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Prairie Harm Reduction, a supervised drug-use facility in Saskatoon, opened in October, 2020. It was the first in Saskatchewan to offer such health care oversight to people who inject or smoke drugs. This is a proven model in Canada, one that saves lives in the unending epidemic of toxic drug overdoses. The province, however, refused to provide funding, so PHR relied on donations. They raised $65,000, enough to pay one paramedic and open six hours on weekdays.

In 2021, PHR helped 508 people in a total of 3,680 visits. There were four overdoses and no deaths. There were also hundreds of referrals to other services, such as housing and counselling. But last week the conservative government in Saskatchewan, for the third consecutive year, denied public funding to this lifesaving service. PHR will again turn to donations.

What’s also happening in Saskatchewan is the plague of illicit drug overdose deaths that is ravaging Canada, north to south, east to west. According to the Saskatchewan Coroners Service, overdoses killed 446 people in 2021 – up more than a third from the 329 people killed in 2020 and more than double the 179 killed in 2019.

That is a picture of a national health crisis in close focus in a small province. Across Canada, overdoses have killed almost 27,000 from the start of 2016 through end of summer 2021. The deaths are rising at an alarming rate – almost doubling in a year.

We know what’s wrong – the poisoned supply of drugs on the streets – and we know what to do about it. But, like Saskatchewan, Canada is not doing anywhere close to as much as it should. The Public Health Agency of Canada suggests the likeliest future is at least 3,000 more deaths in the first half of 2022. Yet efforts to advance public policy – backed by reams of expert advice – are stalled.

What we don’t need are more reports. What we need is action. But in the face of political inaction, it is important to focus on what works. Among wide-ranging experts, there is a striking unanimity. We know what to do.

In early March in British Columbia, where the epidemic of deaths is the worst in Canada, a panel convened by the BC Coroners Service called for the province to “ensure a safer drug supply to those at risk of dying from the toxic illicit supply.” This means a far more widely available flow of regulated drugs. B.C. is a pioneer in safer supply, but has not yet gone as far as it needs to.

Still, to focus on any single measure is a mistake. Safer supply is one intervention. Another is decriminalization of small amounts of drugs. The crisis is a health issue, not a criminal one. Many bodies support this, including in 2020 the Canadian Association of Chiefs of Police, who also back safer supply. Yet Ottawa has for many months sat on decriminalization applications from Vancouver and other places. Nothing’s happened.

There are big challenges in providing housing for people who use drugs, and then there is the more difficult goal of treatment for their addictions. But without such steps as a rewrite of drug laws, supervised drug-use sites and safer supply, there is no treatment. As this page has grimly noted before, you cannot rehabilitate the dead.

In Ottawa, all these ideas are on paper, sitting on ministers’ desks. Last year, two expert reports backed all of them, from the urgent need for a safer supply to an overhaul of Canada’s drugs strategies, including treatment and recovery. The Liberals, before last summer’s election, said the reports would “inform our next steps.” Yet in December Prime Minister Justin Trudeau mostly ignored overdoses in mandate letters to his ministers. Last week, when the Liberals and NDP agreed to back each other in Parliament, overdoses were fully ignored in the text of their deal.

Yet in the House of Commons there is an NDP private member’s bill, C-216, that proposes decriminalization, as well as a national strategy on substance use that includes “low-barrier access to a safe supply of medically regulated substances” and “universal access to recovery, treatment and harm reduction services for problematic substance use.”

C-216 sits in the purgatory of second reading. How to change the course of a ruthless epidemic of overdose deaths is right there in front of all MPs.

The pile of evidence, from too many deaths to the policies to save lives, is sitting right there.

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