Alberta
Fortis et Liber: Alberta’s Future in the Canadian Federation
From the C2C Journal
By Barry Cooper, professor of political science, University of Calgary
Canada’s western lands, wrote one prominent academic, became provinces “in the Roman sense” – acquired possessions that, once vanquished, were there to be exploited. Laurentian Canada regarded the hinterlands as existing primarily to serve the interests of the heartland. And the current holders of office in Ottawa often behave as if the Constitution’s federal-provincial distribution of powers is at best advisory, if it needs to be acknowledged at all. Reviewing this history, Barry Cooper places Alberta’s widely criticized Sovereignty Act in the context of the Prairie provinces’ long struggle for due constitutional recognition and the political equality of their citizens. Canada is a federation, notes Cooper. Provinces do have rights. Constitutions do mean something. And when they are no longer working, they can be changed.
Mahatma Ghandhi was once allegedly asked what he thought of Western civilization. “I think it would be a good idea,” he is said to have replied. One could answer the same about Canadian federalism: it would be a good idea.
Not too long ago I was interviewed by a CBC journalist from Toronto regarding the Alberta Sovereignty within a United Canada Act, which upon its introduction by Premier Danielle Smith’s UCP government in November 2022 was attacked as needlessly provocative, deeply unconstitutional, legally unsustainable and shamelessly populist. “What is your vision of Canada?” the CBC reporter wanted to know. I told her the following: that Canada might be a federation. The implication was obvious: Canada is not a federation at present and, arguably, never has been. Many Canadians would find such a remark not arguable but outrageous. So here is my argument. My focus is on the Prairie West, not Laurentian Canada, the Maritimes, Newfoundland or B.C., each of which retains the story of its connection to Canada.
For 200 years Rupert’s Land (its flag shown on top left) along with the Northwest and Northeast Territories were the exclusive commercial domain of the Hudson’s Bay Company (HBC), granted by the British Crown; Great Britian officially transferred these vast lands to the Crown in Right of Canada in 1870. (Source of map: Golbez, licensed under CC BY 2.5)
Before Canada became a country in 1867, the vast tracts administered by the Hudson’s Bay Company – Rupert’s Land and the Northwest and Northeast Territories, including what became Labrador – were governed from London under Imperial orders and statutes. In law, Rupert’s Land was a plantation – a cold-weather plantation, to be sure, but a plantation nevertheless. The transfer of Company lands from the Imperial Crown to the Crown in Right of Canada took place by means of an Imperial Order-in-Council (passed under appropriate statutory authority) on July 15, 1870.
This all-but-forgotten history is important for understanding our present discontents. Not only was Rupert’s Land a territory politically distinct from the colony of Canada, but the manner of its acquisition by Canada underlined its distinctiveness. In 1868, a year after Confederation, the British Parliament passed the Rupert’s Land Act, specifying that the Hudson’s Bay Company would surrender its “lands, rights, privileges, liberties, franchises, powers and authorities” under certain terms and conditions to be negotiated by the Company, the Colonial Office and the Canadian government.
The negotiations were protracted and the specification of the terms and conditions took years of haggling among all the parties, some of which erupted into lawsuits. In the background there remained the unacknowledged claims of the inhabitants of the Red River Settlement (in what later became the Province of Manitoba), who were decidedly cool about the prospect of being incorporated into Canada. Neither they – whether of British, French, Métis, “country-born” or Indian stock – nor the other natives of Rupert’s Land were consulted about their new status.
Obscure but legally important: Canada is often said to have “purchased” Rupert’s Land from the Hudson’s Bay Company, but Canada did not actually pay for the land, only for the company’s capital improvements such as Lower Fort Garry in the Rural Municipality of St. Andrews (aka the Stone Fort, top), Fort Edmonton (middle), depicted here after construction of Alberta’s Legislative Assembly building, and the Hudson’s Bay Brigade Trail (bottom). (Sources of images: (top) Gordon Goldsborough, 2014-0038; (middle) Peel’s Prairie Provinces)
Rupert’s Land was not, therefore, on the market the way Alaska had been in the 1860s, when it was purchased from Czarist Russia by the United States for US$7.2 million (or 2 cents per acre), a transaction that took place in March 1867 through a signed treaty. True, many Hudson’s Bay Company stockholders similarly wished to sell Rupert’s Land to the highest bidder and hoped to begin the auction with an offer from China. Russia and the United States were also expected to join the bidding, along with Canada.
Some Canadian politicians spoke of the subsequent Canadian “purchase” of Rupert’s Land; some Canadian historians still do. But the transfer of Company lands to Canada was not a real estate deal. The Imperial Crown simply transferred its authority to the Crown in Right of Canada. Canada “indemnified” – i.e., bought off – the Hudson’s Bay Company not for the territory of Rupert’s Land but for the several capital improvements made during the previous 230 years. These included such structures as the Stone Fort at Red River and the timber fort at Edmonton, but also far-flung portage trails and the like.
Looked at from the perspective of Laurentian Canadian history, Rupert’s Land was a gift to the new Confederation from the Imperial Crown, the missing link between Canada and the colony of British Columbia that inspired the empire-builders of the Macdonald-Cartier coalition to extend the new eastern political entity to the Pacific Ocean, to build the Canadian Pacific Railway and to incorporate the province of B.C. within Canada. As for the Company lands to the east of Hudson Bay, very little commercial viability was expected. This was fur territory peopled by Indigenous trappers and barbaric traders as it had been for centuries. Canada later gave Ontario and Quebec additional territory carved from those former Company lands.
Canada expanded in a mode quite different from the United States. Unlike the generally well-planned and logical formation of new states from territories – a process meant to reflect an area’s maturation from thinly populated, intermittently governed and often lawless frontier to incipient civilization – there was nothing in Canada akin to the American Northwest Ordinance or to its successor laws. A key difference was that a newly formed U.S. state gained the same rights and privileges as other states, an important element of real federalism.
The second policy area where Canada’s expansion westward differed profoundly from America’s was the absence of consultation with the inhabitants of the newly acquired Canadian territories. In the U.S. this always entailed serious two-way discussions.
Here one should note that there are two elements essential to any federation. The first is a constitutionally defined division of responsibility between the central government and the constituent sub-national jurisdictions – provinces in Canada, states in the U.S. In a well-run federation each order of government stays in its constitutionally defined lane. The second element is that representation in the federal government combines numerical equality or “representation by population” with equal constitutional standing and privileges for all component jurisdictions.
“Enter the Union on an equal basis with existing states”: In contrast to Canada, the U.S. Northwest Ordinance of 1787 provided a formal and transparent mechanism by which newly settled territories could graduate to statehood if they met certain conditions – gaining the same rights and privileges as the original 13 states.
This second element is why the Americans combined in Congress a House of Representatives based on the principle of one person, one vote, with a Senate where each state – whatever its population – would send two senators to Washington, D.C. Because Canada does not provide equal provincial representation in the Canadian Senate (and for a few additional reasons) it has been called by political scientists a “quasi-federal state”. This particular anomaly (or defect) lay behind the attempt starting in the 1970s to establish a Senate that would have an equal number of Senators from each province, who would be elected and whose resulting legitimacy would allow the Senate to become effective in defending the rights of the provinces – the “Triple-E” Senate.
The second policy area where Canada’s expansion westward differed profoundly from America’s was the absence of consultation with the inhabitants of the newly acquired Canadian territories. In the U.S. this always entailed serious two-way discussions; ambitious pioneers would sometimes move out to a territory with the intention of taking part in its development and participating in its graduation to statehood.
In Canada, it was precisely the neglect and lack of communication that eventually led future rebel leader Louis Riel and his compatriot John Bruce to argue that the Western inhabitants of the Hudson’s Bay Company lands had been “abandoned” by the Imperial Crown. The Red River Settlement existed after the 1870 transfer, as they described it, in something akin to a Hobbesian state of nature. Consequently, they declared, the inhabitants of all the former western Company lands “refuse to recognise the authority of Canada,” which was seeking to coerce these subjects of the British Empire by imposing “a despotic form of government” on them.
“Our lives our fortunes and our sacred honour”: Métis leaders Louis Riel (top left) and John Bruce (top right) saw the 1870 transfer of Rubert’s Land to Canada as an act of “abandonment” by the British Crown; to protect the interests of the Red River Settlement (bottom), they “refus[ed] to recognise the authority of Canada.” (Sources: (top left photo) Library and Archives Canada, C-018082; (top right photo) Manitoba Historical Society Archives; (bottom map) Manitoba’s Red River Settlement, by Douglas Sprague and Ronald Frye)
Much like the British subjects a century earlier who became signatories of the then-colonial Declaration of Independence in 1776, the Red River authors declared “to the world” and to Canada in particular that they had established a Provisional Government and, closely following the final paragraph of U.S. Founding Father and future President Thomas Jefferson’s text, “mutually pledge ourselves on oath our lives our fortunes and our sacred honour to each other.” (Original non-punctuation)
Although this statement might sound hopelessly grandiloquent to modern-day ears, their claims were not without a political basis. As my friend and U of C colleague Tom Flanagan pointed out in his 1978 essay “Political Theory of the Red River Resistance: The Declaration of December 8, 1869”, the Declaration of the People of Rupert’s Land and the North West certainly rested on highly questionable legal grounds. To begin with, as noted, the land transfer was an intra-Imperial action. It was not the act of a sovereign power called the Hudson’s Bay Company abandoning the inhabitants of “its” territory and turning them over to another and alien sovereign power, Canada. The Company was not at all sovereign, and Canada was not fully sovereign.
The legal issue was of secondary importance, however, to the political significance of the Red River inhabitants’ response to the actions of Canada, starting with the Declaration and including not one but two open rebellions, the second of which was a serious armed conflict in which Canada’s control hung in the balance. In that second one, in 1885, Laurentian Canada mobilized and commanded Imperial military assets to impose its law on the rebellious Northwest. To the inhabitants, these actions, even if by then they themselves opposed Riel, looked like a continuation of the style of rule from London they had previously endured by way of the Company. That is, rule of the Northwest by “imperial” Canada was of a piece with British Imperial rule prior to 1870.
Between the Red River resistance and the truckers’ Freedom Convoy, over 150 years apart, came Prime Minister Macdonald’s grossly misnamed ‘National Policy’, which subordinated the economic vitality of Prairie agriculture to Laurentian industrial commerce. The National Policy amounted to simple exploitation of the West.
This was why James Mallory, a distinguished 20th century McGill University political scientist, in his 1954 book Social Credit and the Federal Power in Canada referred to the Prairie provinces as “provinces in the Roman sense”. Whatever did he mean? A Roman provincia was distinguished by two major attributes. First it was a locale where imperium, administrative rule, was exercised by Rome or an agent of Rome. Second, unlike the inhabitants of Italy, “provinces” paid tribute to the capital. Moreover, the etymology pro-vincere (Latin for something that was defeated or vanquished) suggests the provinciae were conquered territories. Aside from their military and geopolitical significance, Roman provinces were there to be taxed and to enrich their Roman rulers.
The analogies to 19th and 20th century Canada are clear. Ottawa – as pitiful a town as it was – acted as a new Rome on the Rideau. The territories (and soon-to-be second-class provinces) were acquired additions; they existed to strengthen and benefit Laurentian Canada by analogy with Roman Italy, and to enrich its leading citizens. And the provincials were expected to behave themselves. To this day, the embarrassment of 1885 has not been forgotten by Laurentian administrators. Of course, the Canadian punishment for rebellion was not Roman in its ferocity, although the result for Riel was equally final.
“Provinces in the Roman sense”: According to political scientist James Mallory, Canada’s Prairie provinces were akin to “provinciae” in ancient Rome – conquered lands whose inhabitants were not citizens and who existed to serve the interests of the Imperial Capital and the Italian heartland. Shown, the fall of Macedonia in 168 BC depicted in The Triumph of Aemilius Paulus by Carle Vernet, 1789. (Source of painting: The Metropolitan Museum of Art)
Northrop Frye once remarked that if history is a narrative of what happened, myth tells the story of what happens all the time. In that sense, myth is a major constituent of what we now call political culture. The Red River resistance, however comic and ineffectual it appeared to later Laurentian historians, became part of a Western myth, the most recent manifestation of which was the Freedom Convoy of 2022. And, incidentally, Laurentian historians were a self-described “school” centred at the University of Toronto. The most famous of them was the first modern biographer of Sir John A. Macdonald, Donald Creighton. His thesis, The Commercial Empire of the St. Lawrence, published by Yale University Press in 1937, effectively founded the Laurentian school. The second edition, published by the U of T Press, bore a franker title: The Empire of the St. Lawrence. That is the origin of the term “Laurentian Canada”.
Between the Red River resistance and the truckers’ convoy, over 150 years apart, came Prime Minister Macdonald’s grossly misnamed “National Policy”, which subordinated the economic vitality of Prairie agriculture to Laurentian industrial commerce. (To oversimplify somewhat, high import tariffs protected eastern industries while making imported goods critical to the Prairies’ economic development needlessly expensive, in turn making export-dependent Prairie farmers less economically competitive; the National Policy amounted to simple exploitation of the West.) When Alberta and Saskatchewan became Roman-style provinces in 1905, the Dominion Lands Policy saw to it that the major source of revenue from land sales and fees remained reserved “for the purposes of the Dominion”, not them.
The Western political response continued to reverberate for more than a century. Several political parties and social movements formed in opposition to Laurentian policies: the Progressives, Social Credit, the Social Gospel, the CCF, and later the Reform Party and the Canadian Alliance. The fact is, Westerners have typically wanted to make Canada work as a genuine federation. They were neither revolutionaries nor separatists. Like their cousins in the American West, they sought equal rights as citizens and equal representation for Western, especially Prairie, provinces.
In 1905 the Dominion of Canada carved the new provinces of Alberta and Saskatchewan out of portions of the Northwest Territories; the newcomers were treated as distinctly second-class in comparison to the original provinces, among other things only gaining full control over their lands and natural resources in 1930. (Sources of photos (clockwise, starting top-left): Calgary Herald Archives; Provincial Archives of Saskatchewan R-A4110-2; Glenbow Archives, na-1496-2; Western Development Museum)
And while all of these movements mounted often-spirited resistance to Laurentian political and economic controls, they also seemed to accept the political institutions of imperial Canada. Remember the slogan of the Reform Party in 1987? “The West wants in.” Why? To increase the likelihood of self-government, the very desire for which was dismissed by Laurentians as unintelligible: were these pesky Westerners not already citizens of an already self-governing country? They must be alienated, poor things, and in need of the ministrations of an alienist.
David A. Smith, another distinguished political scientist, who taught for many years at the University of Saskatchewan, provided a less condescending answer than the conventional dismissal by Laurentians in his 1969 essay “A Comparison of Prairie Political Movements in Saskatchewan and Alberta”. Westerners, Smith wrote, had tried working within the dominant political parties, then through so-called “third parties” that attempted to persuade the dominant parties, then through balance-of-power strategies. “No other area of the country,” Smith said, “has experimented with so many partisan alternatives and had so little apparent satisfaction from the results.”
A third distinguished political scientist, Alan Cairns, once asked: why were the Social Credit and the NDP called “third parties?” In B.C where Cairns taught, these parties were the government, the major players in a vibrant two-party system. The “third parties” were the Liberals and Conservatives. One might say the same thing about Social Credit and the Cooperative Commonwealth Federation (the future NDP) on the Prairies. That is, the political articulation of the Western provinces is distinct from that of Laurentian Canada.
The Prairie provinces continued to be subjected to destructive Laurentian policies throughout the 20th century, such as prolongation of the Canadian Wheat Board, official bilingualism and the National Energy Program, implemented by Pierre Trudeau in 1981 (shown on bottom left, to the right of Alberta premier Peter Lougheed in the centre). Depicted on bottom right, oil sands facility at Mildred Lake. (Sources of photos: (top left) Canadian Government Motion Picture Bureau/Library and Archives Canada/C-064834; (bottom left) The Canadian Press/Dave Buston; (bottom right) The Canadian Press)
After Canada’s first half-century or so, after the Prairie provinces finally in 1930 gained control over their natural resources (as Canada’s “founding” provinces had had from the start), there followed in the post-Second World War era further nonsensical Laurentian policies: the needless prolongation of the Canadian Wheat Board (whose command-and-control methods evoked the late Roman Emperor Diocletian’s ludicrous economic decrees), the definition of Canada as a bilingual country (the major consequence of which was to ensure that most Westerners did not find a professional career in Ottawa attractive), and of course the unforgettable National Energy Program, seen by many Albertans as the 20th century successor to the National Policy.
Then, the 1982 Constitution Act gave the Supreme Court of Canada effective control of legal aspects of the Constitution. And, like the first Supreme Court of Canada, it has acted largely as a centralizing creature of Laurentian Canada. One must be remarkably naïve not to think that Prime Minister Pierre Trudeau had something like this in mind when he began campaigning to “patriate” the Constitution nearly two generations ago. In any event, a major consequence of the 1982 Act was to undermine the institutions of federalism, particularly provincial responsibility for natural resources and the environment, which had been sustained by the jurisprudence of Britain’s Judicial Committee of the Privy Council in earlier times and largely respected after 1949 when judicial appeals to the Law Lords were abolished.
For Livingston, ‘Legal answers are of value only in the solution of legal problems.’ In contrast, he argued, ‘Federalism is a function not of constitutions but of societies.’ Consequently, federalism is concerned with economic, historical, social, political and cultural realities, which is a great deal more than law.
Today almost all the malign aspects of Canada’s Constitution are encapsulated in the federal equalization program. As Rob Anderson, Derek From and I point out in the Free Alberta Strategy (there’s also good material in this C2C essay), the Government of Canada has for decades expropriated vast amounts of fungible wealth from the taxpayers of the Prairie West and especially from Albertans – amounting to literally hundreds of billions of dollars. Moreover, the latest assault by the Justin Trudeau government has combined this traditional wealth removal with a novel attack on the source of provincial prosperity, the oil and natural gas industry in general and the oil sands in particular. For many Albertans, Ottawa has definitively breached the principles of the federal Constitution.
Now what?
First, recall the historical importance of federalism. In those remote days prior to the Canadian Charter of Rights and Freedoms, the focus of Canadian constitutional politics was on the balances struck over the years between responsibilities under s. 92 of what was then known as the British North America (BNA) Act that belonged chiefly to the provinces – such as transportation, regulation of businesses and professions, creation and oversight of municipalities, education, courts of law, health care and natural resources – and those given to the Dominion government under s. 91 – such as national defence, foreign relations, the criminal law, relations with Indians and international trade.
Of all the theorists of federalism to whom I was introduced as an undergraduate, William S. Livingston has remained my favourite. His Federalism and Constitutional Change was published by Oxford in 1956. It was preceded by an article, “A Note on the Nature of Federalism”, that established his main arguments. In my opinion they have not been superseded though they may have been forgotten.
“It’s not like Ottawa is a national government”: The Alberta Sovereignty within a United Canada Act, passed in late 2022 by the UCP government of Premier Danielle Smith, pictured, aims to strengthen the province’s ability to limit unconstitutional intrusions of federal policy and law into areas of provincial jurisdiction, thereby reaffirming that Canada is a federal state. (Source of photo: The Canadian Press/Jason Franson)
This is the context within which Premier Smith’s remark is to be understood when she said on third reading of Bill 1, later the Sovereignty Act, “It’s not like Ottawa is a national government.” (Emphasis added)
Social and political realities change: formerly poor jurisdictions such as Alberta grow wealthy; formerly rich jurisdictions such as the Maritimes grow poor. Political institutions eventually display the characteristic of serving purposes for which they were not initially designed. Just as federal societies change, federal institutions are required to change as well in response to new realities. If federal institutions are incapable of responding to changes in federal societies, the result is political dissolution, which is to say, independence of a former constituent jurisdiction. That was the prospect posed by Quebec in the 1970s after its “Quiet Revolution”. Quebec separatism spooked Canada sufficiently to change the effective federal Constitution to reflect the new configuration of the federal society.
This is not to say that legal federalism, which defines the primary areas of jurisdiction of Ottawa and the provinces, is unimportant. Sections 91 and 92 of the BNA Act are still in force and effect. Moreover, reasserting and defending the constitutional validity of the division of powers is the primary purpose behind Alberta’s Sovereignty Act.
Although attacked by critics, Alberta’s Sovereignty Act has received strong popular support for challenging the Justin Trudeau government’s constant intrusions into areas of provincial constitutional jurisdiction; the author points out that the Constitution does not require provinces to enforce federal laws, and that the Supreme Court of Canada has confirmed this. Shown, supporters of the Sovereignty Act outside the Alberta legislature, December 2022. (Source of photo: CityNews/Laura Krause)
Its central provision regarding federalism enables the provincial government to refuse to enforce federal laws. The decision not to do so would be based on the judgment of the legislature that the federal law in question was illegal, unconstitutional, harmful to Albertans or contrary to Alberta’s interests, based primarily on the text of ss. 91 and 92 and how those provisions were put into practice over Canada’s first century – but which recent federal governments have successively and, in the Justin Trudeau government’s case, systematically undermined or overridden as if they weren’t even there.
What is novel about this provision is that it would require Canada to take Alberta to court and there to prove its case, not the other way around as is the current practice. Nowadays when Ottawa first intrudes upon or overrides provincial jurisdiction and puts its unconstitutional policy or law into practice, it forces one or more provinces to try to stop it – even as the damage is already being done and the new policy threatens to become institutionalized through force of habit.
Equally important, there is no provision in the Constitution requiring any province to administer or enforce federal law. (Please see also this article and this article for supporting evidence of that contention.) The reason is obvious: Canada remains in law and reality a federation, not a unitary regime where provinces are simply agents of Ottawa the way Alberta municipalities are creatures of the provincial government. One reason for the political support that the Sovereignty Act has received are the objections to the arrogant default assumption of the Trudeau government that it is (except for Quebec) a “national government” – precisely what Danielle Smith denied. That is why it was originally and for a long time thereafter referred to as the Dominion government and today is called the federal government, which implies a government with limited and clearly enumerated constitutional scope and powers.
The political distance dividing Alberta’s Sovereignty Act from Ottawa’s Clarity Act is huge. The one contemplates a restoration of federalism, the other an end to it. If Alberta is to remain strong and free – fortis et liber – Laurentians will have to change their attitude and their political culture.
Another way of indicating the issue of connecting the reality of a federal society to a federal constitution is found in a remark of the late U.S. conservative journalist Andrew Breitbart, who famously observed that “politics is downstream from culture.” This is a snappy version of Frye’s remark regarding myth or what Livingston meant by the primacy of society. But what is downstream from politics? The answer is simple: the law of the Constitution.
Ask yourself: where did the BNA Act come from back in 1867? Or the 1982 Constitution Act? They came from political negotiations and political deal-making in response to political ideas and demands generated by the changing realities of a federal Canadian society. In that context, the 1982 Constitution Act looks like a legal response to the social changes of the “Quiet Revolution”. That is also where Alberta’s Sovereignty Act came from. Indeed, it can be seen as the current expression of a not-so-quiet Alberta revolution initiated by Ralph Klein, premier of Alberta from 1992 to 2006.
Those who say the Constitution is set in stone and can never be re-opened are legal fundamentalists and they are wrong. All constitutional documents, so revered by lawyers, especially the ermine-clad lawyers on the bench of the Supreme Court of Canada, were all downstream from political deals that reflected changing social, economic, cultural, etc. realities. Of course the Constitution can be re-opened! That is one of the long-range purposes of the Sovereignty Act.
“Clear majority on a clear question”: Two years after the 1998 Quebec Secession Reference case before the Supreme Court of Canada, the Liberal government of Jean Chrétien (on bottom, leaning forward) introduced the Clarity Act, establishing the conditions under which Canadian provinces may be allowed to begin the process of secession. The author considers this another act violating the concept of federalism, with Ottawa unilaterally calling the shots and placing provinces in a subordinate position. (Sources of photos: (top) @Law Scribes/X; (bottom) CP Photo/Fred Chartrand)
If Laurentian Canadians and lawyers nearly everywhere say that the Sovereignty Act is unconstitutional, I agree but with the following qualification: legal unconstitutionality is simply another way of saying it’s time to change the law of the Constitution. That is what Bruce and Riel had in mind so many years ago. The law of the Constitution may work well even today for Laurentians and for Ottawa bureaucrats, but they have become what English historian and philosopher Arnold Toynbee called a “dominant” rather than a “creative” minority. More to the point, if the law of the Constitution does not work for Albertans and for others in the Prairie West, why should it be respected? All the strategies listed by David Smith have not made a dent in the adamantine attitudes of Laurentian Canada. In their collective imperial mind, in their political culture, the Prairie West remains a colony. The Sovereignty Act aims to bring an end to a very unpleasant history.
And then there is the Clarity Act to consider. In the 1998 Quebec Secession Reference case brought by the Government of Canada, the Supreme Court of Canada required that any provincial referendum on secession receive a clear majority on a clear question in order to be valid and so to trigger mandatory negotiations. The Court did not define what either a clear majority or a clear question might be.
Two years later the Jean Chrétien government (under great pressure from the Reform Party) introduced what became the Clarity Act, according to which the Parliament of Canada would determine before any provincial referendum on potential secession whether the question was clear enough and, after the vote, whether the degree of support was sufficient to require negotiation on the terms of secession. If a referendum met those two criteria (according to Parliament), then a constitutional amendment requiring the consent of Parliament and the provinces would also have to be passed.
A few years later, former Parti Quebecois leader and Premier Jacques Parizeau told CTV News that the Clarity Act “meant nothing.” One reason for his remark was not just that Parliament had stacked the deck but that Quebec had passed its own law, one which emphasized the right of Quebec citizens to self-determination. Now, if push came to shove, one might expect Alberta to do the same.
The political distance dividing Alberta’s Sovereignty Act from Ottawa’s Clarity Act is huge. The one contemplates a restoration of federalism, the other an end to it. If Alberta is to remain strong and free, fortis et liber, as indicated on its coat of arms, Laurentians will have to change their attitude and their political culture. That is the challenge of political federalism today. Acknowledging that reality is the condition for making Canada a genuine federation in law. If not, it will take the more desperate remedy outlined in the Clarity Act to induce some sobriety into Laurentian consciousness.
Barry Cooper is a professor of political science at the University of Calgary. His latest books are Paleolithic Politics (2020) and, with Marco Navarro-Génie, COVID-19: The Story of a Pandemic Moral Panic (2020).
Monty Ghosh at Highlevel Diner, May 30. Photo: Paul Wells
By 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?”
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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Marshall Smith. Photo: PW
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Alberta’s system builder
The Alberta model, made in BC
“I, as you know, have been everywhere in this field, from eating out of garbage cans to this office,” Marshall Smith said. “So I have a deep respect for everybody who works along that continuum.”
We were sitting in the office at the Alberta Legislature reserved for chiefs of staff to Alberta premiers. That’s Smith’s current job. Premier Danielle Smith was probably nearby, though I didn’t see her on this trip. On a shelf behind Marshall Smith were two coffee mugs of different design, each bearing the inscription WAKE UP. SAVE LIVES. REPEAT.
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Anyway, Marshall Smith (all future uses of “Smith” in this post will refer to him, unless I specify the premier) was talking about the continuum from dumpsters to the centre of power. “Where you work on that continuum obviously colours the way that you enter this conversation,” he said. “When you are standing on a sidewalk with a person in front of you, the solutions to that person’s problem look very different than what you might do to plan a broader system of care, for a large population of people.”
This was his way of anticipating criticisms he faces as a leading strategist behind Alberta’s emerging strategy for handling a deadly progression in opioid doses. Since he entered Alberta’s government as a more junior staffer in the government of former premier Jason Kenney in 2019, Smith has been working to put a much greater emphasis on recovery from addiction than on “harm reduction,” whose valuable goal is to keep drug users alive whether they recover or not. This makes him a bête noire among harm-reduction advocates. (You can read a mild critique of his efforts here; or a real scorcher here).
What Smith was saying was, in effect, If you work on the street, you’re going to be all about harm reduction, and I respect that. But he is working on drug policy for a whole province, and perhaps beyond, so he needs a broader perspective. “I’m a system builder. So I don’t have the luxury of just focusing on one particular substance. I have to worry about the whole population. I have to worry about the disease burden of addiction and drug use more broadly.”
He sees much to worry about. “Over the last 30 years in Canada, successive governments have failed miserably to anticipate and adequately address the type of services — both from a capital investment and an operating investment — to help people do this.” By “this,” he means escaping addiction. “We have not cared about people with mental health and addiction issues. And we had the ability to not care because up until the last six or seven years, the evidence of them was hidden away.”
Smith first started thinking about this when he was in British Columbia, where he began his recovery from a history of drug use. In 2018, at the BC Centre for Substance Use, Smith co-wrote a report with Dr. Evan Wood that called for a large new investment in facilities and programs to help people recover from addiction. The report is no longer on the BCCSU website, but you can download a copy here.
“It was a 39-point strategy to transform the system in British Columbia,” Smith recalled. “The government of British Columbia wasn’t interested in that strategy. They wanted to go a particular direction.
“So that report is now known as the Alberta model.”
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Marshall Smith in the dining hall of the Lakeview Recovery Community, opening in July. Photo: PW
In its first page, the Wood/Smith report said “British Columbia has long suffered because of the lack of an effective system to support individuals in and pursuing recovery from substance use disorders.” The system’s “overwhelming focus” was on keeping people alive rather than helping them get better. Wood and Smith wanted that to change.
The need for major new investments in addiction recovery was essentially uncontroversial in B.C. Indeed governments there still periodically announce they are making such investments. But Smith was perpetually unsatisfied with the scale of that commitment.
A year after BC’s new NDP government could-shouldered his report, Smith began working in the UCP government of Alberta’s then-new premier, Jason Kenney.
“Obviously we started off very modestly,” Smith said. “I worked in an office down in the basement. Mental health and addiction wasn’t a big deal. It really was very much a group of cubicles.”
Today, Alberta’s department of mental health and addiction is the seventh-largest ministry in the provincial government.
“The ROSC transformation that is going on in Alberta is massive. It is one of the most massive whole-of-government system transformations that I’ve seen,” Smith said. The premier chairs a ROSC committee of cabinet with seven ministers.
I guess I’d better unpack that acronym. ROSC stands for “recovery-oriented system of care,” a term that appeared in the 2018 report Smith co-wrote.
So you get the premier and her ministers of mental health and addiction, Indigenous relations, advanced education, health, community and social services, public safety and the attorney general meeting regularly to coordinate recovery policy. The premier’s chief of staff is on the file constantly. As I mentioned on Monday, he devoted a full day to explaining this broad effort to me.
“We spend enormous amounts of time and energy,” Smith said. “All of us live and breathe this. Anybody out there that thinks that we’re just, from a conservative perspective, just cavalierly doing this, that just couldn’t be more untrue. We we are in this completely and totally. We monitor almost everything that goes on in the system.”
What are they working on? Smith said the “recovery” part of that “recovery-oriented system of care” jargon-ball gets most of the attention, because it draws attention to the contrast between harm-reduction and abstinence-based recovery models. But Smith is a wonk, and if anything he is more interested in the “system of care” part. His goal is to ensure that every interaction an opioid user has with the modern government apparatus is designed to encourage recovery from dependency. Since people who use drugs tend to bump up against the state a lot, Alberta’s emerging system has a lot of moving parts. The goal is to hook the parts up more effectively.
One of the other men in Smith’s office, Dr. Nathaniel Day, chimed in. He’s been the lead strategist on substance use at Alberta Health Services. He’s an important Smith collaborator.
“Across Canada,” he said, “the system of care for people with addiction has been fragmented, poorly thought out — convenient.” He meant services had generally only been provided when, and where, it was easy for government to provide them. “If you look at opioid dependency treatment, if you lived in a suburban or rural community, it didn’t matter that you had an opioid use disorder. Tough. We had no services for you.”
Day designed the Virtual Opioid Dependency Program, which provides online consultations to patients anywhere in Alberta, and if needed, prescriptions to medications that can be filled at local pharmacies. For patients without coverage, the medication is free and if their local pharmacist has it in stock, available on the day of the call.
“We went in and said, enough is enough,” Day said. “What would be good enough for you and your family? And how do we take that to everybody?”
Which medication? “In this province, we’re huge fans of gold-standard opioid-replacement medications, and we use it a lot,” Smith said. “We have Sublocade, which is something that other provinces don’t have because it’s very expensive. It’s the injectable version of Suboxone. It’s a subcutaneous injection, it goes under the skin, it lasts for 30 days, where the oral is 24-hour. So that’s a thousand bucks a shot, and we pay for that.”
An obvious point about this is that these so-called opioid agonist treatments, or OATs, are big-time harm reduction. They greatly reduce both withdrawal symptoms and highs. One question that I still have, after watching everything Smith and the Alberta government are doing on drug recovery, is whether other provinces could afford to match it.
Running into those institutions
VODP is useful for people who are able to reach out for help from home. But other potential beneficiaries are distracted, or in distress. Very often they run into the police.
“So we took that technology” — the virtual access to physicians and treatment — “and we gave it to the 34 police agencies that we have in the province,” Smith said.
“We said to the officers, ‘If you encounter somebody who has an opioid-use disorder, you can get them started on opioid-use medication. You can, officer. Here’s the phone number to call. Put them on. We make the arrangements. They go to the pharmacy, right then and there. If they’re on the street, that can be done right in the back of a police car.
“If they are in custody at the cell block and they go into the cell block, we have put paramedics in every cell block in Alberta. So the first thing that happens to somebody when they’re arrested and they go into into municipal cells, they’re met by a paramedic that says, ‘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?’ Through our police programs, we’re probably up to like 4,000 people who have taken us up on that.”
That’s what you can get done in a police cruiser or a holding pen. Lots of people go much further into the correctional system than that. So does Smith’s system of care.
“[Alberta’s] focus on corrections and police right now, admittedly, is the opposite of what some other jurisdictions are focusing on,” Smith said. If anything this was an understatement. A major argument for decriminalization and safe supply is that the last thing a drug user needs is the stigma of a criminal record. Other jurisdictions, Smith said, “are running away from those institutions when they should be running into those institutions.
“I’ll give you a very direct example why.
“We know, from the 2017 coroner’s report in Alberta that 40 percent of the people who died [of opioid-related causes] were in custody in the year prior to their death. That’s a really important piece of information, because it tells me I have a big chunk of population there that — if I can get at them, and if we can change the way that they experience this process — we can make a big dent in these numbers.”
A lot of people in the correctional system have substance-use disorder, even if that’s not what they’re in for. “We said, ‘Let’s really do a different way of thinking on this,’” Smith said. “Even though Corrections is a public-safety agency, we want the Ministry of Mental Health and Addiction to take over all Corrections health care.”
Perhaps four in five detainees, he said, “have alcoholism, addiction and mental-health issues. They’re all pooled up in one place and they’re not doing anything. They’ve got nothing but time on their hands. And I don’t have to build a new building? You’re kidding me! This is fantastic! Why wouldn’t I just put therapists in? So we now have treatment programs inside correctional centers.”
Of course a lot of places do programs for inmates. “But what they’re going to show you when you unpack that is, ‘Well, we give them this workbook,’” Smith said. “What they’re not doing is the deep transformative, therapy work that is necessary. And honestly, Paul, our Therapeutic Living Units are probably the best treatment programs we have in Alberta.”
With that, we piled into Smith’s SUV — Smith, Day and the third member of Smith’s team that day, a physician and consultant named Dr. Paul Sobey. A half-hour later we arrived at the Fort Saskatchewan Correctional Centre, northeast of Edmonton.
Here we visited the Therapeutic Living Unit, a full-time addiction-recovery program for 21 women who are housed separately from the general inmate population. That’s about 10% of the total population of women at Fort Saskatchewan. The program opened in February. Participants, who must apply, run through a 12-hour daily program of activity: morning check-in meetings, physical exercise, twice-daily smudge ceremonies reflecting the large Indigenous population in the correctional system, frequent meetings of Alcoholics Anonymous and Narcotics Anonymous as well as the more recently developed SMART Recovery system. Participants are rarely alone during daylight hours. The program is designed to last for months, which struck me as an unusually long time for a recovery program.
Four of the program’s participants sat on a sofa and talked about their experience in the program. “I’ve been wondering and wondering if a program like this was going to happen,” one said.
“It’s like an answered prayer, honestly,” said another. “So I would just encourage you to keep opening places like this.”
That’s the plan. “We’ve got 12 correctional centers in Alberta,” Smith told me before our road trip. “Our goal is to have Therapeutic Living Units [in all of them]. There will come a time where we have whole correctional centers that are working on this model, right? This requires massive intervention, not tinkering around the edges. This is generational change in the way that we do corrections in Alberta.”
Connections
All of the four young women we heard from said they’re nervous about what happens when they get out of detention. Old acquaintances can encourage a return to old habits. Which is part of the reason why Alberta is also building a network of live-in Recovery Communities, long-term residential rehab programs to reinforce the lessons learned in the TLUs — or to help other people begin recovery if they didn’t arrive via the correctional system.
Once the system is fully built in 2027, “every correctional centre will have a sister Recovery Community,” Smith said. “That’s why we’re building 11 of them around the province. Five of them are on First Nations, in partnership with the First Nations.”
Here’s where the system starts to look like a system. After all, in the broadest outlines nothing’s new here. People in prisons have long received addiction counselling, and the Alberta government and various private groups have long run rehabs. But for the longest time, these assorted parts of the system could barely talk to one another. So the chances of a seamless transition from the correctional system to recovery care were lousy. They’re still not great, because the system is still being built, but the goal is a seamless network of care.
“Services in 2018, 2019 were very disconnected,” Warren Driechel, the Edmonton Police Service deputy chief we met the other day, told me. The bureaucratic runaround that we all have to face can be brutal on people with high needs and impaired function. Say you want to get on AISH, an income-support program for people with a medical condition. To do that, you need a doctor’s appointment. To get one, you need identification. To get ID, you need an address.
Public officials are working to provide services that match that complexity.
In January 2021, the EPS launched a “HELP Unit” to refer people to social services instead of just arresting them.
In September 2023, the police replaced the old holding cells where intoxicated people could dry out and then get dumped back on the street with an Integrated Care Centre where they could connect with social services that operate right in the centre.
And in January 2024, after many of the tent encampments were dismantled, a new Navigation and Support Centre became the city’s hub for providing medical, legal and bureaucratic help for people who have often been bereft.
The Nav Centre has nine shelter beds in the back where people can rest, if needed, while on-site staff and volunteers process their files. (Pets are welcome, unlike in some of the city’s shelters.) The centre has the province’s only on-site Service Alberta photo-ID station. On the day I visited, the Nav Centre assisted 50 people, with 24 visiting the desk run by the Hope Mission, 10 being helped by staff from Radius Health, 12 by the provincial department of mental health and addiction.
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Everything old is new
Our final stop was the Lakeview Recovery Community outside Gunn, northwest of Edmonton. When it opens in July, it’ll be the third or fourth in a network of such long-term residential programs. Lethbridge and Red Deer have been open for a while. The goal is to have 11 centres up and running across the province by 2027. Smith hopes that once the full network of centres is open, long wait times in Red Deer and Lethbridge will shrink, perhaps to the point where some beds will be available on-demand.
Each recovery community has its quirks. Lakeview will be for men only. Five of the centres will be on Indigenous land. The minimum stay will be four months, with some residents staying for up to a year. That’s a long stint for a rehab; in some private rehabs, it’s unusual to stay for even a month. In theory every day you spend with a combination of counselling, group therapy, twelve-step programs and medical care will increase your chances of success. No resident will pay for their stay at any recovery community. It’s covered by the government.
Work crews have been renovating the Lakeview site since 2022. It’s an impressive place, roomy and bright, with rooms where residents can meet visiting family, a huge kitchen where residents will learn cooking skills, and a dispensary for opioid agonist treatment. Residents will share bungalows while they’re in the program, five or six to a house.
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But it didn’t just come into existence. What’s now Lakeview began its existence as the McCullough Centre for homeless World War II veterans. It had been operating for years as an addiction rehab centre when Jason Kenney’s government closed it in 2021. When the government announced the site’s eventual reopening barely a year later, observers were baffled. Closing the centre fit a narrative about a government that put the bottom line over Albertans’ wellbeing. Refurbishing and reopening it was.. harder to explain. Fitting it into a network of nearly a dozen such centres that will, themselves, be better connected to street-level services and to the corrections system… well, we’ll see, won’t we?
I’m conscious of ending this installment in my series on opioids in Alberta on an ambivalent note. I simply don’t know how this will turn out. My first article, earlier this week, was about the scale of the challenge. This one is about the scale of the response. It’s impressive. It’s getting attention across the country. Sobey, the physician who was the third member of our little party as we toured the region’s facilities, has a consulting firm whose aim is to design recovery-oriented systems of care to any government that wants to start the conversation. His phone pinged with an inquiry from another provincial government while we were visiting the Fort Saskatchewan prison. These ideas may come soon to a province near you.
What we don’t know yet is whether they’ll work, or how well. In the third and final installment in this series, I’ll discuss a few reasons to reserve judgment.
But what Alberta is trying is, in many ways, not heretical. Nobody thinks it’s great design to leave desperate people to wander helplessly thorugh a piecemeal hodge-podge of social services and treatment options, with police and corrections hovering over it all as an aloof menace. Smith, his boss the premier, and several government departments are trying to build a better system.
There is room for many devils in the details. But if federalism is supposed to be a laboratory for testing different approaches to thorny problems, Alberta is testing this approach ambitiously. Watching Marshall Smith, I found myself wondering what other intractable governance problems could benefit from the sustained attention of an empowered senior staffer, a supportive head of government, and ministers and public servants working in close coordination.
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Alberta and opioids III: You can’t always just stop
