Fatal drug poisonings in Canada caused by illicit drugs remain at a crisis level. The most recent update from the Public Health Agency says an average of 17 people die every day from opioids such as fentanyl. Yet at a moment when responses based on reducing harm are urgently needed, some governments are making an ideological choice to limit the very services that have been shown to save lives.

This shift is visible across the country. Municipalities in British Columbia and provincial governments in Ontario and Saskatchewan are choosing to ignore evidence of how best to protect people using drugs.  

In Alberta, the move away from harm reduction has been particularly pronounced. The provincial government has closed supervised consumption and overdose prevention sites across the province, including in Edmonton, and has announced plans to close the only remaining site in Calgary in 2026.

The governing United Conservatives have developed a drug policy that rejects harm reduction in favour of abstinence, often referred to as recovery-oriented care. Last spring, they passed the Compassionate Intervention Act, which allows for the forced treatment of people deemed to be a danger, because of their drug use, to themselves or others.

Municipalities have also taken steps to restrict access to harm reduction services. Last month, council members in Lethbridge, Alta., voted to request the province close the city’s only overdose prevention site. Mayor Blaine Hyggen argued that a lower fatal drug poisoning rate was evidence that the site is no longer needed.* His motion also suggested the service did not align with the council’s vision for a “safe and viable” community nor recovery-oriented care.

Reframing harm reduction

“Recovery-oriented” and “compassionate intervention” may appear to be desirable approaches on the surface, but these policies ignore the needs of communities, create barriers to care and limit the ability of adults to make their own decisions about their health. The Alberta government is viewing drug use as a moral failure that requires treatment — even at times when it is not wanted.

Taken together, provincial and municipal decisions signal a broader retreat from harm reduction, which has been reframed as the “cause” rather than an effective response to the drug crisis. This fails to recognize that, in addition to saving lives, such a service connects people with health care and social supports to make sure those who are ready for treatment have access to it. Harm reduction and treatment should not be seen as conflicting “one-or-the other” approaches, but as essential components of holistic care for people who use drugs.

When harm reduction services are withdrawn

Lethbridge offers a clear example of what is at stake.

In 2020, the Alberta government closed the city’s supervised consumption site, which had been Canada’s busiest. It was the first on the continent to provide a place for people to smoke or inhale illicit substances under supervision. It also offered supports, including cultural services, housing initiatives, sterile supplies and clinical nursing care.

A peer-reviewed study done by a research team from the University of Lethbridge examined the closure’s impact on people who use drugs and on community support organizations. Participants generally believed that the decision to close the supervised consumption site was ideologically motivated and that the site was being used as a scapegoat for the challenges created by the unregulated drug poisoning crisis.

The study’s participants described being pushed into more dangerous patterns of taking drugs, including using alone. They also lost access to sterile supplies, health and social services and trusted relationships with providers. Many participants associated the increase in drug poisonings following the site’s closure with the reduced ability of people to protect themselves from the toxic drug supply.

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Community-based organizations described needing to balance their desire to reduce harm with a fear that they, too, would be defunded for not aligning with the government’s abstinence-based approach. This led to changes that sometimes limited people’s ability to receive evidence-based interventions.

Why this matters now

This context is essential for understanding what is likely to happen in Lethbridge if the overdose prevention site closes and in other jurisdictions considering similar cuts to harm reduction services. People will suffer needlessly.  

The overdose prevention site in Lethbridge does not have the same capacity as the previous supervised consumption site, but it continues to be well used, including in months during which city council noted there were fewer fatal drug poisonings. An Alberta government reporting site recorded more than 15,500 visits from 613 individuals in the third quarter of 2025. (See graph under “supervised consumption services utilization” tab of the report.) Each of those visits represented a moment when someone did not have to use drugs while alone.   

Moves by municipalities to line up with the province’s approach may be justified as strategic, particularly given the fear of backlash, but less focus on harm reduction does not reduce drug use or improve community safety. It only forces people to use drugs in public and dangerous settings.

An evidence-based approach

Provincial governments should ground their decisions in evidence that shows the effectiveness of harm reduction in preventing fatal drug poisonings. Municipalities should advocate for safe sites as well as for increased sterile supplies and naloxone distribution. Reducing harm must be part of any government’s strategy in the drug poisoning crisis.

It is important to note that many decisions, including Lethbridge’s recent call to close its overdose prevention site, are made without meaningful involvement of people who use drugs. Yet they know best the dangers of a toxic supply as well as the services they need. Excluding them not only reinforces the stigma associated with drug use, but also leads to dangerous policies, like the Compassionate Intervention Act, that attempt to reduce substance use through coercion and punishment.  

Key to addressing the drug poisoning crisis is recognizing that the root cause of harm is not the moral failing of individuals but rather the decision to prohibit drugs themselves. This has made illicit substances increasingly toxic and caused significant health and social harms. Creating a safe supply is essential in preventing fatal drug poisonings, although harm reduction will remain necessary to protect people from toxic substances.

Drug policy must be grounded in evidence. Lethbridge has already shown us what happens when harm reduction is withdrawn. People who use drugs — and the communities they are a part of — will bear the brunt of regressive and ideological decisions. And lives will be lost.  

Note to readers: This article has been updated to correct the spelling of Blaine Hyggen’s first name.