The Way Out: Addiction in Alberta

Sitting on the north edge of Red Deer, Alta., where industrial land meets farmland, is the centerpiece of Albertas answer to the opioid crisis.

The Red Deer Recovery Community sits on a sprawling six-hectare compound; it has stylish metal-sided buildings with big, modern-looking windows. It looks like an Ikea store mated with an ATCO trailer.

This residential treatment centre wont officially open for another two months, but once it does, it will have room for 75 clients (50 men and 25 women) all looking for publicly funded drug and alcohol addiction treatment.

A similar recovery community will soon open in Lethbridge, and the land has been picked for a third on the Blood Reserve in the southwest corner of the province.

All told, the province has set aside funding for 6 of these residential treatment facilities more than doubling the current number of public treatment beds in the province.

Where B.C. has doubled down on its harm reduction strategies by decriminalizing small amounts of illicit drugs, Alberta wants to pursue a very different strategy by trying to become the Canadian epicentre of the treatment and recovery movement.

And the man behind the movement is Marshall Smith.

Once addicted to drugs and homeless, he now has the ear of politicians across the country.

If you dont know Smiths name, a good place to start is a video recently released on YouTube by Conservative Leader Pierre Poilievre.

The video is a scathing critique of B.C.s harm reduction policies. In it, Poilievre says overdose deaths are part of a failed experiment to flood our streets with easy access to these poisons.

Set aside the raging debate over whether or not the safe supply of drugs is a lifesaver or a killer, and take a look at the screenshot from the video below.

See the silver-haired man on the left? The one showing Poilievre around?

That is Marshall Smith. He was once homeless on those Vancouver streets. Then he got clean and found a new purpose in life.

Today, hes Alberta Premier Danielle Smiths chief of staff and the architect of a fundamental shift in how Alberta intends to address opioid addiction and treatment in the province.

Marshall Smith swiftly tells CBC News the story of his own decline into addiction, like a man who wants to prove he has skin in the game but also wants to move on to bigger policy issues.

He started drinking alcohol as a teenager: I think some of the difference between me and my friends is that when they stopped drinking, I didnt.

In 2004, after he had started working with the B.C. Liberal government, someone offered him cocaine.

That wound up with me hanging up my suit and tie and sort of vanishing into the streets of Vancouver, he said.

I slept in doorways, ate out of garbage cans, did all of the things that you would imagine people do as theyre trying to survive that ordeal.

Then a couple of Vancouver police officers still his friends today found him and convinced him to go into recovery.

I went to a 35-day program in British Columbia that was publicly funded. And I really enjoyed it, he said.

I took it seriously, and it was the first time in years that I had that kind of connection and interaction in a very meaningful way with my other fellows who are in pursuit of the same recovery. And I enjoyed that process very much.

His north star was set.

I wanted to work very hard to be of service to the community, to give back what I had been given, which was a chance at a different life, at a new life. And so I rededicated my life to that.

Smith started working in the field of addiction treatment, primarily in northern B.C.

He says when he discovered the B.C. government was not interested in his vision, he looked east and accepted the offer of then-premier Jason Kenney to move to Alberta in 2019 and work in the Ministry of Mental Health and Addiction.

When Danielle Smith took over the leadership of the UCP, he moved to the premiers office as her chief of staff.

Now, despite the turbulent first few months of her leadership, he has maintained a focus on promoting, funding and talking up his vision for what is called the Alberta Model.

To understand what Marshall Smith envisions for Alberta, you must first consider what he sees as a failure.

What is going on in British Columbia and what has been going on in Alberta has not been working, he said.

We have had 20 years of this ideology, which has now spread to places like Los Angeles, San Francisco, Portland, Seattle, all up and down the Western Seaboard with devastation. We have to start doing things differently.

Smith says there has been an outsized focus on what he calls boutique interventions around opioids, including all the hallmarks of harm reduction: supervised injection sites, access to safer supply and not enough focus on recovery.

His recovery communities change that, he says.

The Red Deer Recovery Community feels more like a brand-new residence on a university campus than a treatment space.

Its divided into two wings: one for women and the other for men. There is a gym and a movie theatre in each wing. Big windows look out onto outdoor spaces where trees will eventually be planted.

Smith says if people are surprised by how nice it is, thats because they are used to what he calls the legacy system of addictions treatments, where facilities are in old hotels or apartment buildings, not in purpose-built spaces.

This centre cost $23 million to build and will require another $4 million a year to run.

Its publicly funded, but it will be operated by the Edgewood Health Network, which runs a series of treatment centres across Canada.

Smith says its money well spent.

We have a population of people that are living in our urban centres in very dire circumstances. Theyre accessing hospital emergency rooms at $1,000 a day, you know, and causing a lot of difficulty in the rest of the system, he said.

They deserve to have a healing place. They deserve to have a place that is comfortable. So yes, its a very nice facility and it should be. People who have substance-use disorders deserve to have a nice place to heal.

Unlike the traditional treatment centre model, residents will be able to stay beyond the standard 28 days and remain up to a year.

Smith tries to avoid any discussion of whether or not this is abstinence-based programming, knowing how charged a topic that is.

There is a debate within the addiction community about the push to sober living. For some, living without reliance on any drug is the hallmark of recovery. For others, it is dangerous and unrealistic.

At the Red Deer treatment centre, people addicted to opioids could be transitioned onto other drugs to help manage withdrawal, but the goal is to live without the use of drugs.

This is about getting off of drugs and moving on with your life. So all of the programming that happens here is aimed to support the client in the pursuit of a new life for themselves and that is usually drug-free life.

Reaction to the provinces shift in focus is mixed. More treatment spaces are typically good news, but some health professionals say they cant replace other critical services.

Dr. Bonnie Larson is a Calgary family physician who has spent 12 years working closely with people experiencing homelessness and who are using drugs.

She says treatment capacity should be on top of harm reduction methods like safe supply, not instead of it.

Recently, the government made it more difficult to access prescription opioids, which help people trying to transition off of street drugs.

Theyve taken the fourth leg out from under the chair, which is harm reduction. And by doing that, theyve destabilized the whole thing, she said.

Larson says the focus on treatment spaces does not solve the most acute problem: the real issue is the nature of the drugs available.

Theyre increasingly potent and unpredictable, so trying to offer users a safe supply of drugs is more realistic and valuable, she says.

From my point of view, we need it all.

CBC Calgary will explore that this week in our series.

This story is part of a series called The Way Out: Addiction in Alberta. Join the discussion, or read more about the series, here.