Canada’s opioid crisis is showing no signs of going away. Drug overdoses are at an all-time high and are trending upward in nearly every corner of the country.
In this context, a debate has erupted in Parliament over drug policies. Conservative MPs have accused Liberals of fueling addiction by giving funding to harm reduction programs. The Tories have taken particular issue with the idea of “safe supply” programs, which would provide people struggling with addiction with regulated, pharmaceutical alternatives to potentially tainted street drugs.
Despite the controversy in Parliament, however, neither side has the answer to Canada’s drug crisis. The rise in overdoses cannot be attributed to any individual policy. Rather, the opioid crisis is a symptom of the sick capitalist system that both Liberals and Conservatives fight to defend.
‘People are dropping dead on the streets’
Between January 2016 and December 2022, 36,442 Canadians have died in apparent opioid related deaths. Eighty-one per cent of these deaths involved fentanyl. As the weekly medical journal The Lancet put it, “After raging and taking—many young—lives at growing levels for more than a decade, the opioid-death crisis is very much alive in Canada; worse yet, it has become widely accepted as a part of everyday reality and therefore embraced as a kind of ‘new normal’.”
The hardest-hit areas have been Ontario, Alberta, and British Columbia. These three provinces alone account for 87 per cent of opioid overdoses since 2016. In Ontario, opioid deaths for teenagers and young adults have tripled and ER visits for overdoses have quadrupled since 2014.
British Colombia had already seen more than 1,000 drug overdoses by May of this year alone. Horrifyingly, illicit drug overdoses are now the leading cause of death for people between the ages of 10 and 59. In B.C., there are more people in this age range dying of drug overdoses than by accidents, homicides, suicides, and natural diseases combined.
In April, Alberta experienced its deadliest month for drug overdoses ever recorded. In June, emergency workers in Edmonton responded to 753 overdoses calls, compared to 306 the same time last year.
Dr. Darren Markland, a physician working in intensive care at the Royal Alexandra Hospital in Edmonton, said that “I have never seen so many opiate overdoses and out-of-hospital cardiac arrests as a result of drug poisoning in my entire life, and that’s saying something for a doctor who has worked 20 years in an inner city hospital.”
He added bluntly, “People are dropping dead on the streets.”
As usual, those suffering the worst are Indigenous communities. Indigenous people in British Columbia are six times more likely to die of drug-related deaths, and in Alberta seven times more likely. Recently, the Confederacy of Treaty 6 First Nations declared a state of emergency over opioid-related deaths.
While these three provinces have been the most affected, things have not fared better throughout the rest of Canada. Quebec has experienced an “unprecedented” number of opioid deaths as well. There were 1,258 drug overdoses recorded between January 2019 and July 2022. That’s nearly one overdose a day. Up in the territories, the Yukon currently suffers from the worst per capita drug death rates in the entire country.
Opioid deaths have been the most pronounced trend, but things are further complicated by the use of multiple drugs together, which has become increasingly more common. For instance, methamphetamine use has skyrocketed over the past decade. Hospitalization rates related to amphetamines increased by 15 times in Ontario between 2003 and 2020.
Harm reduction and the ‘culture war’
As the crisis has worsened, many health advocates have demanded a new path for dealing with addiction. Typically, drug addicts have been treated like criminals. From the 1980s and up until very recently, Canada has taken a “War on Drugs”-style approach to dealing with addiction. Anyone caught with drugs would be thrown into prison with the hope of deterring others from doing drugs themselves.
Nowadays, this approach is widely understood to be ineffective. Criminalizing addiction doesn’t affect the drug trade, but it does deter those struggling from addiction from seeking help. As the Global Commission on Drug Policy put it in 2011, “Arresting and incarcerating tens of millions of these people in recent decades has filled prisons and destroyed lives and families without reducing the availability of illicit drugs or the power of criminal organizations.”
Many of those critical of this approach have instead argued for harm reduction, which is the idea that addiction should be treated like a medical issue and that addiction services should serve to alleviate the negative effects of drug use as much as possible.
One popular harm reduction measure is the idea of safer consumption sites, where people can use drugs in a clean, supervised, and controlled environment. The hope is to lower the risk of overdoses by having health-care professionals on hand, and to avoid the dangers of drug users using unsanitary equipment. Providing clean needles, for instance, not only makes drugs safer, but slows down the spread of diseases like hepatitis and HIV.
Another increasingly popular measure is safer supply, as described above. Providing drug users with regulated pharmaceutical alternatives to street drugs has clear potential benefits. It would significantly lower the risk of drug users consuming tainted drugs bought off the streets. It could also lower rates of overdoses by helping to regulate the amount of drugs that users consume and providing them with less potent and, therefore, less deadly drugs.
Safer supply can also help lessen the severity of withdrawal symptoms. Cutting someone off from opioids cold turkey is not only difficult, but dangerous. Withdrawal symptoms can be severe enough to cause death.
These measures have managed to find some support in government in the past couple years. Most provinces today have some kind of safer consumption sites. Currently, the federal government also gives funding to 25 safer supply pilot programs.
Recently, Conservatives across the country have begun viciously attacking these initiatives, and have made it part of the wider “culture war” against the Liberals. Federal Conservative Leader Pierre Poilievre has said the opioid crisis is the result of a “deliberate policy” by “woke Liberal and NDP governments” to “flood our streets with easy access to these poisons.” In May, Poilievre introduced a failed motion in the House of Commons to ban safer supply programs entirely.
The right-wing National Post has published a slew of articles falsely claiming that safer supply is “destroying lives”. Alberta Premier Danielle Smith has rallied against it as well, saying, “There’s no such thing as a safe supply of fentanyl.” Smith’s predecessor Jason Kenney attacked consumption sites on the basis that they help people “inject poison into their bodies.” His government shut down a number of safe consumption sites in Alberta, including one in Lethbridge which was the busiest site in all of North America.
Of course, these attacks are based in total fantasy. No safer injection site or safer supply program provides open access to illicit drugs. As already stated, recipients of these programs receive limited, regulated, and supervised supplies of pharmaceuticals. No one is walking into their local clinic and walking out with a baggie of heroin. Likewise, all evidence points to the clear fact that the vast majority of overdoses are caused by street drugs, namely fentanyl.
These attacks from the right will only serve to make the crisis worse. Destroying harm reduction programs would strip away the little support that many who struggle with addiction receive. It would push drug users further away from mainstream society and force them to seek out more dangerous sources for drugs. Conservative addiction policies will kill people.
At the same time, however, it must be pointed out how weak the Liberals’ approach to addiction treatment really is. The right has been able to win some people over with its criticism because it contains one kernel of truth: It’s precisely under Justin Trudeau’s government that the opioid crisis has spiraled so heavily out of control. The Liberals have no basis in reality to paint themselves as the true heroes in the struggle against drug addiction.
Contrary to the right’s exaggerations, access to harm reduction services still remains very limited. For example, most overdoses today are caused by inhalation. In 2022, smoking accounted for 68 per cent of drug fatalities in Ontario. Despite this, there are only five safer consumption sites in the entire country that allow for indoor smoking.
Likewise, the outlook of these programs tends to be quite limited. Few safer consumption sites or safer supply programs provide a greater plan to help users wean themselves off of drugs in the long term.
They also don’t typically provide assistance in helping drug users get back on their feet. When taken on its own, harm reduction can actually be quite shortsighted. To really help someone over their addiction, they need to receive total follow-through. That means providing them with food and shelter, giving them access to mental health treatment, and, eventually, helping them find a job. All of these things require time, resources, and most importantly, money. But the government is unwilling to foot the bill. Instead, the Liberals have chosen the absolute barest of minimums: Provide addicts with an unlaced supply so they die less often, while doing nothing to better their conditions.
The Liberals’ gestures towards harm reduction appear hollow and hypocritical when you compare them to the rest of their program. From the beginning, Trudeau and his government have unleashed a series of attacks on working class and poor people. The federal government’s most recent budget applied cuts to health care, education, and other social programs. The Liberals run a government for the rich and against the poor, and this has played a huge role in exacerbating the crisis.
There is a clear relationship between poverty and addiction. It should not be difficult to see why. The conditions of poverty are enormously stressful, and unfortunately many turn to addictive substances like opioids as a way to cope. Once someone gets addicted, it becomes significantly harder to hold down a job and to maintain a regular life, which only makes things worse. The Liberals have played a criminal role in making the lives of impoverished people even more difficult, and deserve their fair share of the blame for causing this crisis.
Similarly, opioid use is encouraged by the working conditions of capitalism itself. Workers with a history of employment in manual labour die of overdoses at a highly disproportionate rate. For example, in Ontario, construction workers made up the majority of employed people who died of an opioid overdose in 2022. Many people addicted to opioids are low-income workers suffering from injuries they got on the job, but who don’t have access to sufficient workplace compensation or medical treatment. They then turn to drugs to cope with the physical pain they’re forced to work through. This is all spurred on by large pharmaceutical companies that knowingly over-prescribe pain medication to turn a quick buck.
End addiction by ending capitalism
Of course, the labour movement needs to defend harm reduction against the hypocritical attacks by Conservatives. In fact, the labour movement should go further and fight to expand current programs by connecting it to a wider fight for truly universal health care.
But the struggle cannot stop here. Harm reduction has clear benefits in decreasing the risk of overdose and helping drug users in the immediate term. Clearly, it can help soften the blow of the crisis. But no amount of harm reduction is enough to end the crisis.
It should go without saying that Marxists support each and every measure that makes the lives of oppressed people less difficult. This includes safer injection sites and safer supply programs. At the same time, the movement cannot limit itself to supporting measures that merely weaken the negative effects of capitalism, especially when there are people within the system who are constantly trying to strip these gains away.
Addiction is spurred on by poverty, which is an inevitability under capitalism. While there is a rich upper class, there will always be poor. As Karl Marx once put it, under capitalism, “Accumulation of wealth at one pole is at the same time accumulation of misery, agony of toil, slavery, ignorance, brutality, mental degradation, at the opposite pole.” The only way to solve addiction on a mass scale is to turn the system up by its roots.
A socialist economy, based on the democratic planning of the country’s economic resources, would be able to provide healthy, stable conditions for all. Everyone would be entitled to quality education, health care, and housing, and everyone would have easy access to a job. People would have control over their own working conditions, meaning no one would be forced to work through chronic pain or an injury.
This obviously isn’t to say that no one would ever get addicted to drugs under socialism. However, when the conditions of poverty are abolished, it will cease to become a mass problem, and addiction would then be treated on an individual level. The only way forward is by ending the system that has created the opioid crisis and building a new system on its grave.