From the Fraser Institute

By Jake Fuss and Grady Munro

On Tuesday in Ottawa, Prime Minister Mark Carney unveiled his new cabinet, consisting of 28 ministers and 10 secretaries of state. They have their work cut out for them. In addition to President Trump’s trade war, the Carney government must tackle several other critical issues that have persisted since long before Trump was re-elected.

First and foremost, the Carney government should address stagnant living standards for Canadians. From the beginning of 2016 to the end of 2024, per-person GDP—a broad measure of living standards—grew by only 2.5 per cent in Canada compared to 18.7 per cent in the United States (all figures adjusted for inflation). While U.S. tariffs threaten to further reduce living standards in Canada, the marked decline began almost a decade ago.

There’s a similar gloomy story in worker incomes as Canadians continue to fall further behind their American counterparts. According to the latest data, median employment earnings (in Canadian dollars) in all 10 provinces ranked lower than in every U.S. state in 2022—meaning Americans in low-earning states such as Mississippi ($42,430), Louisiana ($43,318) and Alabama ($43,982) typically earned higher incomes than Canadians in the highest-earning province of Alberta ($38,969).

Why is this happening?

Part of the problem is the state of federal finances. Even Prime Minister Carney has criticized the Trudeau government’s approach to spending increases and debt accumulation, which diverts taxpayer dollars away from programs and towards debt interest payments, and burdens younger generations with higher taxes in the future. But unfortunately, according to Carney’s election platform, his government plans to borrow $93.4 billion more over the next four years compared to the Trudeau government’s last spending plan. The prime minister and his new cabinet should rethink this approach before tabling their first budget.

The Carney government should also cut taxes. Canadians in every province face higher combined (federal and provincial) personal income tax (PIT) rates than Americans in virtually every U.S. state across a variety of income levels. Canada’s PIT rates are similarly uncompetitive compared to other advanced countries. High taxes impose a burden on families, but they also make it harder for Canada to attract and retain high-skilled workers (e.g. doctors, engineers), entrepreneurs and investment, which drives economic growth and prosperity.

Finally, the Carney government should meaningfully address Canada’s housing affordability crisis. Housing costs have risen dramatically due to a significant gap between the demand for houses and the supply of housing units. In 2024, construction began on 245,367 new housing units nationwide while the population grew by 951,717 people due in part to one of the highest levels of immigration in Canadian history. This problem has been growing for decades—housing starts per year have remained stuck at essentially the same level they were in the 1970s while annual population growth has more than tripled. If policymakers want to help lower housing costs, they must reduce the imbalance between population growth and housing starts.

For the federal government, that means aligning immigration targets more closely to housing supply and rethinking policies that increase housing demand such as homebuyer tax credits and First Home Savings Accounts. Meanwhile, provincial and local governments should reduce red tape and construction costs to increase supply.

The Carney government has its work cut out for it. Besides U.S. tariffs, Canadians face several critical issues, which have persisted long before Trump was re-elected, and will continue unless something changes.

Jake Fuss

Director, Fiscal Studies, Fraser Institute

Grady Munro

Policy Analyst, Fraser Institute

By Adam Zivo

Harm-reduction activists claim evidence supports “safer supply,” but their studies don’t back that up.

Canada, where I call home, is the only jurisdiction in the world that hands out free addictive drugs to addicts. Under the “safer-supply” policy, Canadian health authorities distribute hydromorphone—an opioid as potent as heroin—as well as, to a lesser degree, oxycodone, pharmaceutical fentanyl, and mild stimulants. These drugs are provided at no cost and, until recently, rarely had to be consumed under medical supervision.

Some American harm-reduction activists claim that Canada’s experience—and studies of it—prove that safer supply saves lives. In reality, the studies they cite are deeply flawed. They rely on weak methodologies, including biased interviews and self-reported surveys, and fail to isolate the effects of safer supply from those of other interventions. U.S. policymakers should not let such shaky evidence justify similarly misguided policies at home.

Canada piloted safer supply in 2016 with no evidence that it worked. Some clinical trials suggested that administering pharmaceutical-grade heroin under careful medical supervision could stabilize severely addicted drug users. But advocates took this evidence and claimed that it supported their safer-supply experiment, despite crucial dissimilarities—the most important being the lack of witnessed consumption.

Over the following years, radical activist-scholars produced numerous evaluations and studies declaring that safer supply “saves lives” and improves recipients’ quality of life. As Canada expanded program access nationwide in 2020, policymakers latched on to this “evidence-based” experiment, condemning critics as anti-science.

This evidence is predominantly composed of qualitative studies, which rely not on data but on interviews with safer-supply recipients and providers. The interviewees naturally say that the program is wonderful and has few downsides. Advocates then frame these responses as objective evidence of success.

Notably, the studies never reach out to those who might provide negative evaluations of safer supply—doctors, addicts uninvolved with these programs, or individuals newly in recovery. Addiction experts throughout Canada have dismissed these studies as glorified customer testimonials.

Some studies involve surveys, converting patient responses into quantitative data that can be statistically analyzed. For example, the London InterCommunity Health Centre (LIHC), one of Canada’s leading safer-supply prescribers, publishes survey-based evaluations that claim approximately half of its patients reduced their fentanyl consumption after enrollment. This quantitative method does not change the unreliability of self-reported data, however, and there’s nothing that keeps patients from giving false answers if it suits their interests.

A 2024 study conducted by Brian Conway, director of Vancouver’s Infectious Disease Centre, indirectly validated these criticisms. The study distributed surveys to 50 of his safer-supply patients and then collected urine samples immediately afterward. Conway discovered that, while only 4 percent of these patients self-reported diverting (selling or trading) all their safer-supply hydromorphone, 24 percent had no hydromorphone in their urine. That suggests a significant portion of patients lied on their surveys.

A few studies use administrative health data to show that enrollment in federally funded safer-supply programs correlates with improved health outcomes. But these studies make no effort to determine whether the free drugs themselves are responsible. The real driver could be the extensive wraparound services the programs offer, such as housing assistance and access to primary care. It’s like giving an obese man a personal trainer and a daily slice of cake—and then, when he loses weight, crediting the cake.

Last year, the British Columbia Centre for Disease Control (BCCDC) published a study in the British Medical Journal examining the health data of 5,882 drug users over an 18-month period between 2020 and 2021. The study found that individuals who received safer-supply opioids were 61 percent less likely to die over the following week than those who didn’t. This number rose to 91 percent for those receiving safer-supply opioids for four or more days in a single week.

Encouraging, right? But not so fast. When a team of seven addiction physicians reviewed the study, they discovered that the researchers misrepresented their data. Safer-supply patients are often co-prescribed traditional addiction medications, such as methadone and Suboxone, that have long been proven to reduce overdoses and deaths (these medications are often referred to as opioid agonist therapy, or OAT). The study data showed that safer-supply patients who did not also receive OAT medications were just as likely to die as those who did not get safer supply. In other words, the benefits that the BCCDC researchers touted were likely driven primarily by OAT, not safer supply.

The study data also showed no significant mortality reductions after one year of accessing safer supply. One wonders why the researchers chose to fixate on the one-week follow-up numbers.

Most recently, a study published in JAMA Health Forum found that, between 2020 and 2022, British Columbia’s safer-supply policy was associated with a 33 percent increase in opioid hospitalizations and no change to drug-related mortality. The researchers arrived at this conclusion by comparing the province’s publicly available health data with data from a control group made up of a handful of other Canadian provinces. The study raised further doubts about safer supply’s scientific basis.

Over the past two years, Canadian policymakers have openly, if reluctantly, acknowledged that safer supply is not as well-supported as they once claimed. British Columbia’s 2023 safer supply fentanyl protocols clearly state, for example, that “there is no evidence available supporting this intervention, safety data, or established best practices for when and how to provide it.” Similarly, the province’s top doctor released a report in early 2024 admitting that the experiment is “not fully evidence based.” Just last autumn, the Canadian Research Initiative in Substance Matters acknowledged in a major presentation that safer supply is supported by “essentially low-level evidence.”

This about-face has been hastened by investigative media reports confirming that safer-supply drugs were being diverted to the black market, enriching organized crime and corrupt pharmacies in the process. Public support for the policy has apparently declined, as once-taboo criticism becomes normalized among Canadian politicians and commentators. The Canadian federal government has now quietly defunded its safer-supply programs (though independent prescribers still operate), while British Columbia mandated earlier this year that all safer-supply drugs be consumed under supervision.

Harm-reduction activists nonetheless maintain that the blowback against safer supply represents a “moral panic,” and that politics is overriding evidence-based policymaking. “Safer supply saves lives! Follow the science!” they insist. International policymakers, especially in the United States, should see through these misrepresentations.