MINI-EP: Alberta’s Abstinence-Only “Recovery” Model

The opioid crisis is killing more Albertans than the COVID-19 crisis— but Jason Kenney’s UCP government is intent on pursuing an abstinence-only model that rejects harm-reduction approaches. Joining Team Advantage are Garth Mullins, host of the CRACKDOWN podcast, and Jeremy Appel, author of a recent Progress Report piece titled The Alberta Model: Who benefits from the Alberta government’s shift away from harm reduction to abstinence-only recovery.

Follow Jeremy Appel on Twitter @JeremyAppel1025, and follow Garth Mullins on Twitter @garthmullins. Listeners may also be interested in the work of @momsstoptheharm and @HIVCommLink.

A full transcript follows the link.

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Kate: Hello, and welcome to The Alberta Advantage. I am your host, Kate Jacobson. Late on the afternoon of Friday, December 18th, the government of Alberta announced updated numbers regarding the opioid crisis in Alberta. So, in today’s episode, we are going to talk about addiction recovery, capitalism, and, specifically, how Alberta is shovelling public dollars into the pockets of private recovery providers, often with very dubious results. Joining me here on Team Advantage today is Jeremy Appel, author of a recent Progress Alberta piece titled The Alberta Model: Who benefits from the Alberta government’s shift away from harm reduction to abstinence-only recovery. Jeremy, thank you for joining me here on the podcast.

Jeremy: Thanks for having me. Long time, first time.

Kate: Also joining us today on The Alberta Advantage from Vancouver, British Columbia is activist, writer, broadcaster, musician, and host of the CRACKDOWN podcast Garth Mullins. Garth, we are very big fans of your podcast, so thank you for joining us here on Team Advantage.

Garth: Well, same back at ya, and thanks for having me again.

Kate: So, to begin, I think we should set the scene for our listeners a bit. As of this recording, there have been 841 deaths from COVID-19 in Alberta. What has received a lot less attention, however, is the fact that there has been 904 deaths from opioid poisoning in the first nine months of 2020. And this statistic may have our listeners asking themselves, “What is Jason Kenney and the government of Alberta doing with a health crisis that is killing more people than COVID-19?” Jeremy, since you wrote a piece about it, what has been Jason Kenney and the UCP’s attitude towards addiction treatment and the public health crisis surrounding it?

Jeremy: So, I would generally characterize it as being actively hostile to people who use drugs and solutions that will keep them alive. At the same time, as we’ll see, the government is exceedingly generous towards not-for-profit, abstinence-only clinics that involves an approach of moralizing to people who do drugs, that what they’re doing is bad and they need to stop. An example of this is the associate minister of Addictions and Mental Health, Jason Luan, wrote an op-ed in the Edmonton Journal where he said, “Addiction does not exist in drugs — it exists in people. Therefore, the solution exists in people and not in tinkering with the drug supply.” And so, as I put in the piece, according to this view, the problem is you, and the only way that you can get better is through abstinence, and if you can’t abstain, the implication is that you’re a failure. This is despite there being clear evidence that drug supply is, indeed, the issue at hand; that’s what’s killing people. The pandemic, in particular, has led to an increasingly toxic supply as borders close and illicit supply chains are disrupted. In October, for instance, police in Victoria seized a supply of fentanyl at 90% concentration. That’s compared with a usual 10% concentration. So, that’s really powerful fentanyl. And, if you look a bit west to BC, they are tackling this issue with safe supply programs, and have for quite some time. But, to the UCP government, that approach is just out of the question because they’ve embraced this extreme abstinence-focused strategy that runs counter to best practices as there’s much evidence to back up.

Kate: In fact, it’s so bad that once-chief of staff Marshall Smith has stated that, and I quote, “I think that there is a certain shroud of stigma that needs to remain around addiction.” A truly grotesque way of approaching this issue, and one that’s really devoid of any compassion and is extremely dangerous. One thing I do think might be useful here is to define our terms a bit for our listeners. So, what is a safe supply program, and what is the difference between a harm reduction model of addiction recovery versus an abstinence-only model of addiction recovery?

Garth: I came up in the time of D.A.R.E. and “Just say no” and all that, and I think that’s still very much alive in Alberta. And that’s abstinence — it’s just, like, you should not use drugs. And there are perhaps people who can get there, but, when the drug supply is so toxic, it’s hard, because, if you could die from using once, you might never get the chance to pursue abstinence. So it’s not appropriate to an overdose crisis. So, yeah — abstinence is just “no drugs,” like a 12-step program that is just “No drugs, no methadone.” That’s it. Harm reduction accepts that people do use drugs — this does happen — and they try to reduce the harms that come with it. So, for example, the first harm reduction I experienced in my life was when someone gave me a new needle so that I didn’t have to use an old, dull one or, even worse, potentially share with other people. And, at every step of the way, there have been conservative voices, from the federal government or local conservatives in Alberta or in British Columbia, saying, “No, no, no — we shouldn’t give out syringes. No, no, no — we shouldn’t prescribe methadone. No, no, no — we shouldn’t prescribe what they call safe supply, other types of opioids that might replace the toxic drug supply.” And, at every step of the way, the offer is abstinence, is, “Just don’t do drugs. Don’t do drugs.” Maybe we’ll fund a bed for you to go lie in while you go to a 12-step program during the day where you learn “don’t do drugs.” And there are some places in BC that are now beginning to offer suboxone or something like that, but this is still the primary go-to of most places in North America, is that you should get a 12-step program. If the Alberta model is to have its way, that would be the only game in town.

Kate: One thing I’m interested, if you could explain to us, is: why doesn’t the abstinence-only model work? What’s wrong with it? Why doesn’t it help people?

Garth: Even if you look at the literature produced by some of those same groups — 12-step groups — it’s kind of a coin toss whether it’s going to stick or not. What they told me — because I spent a long time going to 12-step groups, and they said, “Well, you’ll relapse. This’ll happen. You gotta keep coming back, keep coming back.” And everybody in the group would talk about, oh, they went to a 12-step for a while, they went out and used again, they came back, and they said, “Keep coming back. The system works,” or, “The program works if you work it.” The problem with that, though, is: now, you could die. So, some people, it takes years to get there. Some people, like me, I never — abstinence never stuck for me. But, along the way, in these programs, you’re supposed to make a searching and fearless moral inventory, and that means you’re to identify your own moral defects and maybe go apologize to people that you’ve wronged and all this. And I think there’s something to apologizing if you’ve screwed somebody over, but searching yourself for these problems and trying to delete, and actively turning away from the structural forces in your life that may have fucked things up, it seems like gaslighting to me, because every time you try to think about any other structural force that might be going on in somebody’s life — you might have a sponsor around that says, “Whoa, no, you’re just rationalizing your drug use. You’re trying to make up a nice sociological excuse to go get high.” And that doesn’t work because, when people’s lives are going down a certain path, you kinda need something else. To me, it’s like first aid. It’s like if you have a car crash or something like that, and you’re like, “No, no, no. It’s full health only. We don’t do first aid at the side of the road. They just have to hit rock bottom. They have to crawl to the hospital,” or something like that. Harm reduction’s first aid. It’s triage. It’s a super important step.

Jeremy: What you said, Garth, about how these abstinence-only clinics encourage you to keep coming back — maybe I’m being overly cynical (but I don’t think so), but a lot of these clinics cost a lot of money to attend. So, it is, in a sense, in their own interest to have people relapse and then keep coming back. Now, in Alberta, the government made a whole spectacle of them eliminating fees for publicly-funded beds at private clinics in Alberta. So, these companies are not-for-profit, so they’re not making profits; they’re still in line to get some funding if you keep relapsing and coming back.

Garth: Yeah. I mean, this whole thing, the way I saw it, is: we would all measure our clean time, and you would count it in days — and I know some people who’ve succeeded this way, and they’re very proud to have ten years or whatever — but you’d count it, and, at the end of the meeting, you’d come up and you’d get a keychain that represents if you’ve had days or weeks or months or years or something. And, for me, I always just got the white keychain [laughs] that says “Just for today,” and that means that you have no time. But the problem is: it’s like an odometer on your car, one of those old ones that goes up and up and up, but then if you use once it flips to zero. So it puts this huge pressure on you, like you’ve completely failed, like it’s digital — either you’re clean or you’re not. And it’s very hard. Whereas harm reduction just says, “Well, okay, you’ve managed to use at a safe injection site where someone can give you NARCAN and prevent your overdose if it’s too much. You’ve managed to use a little bit first. You’ve managed to use not alone, or maybe you’re smoking instead of injecting, or maybe there’s some other way, or maybe you’re taking methadone so that you don’t have to use quite as much of the toxic street drug.” Those are considered successes, right? The person can define for themselves what their goals are. And it seems like a very small goal, but the goal of all public health programs, first, should be to stop the deaths, and everything else second. So, this is the big disconnect in Alberta, is that the two Jasons seem to be more worried about people using drugs than people dying. So they’re aiming squarely at their ideas, all on, “Oh my god, we don’t want people to use drugs, we don’t want people to get high,” instead of, “We want people to be alive.” And those are completely different things.

Kate: Yeah. You can’t get clean if you’re dead, and I think the way the government has approached it is strictly as a moral issue, like the idea that drug use is morally bad, therefore people who use drugs are morally bad or have some kind of moral defect. And I think what I find so deeply reprehensible about that is not only the direct harm it leads to in terms of people not being able to get help and using drugs that are unsafe, but also, if you look at any research on drug use and on the opioid crisis and the opioid epidemic, opioid use tracks very strongly with deindustrialization, tracks very strongly with the financial crash, with poverty, with not being able to find a job, with our society collapsing around you.

Garth: Fucking A! Absolutely! Yeah.

Kate: And yeah. What I find so frustrating about it is that these are the same people who created all of those problems, and then, when people’s lives are unbearable and, for whatever reason, they end up using drugs, it’s not the society you live in that created the conditions for drug use, it’s that you’re morally a bad person. It’s just really upsettingly grotesque.

Garth: Yeah, and you think about the UCP, right? They like to pretend to be blue collar resource workers, right? They like to have Bernard the roughneck around them, or whatever. And I call bullshit on that, first of all, but I was a resource worker. I would fly to a mine in Northwest Territories out of Edmonton and I worked in the mill, and people worked underground, and, when you got off of your two-week shift where you worked 12 hours a day, and you got out of that camp that was nowhere near a city, you bloody well wanted to party, right? And maybe, if you got hurt, you wanted to party a little bit differently — you wanted to address the pain that you got, and maybe, if you got laid off, you were doing something different. But it’s all drug use. So, the people that they are stigmatizing in Alberta — the peopole that Jason Kenney and Jason Luan do not like — are resource workers, are unemployed resource workers! My god, same in BC and Alberta — people doing a bunch of coke on the weekend to blow off steam, that’s tradition, you know? [laughs] So, it’s not just everyone being a wired daily opioid user like me, people just also want to party, and half the people who are dying of overdose come to it that way. It’s not all this idea of the gritty urban drug user that, maybe, is in the fevered imaginings of the premier’s office. This is, really, the people that they claim to care about, and it just shows how shallow that care actually is.

Jeremy: Yeah, and I think that this moralistic approach is fundamentally connected to neoliberal ideology, that only individuals exist, and they make choices, and they simply need to make the right choices and everything will be great, right? There’s no context or background that is important to take into account, right? 12-step works for some people, but it doesn’t for everyone, and I think that’s the fundamental issue here. You need a diverse array of strategies to deal with the opioid crisis.

Garth: For sure. I think about my friend Guy Felicella. He does Ted Talks, he’s very vocal about his recovery, right? Abstinence worked for him. He takes nothing. I don’t think he drinks or anything. But he also says: before he got on that path, he overdosed six times and wouldn’t be alive had it not been for harm reduction. So, he says you cannot have — the Alberta model of abstinence only would have killed him. And he’s the guy who sits there and talks about recovery being really important, right? His abstinence life is really great for him. He used drugs and lived partly on the street on the downtown East Side for three decades before he was overdosing and then into recovery and all that, and he’s got a house and a wife and three kids and all that, but he says it never would have possible if not for harm reduction.

Kate: So, Jeremy — one part of your story involves details about Jason Luan’s chief of staff, Marshall Smith. Could you tell me a bit more about him? Where did he come from, and why is he so into this abstinence-only model of addiction recovery?

Jeremy: So, Marshall Smith is sort of this mysterious figure lurking in the background through all this. His story’s quite interesting, actually, because he was sort of this rising star within the BC Liberal Party, which is a conservative party. He was tasked with assisting in the preparations for the 2010 Paralympic Games. Around that time, he was busted twice for selling cocaine and crystal meth. This is in 2004. Between 2004 and 2007, he was on the streets selling drugs to feed his habit, sleeping in parks and on the run from police. And this was a guy who was a big deal in political circles in Vancouver. 2007 comes around and he goes to rehab — an abstinence-only private recovery clinic — and becomes this evangelist for that very model. And this is his personal narrative — all we really know about him is what you read about in fawning profiles about him. I tried to get comment from him and/or Jason Luan for this story; they didn’t respond. That was what I expected. What’s interesting is: his first place where he worked after rehab, a place called the Baldy Hughes Therapeutic Community & Farm, which is a men’s only recovery clinic, and they received a $1,000,000 grant from the BC government in 2015. Now, at the time, Smith was employed at another not-for-profit abstinence-oriented rehab clinic called Cedars at Cobble Hill where he became the executive director in 2016. So, Smith is — or, at least, he was — the chairman of the BC Recovery Council, which I looked into, and it doesn’t appear to exist beyond mention in op-eds he writes or in these profiles of him or on the recovery capital lecture circuit, which is focused around building one-zone recovery capital.

Garth: Yeah, I think it’s like the corporate world, where you build up capital so you can invest it or produce more jobs or produce more productivity in your output; you have to build up this capital in yourself. It’s using a financial metaphor to say you have to build up resources of your ability to recover, your emotional/internal resources, your knowledge of the system. It’s a very strange metaphor to use. I always react this way when people describe relationships with financial metaphors, too, like, “Oh, you have to make sure you put some deposits in your love bank” or whatever. People [laughs] try to make financialized relationships when [laughs] it just seems like a strange thing to do. But that’s, I think, the metaphor they have chosen. And it also speaks to a sort of individualism in the same way that capitalism looks to individuals, and even individuals in competition with each other, so, too, is recovery capital understood as: you build that capital up as an individual, not as a community. I do know that it attracts a lot of people, and I should say this in defence of 12-step. That’s the thing that I actually liked about it. I really liked the smoke break [laughs]; I really liked the people that you met around there. There was nobody else. In 12-step programs, it’s just us — there’s no social worker or anybody else running the thing. So I did like that about it. And I bet you that people do find each other at those recovery capital events. So, I think it’s worth separating the rank-and-file people who go to those things from the people who are running — which I don’t really know; I don’t really know much about that.

Jeremy: But also, what I found interesting about Smith’s time at Ceders Cobble Hill — there was a story in 2018, in the Victoria Times columnist, which quotes Smith as calling for more funding for recovery centres. The story was pitched as, “Look at these clinics, and look how few publicly-funded beds they have,” and so they quote Smith saying that to that effect, but they don’t identify him as the executive director of Ceders, which he was at the time, but the chair of this BC Recovery Council that isn’t registered as a corporation in British Columbia and doesn’t even have a website.

Garth: The thing that I can add about the metaphor of recovery capital is that it also is a little bit like capitalism in that it really does not want government regulation. So, a lot of the people that are attracted to the ideology, or who might be involved in the industry or running a recovery house or something like that, they prefer for there to not be regulation on what they do at those places. And, most of the time — in British Columbia, anyway — there hasn’t been. In fact, regulations had to be added a few years ago to make sure people got proper food. But, in terms of what actually goes on for treatment in these places, there’s no regulations about that. So, the things that I know that have been offered there are: art therapy, music therapy, breathology, energy work, poetry — all kinds of things, all kinds of activities. A lot of them sound nice (I like music), but we don’t know: do you have prove — does this work? Does this help? And then 12-step — and 12-step exists as: sometimes they have meetings in the place, or sometimes people go from the recovery house down the street, but this is not regulated. So, what the actual treatment is is not regulated. There’s a bed, there’s a door, the building’s up to code, there’s food and it’s nutritious, but other than that, at least, that’s something still to come.

Jeremy: Yeah. It seems to me that they want the government’s money but not its oversight.

Garth: Yeah, and I think that’s very true of a lot of industry. So that’s why I think the recovery capital is a fitting metaphor for some of that. Maybe they’ve chosen well.

Kate: So, Jason Kenney campaigned in the spring of 2019 on, basically, cracking down on safe consumption sites. He argued that harm reduction advocates were, and I quote, “helping addicts inject poison into their bodies at NDP drug sites.” Once elected, he commissioned a very torqued report that examined the social and economic impacts of the sites — basically, what businesses, residents, and people who own property thought of the site — but didn’t actually bother to examine whether or not the sites and the services were saving people’s lives. This is particularly awful in the case of Lethbridge ARCHES, which was shut down despite being North America’s busiest supervised consumption service. Could you talk a little bit more about what happened here?

Jeremy: Yeah. So, there were major issues with regards to management at Arches, right? They had a $1,600,000 shortfall, management were spending money on travel, unauthorized overtime pay in gift cards — very shady stuff. But I would say that these are the type of things you hear about in government all the time, and we don’t just get rid of government. If the UCP wanted to actually keep the site open, if this wasn’t a politically-motivated audit that was intended to find a pretext to shut them down. They could’ve just gotten rid of management, right? They could have brought in new management and allowed the frontline workers to continue delivering the care they were delivering, but, instead, they opted to shut it down. ARCHES shut down in August. Now, the opioid data that was just recently released by the government for the first three quarters of 2020 shows that, in Lethbridge, opioid poisoning deaths have more than doubled in just the first three quarters of 2020. There were 42 this year, and there were 20 in all of 2019.

Garth: It’s even worth looking a little closer at that number, too. If you think about it, ARCHES had suffered (like most harm reduction places), under COVID, a reduction in capacity and being closed at some points. So, the numbers you see are a preview of what’s to come. Those numbers, those stats, those deaths were collected during times when ARCHES was constrained by operating from COVID circumstances, and then being shut down entirely will just make it worse.

Jeremy: Yeah, exactly. At his absolutely horrific press conference, Jason Kenney was asked about supervised consumption sites in general, and also Lethbridge in particular. He said, “Well, what do you mean? Lethbridge, there’s a replacement, there’s a mobile site,” but, as people who actually worked at ARCHES pointed out, the mobile site is completely insufficient. It has way less capacity, it’s not open 24 hours a day.

Garth: Talking to a couple of people who work there, you start to understand what’s going on. Tim Slaney and this guy Dubious, who both worked in the ARCHES supervised consumption site in Lethbridge, they’ve been involved in doing unpaid work afterwards to try and fill the void, right? And this just shows that the frontline workers aren’t in it for the big bucks and, I think, didn’t really know about — as, mostly, you don’t, as a frontline worker, you don’t about the management decisions that are happening at the top. And this is a site that had 800 people a day going through, in a regular business day. And that is enormous! That is the biggest number in North America;=, probably the world; maybe the busiest safe consumption site in the world. And there’s no way that a van can replace that, not just in capacity, but also — people built relationships in this place. I’ll tell you about Dubious. He had a little booth in the corner where you could record a hip-hop track. And I know this is probably super angering to people, to think, “Oh, drug users go in there and shoot drugs and then make music!”, but that’s how music therapy should work — it’s liberating, it’s reinforcing something that’s a safe public health practice, it lets people have artistic expression. And they make great tracks! You can go look that up on, I’m pretty sure, on SoundCloud. And it made that a really welcoming place. This is the difficulty with public health — you see it all the time in the pandemic — if it’s too official, if it’s too sterile, it doesn’t connect with people and they don’t abide by it, they don’t buy into it, whether it’s COVID-19 or whether it’s harm reduction. And so a place like that, that they built in Lethbridge that felt like a real centre for the community, a real place where people could go for all kinds of things — not just supervised consumption of drugs — that’s not easy to replace. That’s something that’s built very carefully and very thoughtfully, and wiping it out with a wrecking ball or a stroke of a pen is just so irresoponsible. We shouldn’t forget — Jason Kenney is a guy who’s been trying to shut down safe injection sites, or part of a little team, for a lot longer than he’s been Premier of Alberta. He was with the Harper government, and they sought, for pretty much the whole time they were in power, to shut down Insite, the safe injection — the first one in North America. It’s in Vancouver. And they did not succeed in that. I mean, it took us getting a lawyer, the late Joe Arvay, to represent us all the way to the Supreme Court and try to back off this whole situation, which we managed to in 2011. But the conservative tendency, from which Jason Kenney is a part, this is the ghosts of Harper in Lethbridge, no question about it.

Jeremy: Mhm. And I think it’s also worth pointing out a piece in the Star from August of last year that they sent a reporter to ARCHES to spend a day there and see what they do. There are some stats that they had that I thought were very revealing in that they shred the misconception that SCSs are just reversing overdoses and, as some in the UCP would say, are enabling people to use drugs. So, they reversed 2500 overdoses from 2018 to 2019. At the same time, they referred 9000 people to various forms of treatment. So, those who say that supervised consumption sites are just allowing people to inject drugs and are enabling them are arguing in bad faith because the evidence suggests a much more holistic approach than the political rhetoric would suggest.

Kate: I want to tie this in to the general approach of the government to public services in Alberta, whether it’s the public education system or the public healthcare system more generally, and their approach is, frankly, stripping the copper out of the walls — or, more precisely, starving the public system of funds in order to subsidize private delivery. And I think it’s really important that we see the attack on safe consumption sites as part of a broader attack on social goods and as public goods and as things that improve our society. And I feel like, here in Alberta, we have a government that basically says to people, “You should die alone and in pain. We would prefer that instead of having a society where we take care of each other, so we’re going to strip the funding from public healthcare. We’re going to strip the funding from long-term care, we’re going strip the funding from supervised consumption services, we’re going to strip the funding from public education.” And it’s all part of creating a society that is meaner, that is more cruel, and that encourages people to be at each others’ throats and to perceive the problems in their lives and in the lives of their communities as their own fault or as, somehow, moral failings of themselves or the people around them. And I really see it as part of an overall project of creating a society that is much, much crueller to the benefit of very, very few people who get to sell the copper they’re stripping out of the walls of this province. And those are the people who own these particular models and are able to make money off of it, and I find it profoundly grotesque and upsetting.

Jeremy: Yeah, and I think it’s also worth pointing out that the money that the government is throwing at these private recovery clinics are people who were appointed to their council on mental health and addictions recovery; two in particular. Stacey Petersen, of Fresh Start Recovery Centre, received $1,560,000 to fund 294 beds over three years, which she called a game-changer and said that the level of support the government has provided for abstinence-based treatment and long-term recovery is unprecedented. Now, nowhere in the news release announcing that funding commitment did it mention that she sat on the government panel that presumably, in part, made the decision of where to send this money to. And the same is true of Poundmaker’s Lodge, whose executive director Brad Cardinal also sits on that panel. They received $1,400,000 to fund 28 new beds and seven existing beds in December of last year. Poundmaker’s is built on the site of a former residential school, and it’s also under investigation by two police forces in Morinville and Edmonton for allegations of sexual impropriety against staff. So, probably not the best place to be throwing money at. And there’s also — the government has made a commitment of $25,000,000 to build five new recovery centres making up 400 beds across the province, but it’s not clear who’s going to own and operate these, and, given this government’s M.O., I think we know that it’s not going to be Alberta Health Services.

Garth: I think the images are also powerful in this, right? You think about the unit: a bed. That’s how they’re measuring this, right? On our side, we’re measuring this in deaths, and these are really different kinds of metrics. The conservative side imagines these places where people are injecting drugs into their arms, and it’s horrifying to them, whereas, with beds, you imagine someone being tucked in there, all safe — not shooting drugs into their arms, not breaking into your car or something that. And the idea of it, you don’t need much more than to say “bed,” and that’s what most of the rhetoric is, is this “bed.” And then you ask — what happens in the bed and the space around the bed and the programming around the bed? And that’s less regulated and less defined, less evidence-base and less tested to see if it’s getting results. So, I am actually not against beds — I mean, I sleep in one every night — but it’s like if you declare war on every part of the system except a privately-run bed, then you’re just going to dig the graves deeper. There’s no way around that.

Jeremy: And I’m somewhat puzzled by the cost of each bed, because they seem to vary wildly, right? At Fresh Start, they’re getting $1,560,000 for 294 beds; at Poundmaker’s, it’s $1,400,000 for 35 beds; at Thorpe Recovery Centre in Lloydminster, it’s $2,200,000 a year for 1722 spaces, and at Sunrise Healing Lodge here in Calgary it’s half a million to fund 150 beds. Why are the costs of beds so different for different clinics?

Garth: I can tell you, in BC, that the length of stay, the type of programming, the amount of space each person has, the quality of the place — those all vary a lot, and all of us drug user who’ve been through those things, people have different opinions about — they like this one, they don’t like this one, they’re hopeful about this one — and people who’ve been around for long enough have been through a bunch of them and are maybe through with that. But we also have the experience, here, of anybody who has a house putting some mattresses in the basement and saying, “Alright, I’m running a recover house!” And I think we’re trying to get away from that complete Wild West of anybody can run one, but, certainly, I think what they do in there varies a lot. And then, of course, how much of that is given over to the salaries of management, to administration, to all of those other kinds of costs.

Jeremy: And, while the government is lavishing these funds on private recovery clinics, they’re also cutting down AHS-operated facilities like the McCullough Centre up in Gunn, which was for homeless people, specifically. And it took them beyond the old-school 30-day recovery model to give their patients, or clients, sufficient time to get their lives on track, and acknowledging that that is different for different people. This defunding, this closing this centre, will save the province $3,000,000, which is nothing in a provincial budget. And, as of October, they had 11 of 75 beds filled, but they had a waiting list of 150 people, and the reason they didn’t have those beds filled was because the government told them that they’re shutting them down and not to take any new patients. But there was clearly a lot of demand for it, and I’ve been told anecdotally, by someone I know who works in the field, that it had a very good success rate. So, again, they are holding up these private clinics as the one true solution while cutting away at everything else, especially things that are publicly funded.

Garth: This is dangerous for us too, right? When you remove this stuff out of the public sphere — when you make the time in a bed into a commodity — then you increase the incentive to get people out of that bed so you can get someone else in and double-charge for a month. And we have seen that before, out here. Not everybody does it, but there are some operators that do, and the more that you commoditize and marketize something, the more you incentivize moving people through — so, finding a pretext to kick people out. So, for example, if you are in a lot of recovery houses and you relapse and use, they can kick you out. So, you’re there to get treatment for what they’ll tell you is a disease, and they’ll tell you it’s chronic and relapsing, but then, if you have a predictable symptom of the disease — I’m not convinced of this model of looking at it, but it’s what they — if you have a predictable instance of the disease, a relapse, you’re out! [laughs] And we know lots of people, and I’ve interviewed lots of people, who this has happened to and have been out for lesser reasons, too. It’s a really dangerous slippery slope to too much marketize, or too much commoditize, those spaces.

Kate: Yeah. Call me old-fashioned, I just personally don’t believe that profit should be involved in care, because every dollar that goes towards generating profits is money that could have been spent on creating a service that works better for the people that it is intending to serve in some way.

Garth: Okay, I’ll do it: you’re old-fashioned! You’re old-fashioned, like Rosa Luxemburg.

[laughter]

Kate: Garth, you wanted to talk a little bit more about the press conference that Jason Kenney gave and some of the ways he was talking about supervised consumption services. What are some of the things that stood out to you in parts that you listened to and what you heard?

Garth: I didn’t see the whole press conference, but I did see part of it.

[recording starts]

Jason Kenney: The federal CERB income benefit, while very well-intentioned and very helpful to millions of Canadians, had the unintended consequence of significantly increasing the ability of people trapped in addictions to purchase dangerous drugs. The increased income available to people whose first and last dollar sometimes goes to feed a dangerous addiction, through the CERB and other income support programs, by many accounts, could also help to drive up the opioid deaths this spring and summer.

[recording ends]

Garth: The part of the press conference that really struck me is that Jason Kenney was blaming CERB. He was having a press conference responding to the overdose statistics, and he was saying that part of the problem was that people were getting money from the Canadian Emergency Response Benefit. And it’s true that, probably, a bunch of drug users have gotten CERB cheques, and that’s more money than people would usually have just on social assistance, but let me tell you from personal experience — if you’re wired, your support, part of your social assistance — that little bit of your dole cheque — is not covering your habit. You’ve got to get that money from doing other shit, sometimes which is risky or sometimes even illegal. And I know this; I’ve lived this. When you have another source of income, you can replace that and you can do less risky and less illegal shit, but it’s not like people are sitting there doing a very little amount of drugs and then, all of a sudden, CERB is jacking that up and that explains the overdoses. In fact, I would think CERB can allow people to have a little bit less of a stressful and chaotic life as someone who’s wired or as someone who’s using every day. And, certainly, these programs should continue at a bare minimum, but you can see it’s not just Jason Kenney doesn’t like drug users having access to CERB; I think he probably doesn’t like the program in general, at least that’s the feeling I got from the press conference. I live in BC, so, on the one hand, I don’t know what it’s like to have Jason Kenney as a prenmier, and so I really feel for you all, but I have lived through the entirety of the Harper regime, so I do know, a little bit, what it’s to like to have conservatives trying to shut down harm reduction, and I can say: the only thing that works is to fight back. The only way the worked for us was to organize as drug users and allies and people who supported harm reduction and to fight back, and I see that happening in Alberta. I see that happening in Lethbridge amongst the people who used to work there, at ARCHES, and I see it happening in other places, and I just want to give a huge shout-out to those comrades who are in the trenches fighting back. Tons of respect. When I was watching that press conference, I was feeling it through what I thought might be their feelings, and I know just how fucking hard that is, and I am there with you. I’m feeling it. More power to you.

Jeremy: Yeah, shout-out to Moms Stop The Harm and HIV Community Link and other organizations in this province that are promoting a sensible, evidence-based, holistic drug policy.

Garth: Yeah, and congratulations, Jason, on being able to fuck up two public health emergencies at the same time.

Kate: They make ‘em different in Alberta.

Garth: That’s the Alberta advantage!

[laughter]

Kate: Ah, roll credits.

Garth: Ba-boom!

Kate: Jeremy, thank you for joining us here on The Alberta Advantage to walk through your piece in the Progress Report. If our listeners want to read your piece and follow you and your work, where should they look?

Jeremy: They should go to theprogressreport.ca to read my piece as well as many other great articles from a pretty wide array of authors. I can also be found on Twitter at @jeremyappel1025. I also am the city hall reporter for The Sprawl, and you can sign up to my weekly newsletter, which is on a brief hiatus for the holidays, at sprawlcalgary.com. I also write the Passage newsletter a couple times a week, which you can subscribe to at readpassage.com. And, finally, I co-host two podcasts: Big Shiny Takes, which takes a humorous look at some of the really bad punditry here in Canada, and The Forgotten Corner, which is more of an interview podcast where we sit down with people we find interesting.

Kate: Garth, it was a real pleasure finally having you here on The Alberta Advantage, and a real privilege for us. If our listeners want to follow you and your work, where can they go?

Garth: They can just follow me on CRACKDOWN — we’re on Twitter at @crackdownpod. The podcast comes out irregularly [laughs]; tries to be monthly. And I’m at @garthmullins on Twitter.

Kate: Incredible. Thanks to both of you for jouining us here on The Alberta Advantage, and thank you to our listeners for [outro music begins fading in] joining us for another episode of the podcast. Take care out there.

Garth: Thank you, see ya.

Jeremy: Bye!

Garth: Be safe! Keep six!

Kate: If you liked today’s episode, you should check out the Harbinger Media Network, featuring shows like the popular, bi-weekly Toronto Ecosocialist podcast Oats for Breakfast, which approaches questions related to socialist strategy from an open, non-dogmatic perspective with hosts Umair, Sadia, and a rotating panel of guests. Find out more about the Harbinger Media Network and the entire cross-country line of podcasts at harbingermedianetwork.com.

[outro music ends]

[bird call]

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