Alberta proposes new mental health and addiction agency as toxic drug deaths reach historic high
The Alberta government announced it will create a new provincial health agency responsible for mental health and addiction services.
The announcement comes a month after new data shows the province saw the highest number of toxic drug deaths in history last year.
More than 1,700 people died from toxic drugs between January and November last year, making it the worst year since the province’s substance use surveillance system was made publicly available in 2016. That is 24.07 per cent higher compared with the same time period in 2022, 28.46 per cent higher compared with the same time period in 2021 and 69.08 per cent higher compared with the same time period in 2020.
On Tuesday, Premier Danielle Smith announced that the United Conservative government will introduce new legislation this spring that will see the creation of Recovery Alberta, a new provincial health agency responsible for the delivery and oversight of mental health and addiction services. Currently, mental health and addiction care are being provided by Alberta Health Services.
Smith said if the legislation passes, the United Conservative government will aim to transition these services to Recovery Alberta by July 1 of this year. Those who are accessing care through AHS will be able to continue to use these services through Recovery Alberta and the government is working with AHS to ensure the transition is “as smooth as possible.”
“There is still so much more work to address mental health and addiction in Alberta … For too long, the planning and delivery of mental health services was fragmented throughout AHS and unfortunately, this lack of focus has led to systemic deficiencies in the system,” Smith told reporters on Tuesday.
“To effectively plan and deliver mental health and addiction services in Alberta, we need an organization dedicated specifically to that.”
Smith later added Recovery Alberta will be “government-funded.” According to Tuesday’s news release, the Alberta government will fund Recovery Alberta’s annual operating budget of $1.13 billion. This money is currently being used to support the delivery of mental health and addiction services at AHS.
The Alberta government also announced it will be establishing the Canadian Centre of Recovery Excellence (CORE), to build “recovery-oriented systems of care” by researching best practices, analyzing data and making “evidence-based recommendations. Kym Kauffman, former deputy minister of mental health and community wellness for Manitoba, will lead the crown corporation’s creation as its new CEO.
“Despite all provinces across Canada facing an addictions crisis, there is no clear centre of recovery excellence that can advise on what works and does not work when it comes to mental health and addictions,” said Minister of Mental Health and Addiction Dan Williams on Tuesday. “It is important to have jurisdictions working together, growing in the same direction when it comes to creating healthy societies.”
The government did not clarify if there was any consultation with front-line workers and AHS about the transition.
Kerry Bales, the current chief program officer for addiction and mental health and correctional health services within AHS, said there were no direct engagement from a staffing perspective when the consolidation of mental health and addiction services began last summer.
However, Bales said there will be town halls in the future to gather input from health-care workers.
“Since we’ve been doing the consolidation work that began in the summer, and even prior to that, it’s been an iterative piece of work where we’ve been engaging with our staff, our leadership and clinicians,” Bales said. “As always, we generally feel as though we’re never able to engage enough … There’s been a lot of work done leading into the consolidation this fall and the transition into Recovery Alberta this July.”
The Alberta Union of Public Employees (AUPE) said its members were not given time to consider how the transition will affect their work. The union said the announcement will affect 3,500 AUPE workers. Around 2,000 of those work in nursing care and 1,500 work in general support services.
“It’s crystal clear from today’s announcement that the government feels it does not need to consult with front-line workers before doing what it already decided to do,” said Sandra Azocar, vice-president of the AUPE, in an emailed statement.
“When you rush big systemic changes without considering the impact on staff and the Albertans who rely on these services, you run the risk of the system collapsing. People will die. Their lives will be on the government’s hands. These are ideologically driven decisions, not evidence-based decisions.”
Janet Eremenko, Alberta NDP mental health and addictions critic, said the United Conservative government’s announcement does not solve the province’s toxic drug crisis.
In a release on Tuesday afternoon, Eremenko said Smith and her government are doing nothing to address permanent supportive housing, treatment wait times and wraparound services which are crucial to mental health and addiction care.
“Front-line health-care workers know what works to save lives. Four virtual sessions won’t ensure the minister will truly engage with these staff, and we know the UCP has a history of hosting performative consultations without implementing any expert opinions,” Eremenko said in an emailed statement.
“Danielle Smith’s chaotic and expensive re-organization of AHS doesn’t solve the problem of drug poisonings, nor will spending more time and money on a new agency. The UCP needs to ensure the new agency isn’t siloed away from critical integration into the rest of the health-care system.
“There are many established organizations that have been consistently delivering, with a proven track record of success, wraparound treatment services in this province. These organizations have spent decades building trust within the community. Rather than funding these organizations, the UCP is moving forward with opaque, private contracts. This undermines the trust and transparency that Albertans require, particularly in a ministry dedicated to the sensitive care of vulnerable individuals.”
Questions raised about evidence, data used in announcement
During the news conference, Smith claimed “many drugs have their lowest mortality rate on record since 2021.” According to Smith, alcohol poisoning deaths are down by 60 per cent, deaths from methamphetamine are down by 41 per cent and deaths from cocaine are down 61 per cent.
However, data from Alberta’s substance use surveillance dashboard said the percentage of deaths involving alcohol in 2021 was 23 per cent compared with 17 per cent in 2023.
Sam Blackett, Smith’s press secretary, said in a follow-up email that the data the premier used was found on the same dashboard which listed alcohol as the primary cause of death.
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“Anybody who is in the despair of a drug or alcohol addiction should know that recovery is not only possible, it’s actually the more likely outcome,” Smith said at Tuesday’s news conference.
“We have a recovery community that is tens of thousands strong. We’ve got a recovery conference starting tomorrow that has sold out and is on a waiting list. We’ve got 2,000 people from around the world who are working in this area and excited about the approach we’re taking.
“So have we seen immediate success? Not yet, But I’m very confident that we’re on the right track and we’re working on programs that will save people’s lives every day.”
Smith also said the government now has data to show that its recovery programs are working, claiming around 8,000 people are part of the province’s virtual opioid dependency program. However, at the time of writing, treatment data is not publicly available.
“I think we’ve got a lot of data now, and we just want to make sure that we’re we’re making the best decisions to continue to, to support recovery,” she said.
Chris Gallaway, executive director of Friends of Medicare, said the United Conservative government is refusing to address the fact that Alberta saw the highest ever number of drug poisoning deaths by cherry-picking data to justify the creation of Recovery Alberta and CORE.
“What we’ve really seen from this government is the pushing of this false dichotomy of treatment versus harm reduction. That’s not how it actually works. They’re not two separate silos. We need a spectrum of addictions care for Albertans,” Gallaway told Global News.
“Our message has been consistent for years to this government. There’s no recovery if you are dead and people are dying in record numbers every single day in Alberta. So we need to treat that situation as an urgent situation and act to keep people alive so that they can be well.”
Gallaway also expressed concerns about the ongoing restructuring of AHS, which he said will further “silo” the public health-care system without addressing the challenges it is already facing.
He also expressed concerns about the Alberta government privatizing mental health and addictions care.
“That’s the agenda they’ve been rolling out and the shift to pull everything out of AHS, put it into its own entity, just helps them further that privatization agenda. It’s what they’ve been doing throughout health care, not just in mental health and addictions. You carve it up and you privatize it,” Gallaway said.
Elaine Hyshka, associate professor and Canada Research Chair in Health Systems Innovation at the University of Alberta, said by the time the numbers are fully calculated, Alberta will have close to 2,000 people dead from toxic drug poisonings in 2023.
According to Hyshka, it is still too early to tell if the restructuring of Alberta’s mental health and addictions care system is working. However, Hyshka said Tuesday’s announcement is good news for the province.
“What I do know is that we have seen a emphasis on responding to the crisis of drug poisoning deaths,” she said. “It’s okay to make investments in treatment. It’s okay to make investments and new approaches. The reality is, we have not been expanding effective and proven solutions like harm reductions services that are going to save lives in the short term and support to eventually get into recovery.”
Hyshka said public data on treatment is needed to be able to evaluate whether or not the programs are effective. She said she wants the Alberta government to invest money into expanding access to treatment and access to harm reduction services.
“There’s a lot of attention being paid to this issue but at the end of the day, deaths continue to rise and we have yet to see any data coming out of these new investments that they’ve been making for several years now to show that they are effective or that they are even putting Alberta on a better path in terms of reducing the death rate,” she said.
“We really need a coordinated and comprehensive public health approach that focuses on the full range of care that can save lives and support people to access substance use treatment and recovery and right now, unfortunately, we are seeing a myopic focus on one part of the treatment continuum that is not particularly effective for opioid use disorder or for saving lives and preventing deaths.”
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