Harm-reduction advocates are viewing a host of actions announced by Ottawa this week as an encouraging but modest step in combatting Canada's overdose crisis.
Federal Health Minister Ginette Petitpas Taylor said on Wednesday that Ottawa would allow initiatives such as drug checking, pilot projects to provide safer alternatives to opioids and a streamlined permission process for provinces to open temporary overdose-prevention sites in emergency situations.
Ms. Petitpas Taylor's office says the measures stem from discussions with provincial and territorial health ministers who had expressed a need for more provincial autonomy to offer harm-reduction services centred on the needs of users. However, many of the initiatives announced on Wednesday are already under way.
In response to concerns over the lengthy application process for opening supervised-consumption sites, for example, Ms. Petitpas Taylor announced "a streamlined pathway to establish temporary overdose-prevention sites" if there is an urgent public health need.
Marilou Gagnon, an associate professor in nursing at the University of Ottawa and a core organizer of Overdose Prevention Ottawa (OPO), said the new process adds a layer of bureaucracy to what was born as an emergency measure taken without seeking federal permission because the formal application process was taking too long.
"They were created for a system that was failing to begin with," Dr. Gagnon said. "Now suddenly there's a protocol, we have to demonstrate a need, and they are being framed as temporary. The language to me is concerning."
Ottawa's overdose-prevention site operated for just more than two months, until cold weather and a lack of municipal support forced it to close last week. One remains open in Toronto, as do 18 in B.C.
The concept of "overdose-prevention sites" – de facto supervised-consumption sites – was first referenced in guidelines prepared by Vancouver Coastal Health in 2016. As a cold snap hit B.C. last December, the province's deadliest month on record for overdoses, Terry Lake, then health minister, enacted a ministerial order under the province's Emergency Health Services Act directing B.C. health authorities to open more than 20 of the sites, side-stepping the federal exemptions needed for formal supervised-consumption sites.
In an interview on Thursday, Mr. Lake acknowledged that it was seen as a drastic action that took some people outside of B.C. by surprise.
The province sought legal advice before proceeding, and felt that the ministerial order would shield health authorities from any federal legal impediment.
Ms. Petitpas Taylor's announcement "is not much new in terms of B.C.," Mr. Lake said, "but I think it's an important signal to other provinces that, in fact, the federal government has their back when they are responding to the opioid crisis in the different jurisdictions."
B.C. has also offered drug-checking for fentanyl on a small scale since July, 2016, recently expanding it to all overdose-prevention and supervised-consumption sites.
Ontario announced in September that it would also launch such a program, offering it first at four supervised-consumption sites and one overdose-prevention site.
Elaine Hyshka, co-chair of Alberta's Opioid Emergency Response Commission, said Wednesday's announcement was positive, but will not likely change much on the ground. Alberta has six applications for supervised-consumption sites working their way through the approval process, and one temporary site in operation.
Alberta's priorities include dramatically scaling up drug-substitution treatment for opioid dependency services and access to naloxone, a drug that reverses the effect of an opioid overdose, Dr. Hyshka said.
It may look at drug-checking services in light of Ms. Petitpas Taylor's announcement.
"Are these announcements going to turn the ship on the opioid crisis and reduce deaths overall? No, I don't think so," Dr. Hyshka said.
"But I think they are a step in the right direction. More is needed."
She, as others have, expressed frustration at the federal government's unwillingness to consider drug decriminalization.
More than 3,000 people in Canada are expected to die of opioid-related overdoses this year.