Guest column: Don’t let politicians abandon evidence for ideology

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By: Robin Baranyai

Evidence is reassuring. It suggests we have good reasons for getting patients up and moving after surgery, or reading to young children. We put our faith in evidence-based practices, because there’s a body of data supporting improved outcomes.

So, it’s frustrating to see policy makers prioritizing ideology over evidence when it comes to addiction.

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Alberta announced the province will build two involuntary treatment centres for people experiencing severe addiction. “Compassionate intervention centres” — doublespeak for forced treatment — will create 300 beds for people deemed a danger to themselves or others. Critics have noted there is not enough capacity to meet the existing demand for voluntary treatment, nor any high quality evidence that treating people against their will actually works.

Disturbingly, Premier Danielle Smith framed the health announcement in the context of border security. “If Canada does not willingly take steps to get this crisis under control and stop the flow of deadly drugs, such as fentanyl, the U.S. will impose tariffs to force us into responsible actions,” she said last week.

Smith certainly knows there is substantially more fentanyl flowing north across the border into Canada than is moving in the opposite direction. She also knows the U.S president cares little for evidence. We are all living in Donald Trump’s made-up reality now, where a trade deficit is a “subsidy,” Ukraine is the aggressor against Russia, and Panama owes him a canal.

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There’s no clear playbook for dealing with a person who governs like the Dungeon Master in a game of Dungeons and Dragons, dictating the story and his own rules of play. Elected officials find themselves with a handful of confusingly shaped dice, and no idea when the rules will change next. What should be clear, however, is that tying the whims of this chaos agent to provincial health policies will do nothing to help people living with addiction.

Meanwhile in Ontario, Premier Doug Ford has called supervised consumption sites a “failed experiment,” despite abundant evidence they save lives and reduce the spread of HIV and hepatitis C. In December, Ford’s Conservatives pushed through legislation to close nearly half the publicly funded sites in Ontario, citing their proximity to schools and daycares, including the only facility in opioid-ravaged Thunder Bay. Tellingly, the government bypassed committee hearings, where it would have heard testimony from health researchers and medical experts — in other words, evidence.

Ontario’s plans for 19 HART hubs with wraparound services for people experiencing homelessness and addiction are refreshingly grounded in evidence. Unfortunately, the approach embraces treatment at the expense of harm reduction, when in fact the two approaches are complementary and necessary.

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The idea that taking away a safe place to use drugs will end illicit drug use in these communities is magical thinking. It’s not the first ideological attack on supervised consumption by the Ford government, which brought in crippling regulatory hurdles when it first came to power, and capped the number of sites provincially, despite the growing opioid crisis.

We know harm reduction improves health outcomes, whether people are working to reduce their drug use, seeking help to quit, or just trying to survive the day. We know this because we have collected evidence, painstakingly, during more than two decades.

Vancouver’s Insite, the first supervised consumption pilot project in North America, opened in 2003. The results were indisputable: blood-borne infections dropped, more people connected to recovery services, and nearly 12,000 overdoses were reversed.

By all means, pilot new approaches and collect more evidence, but don’t abandon what works.

Robin Baranyai’s columns are regularly featured in Postmedia News publications. She can be reached at write.robin@baranyai.ca.

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