Base your solutions on actual evidence

Opinion

The Stefanson government would have us believe it has softened its stance on the use of supervised substance-consumption sites as a means to fight growing addiction in this province. But the timing and tone of the province’s actions over the past few days suggest otherwise.

In an opinion piece penned by Janice Morley-Lecomte, Manitoba’s minister of mental health and community wellness, that was published by both the Brandon Sun and Winnipeg Free Press this week, the minister offered what appeared to be an olive branch to critics of the government’s ideological stance against such sites.

She wrote of “forthcoming measures that could open a new window in the future for licensed and regulated supervised-consumption sites to be established in Manitoba, appropriately situated within a continuum of addictions care facilities, along with broader efforts to promote recovery.”

This apparent change of tone by the government was then followed up on late Tuesday by a bill tabled by the minister herself that would establish licensing requirements for addiction treatment centres, including supervised consumption sites.

But when Morley-Lecomte spoke about the bill, it was clear the province wasn’t actually supportive of the creation of safe consumption sites, and was rather bowing to the fact they could not stop their creation under federal exemptions. Instead, the minister signalled that such sites and other treatment centres would have to follow strict guidelines or face some hefty fines.

If passed into law, The Canadian Press reported, the legislation would require supervised consumption sites, addiction centres with beds and withdrawal-management services to apply for a provincial licence. The licence would spell out what kind of services can be offered and, among other things, set standards of care and require minimum levels of medical supervision.

Accordingly, the province would then have inspectors enforce the law, and providers that break the rules would face fines of up to $50,000 per day.

This legislation was tabled the same day the province announced a $12-million program to fund new treatment spaces, increase capacity of existing treatment agencies and create new withdrawal-management beds in Manitoba regional health authorities including Prairie Mountain Health.

Until now, Premier Heather Stefanson has defended her government’s “recovery approach” to treating addiction by stating that evidence, not ideology, is behind their rejection of safe consumption sites. In fact, the premier and a succession of ministers have attempted to vilify those who point to growing evidence that safe consumption sites save lives while providing access to necessary services.

Last November, in a podcast interview with the Sun, the premier took issue with people who look at supervised consumption sites as a “panacea to end addiction issues.”

“It’s just not right, it’s not true, and I would argue that perhaps some of those people are taking an ideological approach,” Stefanson said at the time.

In her op-ed description of advocates of supervised consumption sites, Morley-Lecomte echoed the premier, stating that “too often, advocates of harm reduction profess mistakenly that supervised consumption sites are the ‘silver bullet.’” She also argued that such advocates have a singular focus on harm reduction that “keeps people mired in active addiction.”

But this depiction is erroneous, as no responsible health professional, mental health organization or addiction facility staffer would take such a singular and unreasonable approach to public health. The assertion has always been that recovery and harm reduction must be a simultaneous policy, with the understanding that keeping people alive is just as important as offering addiction recovery programming and necessary support.

After all, dead people do not need treatment, nor do they seek it.

Not surprisingly, the minister’s decision to exert control over SCSs and implement fines was panned by several Manitoba community groups and organizations that provide addictions services. Groups like the Manitoba Health Coalition suggested the province chose to discredit harm reduction services, and target organizations that provide these life-saving services, and further accused Morley-Lecomte of pushing “misleading rhetoric” in her op-ed.

In both her written words and spoken comments, Morley-Lecomte directly criticized the federal government for allowing the establishment of supervised consumption sites in Manitoba — such as the mobile site that started up last year in Winnipeg — without the provincial oversight or even asking permission of the province to do so.

This messaging was clearly conceived in anticipation of Wednesday’s visit to Winnipeg by Carolyn Bennett, the federal minister of mental health and addiction, who announced $13 million for harm reduction and treatment services projects across the Prairies, the Northwest Territories and Yukon.

In comments made to media, Bennett reiterated the federal government’s position that supervised consumption sites are essential elements to addressing overdose deaths and addiction issues. Bennett also said the large number of overdoses that have been reversed at such sites in Canada proves the benefits of SCSs are backed by evidence, and not rooted in ideology.

But by its actions, our provincial government has shown an unwillingness to put the public good ahead of its own ideology.

For example, even as the province attempts to hide them from the public eye, the number of overdose deaths in Manitoba remains stark. As the Free Press noted again this week, at least 424 Manitobans died from overdoses in 2021 and at least 377 people died between January and November 2022, according to data from the Office of the Chief Medical Examiner.

We will not argue against the need for more and better access to addiction treatment in Manitoba, and the new resources announced Tuesday should be duly welcomed. But a dual approach utilizing harm reduction methods would be far more effective.

The complex health challenges alluded to by Morley-Lecomte require equally complex and thoughtful solutions that move beyond ideological blinders and that are based on actual evidence. It’s unfortunate the Stefanson government seemingly does not understand this simple fact.

» Matt Goerzen, editor