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The forgotten public health crisis

Once government lead on the overdose crisis, Katy Merrifield hopes John Horgan follows his own advice.
(EJ Nickerson /

“[British Columbians] voted for a government that works for people, a government that will tackle the fentanyl crisis and save lives.” John Horgan, NDP Caucus news release, June 12, 2017

In 2016 and 2017, I got a small taste of what being a politician must be like. 

I was the lead in the Premier’s Office on the overdose file. I worked with senior officials in the Ministry of Health, recruited stakeholders, directed communications, and helped shaped policy, strategy and execution. 

Together we spent over $150 million rapidly scaling up treatment options ranging from harm reduction to recovery, creating public education campaigns, massively distributing naloxone, increasing access to therapies like suboxone, and leveraging the federal government to impose stronger measures to support drug interdiction. 

I was, in a word, obsessed. I felt personally responsible, despite not being the one to publicly face the tough questions. 

Packing up my desk after receiving word the NDP would be asked to form government with Green support, the first stories that trickled in attacked the BC Liberals for not doing enough to save lives – and worse, for not caring

I burst into tears. In front of a lot of people. 

Not my finest moment. It was also the moment I realized in politics it doesn’t matter how much you try, or how much you care. What matters is what you promise, and what you deliver. 

I burst into tears. In front of a lot of people. 

This brings me to today. BC has a Premier who promised to appoint a minister empowered to focus solely on mental health and addictions, to meet the needs of people desperate to find care and save their brother/daughter/parent/child from the unyielding hell that is drug addiction. 

Has it worked?

The data speaks for itself – and tells a grim story. Last year we lost a record 1,716 people, a 74 per cent increase from 2019. January 2021 saw 165 deaths, the largest-ever number of lives lost in the first month of a calendar year. 

Almost every day brings another story in Vancouver or Victoria about a life lost to overdose, or an innocent person inadvertently caught up in the violence stemming from some living in the deplorable conditions of a haphazard tent city. No wonder a recent Angus Reid survey shows two-thirds of British Columbians disapprove of the NDP’s response – the worst in the country. 

There are other forces at work here, of course, starting with a global pandemic that has commanded all government resources and then some across this country. And to its credit, the NDP government has invested in mental health and addiction supports, albeit largely a continuation of BC Liberal policies like funding beds, education campaigns, youth mental health resources, and contemplating changes to compulsory treatment under the Mental Health Act. 

Safe supply is intended to reduce the potential of overdose from a tainted source – but it’s not addiction treatment.

Their next big move appears to be embracing the controversial policy described as “safe supply.” Essentially, this means replacing fentanyl-laced street drugs with pharmaceutical grade alternatives. For example, instead of heroin, the user would be given hydromorphone – a drug often given in hospital after major surgery. 

There are a few important points to understand here. 

First, safe supply is intended to reduce the potential of overdose from a tainted source – but it’s not addiction treatment. Second, an explicit goal is to “remove barriers to access,” which in practical terms often means using drugs without medical supervision. Third, many see safe supply as the next step in a human rights-based approach to drug use; the goal is not associated with reducing drug use, much less eliminating it. 

While this model is not ubiquitous in British Columbia yet, it’s embraced and promoted by many political leaders, public health officials, and drug activists. 

Preventing tragic overdose deaths is laudable. But it’s worth asking if this direction will help “meet the needs of people and families desperate to find help when it comes to opioid addiction,” as the Premier promised in opposition. 

Next door in Alberta, often the province second-hardest hit by opioid overdoses, the government is going in a remarkably different direction. In addition to funding necessary harm reduction initiatives like naloxone distribution, opioid agonist therapies, and overdose prevention services, they have explicitly committed to a full continuum of care through massive investments in recovery. 

In practice, this means 4,000 additional addiction treatment spaces, five long-term residential therapeutic communities, the expansion of drug treatment courts, and most significantly, the removal of all user fees for publicly funded addiction treatment beds. 

Levelling the cost of treatment is essential. For the first time, Albertans struggling with addiction will be able to access residential treatment without paying out of pocket. If you’ve been fortunate enough never to have to learn about this, this means saving thousands of dollars; previously, they would have to pay privately or be on income assistance to receive addiction care. 

Expressions of sorrow won’t fix this crisis.

We could learn a lot from this – which is exactly what Premier Horgan said he’d do. 

Coming into office in 2017, the Premier promised to learn best practices from other jurisdictions, raise them, talk about them, and implement them. This is good advice, and I genuinely hope he follows through. Alberta’s approach of giving addicts a chance at a better life is preferable to giving them the very drugs they’re addicted to. 

The uncomfortable fact is that this crisis has unequivocally gotten worse under a government that promised to do better. And speaking of doing better, I would never accuse political opponents of “not caring enough.” I’m sure there are people in this government who not only care, but take it as personally as I did. 

But no matter how heartfelt, expressions of sorrow won’t fix this crisis. And neither will exercises in social libertarianism presented as a panacea for addiction care.  

With the end of COVID-19 mercifully on the horizon, it’s time for this government to turn its attention to this forgotten pandemic. 

Katy Merrifield is the Vice-President for BC at Wellington Advocacy, who has served as Communications Director to Premiers of both Alberta and British Columbia, and was the youngest woman to run a winning leadership campaign in BC.