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2025 Federal Election

Study links B.C.’s drug policies to more overdoses, but researchers urge caution

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8 minute read

By Alexandra Keeler

A study links B.C.’s safer supply and decriminalization to more opioid hospitalizations, but experts note its limitations

A new study says B.C.’s safer supply and decriminalization policies may have failed to reduce overdoses. Furthermore, the very policies designed to help drug users may have actually increased hospitalizations.

“Neither the safer opioid supply policy nor the decriminalization of drug possession appeared to mitigate the opioid crisis, and both were associated with an increase in opioid overdose hospitalizations,” the study says.

The study has sparked debate, with some pointing to it as proof that B.C.’s drug policies failed. Others have questioned the study’s methodology and conclusions.

“The question we want to know the answer to [but cannot] is how many opioid hospitalizations would have occurred had the policy not have been implemented,” said Michael Wallace, a biostatistician and associate professor at the University of Waterloo.

“We can never come up with truly definitive conclusions in cases such as this, no matter what data we have, short of being able to magically duplicate B.C.”

Jumping to conclusions

B.C.’s controversial safer supply policies provide drug users with prescription opioids as an alternative to toxic street drugs. Its decriminalization policy permitted drug users to possess otherwise illegal substances for personal use.

The peer-reviewed study was led by health economist Hai Nguyen and conducted by researchers from Memorial University in Newfoundland, the University of Manitoba and Weill Cornell Medicine, a medical school in New York City. It was published in the medical journal JAMA Health Forum on March 21.

The researchers used a statistical method to create a “synthetic” comparison group, since there is no ideal control group. The researchers then compared B.C. to other provinces to assess the impact of certain drug policies.

Examining data from 2016 to 2023, the study links B.C.’s safer supply policies to a 33 per cent rise in opioid hospitalizations.

The study says the province’s decriminalization policies further drove up hospitalizations by 58 per cent.

“Neither the safer supply policy nor the subsequent decriminalization of drug possession appeared to alleviate the opioid crisis,” the study concludes. “Instead, both were associated with an increase in opioid overdose hospitalizations.”

The B.C. government rolled back decriminalization in April 2024 in response to widespread concerns over public drug use. This February, the province also officially acknowledged that diversion of safer supply drugs does occur.

The study did not conclusively determine whether the increase in hospital visits was due to diverted safer supply opioids, the toxic illicit supply, or other factors.

“There was insufficient evidence to conclusively attribute an increase in opioid overdose deaths to these policy changes,” the study says.

Nguyen’s team had published an earlier, 2024 study in JAMA Internal Medicine that also linked safer supply to increased hospitalizations. However, it failed to control for key confounders such as employment rates and naloxone access. Their 2025 study better accounts for these variables using the synthetic comparison group method.

The study’s authors did not respond to Canadian Affairs’ requests for comment.

 

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Correlation vs. causation

Chris Perlman, a health data and addiction expert at the University of Waterloo, says more studies are needed.

He believes the findings are weak, as they show correlation but not causation.

“The study provides a small signal that the rates of hospitalization have changed, but I wouldn’t conclude that it can be solely attributed to the safer supply and decrim[inalization] policy decisions,” said Perlman.

He also noted the rise in hospitalizations doesn’t necessarily mean more overdoses. Rather, more people may be reaching hospitals in time for treatment.

“Given that the [overdose] rate may have gone down, I wonder if we’re simply seeing an effect where more persons survive an overdose and actually receive treatment in hospital where they would have died in the pre-policy time period,” he said.

The Nguyen study acknowledges this possibility.

“The observed increase in opioid hospitalizations, without a corresponding increase in opioid deaths, may reflect greater willingness to seek medical assistance because decriminalization could reduce the stigma associated with drug use,” it says.

“However, it is also possible that reduced stigma and removal of criminal penalties facilitated the diversion of safer opioids, contributing to increased hospitalizations.”

Karen Urbanoski, an associate professor in the Public Health and Social Policy department at the University of Victoria, is more critical.

“The [study’s] findings do not warrant the conclusion that these policies are causally associated with increased hospitalization or overdose,” said Urbanoski, who also holds the Canada Research Chair in Substance Use, Addictions and Health Services.

Her team published a study in November 2023 that measured safer supply’s impact on mortality and acute care visits. It found safer supply opioids did reduce overdose deaths.

Critics, however, raised concerns that her study misrepresented its underlying data and showed no statistically significant reduction in deaths after accounting for confounding factors.

The Nguyen study differs from Urbanoski’s. While Urbanoski’s team focused on individual-level outcomes, the Nguyen study analyzed broader, population-level effects, including diversion.

Wallace, the biostatistician, agrees more individual-level data could strengthen analysis, but does not believe it undermines the study’s conclusions. Wallace thinks the researchers did their best with the available data they had.

“We do not have a ‘copy’ of B.C. where the policies weren’t implemented to compare with,” said Wallace.

B.C.’s overdose rate of 775 per 100,000 is well above the national average of 533.

Elenore Sturko, a Conservative MLA for Surrey-Cloverdale, has been a vocal critic of B.C.’s decriminalization and safer supply policies.

“If the government doesn’t want to believe this study, well then I invite them to do a similar study,” she told reporters on March 27.

“Show us the evidence that they have failed to show us since 2020,” she added, referring to the year B.C. implemented safer supply.


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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2025 Federal Election

Protestor Behind ‘Longest Ballot’ Chaos targeting Poilievre pontificates to Commons Committee

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The Opposition with Dan Knight

Dan Knight's avatar Dan Knight

Lawmakers confront organizer Tomas Szuchewycz for flooding ridings with placeholder candidates, targeting Pierre Poilievre’s seat, and wasting public resources.

A House of Commons committee hearing erupted into pointed exchanges Tuesday as MPs pressed Tomas Szuchewycz, the man behind the Longest Ballot Committee (LBC), a fringe protest group that set out to disrupt Canada’s federal election by nominating dozens of placeholder candidates in single ridings.

Szuchewycz’s most notorious move came in Carleton — the riding of Conservative Leader Pierre Poilievre, where the ballot swelled to 91 names, stretching nearly a metre and forcing Elections Canada to redesign how it printed and handled the vote. The LBC framed the stunt as a protest against Canada’s first-past-the-post electoral system. But to most voters, it looked nothing like a principled reform campaign. What they saw was an effort aimed squarely at Poilievre, meant to bury his name among a wall of nobodies and turn the vote into a farce.

Elections Canada had to scramble to manage the chaos: printing extra‑long ballots, re‑training workers, and creating a last‑minute write‑in workaround in Battle River–Crowfoot to keep ballots usable. Seniors and disabled voters complained about the physical size and complexity of the ballot; poll workers faced new logistical headaches; public money was wasted.

At Tuesday’s hearing, Szuchewycz showed no contrition and offered no practical alternative to the system he had tried to upend. Instead, he accused MPs of having a “conflict of interest” in writing election law and demanded that power be handed to an undefined “permanent, non‑partisan body” — without explaining who would select it, how it would operate, or how it would be accountable to Canadians.

The LBC, whose actions led to metre-long ballots in ridings like Carleton (91 candidates) and Battle River–Crowfoot (86), claims to oppose Canada’s first-past-the-post system. But when asked how his proposed independent reform body would be formed, selected, or held accountable, Szuchewycz had no answers.

Conservative MP Michael Cooper led the charge, accusing Szuchewycz of overseeing a signature-harvesting scheme that involved electors signing blank nomination forms—potentially in violation of the Canada Elections Act. He tabled a January 2024 tweet and an August 2024 YouTube video showing organizers gathering signatures under the claim that candidate names would be “filled in later.”

Szuchewycz denied the accusation, claiming nomination papers had either candidate names or the phrase “all candidates” filled in. But when he tried to discredit Cooper’s evidence by calling it “AI-generated,” the committee chair issued a warning for casting doubt on the authenticity of a Member’s documents without basis. The comment was withdrawn under pressure.

Still, Cooper was unsatisfied, warning Szuchewycz that misleading Parliament could amount to contempt.

Other witnesses—experts and former elected officials—were equally critical of the LBC’s tactics. Dr. Lori Turnbull, a professor at Dalhousie University, called the stunt “undesirable” and a “waste of resources,” though she praised Elections Canada for adapting quickly by allowing a write-in workaround in Battle River–Crowfoot to avoid printing a literal wall of names.

Professor Peter Loewen of Cornell University added that the LBC’s ballot-stuffing “violates the spirit” of competitive democracy and burdens front-line elections staff with unnecessary logistical chaos. He warned that a third-party group acting like a political party without oversight was a loophole that needed closing.

Meanwhile, former Liberal MP Louis-Philippe Sauvé described the real-world toll of the stunt: longer lineups, stressed poll workers, and accessibility hurdles for elderly and visually impaired voters.

In stark contrast to these grounded critiques, Szuchewycz’s testimony revolved around vague accusations of “conflict of interest” by MPs and a call to remove Parliament from electoral reform altogether. No constitutional roadmap. No governance model. No practical enforcement mechanism.

At the end of the day, what Tomas Szuchewycz has done isn’t just a stunt, it’s an insult. He claims Canadians “know what he’s protesting,” but let’s be honest: most voters had no clue this was about electoral reform. What they saw was a campaign to flood ballots with nonsense names in key ridings, especially against the Leader of the Opposition, and create chaos for chaos’s sake.

The takeaway wasn’t a conversation about democracy. It was a spectacle, and one that mocked the very voters he pretends to represent. Lets be clear, This wasn’t activism, it was ego masquerading as principle. And it reeked of entitlement.

Tomas Szuchewycz is the embodiment of unchecked privilege: a man who hijacked our electoral process, wasted taxpayer dollars, and offered nothing in return but smug contempt for the very democracy that gave him the space to pull his stunt.

He claims Canadians understood his message. They didn’t. Most people saw a confusing mess, an attack on the Opposition Leader, and a joke made at the expense of voters, poll workers, and the electoral system itself.

So yes — reform is coming. And it can’t come soon enough.
Parliament must not just close the loopholes it should make sure that when someone deliberately sabotages the integrity of an election, they are held accountable, including being forced to repay the public for the cost of their chaos.

Because in a democracy, you have the right to protest.
But not the right to turn an election into a farce on the public’s dime.

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2025 Federal Election

Post election report indicates Canadian elections are becoming harder to secure

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The Opposition with Dan Knight

Dan Knight's avatar Dan Knight

Chief Electoral Officer Stéphane Perrault highlights strong participation and secure voting, but admits minority politics, rising costs, and administrative pressures are testing the system’s limits.

Monday in Ottawa, Stéphane Perrault, Canada’s Chief Electoral Officer, delivered a long press conference on April’s federal election. It was supposed to be a victory lap, record turnout, record early voting, a secure process. But if you listened closely, you heard something else: an admission that Canada’s election machinery is faltering, stretched thin by a system politicians refuse to fix.

Perrault touted the highest turnout in 30 years, 69 percent of eligible voters, nearly 20 million Canadians. Almost half of those ballots were cast before election day, a dramatic shift in how citizens take part in democracy.

“Twenty years ago, less than 7% voted early. This year, nearly half did,” Perrault told reporters. “Our system may have reached its limit.”

That’s the core problem. The system was built for one decisive day, not weeks of advance voting spread across campuses, long-term care homes, mail-in ballots, and local Elections Canada offices. It’s no longer a single event; it’s an extended process that stretches the capacity of staff, polling locations, and administration.

Perrault admitted bluntly that the 36-day writ period, the time between when an election is called and when the vote happens, may no longer be workable. “If we don’t have a fixed date election, the current time frame does not allow for the kind of service preparations that is required,” he said.

And this is where politics collides with logistics. Canada is once again under a minority government, which means an election can be triggered at almost any moment. A non-confidence vote in the House of Commons, where opposition parties withdraw support from the government, can bring down Parliament in an instant. That’s not a flaw in the system; it’s how parliamentary democracy works. But it leaves Elections Canada on permanent standby, forced to prepare for a snap election without knowing when the writ will drop.

The result? Sixty percent of voter information cards were mailed late this year because Elections Canada couldn’t finalize leases for polling stations on time. Imagine that, more than half the country got their voting information delayed because the system is clogged. And that’s when everything is supposedly working.

The April election cost an estimated $570 million, almost identical to 2021 in today’s dollars. But here’s the kicker: Elections Canada also spent $203 million just to stay ready during three years of minority Parliament. That’s not democracy on the cheap. That’s bureaucracy on retainer.

Perrault admitted as much: “We had a much longer readiness period. That’s the reality of minority governments.”

No Foreign Interference… But Plenty of ‘Misinformation’

Canada’s top election official wanted to make something perfectly clear: “There were no acts of foreign interference targeting the administration of the electoral process.” That’s the line. And it’s a good one… reassuring, simple, the kind of phrase meant to make headlines and calm nerves.

But listen closely to the wording. He didn’t say there was no interference at all. He said none of it targeted the administration of the vote. Which raises the obvious question: what interference did occur, and who was behind it?

Perrault admitted there was “more volume than ever” of misinformation circulating during the 2025 election. He listed the greatest hits: rumors that Elections Canada gives voters pencils so ballots can be erased, or claims that non-citizens were voting. These are hardly new — they’ve appeared in the U.S. and in Europe too. The difference, he said, is scale. In 2025, Canadians saw those narratives across more channels, more platforms, more communities than ever before.

This is where things get interesting. Because the way Perrault framed it wasn’t that a rogue actor or a foreign intelligence service was pushing disinformation. He was blunt: this was a domestic problem as much as anything else. In his words, “whether foreign or not,” manipulation of information poses the “single biggest risk to our democracy.”

Perrault insists the real danger isn’t foreign hackers or ballot-stuffing but Canadians themselves, ordinary people raising questions online. “Information manipulation, whether foreign or not, poses the single biggest risk to our democracy,” he said.

Well, maybe he should look in the mirror. If Canadians are skeptical of the system, maybe it’s because the people running it haven’t done enough to earn their trust. It took years for Ottawa to even acknowledge the obvious , that foreign actors were meddling in our politics long before this election. Endless commissions and closed-door reports later, we’re told to stop asking questions and accept that everything is secure.

Meanwhile, what gets fast-tracked? Not a comprehensive fix to protect our democracy, but a criminal investigation into a journalist. Keean Bexte, co-founder of JUNO News, is facing prosecution under Section 91(1) of the Canada Elections Act for his reporting on allegations against Liberal candidate Thomas Keeper. The maximum penalty? A $50,000 fine and up to five years in prison. His reporting, incidentally, was sourced, corroborated, and so credible that the Liberal Party quietly dropped Keeper from its candidate list.

If people doubt the system, it isn’t because they’re gullible or “misinformed.” It’s because the government has treated transparency as an afterthought and accountability as an inconvenience. And Perrault knows it. Canadians aren’t children to be scolded for asking questions, they’re citizens who expect straight answers.

But instead of fixing the cracks in the system, Ottawa points the finger at the public. Instead of rebuilding trust, they prosecute journalists.

You don’t restore faith in democracy by threatening reporters with five years in prison. You do it by showing, quickly and openly, that elections are beyond reproach. Until then, spare us the lectures about “misinformation.” Canadians can see exactly where the problem lies, and it isn’t with them.

The Takeaway

Of course, they’re patting themselves on the back. Record turnout, no servers hacked, the trains ran mostly on time. Fine. But what they don’t want to admit is that the system barely held together. It was propped up by 230,000 temporary workers, leases signed at the last minute, and hundreds of millions spent just to keep the lights on. That’s not stability. That’s triage.

And then there’s the lecturing tone. Perrault tells us the real threat isn’t incompetence in Ottawa, it’s you, Canadians “sharing misinformation.” Excuse me? Canadians asking questions about their elections aren’t a threat to democracy, they are democracy. If the government can’t handle people poking holes in its story, maybe the problem isn’t the questions, maybe it’s the answers.

So yes, on paper, the 2025 election looked like a triumph. But listen closely and you hear the sound of a system cracking under pressure, led by officials more interested in controlling the narrative than earning your trust. And when the people running your elections think the real danger is the voters themselves? That’s when you know the elastic isn’t just stretched. It’s about to snap.

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