Academic journal article obliterates 2020 UCP supervised consumption site report

UCP delegates voted to defund supervised consumption sites on Nov. 4.

Calgary’s Sheldon M. Chumir Health Centre is the location of Calgary’s sole supervised consumption site, which the UCP has pledged to shut down. (Flickr/walkcalgarycommunities)

Two days after delegates to the UCP annual general meeting (AGM) voted to defund supervised consumption sites (SCS), a Nov. 6 article in the Canadian Journal of Public Health dismantles the 2020 report used to justify the Alberta government’s crackdown on harm reduction policies for addressing the drug poisoning crisis.

The article was first submitted on April 27 — at the tail end of the deadliest month for opioid poisoning ever in Alberta — so the timing is coincidental, yet highly symbolic. At 1,262 opioid poisoning deaths in its first eight months, 2023 is already the third-deadliest year on record for drug poisoning in Alberta, and is on pace to surpass 2021 as the deadliest.

The UCP AGM vote comes four years after the UCP began its crackdown on the province’s meagre harm reduction infrastructure, which was introduced during the NDP’s brief tenure in government from 2015 to 2019.

Soon after being elected, in part on a pledge to eliminate “NDP drug sites,” former premier Jason Kenney convened a panel to evaluate the worthiness of SCSs.

But, in a familiar pattern, the panel was expressly prohibited from examining the merits of SCSs in terms of reversing overdoses. Instead, panelists were instructed to only look at the “socio-economic” impacts of neighbourhoods where SCSs are located.

The panel’s report was released in March 2020, just as drug poisonings were about to skyrocket to unforeseen levels owing to the COVID pandemic.

Its primary finding — that SCSs were dens of social disorder — had material consequences, with the Kenney government shutting down the Lethbridge SCS — the most frequented site in North America — and one of three sites in Edmonton.

The government announced plans to shut down the sole SCS in Calgary, Safeworks at the downtown Sheldon M. Chumir Health Centre, and replace it with two more bare boned overdose prevention sites at undisclosed locations. As of writing, Safeworks is still open.

Additionally, the UCP introduced onerous identification requirements for using SCSs, requiring people who frequent them to present their health card so as to more easily integrate them into the government’s coercive “recovery-oriented system of care.”

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The government’s March 2020 report was instantly panned by experts in harm reduction as not being worth the paper it’s written on.

Cameron Wild, a professor at the University of Alberta School of Public Health who focuses on mental health and addictions, called the UCP panel report a “political document and not an objective or scientifically credible evaluation of supervised consumption sites.”

Wild likened the limited scope of inquiry to studying the “impact of post-secondary education programs but we’re not allowed to look into whether students get employed after they graduate.”

University of Calgary sociologist Jenny Godley said the report “wouldn’t pass my undergrad stats class.”

Godley was one of 40-plus Canadian and U.S. academics to sign an open letter calling for the UCP SCS review report to be retracted entirely.

The new Canadian Journal of Public Health piece includes Godley as one of 14 co-authors, alongside lead author Dr. Ginetta Salvalaggio, and prominent harm reduction advocates Dr. Elaine Hyshka and Rebecca Haines-Saah, among 10 others.

The article cites the panel report as an example of “pseudoscience,” one which has produced “misinformed policy” with fatal consequences.

The article notes an abundance of peer-reviewed academic literature attesting to the merits of SCSs, including a 2017 literature review of 47 studies from Vancouver, Australia, Germany, Denmark, Spain, the Netherlands.

It found that SCSs “mitigate drug poisoning-related harm and unsafe drug use practices,” result in increased referrals to addictions treatment and other health interventions, reduce needle debris in their vicinity and don’t increase drug-related crime.

A 2019 study found that B.C.’s SCSs and overdose prevention sites saved 230 lives in a 20-month period.

These academic works were readily available for the government’s SCS review panelists, had they been instructed to look at any aspect of SCSs beyond a narrow conception of their socio-economic impacts.

Subsequently, a 2022 study from Calgary found that the Safeworks SCS saved health-care costs as a result of decreased ambulance responses and emergency room visits for people who have overdosed.

The authors of the Nov. 6 article note:

Given the large body of scientific evidence that refutes these concerns, the extent to which complaints and negative perceptions of SCS are legitimate—and whether they are a direct outcome of SCS provision versus a reflection of broader socioeconomic disparities, misinformation, and prejudice—needs to be rigorously examined.

The government failed to do this, skewing data based on anecdotes that confirmed its predetermined narrative, using “systematically imprecise measurement of observed phenomena,” and failing to even acknowledge, let alone refute, the body of peer-reviewed literature on the merits of SCSs.

The government report has had consequences outside of Alberta, the authors of the Canadian Journal of Public Health article note. In 2021, it was the sole piece of evidence used to deny permission for a proposed overdose prevention site in Philadelphia. The purpose of the government’s report, the authors continue, was to feed a “moral panic” about SCS.

“The continued existence of this pseudoscientific government report risks legitimizing similar approaches to future evidence generation and policy formation,” the authors note, reiterating earlier calls for it to be retracted so it doesn’t again inform misguided drug policy.

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It remains to be seen if Premier Danielle Smith will implement her party membership’s call to defund all SCSs.

But the fact that she promoted Marshall Smith (no known relation) — the father of Alberta’s so-called “recovery-oriented system of care” — to be her chief of staff doesn’t inspire confidence.

Calgary-based harm reduction advocate Danielle English told CityNews that the resolution to defund SCS is clearly linked to the Alberta government’s recovery-obsessed approach to the drug poisoning crisis, which is evidently not working, given the continued increase in drug poisoning deaths.

“Safe consumption sites do not increase crime, and they do not increase drug use,” English explained. “What they do do is decrease the amount of poisonings, decrease the spread of HIV and Hep C, decrease injection-based infection, [and] act as a hub for people who use drugs to get resources.”

She added that she’s “very, very terrified” of what will happen if Premier Smith does defund SCSs.

“I’m also very confused because we have a lot of data around safe consumption sites and the data we have around safe consumption sites lets us know they’re a really integral part of managing and supporting the drug crisis.”