This election could test public support for harm-reduction drug programs
Liberals would support non-abstinence based treatment, Conservatives pledge to get people 'drug free'
Shila Green is convinced she'd be dead if it weren't for a clean supply of opioids she received while in the throes of addiction.
For six months in 2023, she underwent an injectable opioid agonist therapy program in Saint John, which allowed her the stability to transition away from injecting illicit opioids, and on to orally-administered methadone.
"That way I'm not getting dirty stuff on the street, right?," said Green, who now lives in Fredericton.
"If it wasn't for them, I would have died, right?"
The type of program Green participated in typically falls under an umbrella of what have become known as harm reduction services.
They're often provided by non-profits, where the goal isn't necessarily getting users to abstain from substances.
Rather, they offer services ranging from giving out clean needles, to providing a space for people to use drugs under the supervision of a health-care provider, to clinical programs that prescribe patients pharmaceutical-grade opioids to keep them away from the increasingly toxic supply of illicit drugs.
But those harm reduction programs have faced criticism, with opponents linking them to increases in crime and homelessness, particularly in areas where those services are provided.
And with differing solutions on offer from the federal party leaders, this election could prove to be a litmus test for the public's support for those programs.
"There's no question that the harm reduction approach has been criticized quite heavily by downtown Fredericton," said Mike Davis, owner of The Radical Edge, an outdoor sports store in the downtown.
"I think it probably has a place in our society. Whether it's properly located, I'm not sure."
Davis said his and other downtown businesses have experienced an increase in property crime such as theft and vandalism in recent years.
That increase coincided with the COVID-19 pandemic, which upended the mental and financial health of many.
But it also coincided with the opening of harm reduction services, including a centre on King Street offering prescription opioids as an alternative to street drugs like fentanyl.
Davis said he plans to vote Liberal in this election because of the party's more pro-social stance on certain issues.
But he said he prefers Conservative Leader Pierre Poilievre's "hard-nosed" proposals when it comes to tackling crime and addiction.
"I'm not a big believer in, you know, second, third, fourth chances. I think once someone's done something there needs to be a proper place that they can be remediated," he said.
"I'm not sure what a better word is for it, but you know, being remediated out on the street is probably not very easily done where there's so many influences that are around them to not stay clean, or not even try to get more clean."
Poilievre has taken aim at harm-reduction centres like the one on King Street, vowing to cut federal funding for them, and instead fund treatment spots for 50,000 Canadians with the goal of getting them drug-free.
He's also proposed giving judges the power to sentence people to mandatory addiction treatment.
Liberal Leader Mark Carney has pledged to give provinces and territories $500 million to provide a full-range of evidence-based treatment, including those where success isn't defined by long-term abstinence.
Harm reduction programs needed, say users
Those who've battled addiction say getting all users drug-free sounds good in theory, but isn't a realistic goal for everyone.
For that reason, they say continued support for harm reduction programs is needed.
"It keeps them away from crime and stuff like that... and it's cleaner and safer," said Chris Kierstead, who himself has used the centre on King Street to manage his addiction to methamphetamines.
Brad Daly-Young agrees that getting every user drug-free is an unrealistic goal.
He said harm reduction helps those who struggle with abstinence, and takes issue with people blaming those services for increases in crime.
"It's not fair to criticize them for that because you can't blame them for somebody else's actions. It's not their fault. They're here to help us."
Abstinence-based treatment can't be only option, says prof
Strong pledges by both major parties to boost support for addiction treatment is a positive sign, said Shawn Bugden, dean of the school of pharmacy at Memorial University of Newfoundland.
"I think it's encouraging that both the Liberal and Conservative Party are recognizing the challenge of the opioid crisis that we're facing, and both are talking about increased investment in treatment," Bugden said.
Bugden said the treatment programs that get support need to encompass a wide range of options, including prescribed alternatives programs.
Bugden said programs that involve prescribing drugs such as methadone and suboxone for people battling opioid addiction have been widely accepted as effective in Canada for years.
But with language in the Conservative platform around bringing "loved ones home drug free," Bugden said it's "a little unclear" whether Poilievre would close the door on prescribed alternatives programs.
"I think that's a 1930s U.S. perspective, that abstinence approach," Bugden said.
"It's not supported by evidence, and I think that it's an unrealistic goal. And we can help a lot more people by taking the opioid replacement approach than trying to stick rigidly to the abstinence approach.
"If individuals want to move that in that direction or they're able to move in that direction, more power to them, but let's not close the door on opioid replacement."
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