Calgary·Analysis

UCP celebrated Alberta's declining opioid death rates as proof its approach worked. Deaths are up. Now what?

A toxic street supply of opioids has helped make April the province's deadliest month on record. As the reality of Alberta's opioid crisis shifts, Danielle Smith seems uninterested in changing her plan.

Danielle Smith remains opposed to safe supply as toxic drug supply worsens crisis

A man waits to enter a supervised consumption site.
A man waits to enter the Safeworks supervised consumption site in Calgary in 2021. Alberta's death toll from opioid use in April was worse than any month since the province began tracking drug fatalities in 2016. (Jeff McIntosh/The Canadian Press)

For roughly a year, whenever Alberta's minister for addictions or his spokesperson commented on the tragedy of Albertans killed by opioid overdoses, they consistently did so in a sentence's subordinate clause — bracketed by a "while," before veering into positive messaging.

"While every loss of life is tragic, we are cautiously optimistic after seeing fatalities decrease in Alberta in March," then-Associate Minister Mike Ellis said in a news release early last year, acknowledging the deaths of 120 people.

"While every life lost to addiction is one too many, the steady decline in opioid deaths in Alberta is a positive sign and we are optimistic it will continue," Ellis stated last fall, in a news release that reported 92 deceased Albertans in July because of the opioid scourge.

"While each life lost to addiction is one too many, we are cautiously optimistic about the continued downward trend since the peak in late 2021," the spokesman for Ellis' successor Nick Milliken told Global News, regarding 121 people losing their lives from opioid poisoning last November.

The aide gave the exact statement, verbatim, to the Edmonton Journal this past spring, upon confirmation of 110 deaths in January.

On the bright side, officials kept saying, things weren't as bad as they got during the fourth wave of COVID, when opioids killed 173 Albertans in November 2021 (and then 175 the following month, revised stats now say.)

The tone has now shifted. How could it not? The trend UCP ministers were hailing has completely reversed, and a toxic street drug supply is now killing record numbers of Albertans.

If each life lost to addiction is indeed one too many, there were a record 179 too many Albertans killed by opioid poisoning in April. That's part of a disconcerting upswing in the drugs' toll, 168 dead in March and 151 the month before — by far the grimmest figures since government leaders began their cheerier tone in reporting these statistics last year.

In this case, new Minister Dan Williams's response statement lacks qualifiers about fatal overdoses: "The death of any individual is heartbreaking, and we extend our condolences to the family and friends of these loved ones."


UCP officials had repeatedly held up the temporary decline in opioid-related deaths as proof their response to the opioid crisis was working.

Largely self-styled as the "Alberta model," the United Conservatives have decidedly leaned heavily into recovery treatment as a way of curing addicts, and have either de-emphasized or outright decried harm reduction approaches like safe consumption sites and safe supply.

Proponents have also liked holding Alberta's record up against that of British Columbia, which has been prescribing users with a safer supply of drugs, alongside recovery and housing approaches.

"After the pandemic, with our new system coming on board, fatalities in British Columbia have continued to increase and fatalities in Alberta are sitting at about 50 per cent of what British Columbia is at," Marshall Smith, the architect of Alberta's opioid response strategy, said in the recent video Canada is Dying, a YouTuber and B.C. political activist's feature-length warning about B.C. drug policy.

Smith is the former B.C. government aide and admitted former drug addict who became a fierce advocate for treatment centres, moving from a minister's aide in Jason Kenney's UCP government to Premier Danielle Smith's chief of staff.

A man and a woman sit at a table looking at each other in a large office.
Marshall Smith, architect of Alberta's drug policy approach, became Premier Danielle Smith's chief of staff last fall. She's become a chief booster of her aide's strategy. (Judy Aldous/CBC)

While British Columbia is on track for a record level of tragedy itself this year, there is a much smaller disparity with Alberta in the first months of 2023 — 613 opioid-related deaths through April in Alberta, compared to 814 deaths caused by all unregulated toxic drugs in the more populous British Columbia.

Alberta's approach has also become a cause celebre of sorts among other conservatives, most notably Pierre Poilievre. In last year's YouTube video "Everything feels broken," his broadside at federal and B.C. drug policy, Poilievre walks the streets of Vancouver's Downtown Eastside with Marshall Smith.

"In Alberta, which is thoroughly rejecting the decriminalization and tax-funded handout of hard drugs and instead putting the money into recovery, we have seen, in the most recent data, a 30 per cent reduction in the number of overdose deaths," Poilievre told the House of Commons in May.

Cause and effect (or not)

There was never consensus among experts that the decline in fatalities last year was because of provincial action, but the government tended to be optimistic (albeit "cautiously") — even though only one of its 11 much-touted "recovery communities" has opened and begun taking patients.

These issues are always multifaceted and complex, while trends in drug use and supply toxicity are ever changing. This is not a field where simplistic explanations and catch-all solutions tend to thrive.

Meanwhile, is it intellectually honest for a government to credit its policies for fewer deaths and then resist blaming its approach when deaths rise? Live by the sword, and all that?

It appears fully unlikely the Smith government will shift its policies and disdain for safer-supply programs as the trajectory on fatalities has itself shifted. The premier told CTV this week it's "not our approach in Alberta. We don't give up on people."

A green box of medication is pictured. A person's hand is visible in the background with  a tray of medical supplies.
Hydromorphone, a type of opioid, is pictured at a managed opioid program in Ottawa. (Ashley Burke/CBC)

In what may be a chilling forecast of more tragedy, Alberta's EMS trips for opioid overdoses in June have risen beyond what they were earlier in the spring, and are near 2021 records. Premier Smith now acknowledges that the trend may worsen.

"We're going to see a lot more problems as this drug supply continues in Western Canada to be such a problem for us," she told the Calgary Chamber of Commerce on Friday.

The premier, then, is concerned about the toxicity of the supply, but remains adamantly opposed to a solution that distributes pharmaceutically verified supply as an overdose prevention method.

Now that reality has forced Smith's team to stop using one half of the "Alberta's focus on recovery is working because look at the decline in opioid deaths" narrative, one wonders how long they will hang on to the other half.

ABOUT THE AUTHOR

Jason Markusoff

Producer and writer

Jason Markusoff analyzes what's happening — and what isn't happening, but probably should be — in Calgary, Alberta and sometimes farther afield. He's written in Alberta for more than two decades, previously reporting for Maclean's magazine, Calgary Herald and Edmonton Journal. He appears regularly on Power and Politics' Power Panel and various other CBC current affairs shows. Reach him at jason.markusoff@cbc.ca