Trudeau's mandate letter for Canada's new health minister leaves the opioid epidemic off its priorities list

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      Canada’s overdose crisis didn’t receive a lot of attention during last October’s federal election. It wasn’t even mentioned in the English-language leaders debate, for example.

      That’s despite opioids killing more than 13,900 people since 2016, when the federal government first acknowledged the crisis and began counting deaths.

      Now Prime Minister Justin Trudeau’s re-elected government has issued new mandate letters following a cabinet shuffle that was announced on November 20. The instructions for the country’s new Health Minister, Patty Hajdu, similarly say little about overdose deaths.

      “Work closely with other orders of government, as well as substance use experts, service providers, first responders, law enforcement and people with lived and living experience in order to ensure Canada’s response to the current opioid crisis is robust, well-coordinated and effective,” the document reads.

      “Work with the provinces and territories on new investments that expand community-based services, build more in-patient rehabilitation beds, and scale up the most effective programs such as extending hours for safe consumption sites.”

      That’s it.

      Perhaps noteworthy, this section on the overdose crisis appears in Hajdu’s letter outside of a section labelled “priority areas”.

      Health Canada’s new “priorities” are to ensure access to a family doctor, set national standards for mental-health care, make home care and palliative care more available, and implement national universal pharmacare. Most will agree those are all worthwhile objectives. But only one of them could be interpreted as touching on the overdose crisis, which many advocates and health officials now describe as the greatest health emergency this country has faced in a generation.

      The overdose crisis appears a couple of bullet-points further down the page.

      Hajdu does however come with a resume that suggests she’s going to take Canada’s opioid epidemic seriously.

      The Liberal MP for Thunder Bay-Superior North previously served as executive director of Thunder Bay Shelter House, a support centre for people experiencing homelessness or otherwise living in poverty. That position involved working with people who struggle with an addiction and responding with harm-reduction programs such as needle exchange.

      In B.C., authorities have credited harm reduction and especially the establishment of new overdose-prevention sites with success in managing this province’s rise in overdose deaths.

      “The rapid expansion of harm-reduction services in response to B.C.’s overdose crisis prevented more than 3,000 possible overdose deaths during a 20-month period, reads a June 2019 B.C. Centre for Disease Control (BCCDC) media release. “The study estimates that without access to and rapid scale up of harm reduction and treatment strategies, the number of overdose deaths in B.C. would be 2.5 times as high.”

      Harm-reduction advocates have greeted Hajda’s appointment as Canadian health minister with approval (and high expectations).

      Last Friday (December 13), Public Health Ontario reported that fatal opioid overdoses continued to climb during the first three months of 2019. There were 435 deaths in Ontario from January to March, a 40-percent increase over the same period the year before.

      Meanwhile, in B.C., the coroners service’s latest bi-monthly report shows that a decline in deaths observed since the beginning of 2019 continued through to the end of October.

      There were 823 illicit-drug overdose deaths during the first 10 months of 2019, putting B.C. on track for an estimated 988 deaths by the end of the year.

      That would be down quite a bit from 1,542 fatal overdoses in 2018 and 1,495 the year before that. However, 988 deaths remains miles above what was once considered “normal” in B.C. Just five years ago, in 2014, there were 367 fatal overdoses, roughly one-third the number that B.C. is projected to record this year.

      Several high-profile Vancouver care providers and B.C. health officials have repeatedly asked the federal government to decriminalize drugs and help expand access to “safe supply” programs that offer people addicted to drugs a pharmaceutical alternative to illicit opioids purchased on the street.

      Travis Lupick / B.C. Coroners Service

      In July, Health Canada announced money was being made available for safe-supply initiatives. But it has yet to make it’s way to B.C.

      Vancouver mayor Kennedy Stewart has said he encouraged by Hajdu’s appointment as health minister.

      "We're in a minority government situation and there's windows to co-operate, come together, build things that Canadians want," Stewart told the Canadian Press last month. "I want to make sure this window doesn't close before we deliver on these key priorities."