By Dr. Elaine Hyska, re-posted from Twitter (January 21, 2020) with permission.

This is a response to Alberta Premier Jason Kenny’s stance against supervised consumption services (SCS) and his claim that in the past few years investments in AB were only in harm reduction and treatment was ignored.

MSTH would like to thank Dr. Hyska for this detailed and evidence based analysis that provides important context to the discussion on the fate of Supervised Consumption in Alberta.

#ABleg #ABpoli #ABhealth #SCS

Since 2017 Alberta heavily invested in new *treatment, prevention AND harm reduction* programs. Now in 2019, OD deaths are steadily declining. Cutting effective interventions could undo this progress and put more lives at risk . [The premiers position is stated in this article by Global News].

Between 2015 and 2019 the # of Albertans engaged in (gold standard) medication treatments for opioid use disorder grew from ~4200 to ~11,000; and AHS added 4000 new treatment spaces across the province. {See AHS infographic]

The province also opened 7 community-based supervised consumption services, which have collectively supervised over 307,793 visits with 0 deaths and 4587 overdoses reversed as of Sept. 30 2019.

Note the SCS stats below exclude visits and overdoses for 2 other SCS: a hospital-based service in Edmonton and Red Deer's (provincially funded) overdose prevention site.

Further, almost 200,000 naloxone kits have been dispensed to date by community-based harm reduction service providers, pharmacies, AHS, and other sites.

2020-01-22 08_31_38-Opioid Infographic_31MAY19.png

These investments were made on the best available evidence, which tells us that the most promising strategies for averting overdose deaths at a population level are 1) naloxone kits, 2) treatment w/ medication, and 3)supervised consumption services.

2020-01-22 09_10_17-Modelling the combined impact of interventions in averting deaths during a synth.png

Collectively, these 3 strategies have been estimated to have *averted 3030 overdose deaths* in British Columbia between April 2016 and December 2017 [See Research article by Irvine and others, 2019). You can see from the results of study below, that SCS (or overdose prevention sites) contribute a smaller but still significant proportion of deaths averted. It is thus very distressing one of the few strategies shown to save lives could be defunded in Alberta.

2020-01-22 09_10_38-Modelling the combined impact of interventions in averting deaths during a synth.png

Beyond these 3 interventions, the previous government funded community-led prevention efforts, reductions in inappropriate opioid prescribing, and introduced long overdue consumer protections for people seeking care in private residential addiction treatment facilities.

Their overdose response plan was expert-led (by the MOERC, which (full disclosure) I Co-Chaired alongside the province's Chief Medical Officer of Health. You can read all 32 recommendations implemented here:

The new gov't has announced funding for 4000 new treatment spaces. Details are still to be determine, but this appears to be new residential treatment spaces, which though helpful for many w/ addiction, are not very effective for treating opioid use disorder or reducing deaths. In fact, some evidence suggests that periods of abstinence associated with short-term residential treatment and detox programs can actually increase someone's risk of overdose death (due to decreased tolerance and high rates of relapse).

Every overdose death represents a friend, family member, or neighbour. With so many loved ones grieving across Alberta, I hope the current gov't will recognize the value of saving lives and reconsider the wisdom of cutting these services.