, mobile power generation system for drilling rigs that uses smart energy to automatically start and stop generators to match the power demand of the rig.

DOWNSTREAM AND VALUE-ADDED PROJECTS:

ATCO Gas and Pipelines Ltd.
Fort Saskatchewan Hydrogen Blending
Total project value: $5,700,000 | ERA commitment: $2,800,000
Pilot project to test hydrogen blending in ATCO’s Fort Saskatchewan natural gas distribution system. The project will source and test equipment and determine applicability of existing codes, standards, and legislation.

Ekona Power Inc.
Development and Field Testing of a Tri-Generation Pyrolysis (TGP) System for Low-cost, Clean Hydrogen Production
Total project value: $13,800,000 | ERA commitment: $5,000,000
Prototyping a new approach to converting natural gas to hydrogen and a solid carbon by-product representing a new pathway to produce zero-emissions hydrogen, electricity, and other products by decarbonizing natural gas.

Standing Wave Reformers Inc.
A New Wave in Hydrogen Production
Total project value: $8,200,000 | ERA commitment: $3,000,000
Design optimization, system integration, pilot demonstration, techno-economic analysis, and advancement of commercial deployment plans for a technology system to decarbonize natural gas.

ATCO Gas and Pipelines Ltd.
ATCO and Future Fuel RNG
Total project value: $15,900,000 | ERA commitment: $7,900,000
First-of-its-kind commercial demonstration to produce renewable natural gas (RNG) to be sold and used within the province in Compressed Natural Gas (CNG) fleet vehicles and commercial applications.

Sustainitech Inc.
Co-Locating Natural Gas and Indoor Agriculture for Alberta’s Future
Total project value: $17,900,000 | ERA commitment: $5,000,000
Design, construction, and operation for a first-of-kind commercial deployment of a modular farming system that combines automation, hydroponics, adsorption cooling, and advanced lighting to grow crops.

Enersion Inc.
Greenest Natural Gas-Powered Quad-generation with a 41% GHG Reduction
Total project value: $3,800,000 | ERA commitment: $1,800,000
Technology that uses natural gas to generate electricity, cooling, and heating in an integrated package for multiple applications, including industrial, agricultural, commercial, and residential sectors

Stone Mountain Technologies, Inc.
Demonstration of Thermally Driven Heat Pumps for Residential Heating Applications
Total project value: $2,000,000 | ERA commitment: $990,000
Design and prototyping of technology that uses natural gas to drive a heat pump cycle. Unlike electrically-driven heat pumps, the technology is ideal for cold climates.

Anax Power
Turboexpander Project
Total project value: $6,200,000 | ERA commitment: $2,400,000
Installation and operation of technology that provides clean, distributed electricity from the pressure and flow of natural gas without combustion.

Innovative Fuel Systems
Advanced Dual-Fuel System Commercial Demonstration
Total project value: $2,800,000 | ERA commitment: $1,200,000
Commercial validation of technology that allows heavy duty truck engines to displace up to 50 per cent of their diesel with cleaner burning natural gas.

Converting Landfill Gas to Renewable Natural Gas
Total project value: $25,000,000 | ERA commitment: $10,000,000
The project will explore opportunities to upgrade landfill gas (LFG) at Clover Bar Landfill and inject it into Alberta’s natural gas system as renewable natural gas (RNG). Stakeholders in the Clover Bar Landfill, the City of Edmonton and Capital Power, are exploring these possible opportunities.

All recipients are required to produce a final outcomes report that will be shared publicly for the broader benefit of Alberta. All projects involve field piloting, demonstration, or commercial deployment of technology within the province.

Click the links below for more details on ERA’s Natural Gas Challenge:

WHY TARGET THE NATURAL GAS VALUE CHAIN?
Natural gas is a critical resource, providing heat and power for Alberta’s residential, commercial, and industrial sectors. It is the least GHG emitting of traditional fossil fuels, and a global shift toward natural gas from coal- and oil‑based resources is underway.

Canada is the fourth largest natural gas producer in the world, with net exports totaling $6.1 billion in 2018. Alberta produces almost 70 per cent of the marketable natural gas in the country. In 2017, the province emitted 35 million tonnes of CO2e from natural gas production and processing. A significant opportunity exists to improve cost competitiveness along Alberta’s natural gas value chain and reduce GHG emissions.

The Government of Alberta is committed to revitalizing Alberta’s natural gas sector. The province is developing and implementing a robust strategy with key recommendations from the 2018 Roadmap to Recovery Report, a document advising the government on reviving Alberta’s natural gas industry.

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Alberta

Alberta gets credit boost because of budget discipline

Published on

News release from the Canadian Taxpayers Federation

Author: Kris Sim

“bringing net adjusted debt to an estimated CAD 57.5 billion in fiscal 2024 (ended on March 31) from CAD 74.6 billion in fiscal 2022”

The Canadian Taxpayers Federation is applauding the Alberta government for its fiscal discipline which earned the province a boost in its credit rating.

“Alberta is one of the only provinces in Canada with a balanced budget, and it shows with this credit upgrade,” said Kris Sims, CTF Alberta Director. “Paying down the debt, restraining spending and saving for the future were very good moves by this government.”

In its most recent budget, Alberta reported a $367-million surplus. That stands in contrast to neighbouring Saskatchewan’s $273-million deficit and British Columbia’s record-breaking $7.9-billion deficit.

The rating agency, Fitch, upgraded Alberta’s credit from AA- to AA this week, highlighting its debt repayment as a key reason for the improvement.

“Alberta used its recent economic rebound to accelerate fiscal improvements and lower its debt, bringing net adjusted debt to an estimated CAD 57.5 billion in fiscal 2024 (ended on March 31) from CAD 74.6 billion in fiscal 2022,” the Fitch report reads.

The agency also cited Alberta’s spending restraint as a reason for the positive outlook.

“The rapid decline in debt and adherence to spending restraint in recent budgets have been complement with last year’s introduction of a fiscal framework requiring balanced budgets, annual contingencies and using surpluses for debt repayment, savings or one-time investment, is likely to bolster future resilience,” the Fitch report reads.

Interest charges on the province’s debt are estimated to cost taxpayers $3.3 billion this year.

“Credit ratings matter because Albertans pay billions of dollars on interest payments on the debt every year, better credit ratings make it less expensive to pay for that debt, and the less money we waste to pay debt interest charges the better,” said Sims.

 

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Addictions

Alberta and opioids III: You can’t always just stop

Published on

Monty Ghosh at Highlevel Diner, May 30.                                                                            Photo: Paul Wells

This is the concluding installment in a series on drugs in Alberta. Previously:

i. “Worse Than I’ve Ever Seen,” June 4

ii. “Alberta’s System Builder,” June 7


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A matter of expectations

Street family

My tour guide for much of my visit to Edmonton was Dr. Monty Ghosh, a clinician who’s on faculty at the University of Calgary and the University of Edmonton. He seems to talk to everybody who works with substance users in Alberta, from his own patients to front-line clinicians to the Alberta government. His relations with the latter go up and down, but he urged me to talk to Marshall Smith, the chief of staff to premier Danielle Smith.

On my first night in Edmonton Ghosh walked me around a neighbourhood that included the George Spady Society  supervised-consumption site, the Hope Mission’s Herb Jamieson Centre, and the Royal Alexandra Hospital, which has a supervised-consumption service on its premises.

A lot of people use the services these places provide. Other people don’t. Shelters in particular are tricky: they’re usually for single people who arrive alone. “The Hope, the Herb, the Navigation Centre, offering the world,” one Edmonton Police Service officer told me. “But all these places have one thing in common: rules.” If you have a spouse or a pet, you want to keep your drug supply or you want to stay close to your “street family” — the community spirit in neighbourhoods like this is striking, and might be surprising to people who prefer to stay away — a shelter’s probably not for you.

Several of the places we visited weren’t ready to welcome us when we showed up unannounced. To say the least, they’re busy. That was the case at Radius Community Health and Healing, an institutional building in a more residential part of the neighbourhood. Radius is a drop-in clinic and, as we’ll see, quite a bit more.

On a sunny weekday afternoon, more than a dozen people stood, sat or lay on the building’s front steps and truncated lawn. One lay on his back, shirtless, not moving visibly. Ghosh asked the man whether he was all right, asked again, finally nudged him. The man stirred, looked around. Ghosh apologized mildly for bothering him, then checked in on two other people who also weren’t moving. They turned out to be all right too.

Francesco Mosaico, Radius’s medical director, was on his way home for the day when we arrived, but we made plans to talk the next day. When I returned, I met Mosaico and Radius’s executive director, Tricia Smith, in her office.

I think it’s important to hear them out, because when drug use becomes the object of political debate, it’s natural to talk as though policy decisions are the main thing keeping people from getting well. This can lead to a lot of blame on one hand, and to excessive optimism on the other. In fact the biggest thing that keeps people from getting well is often the entire sum of their lives until now, compounded by the influence of drugs that are more potent than anything earlier generations had to deal with.


The most complex patients

Radius offers primary care to people “experiencing multiple barriers,” Smith said. That can include homelessness, addiction, severe mental health problems, criminal records. The centre’s team includes 12 family physicians and three psychiatrists. They currently see about 3,000 patients.

Radius has Western Canada’s only non-profit dental clinic. The centre runs a respite program for people who are not sick enough to be in acute care but are too sick to be managing independently on their own. It has a program for pregnant women experiencing homelessness. It runs on a harm-reduction model, so they don’t need to be drug-free to go into the program. It has an interdisciplinary Assertive Community Treatment team to help people with mental-health and substance problems find and stay in market apartments, with frequent assistance. There’s a supervised consumption site in the basement.

“In fact,” Smith said, “we actually have an exemption from the College of Physicians and Surgeons of Alberta to filter out and keep the most complex patients. The least complex, we refer elsewhere.” I couldn’t get care in Radius if I tried; they’d politely refer me elsewhere. They’re for the people who need the most help.

After my visit, Smith wrote to me to add another program to the list: Kindred House, which for more than 25 yearss has supported women and Trans women sex workers. “The women we see are from age 18 to 50, predominantly Indigenous, have intergenerational trauma, past/current trauma, substance use issues, often houseless or couch surfing,” Smith wrote.

Smith has been at Radius for three and a half years. While I was there, I asked her how work at Radius is going. “It’s going fabulously, honestly,” she said. She arrived early in the COVID pandemic, after eight years in Alberta government departments — which in turn followed 20 years as a Canadian Forces army nurse, including in combat zones. “I’m in the right place,” she said of Radius. “It felt like coming home.”

How come? “The staff, the team, the work, the dedication. It just feels like family. I missed that. Being in the military was a big thing. This work that this group does is just really amazing. The team is amazing and it’s hard, but it’s good work.”

And how’s the workload evolving? “Unfortunately, for this population, the struggles are only increasing, and the number of individuals that are experiencing those challenges is not getting less,” she said. “The workload isn’t going anywhere. It’s getting more difficult.”

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“Especially in the last couple years, I don’t think things have ever been worse for the vulnerable population,” Mosaico, Radius’s medical director, added. The same housing crunch that has made homes less affordable for everyone has put thousands of the most vulnerable on the street. Results: more frequent frostbite or burns from lamps lit to keep from freezing. Body lice. Trauma from watching friends die. And to Mosaico’s astonishment, frequent shigella outbreaks.

“Shigella’s a bacteria that causes torrential bloody diarrhea. It can be treated with a single dose of antibiotics. But if you’re homeless and you don’t have a place to take care of yourself… 70 percent of the cases have had to be hospitalized in the last two years…. I mean, they’re talking about potentially calling it an endemic disease, and it’s a disease of destitution. You see it in refugee camps in developing countries, not in the capital of Alberta, you know?”

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Ten thousand times deadlier

Radius also works closely with the Alberta government to integrate its services with the “recovery-oriented system of care” that I told you about last week. There are two Radius staffers working at the Integrated Care Centre the police set up to replace the old, passive holding cells for overnight detention. There are two more at the Navigation Centre, which steers people toward social and government services. If there’s an Alberta model, they’re part of it. So I was fascinated by the response when I asked my hosts the basic question that sent me to Alberta: Why are so many people dying?

“I think it’s the nature of the drugs,” Mosaico said. “You know, people used to overdose and die. But I’ve been here 17 years. I think in the first 10 or 11 years it wasn’t very common to hear about overdoses by opioids. Every once in a while you’d hear about it, but it wasn’t a daily thing. Whereas now with fentanyl and carfentanil, it’s really dangerous.”

Carfentanil is 10,000 times more potent than morphine, 100 times more than fentanyl. The Edmonton Police won’t return stolen cars they recover until they’ve scrubbed them thoroughly, because even trace amounts of these drugs are too dangerous. “We’re finding clients who use methamphetamines and swear up and down they’re not taking opioids,” Mosaico said. “And then we do urine tests and it’s there. We think their dealers are lacing methamphetamine with fentanyl because it increases the addiction.”

The other big thing on his mind, Mosaico said, is that any program to guide users into recovery will bump up against the fact that different people have often lived starkly different lives.


93% 4+

“I don’t know if you’re familiar with Adverse Childhood Experiences — the ACEs study,” Mosaico said. I was, barely, but I needed a refresher.

The original study began in 1985 in San Diego, under Vincent Felitti, who ran an obesity clinic, and Rob Anda from the Centres for Disease Control. (If you want to learn more about the study, this article and this speech on Youtube are good places to start.)

“They surveyed 17,000 people,” Mosaico said. “They found, you know, if people had developmental trauma — so, trauma between the ages of 0 and 18 — and there are 10 different forms of trauma that the study bore out as being detrimental. Things like physical, emotional, sexual abuse; physical, emotional neglect; substance use in the family; untreated mental illness in the family; separation from biological parents; maternal figure being treated violently; and a household member going to jail.

“If those things occurred, you would just tally up the number of types of trauma and you’d get a score out of 10. What they found was, if you scored four or greater, that there seem to be adverse health effects in adulthood. And it wasn’t just the presence of addictions or mental illness. It was lung disease, heart disease, liver disease, certain forms of cancer, diabetes, obesity.” This is almost folk wisdom today, but at the time, Felitti and Anda were amazed at the strength of the correlations between childhood trauma and adult physical and mental health.

The original test has been widely replicated, and it usually finds that the proportion of people in a sample who’ve had four or more adverse childhood experiences is about 12%. So something like every eighth person you meet had a really difficult childhood, and while you can’t predict for individuals from statistical trends, there’s a good chance they’re still living with the fallout.

The team at Radius surveyed a large sample of the population under their care. The prevalence of high-risk ACE scores was about 93 percent, compared to 12 in the general population,” Mosaico said.

“Harvard has a center on the developing child, which has pulled together a lot of the science that explains the neurobiological link between the adverse trauma and the adverse health effects. They talk about limitations in the development of executive function, of decision-making, emotional regulation. Impulse control is underdeveloped, neuroanatomically in the brain. And instead what over-develops is the fight-or-flight response.

“So you’re dealing with a population that, because of their experiences, isn’t the same as the general population . And then that’s compounded by the fact that a high percentage of those clients who have high ACE scores also have traumatic brain injuries from living rough on the street. They also have adult trauma that compounds the childhood trauma. They have [fetal alcohol spectrum disorder], which impairs executive function even further.

“I hear these success stories and I think they’re wonderful, when you hear about people who have a difficult life and then they straighten up. And then, you know, they go back to their jobs and their families and they become leaders in their communities. But this is a population which is over-represented in every aspect of society, negatively as it were. In the prisons and child family welfare services. In the health system, you know, prevalence of HIV, tuberculosis, Hepatitis C, STIs, all that.

“And you look at them and you think, even if they managed to wait, you know, six months to get into an addiction recovery bed, after waiting for weeks to get into detox and they go through the program, what do they go back to? Most of them had to drop out of school. They have criminal records, which makes it hard to get a job. They’re disconnected and estranged from their families. They haven’t learned social skills.

“I had a client who lived in dumpsters for two and a half years. The fact that he just stayed housed — on income support — for the rest of his life was a huge win, right? It was important for his dignity, his quality of life. It’s just a matter of adjusting your expectations of what might actually be realistic.”

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Dr. Larson writes

The idea for these stories goes back to February, when it first became clear to me that 2023 would be Alberta’s worst year for overdose fatalities. I asked the communications team at the University of Calgary for names of people to talk to. Many weeks went by, because sometimes it’s ridiculous how hard it is to extract myself from Ottawa routine. After I published the second article in this series, the one where Marshall Smith showed me all the stuff Alberta is building, I received an email from Dr. Bonnie R. Larson, who’s on faculty at the University of Calgary. She thought I should have talked to her, and she thought I was too credulous in reporting the Alberta government’s side. I asked if I could publish part of her email. Here it is.

What cannot be taken for granted is Mr. Smith’s view that his goals are different, somehow nobler, than those of us on the front line.  Smith paints a picture that front line providers’ priorities are at odds with his own.  His perspective is at once undemocratic, insulting, and arrogant, belittling those who are doing the hard work of keeping people alive every day.  

I will not have Smith speak for me in his suggestion that front liners lack system knowledge and that is why we support harm reduction. This ignores the excellent evidence supporting harm reduction interventions at the population level.  Smith seems to think he knows from whence I “enter this conversation”.  If so, why does he not engage me and my expert colleagues?  Where I “enter this conversation” is at 20 years of working with the affected community and 13 years of post-secondary education.  The only reason I am what Smith likes to dismiss as a “radical harm reduction activist”, is because the UCP, immediately upon taking office, set out to destroy harm reduction in Alberta.  Nobody would have ever needed to fight this soul-destroying battle in the first place if Smith hadn’t put Alberta squarely on its current path of destruction. Yes, we should hope for a better tomorrow but that doesn’t excuse ignoring the past and present.  

I would ask you to think about several additional factors that your analysis appears to ignore, including who actually benefits, in power and wealth, from Smiths’ system of so-called care?  DId you consider the other ways that the UCP policy direction is moving the entire publicly-funded system steadily towards profit?  Gunn (McCullough Centre) was a wonderful non-profit facility that helped many of my patients find their way to recovery from substance use disorders. While I agree that people should not have to pay for treatment, the question remains:  in whose pockets do those tax dollars ultimately land?

You report that Smith indicates that they are “monitoring” the entire system.  Where is the data from that monitoring?  They have had five years now to show some outcomes, but who am I, just a lowly street doctor, to ask for population data?  What I do know is that if deaths begin to decline, it is because so many are already gone.  You should ask to see the data about which Smith so proudly boasts.    

Smith’s entire premise that he is fixing the ‘addiction crisis’ is a fallacy.  Addictions are not increasing.  Deaths by drug poisonings are, however, and Smith’s circus is only making that worse.  Allow me to spell it out for you:  harm reduction addresses the drug poisoning crisis that is, no question, taking a horrific toll in Alberta and nationally.  Smith’s ROSC, in contrast, addresses a figmentary addictions crisis.    

One last tip. Medications used for opioid agonist treatment are not harm reduction, they are treatment.  Nobody here is against treatment or recovery.  But Marshall Smith is against harm reduction.  Why can’t we just have the full spectrum of care???  Polarization is created by politicians to benefit politicians.   

I don’t endorse everything Dr. Larson writes here. The data, or a lot of it, seems to me to be publicly available on the province’s impressive dashboard website. Use the tabs at the top of the page to navigate. And indeed, the story the dashboard tells is alarming, which, as I explained in this series’ first instalment, is why I flew west. But Larson’s years of front-line work has earned her, at the very least, a right of rebuttal.


Synthesis

On my last day in Edmonton, I met Monty Ghosh at Highlevel Diner, at the outer edge of the hip Strathcona neighbourhood on the south of the North Saskatchewan River. Highlevel is famous for its cinnamon buns, which, if I’m going to be honest, are noteworthy mostly for being large.

If the Alberta government and its most vociferous critics are thesis and antithesis, Ghosh tries to provide synthesis. He helped design the National Overdose Response Service, or NORS, which provides some of the emergency-response capability supervised consumption sites offer to people who aren’t near such a site or can’t use it for other reasons. He’s been critical of the Alberta government, but both sides keep lines of communication open.

I asked him about diverted safe supply — the idea that pharmaceutical opioids used in safe-supply programs in BC, principally hydromorphone tablets, are being sold or distributed away from their intended use. “I know it happens,” Ghosh said. “We sometimes get clients from British Columbia who come to Alberta to try to escape BC, because they’re looking for a fresh start. They’re looking for support and they’ll tell me themselves that they’ve diverted their safe supply.”

But what are the quantities? Trivial so far, Ghosh maintains. “Have I seen hydromorphone come into our province? Not at all, not yet.” This is the same thing I heard from Warren Driechel, the Edmonton deputy police chief.

Why do people divert their prescribed safe supply anyway? The answer Ghosh gave me was the answer I heard from everyone I asked. “They never used it. It just was not effective. The potency of the hydromorphone that they’re getting was nowhere near touching the fentanyl that they were using. It wasn’t dealing with the cravings, it wasn’t dealing with withdrawals, they felt it was useless. So what did they do? They sold it. They’re incredibly poor, they cannot afford their substance-use concerns and so therefore they supplement with revenue from hydromorphone.”

Before I flew to Edmonton, when Ghosh and I were trying to gauge on the phone what each of us thought of this infernal crisis, he figured out that I was interested in the differences between government policy in British Columbia and Alberta. “I’m not sure you want to hear this,” he said, “but I think it’s going to be bad everywhere.” I said that’s what I think too. Perhaps I surprised him.

I don’t know what happens next. Maybe things just stop getting worse everywhere on their own, for big complex reasons that resist easy analysis. Overdose deaths were lower last year in the United States, the capital of this hellscape, than the year before.

If not… well, we shall see. I wonder what happens in year six or seven of the effort the Alberta government is building. Is there resentment among people in ordinary hospitals and correctional facilities, who don’t have access to bespoke programs and personal attention? Does the ROSC system become bureaucratized after the first generation of administrators moves on?

Or does it start to win converts? David Eby, the NDP premier of British Columbia, has started putting distance between himself and his public-health advisors on legalization and safe supply. A new appointment in BC is being closely watched in Edmonton.

Or, conversely, does the Alberta recovery effort bump up against the limits imposed by the substances involved and by human nature? Reported recovery rates from addiction vary widely, depending in part on how you measure them. This paper puts the rate at less than 30%. If you even manage to double it, that still leaves a large cohort who aren’t getting better. Would their neighbours see them as people who “failed recovery” or “blew their chance?”

I won’t claim to know. I do hope that in the year ahead, more Canadians check their assumptions and stow their cheap certainties. Especially those who aspire to positions of leadership.

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