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Alberta

How will Alberta’s new Premier deal with Ottawa? These are the approaches of four leading candidates

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21 minute read

No matter who wins the UCP Leadership race, you can count on a turbulent relationship with Ottawa.  Albertans have long had issues with how the Liberal government stifles the critical Oil and Gas industry.  Now Alberta’s farmers are finding out what that feels like, as the federal government is introducing measures to reduce the amount of nitrogen fertilizer they use.

To add to the level of animosity between the two governments, a growing number of Alberta UCP supporters are voicing dissatisfaction over Covid restrictions and mandates.  This group is active politically, and seems to be rallying behind frontrunner Daniel Smith and likeminded Todd Loewen.  The idea is to avoid future restrictions and mandates provincially, and stand up against any federal measures.

It’s no coincidence then, that the leading candidates in the UCP race all have strong platform initiatives to stand up to Ottawa.  Here’s what they look like, beginning with Danielle Smith’s “Alberta Sovereignty Act.

Danielle Smith – Alberta Sovereignty Act

It is clear that my proposed Alberta Sovereignty Act has thus far been the central issue of the UCP leadership campaign. Tens of thousands of Albertans have embraced the idea of actually standing up to Ottawa’s attacks against us, rather than usual ineffective letter writing campaigns and complaining.

It’s been both exciting and heartwarming to see hope restored to so many in our Province, and I want them to know how much their faith and confidence in this initiative strengthen my personal resolve to see it through.

Unsurprisingly, many in the media and establishment do not support the Alberta Sovereignty Act and have turned to the tried and tested methods of fearmongering and disinformation to discredit the idea. Unfortunately, some of my fellow UCP candidates may have fallen into their trap.

My hope in releasing this FAQ sheet on the Alberta Sovereignty Act, is that more Albertans and MLAs will take a thoughtful look at this policy, and join the growing majority of Albertans who want to see us stand up to Ottawa, restore our constitutional rights, and take control of our future in this manner.

I am sincerely looking forward to implementing this critically important piece of legislation together.

– Danielle Smith

What is the Alberta Sovereignty Act?

A proposed provincial law that would affirm the authority of the Provincial Legislature to refuse enforcement of any Federal law or policy that violates the jurisdictional rights of Alberta under Sections 92 – 95 of the Constitution or that breaches the Charter Rights of Albertans.

How will it be used?

When the Federal Government institutes a law or policy that appears to violate the constitution or Charter, the Government of Alberta may introduce a Special Motion for a free vote of all MLAs in the Legislature. The Special Motion would include the following:

1. Identification of the Federal law or policy that it deems to be in violation of the Constitution

2. An Outline of the specific harms that violation of the Constitution imposes on the citizens of Alberta

3. Description of the specific actions the Province will take to refuse the enforcement of that Federal law or policy in Alberta

4. A Declaration that by authority of the Alberta Sovereignty Act and notwithstanding the specific Federal law or policy in question, it shall not be enforced by the Provincial Government within Alberta in the manner outlined by the Special Motion

5. Imposition a specific time frame (no more than 24 months) by which the Special Motion will be reviewed in the Legislature

Will a Premier or Governing Party be able to refuse enforcement of any Federal Law or Policy they don’t like?

No, the Alberta Sovereignty Act may not be used unless specifically authorized by way of a free vote of all elected MLAs in the Alberta Legislature, as explained above.

What examples of Federal Laws will the Alberta Sovereignty Act be applied to?

Examples could include:

– Federal mandatory vaccination policies – Charter violation

– Use of Emergencies Act to jail & freeze accounts of peaceful protesters – Charter violation

– Bill C-69 ‘No New Pipelines’ Law – found unconstitutional by Alberta Court of Appeal

– Mandatory cuts to fertilizer use by Alberta Farmers – violation of s.95

– Mandatory emissions and production cuts to Alberta energy projects – violation of s.92A

– Federal gun grabs – violation of s.92(13)

Is the Alberta Sovereignty Act about Separation from Canada?

No, the entire objective of the Alberta Sovereignty Act is to assert Alberta’s Constitutional Rights within Canada to the furthest extent possible by effectively governing itself as a Nation within a Nation, just as Quebec has done for decades and as Saskatchewan is also now considering.

If anything, the restoration of provincial rights and autonomy of every province from the destructive overreach of Ottawa is likely the only viable way for Canada to survive and flourish into the future. Ottawa’s “divide, control and conquer’ policies have Canada on a path of division and disunity. Alberta can and must lead on this issue going forward.

Is the Alberta Sovereignty Act illegal or does it run contrary to the rule of law?

No, just the opposite.

Over the last several years the Federal Government has triggered a constitutional crisis through repeated lawless attacks on provincial constitutional rights and the Charter.

The Trudeau Government has effectively imposed economic sanctions against Alberta (and parts of Saskatchewan and BC) that have resulted in economic chaos.

Hundreds of billions in investment and tax revenues, and hundreds of thousands of jobs, have been lost to these sanctions as investors around the world find it too risky to do business in Alberta’s energy industry. In fact, no new major development of our world class oil sands has been commenced in almost 20 years as a result.

The idea expressed by some UCP leadership candidates that the Alberta Sovereignty Act would “cause chaos” in the markets is naive in the extreme. The “chaos” is already here and has been caused by both Ottawa’s unlawful policies and an utter lack of provincial leadership on effectively pushing back against those attacks.

The fact is the Alberta Sovereignty Act reimposes constitutional rule of law on a lawless Ottawa by reaffirming the critical import of respecting the powers and jurisdiction of the Provinces under the Canadian Constitution.

 

Brian Jean – Autonomy For Albertans Act

I started with policies designed to change how Alberta reacts to the federal government and Canada. I want us to stop being defensive and go on the offensive. We have to stop covering up and we have to take the fight to Canada. 

The five sets of actions that will protect and enhance Alberta’s Autonomy Within Canada are:

  1. Serve legal notice invoking section 46 of the Constitution and force Trudeau and the Premiers into negotiations.
  2. Stipulate that Alberta government-funded groups will not be able to participate in the WEF.
  3. Use the courts to challenge the tanker ban, the proposed oil production caps, and the fertilizer caps.
  4. Demand the Quebec government stop taking the assets of Alberta energy companies in Quebec and get their attention by acting against SNC Lavalin.
  5. Demand that Alberta be given Canada’s seat on important international energy institutions, just like Quebec gets Canada’s seat at UN cultural institutions.
These actions and this approach is very different than how Alberta has traditionally acted. This is very different from what the other leadership candidates are proposing. First this is about acting, about doing something. The “Alberta Sovereignty Act” proposal is purely defensive and reactive. Instead of saying to Canada “we won’t enforce your rules if you come after us,” I am saying that we need to take the initiative.
The Constitution has not been opened in 30 years.
My proposals are about taking ACTION and going on the offense. Danielle Smith proposes a purely defensive strategy that surrenders on past fights. Travis Toews has no strategy at all in this area — he wants to continue Jason Kenney’s practice of writing stern and meaningless letters whenever we get stepped on.
When we open the Constitution, we can deal with the issues of: pipelines and right-of-ways, access to tidewater, stopping provinces and the federal government from landlocking provinces, and democratic under-representation. Taking the fight to the rest of Canada is the way to actually get results and reverse the damage.
Passing an unconstitutional “Sovereignty Act” that only kicks in the next time we are punched doesn’t change anything. It will likely encourage Trudeau to hit Alberta harder.
Fighting the efforts of the World Economic Forum to change our society is something Alberta should have been doing all along.
No $$ to WEF
As is using the courts intelligently including as a way to get expert testimony into the record in important legal debates. 
Fight the tanker ban, the production caps, and the fertilizer caps
Fighting back against the insults of Quebec and the federal government should have always been our policy. Instead under Jason Kenney we too often gave away things hoping that other provinces would return the favour. They did not.
We play tit for tat with Quebec.
Finally, we should learn from Quebec and have our position in the world recognized by Canada. Alberta is an energy superpower and it should own Canada’s seat at the global table whenever energy issues are discussed. 
We get the Energy seat.

Travis Toews – Toews’ Strategy to Strengthen Alberta

I’m running to ensure our children and grandchildren have the same kind of opportunities and freedoms that Kim and I have been blessed with.

We must strengthen Alberta’s place in Canada and win meaningful reforms. Threats and sternly worded letters aren’t enough, and radical actions that create chaos will only set us back.

I have a real plan that uses our economic and fiscal strength to our advantage. A plan that is strategic. A plan that will get us results.

Here’s my plan to strengthen Alberta:

1. REFORM EQUALIZATION AND FISCAL STABILIZATION.

  • The Fiscal Stabilization program supports provinces experiencing a sudden drop in revenue. These stabilization payments are capped at a low level. As Finance Minister, I led negotiations to raise the cap by $500 million for Albertans. I will continue working to increase this cap.
  • The equalization formula expires in 2024 and I’ll fight to ensure it is renegotiated for fairness, rather than simply being renewed like it was in 2014 and 2019.

2. LAY THE GROUNDWORK AND BUILD SUPPORT AMONG ALBERTANS TO OPT-IN TO AN ALBERTA PENSION PLAN.

  • I’ve always believed that an Alberta Pension Plan holds great promise for Albertans. As Finance Minister, this file was on my desk and I’m convinced an Alberta Pension Plan is an incredible opportunity for the province. If we’re going to win on this critical opportunity, it must be handled strategically in methodology, approach, and timing. We can’t afford to lose, and if this is not done right, we could lose this transformative opportunity for future generations.
  • I will make the case with Albertans for a provincial pension plan. I’m confident we will see this is a transformative opportunity for us to gain autonomy, lower premiums, increase pension benefits, boost our financial sector, and have a more reliable pension long-term.

3. SHIFT TAX POWER FROM THE FEDERAL GOVERNMENT TO PROVINCIAL GOVERNMENTS. 

  • I’ll work with other Premiers to shift the tax power from the federal government to provincial governments. This allows provinces to have the tax capacity to deliver services like childcare, pharma care, and dental care. It would provide Albertans with more autonomy, and make it easier for us to deliver high quality services to all Albertans while balancing the budget.

4. DEFEND AND ADVANCE ALBERTA’S KEY ECONOMIC SECTORS LIKE ENERGY AND AGRICULTURE.

  • Energy and agriculture are the lifeblood of many Alberta communities. My wife Kim and I know this well from our ranching operation and oilfield service company.
  • To back Alberta’s energy and agricultural sectors against Ottawa’s targeted attacks, as Premier I would:
    • Pass enabling legislation so that when Ottawa attacks Alberta’s economy we have a potential suite of targeted levies on goods and contracts we can begin to apply and escalate as needed.
    • Use my experience as an international trade negotiator to lead on the energy file by engaging American and foreign leaders directly.
    • Continue supporting the ongoing legal challenge against C-69 the “No more pipelines act”.
    • Work with Saskatchewan and Manitoba to expand the Port of Churchill to get our energy and agriculture products to world markets.
    • Ensure Ottawa’s climate policies treat all heavy emitters equally instead of targeting Albertans. We can be environmental leaders without impoverishing our future.
    • Enhance the Alberta Indigenous Opportunities Corporation so that more Indigenous communities can be full partners in responsible prosperity.

5. EXPLORE AN ALBERTA PROVINCIAL POLICE SERVICE WITH RURAL ALBERTANS AND MUNICIPAL LEADERS.

  • Kim and I have experienced multiple thefts in our businesses over the years. I know rural crime is a large problem. I am committed to increasing safety for all Albertans by improving policing services.
  • I have deep respect for the RCMP and the work they do to provide safety to Albertans. I also believe there is merit in exploring a provincial police service. This could reduce bureaucracy and lead to an improved culture in the policing service.
  • This is not a policy I would implement on day one. Before moving forward, I would ensure rural Albertans and municipal leaders ultimately support the decision.

 

Rebecca Schulz – 100 DAY PROVINCIAL RIGHTS STRATEGY

A Schulz government would immediately start the 100 Day Provincial Rights Action Plan, with clear steps – and a timeline – to fight, negotiate, partner, and strengthen Alberta’s position with Confederation.

No more letters, no more panels, and no more empty threats – Albertans want action and results when it comes to defending our rights in confederation and seeing our province reach its full potential.” – Rebecca Schulz 

Within the first 10 days, a Schulz government will appoint a Deputy Premier and team with the primary focus to act as Alberta’s lead negotiators in strengthening Alberta’s position in Canada.

This will include:

  1. Presenting the federation with a package of common sense reforms on equalization, fiscal stabilization, and greater provincial control over programs through tax points
  2. Presenting the federation with a list of federal, provincial overlap in regulations/policy and begin negotiations on disentanglement
  3. Pursuing an Alberta Pension Plan, Alberta Employment Insurance and an Alberta Revenue Agency

Within the first 50 days, Schulz and the Deputy Premier would present a Provincial Rights

Framework, to identify every legal and constitutional measure possible to stand up against Ottawa’s continued attacks on provincial jurisdiction.

This will include:

  1. Calling for a Protecting Provincial Rights Summit to bring provinces to the table and identify every measure to stand up for jurisdictional rights against federal interference
  2. Continuing the fight against the Tanker Ban (C-48) and Trudeau’s No-More Pipelines legislation (C-69), alongside all 10 provinces
  3. Taking every proactive legal measure possible against Trudeau’s federal emissions and fertilizer caps.

Within the first 100 days, Schulz and the Deputy Premier would present a new Market Access Plan to create political and economic incentives for federal and provincial governments to negotiate with Alberta in good faith for improved trade and market access.

This will include:

  1. Identifying strategic actions to deter other provinces or levels of government from limiting Alberta’s market access and trade
  2. Developing criteria for when Alberta will Turn off the Taps through the Preserving Canada’s Economic Prosperity Act.

“You don’t need to spend weeks on the campaign trail to understand how frustrated Albertans are of being pushed around. The emissions and fertilizer caps are just two of the most recent examples of governments interfering with our provincial trade and prosperity. It’s about time Albertans were presented with a real plan to take action.” – Rebecca Schulz

 

After 15 years as a TV reporter with Global and CBC and as news director of RDTV in Red Deer, Duane set out on his own 2008 as a visual storyteller. During this period, he became fascinated with a burgeoning online world and how it could better serve local communities. This fascination led to Todayville, launched in 2016.

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Alberta

Alberta gets credit boost because of budget discipline

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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

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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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