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If you want to know why the Alberta government will almost certainly refuse to supply hard drugs like heroin to addicts, a good place to start is the testimony of Michael Shellenberger, author of the new book, San Fransicko: Why Progressives Ruin Cities.

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Shellenberger, now running as an independent to be governor of California, is a hugely influential public intellectual on both environmental and addiction issues, so much so that Alberta Premier Jason Kenney borrows many of his ideas and some of his rhetoric to make his own case on addiction policy.

Shellenberger was among a panel of experts who recently testified before Alberta’s Select Special Committee to Examine Safe Supply. The committee is scheduled to report back to the legislature by the end of the week.

Medical authorities and some politicians, including Edmonton Mayor Amarjeet Sohi, have spoken out in favor of this latest harm reduction idea of ​​safe supply. Four NDP MLAs quit the government committee in early February, saying the United Conservatives had stacked the expert panel with experts against the safe supply model and have “always been hostile to proven harm reduction initiatives.”

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Safe supply programs now run in four provinces, Ontario, New Brunswick, Yukon and British Columbia, which, as Daphne Bramham reported in the Vancouver Sun, it became “the first jurisdiction in the world (in June 2021) to offer free pharmaceutical-grade heroin, benzodiazepines, methamphetamines and alcohol to addicts by prescription but without the requirement that they be taken under medical supervision.”

Overdose deaths in BC soared to 2,224 last year, 26 per cent over the already record-setting number in 2020. In Alberta, the death rate from drug poisoning is lower than in BC but also going up fast, rising to a record 1,771 last year .

That said, I’ll be astonished if the Alberta government goes down the same path as BC, given both BC’s death count and the Kenney government focusing less on harm reduction and more on drug users recovering from addiction.

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Shellenberger testified that Canadian and US jurisdictions are getting it tragically wrong on drug policy. We should instead follow the lead of successful countries like the Netherlands and Portugal, he said.

These European countries don’t simply use the carrots of free needles, free drugs and free shelter to keep drug users alive, but take a mixed approach, employing carrots as well as sticks, including stigmatizing drug use and using forceful measures to push users toward recovery programs.

There is no such thing as a so-called “safe drug supply,” Shellenberger said. “I think that using the word ‘safe’ itself associated with very dangerous and potentially deadly and addictive and intoxicating drug risks is being very misleading.”

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It’s possible to give addicts clean needles but also use coercive measures to encourage or compel recovery, Shellenberger said. “There is a lot of truth to the fact that addicts need to choose recovery, but on the idea that people will hit bottom and then choose recovery, I don’t think it’s the case that that bottom is fixed. If you basically give people drugs to use and make their lives very comfortable to just use drugs every day, you’re effectively lowering the bottom, whereas if you have consequences for behavioral disorders, including public drug use, public camping, public defecation, you may raise the bottom and help people to get into recovery.”

What is really being proposed with safe drug supply is palliative care for all addicts, Shellenberger said, an option that might well be appropriate for a 75-year-old who has been using for decades. “But we’re treating 25-year-olds suffering from opioid addiction, either heroin or fentanyl, as though they’re 75-year-olds at the end of their lives or something. I think it’s crazy.”

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Shellenberger sees opioid alternatives such as suboxone and naltrexone as useful tools, and says in the Netherlands there are 28 places where drugs can be used under supervision. But the focus is still on recovery there and it’s working, with just 120 people on methadone maintenance in a nation of 17 million.

The counterargument from those in the harm reduction camp goes that if a person is dead from bad drugs, you can’t help them recover, hence the need for safe supply. When this was put to Shellenberger, he said giving out drugs is one possible option, but it’s also a radical experiment without evidence of success.

What to make of this highly charged and partisan debate? I don’t pretend to be any kind of expert, just someone like most of you trying to make sense of a complex issue. But to the extent that Shellenberger’s approach balances some harm reduction measures, such as safe injection sites, with more forceful approaches, it’s certainly worth our attention.

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