Do recent mandate letters signal a new direction in the opioid crisis?

As new Parliaments take shape, so too do new cabinets. In December, Prime Minister Justin Trudeau sent mandate letters to cabinet ministers, outlining overarching policy goals for the upcoming session. Among the recipients was Carolyn Bennett, appointed as Canada’s first minister of mental health and addictions on October 26 (she is concurrently serving as the associate minister of health).

The establishment of this new office prompted expectation that meaningful action on the opioid crisis might finally come to fruition. Yet, despite an epidemic which has claimed nearly 25,000 lives since 2016, it is not explicitly mentioned in any of the ministerial mandate letters.

Ostensibly, Bennet’s new ministerial post, and the office it presides over, was established to formally work toward permanent, ongoing funding for mental health services, something that has often been wrapped into Canada Health Transfer negotiations since 2016. This was also one of the Liberal Party’s election platform commitments, along with a promise to address the rising number of deaths from opioid toxicity—1,720 between between April and June 2021 alone.

Judging from the mandate letters, however, the opioid crisis does not appear to be a central issue for the government. Taken together, the mandate letters reiterate the state’s classic position that drug policy lies primarily in the hands of the provinces and territories, law enforcement and the criminal justice system.

What do mandate letters tell us?

Donald Savoie, a prominent scholar of executive politics and public administration, has consistently argued that despite a history of significant power given to ministers and more collaborative governance among the executive, the late-20th century was hallmarked by dominance from the centre—the prime minister, the PCO (Privy Council Office), and the PMO (Prime Minister’s Office).

Savoie’s most recent contribution to this scholarship, Democracy in Canada: The Disintegration of Our Institutions, extends this research to the current era, arguing the Trudeau government represents a continuation of historic dominance by the political centre over cabinet.

Mandate letters, which were not normally publicly available before Trudeau came to office, can pull back the curtain of federal policy priorities and shed light on where the prime minister and close advisors believe ministers ought to direct their attention. They can be an important tool for understanding how that political centre communicates priorities to ministers, mapping the general route the political executive will navigate over the course of their mandate.

This is especially important as complex, multi-causal (“wicked”) problems fall under the purview of several ministerial portfolios. Clear examples of this in the most recent mandate letters are, predictably, the COVID-19 pandemic and the climate crisis.

Where is the “opioid crisis”?

Regrettably, the mandate letter for the ministry Canadians would most expect to mention the opioid crisis leaves it out entirely, along with other measures including safe supply and decriminalization. The closest indication that the federal government is concerned with a scourge that claims 19 lives a day on average is a single, opaque line in Minister Bennett’s mandate letter, directing her to “lead a whole-of-society approach to address problematic substance use in Canada.”

In fact, a tweet from Bennett’s account on December 16 effectively said more about the drug crisis than her mandate letter from the prime minister:

Canada is currently facing a parallel pandemic of mental health problems, increasing substance use & a deadly toxic drug supply. Today I received my mandate letter from the Prime Minister that commits to building a mental health strategy to support all Cdns. https://t.co/76KSuwOtwI

— Carolyn Bennett (@Carolyn_Bennett) December 16, 2021

As with most post-appointment coverage of the new cabinet position, Bennett’s mandate letter focuses mainly on the mental health side of her portfolio, and the need to work with provinces and territories to create a Canada Mental Health Transfer. Of course, mental health, addiction, and opioid-related mortality are deeply connected, but critics say the lack of an explicit mention of the crisis in the mandate letter is troubling.

Only one other mandate letter gives some consideration to drug use: the letter to Minister of Justice and the Attorney General David Lametti, which calls on him to “Continue work to make drug treatment courts the default option for first-time non-violent offenders” and “promote non-criminal approaches for drug possession.”

Putting lipstick on the prohibition pig

While drug treatment courts and non-criminal approaches seek to avoid incarcerating offenders, they are still coercive tools fundamentally rooted in carceral logics and criminal justice policymaking. While they do aim to institutionalize a more health-oriented approach to punishing criminal offenders who are drug users, these policies are by no means the holistic solutions that much of the contemporary, non-partisan evidence suggests are optimal.

Some proposed reforms include decriminalization and the wider availability of a safe drug supply. Adopting a health-oriented approach that rejects the criminal foundation of drug policy ultimately involves reframing addiction and opioid-related deaths as arising from decades of failed ‘War on Drugs’-era policies and poor material conditions, rather than the existence and availability of so-called ‘bad drugs.’

The term “opioid crisis” is the default label used by the Government of Canada and some opposition parties to describe the crisis of deaths as a result of opioid poisoning. However, this term is ultimately problematic. It signals that opioids are fundamentally the cause of the crisis rather than unjust and unsafe governance.

In practice, mainstream rhetoric around the “opioid crisis” echoes past morality politics that have informed drug policy since prohibition was discredited in the 1920s. This approach has effectively limited the array of options conceivable by those in positions of power and authority to what has been done in the past—believing the problem will be solved when there are no more people to sell drugs.

Instead of this status quo rhetoric, we should begin referring to the current situation in Canada as a drug poisoning crisis. This shift would draw attention to the untested and adulterated supply available to drug users that, particularly in the case of fentanyl, can be incredibly difficult to measure for safe consumption. In this way, the crisis can truly be considered a matter of public health, with health care providers integral to harm reduction efforts—rather than police or the courts.

A new direction for drug policy?

Despite platitudes that the opioid crisis is now being treated through “comprehensive, collaborative, compassionate and evidence-based” measures, one would not gather from the mandate letters that the federal government has changed its approach to drug policy in any significant way.

There is an abundance of evidence pointing to meaningful reform that would require substantively altering the institutions central to Canadian drug policy. Decriminalization and providing a safe supply for drug users so they can avoid poisoning are two of the foremost recommendations from those with lived experiences with drug use, advocates and outreach groups, academic and scientific experts, healthcare practitioners, policymakers, and even some law enforcement officers.

These voices are not quiet; their advocacy should be deafening to politicians. But you would not gather that from these mandate letters.

Federal policy on the “opioid crisis” continues to mainly be an effort to reduce stigma and decentralize drug policy to the provinces and territories. As I have documented previously in Canadian Dimension, this is problematic for any kind of national policy coordination on drugs.

With the recent mandate letters, the clear message is that the federal government remains unwilling to begin dismantling the policies that now, during the COVID-19 pandemic, have catapulted the crisis into its deadliest phase yet.

Megan Aiken is a PhD candidate at the University of Alberta, currently residing in Halifax, Nova Scotia. Megan’s research seeks to understand the harmful legacy of opium prohibition in Canada by studying political rhetoric and policy action since 1908.