We the North: Rethinking Addiction & Recovery in Canada

By Erik Haines

Last year, I wrote a short essay inspired by the recovery advocate and UK-based writer Stephen Bamber and published it on William L. White’s website. The general purpose of my article was to distinguish and contrast some of the critical differences between public health, addiction treatment, and recovery advocacy efforts developing in the UK, Australia, Canada, and the United-States.

Following its publication and several personal communications with various stakeholders across the United-States and Canada, I was stunned by the overall lack of historical and theoretical material on the evolution of the field of public health, addiction treatment and recovery in Canada. This second essay, like the first, is effectively my ongoing effort to capture and narrate this evolving theoretical and unfolding historical development in Canada.

As I described in my first essay, Canada (like many other nations) has been facing a rising health and drug crisis to epidemic proportions. In fact, according to recent statistics from Health Canada, more than 12,800 people have died from opioid and other related drug complications since January 2016. Given this dire situation, a growing resistance and intellectual awakening have started to take place in various pockets across the country to address this ever-increasing problem and tragedy as a new generation of leadership has been tentatively emerging.

These new vanguards – as I briefly described in my original article – live and breathe in new digital mediums and are coming from a wide range of life experiences, priorities, institutions, and professional backgrounds to examine and develop new approaches to the current health and drug epidemic crisis. These various individuals and groups – spanning movements such as the recovery advocacy, mutual aid fellowships, addiction treatment, public health (incl. harm reduction) and mental health – are slowly developing a shared vision and language around the evolving concepts of “recovery”, “meaning”, “health” and “self-determination” which seems to be driving a system and theoretical transformation for the delivery of healthcare and political discourse in Canada.

Inspired by the new recovery advocacy movement that developed in the 1990’s in the United-States, through organizations such as Faces and Voices of Recovery and pioneering figures like William L. White, Ernie Kurtz and (now) Dr. John Kelly from the Recovery Research Institute – Canada has seen an explosion of recovery advocacy activity and the development of recovery branded events and institutions across the country. In fact, this year the recovery capital conference – a joint effort between the addiction treatment industry and recovery advocates – saw its events grow from a single city in BC in 2016, to over 6 cities and provinces in 2019, and featuring keynote global speakers such as Gabor Mate, Johann Hari, and David Sheff. Additionally, the Premier of Alberta, Jason Kenny, took the opportunity at the Calgary event and conference to announce the investment of $140 million to improve addiction treatment and recovery-based services in Alberta.

This political maneuver by the newly elected United Conservative Party of Alberta and the private addiction treatment industry didn’t go unnoticed by Donald Macpherson – the Executive Director of the Canadian Drug Policy Coalition (CDPC) – in the lead-up to this year’s federal election. Without very much delay, the CDPC membership base – along with various mutual-aid community groups – began to express their discontent on social media and took their message to traditional outlets to broadcast their preferred policy-based approaches and support for their political parties of choice. Yet as disheartening as this progressive and conservative bickering across the public health, addiction treatment and recovery advocacy movement in western Canada might be – we should not let it overshadow some of the new and exciting emergent developments in other regions of the country.

Canada is world-renowned for its complicated relationship with the United-States and its linguistic, cultural, and political regional differences that contributed to its development and eventual confederation. At various times over its history, this has created multiple fractions of eastern and western forms of alienation and political discourses.  That said, a similar pattern seems to be emerging as to its response to the growing public health and substance use crisis that as spread across North America in recent years.

As briefly highlighted above, Western Canada (i.e. British Colombia, Alberta, Saskatchewan, and Manitoba) seem to have wholeheartedly embraced a harm reduction, private addiction treatment, and recovery-oriented system of care approach to this crisis – though it has been highly conflictual and politized at times. Interestingly, however, Eastern and central Canada (i.e. Ontario and Quebec) seem to be moving in a slightly different direction and are adopting a public health approach deeply informed by mental health and whole-person care medicine delivered by our public healthcare system – as can be ascertained by this year’s recovery-focused conference in Ontario and the third international congress on whole-person care medicine held at McGill University, in my home town of Montreal, Quebec.

Granted, integrating addiction medicine and mental health recovery initiatives have been underway for decades. Yet, since 2010, ten of the thirteen provinces and territories in Canada have adopted an integrated mental health and addiction medicine framework, with varying degrees of specificity in their visions of recovery. Though integrating addiction medicine and mental health concepts into one theoretical model for a shared vision of recovery and well-being has become a normative topic of discussion amongst policy wonks – Canada’s healthcare system is far from being able to deliver these services through its current public healthcare infrastructure. This vacuum of services and support, needless be said, has left many individuals, families and marginalized communities from across the country to cope on their own for decades, and in many cases, left in the deep shadows of our national and collective conscience.

This collective and social malaise has led to the rise of many Canadian intellectuals and academics to comment, theorize, and ultimately attempt to propose solutions to this national tragedy in recent years. A few of the most stimulating names that come to mind and would be worthy of elaborate commentary within this context and their contribution to this evolving and unfolding story in Canada would be: 1) Dr. Bruce K. Alexander 2) Dr. Gabor Mate 3) Dr. Donald Macpherson and 4) Dr. Marc Lewis. Yet as intriguing as all these figures might be, I believe one in particular needs to be singled out from the rest due to his recent rise to fame, and that would be Dr. Jordan B. Peterson. However, I will leave the details of that subject and controversial topic for another article.

Erik Haines is a Canadian Public Health Advocate, Information Professional, & Knowledge Management Consultant currently living in Montreal, Quebec.