Changes afoot in critical portfolio

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This article was published 26/12/2023 (620 days ago), so information in it may no longer be current.

A paper sign bearing the new name of the ministry haphazardly taped to a wooden door signals it’s still early days for Manitoba’s NDP government. But inside, Bernadette Smith is firmly cementing herself in her new job.

Earlier this month, Smith, the recently appointed minister of housing, addictions and homelessness, sat down with the Free Press for one of her first one-on-one interviews since assuming the ministerial role.

The department’s files are all weighty, but addictions is the hot-button issue expected to require a full revamp after seven years of Progressive Conservative government long regarded as hostile to harm-reduction policies.

Former premiers Brian Pallister and Heather Stefanson faced harsh criticism for rejecting calls from drug users and advocates to apply evidence-based approaches, including safe consumption sites, as overdose deaths mounted.

Now, in a government led by NDP Premier Wab Kinew and decision-making power in her hands, Smith is determined to change course on the province’s overdose crisis.

Among the most pressing priorities on her plate is speeding up timelines for reporting overdose death data. The previous government long dismissed calls for more timely reporting. At times, publicly available data was delayed up to five months, with Manitoba lagging far behind other provinces that report numbers each month.

Smith’s plan of attack, she revealed, is to create a “cross-departmental working group” tasked with improving the timeliness of overdose death reporting. She said she has met with the office of the chief medical examiner, which oversees the reporting in Manitoba, and the group is expected to begin its work early in the new year.

“We are closer to getting those actual numbers online,” Smith said. “We know how important that is for families, to have those numbers accurately reflected, but also to be transparent to the communities, as well.”

Dr. John Younes, Manitoba’s chief medical examiner, told the Free Press in an email that delays in reporting can stem from the time it takes to receive toxicology reports from the provincial lab. It typically takes two to three months for his office to receive results after an autopsy takes place.

Younes said more staffing and resources at the St. Boniface-based lab could speed up reporting timelines. He said he is “hopeful” those times will be down to one month by next summer.

Smith said she also would like to see information made public about what was in the toxic drugs people took before they died, but said such decisions will ultimately be made by the chief medical examiner’s office.

“That’s something I did push for,” she said.

Another key election commitment from the NDP was to establish Manitoba’s first-ever supervised consumption site. On that front, Smith is still in the consultation stage.

She said she has spoken with families who’ve lost loved ones to overdoses, with people who use drugs and with community groups such as Sunshine House, which runs Winnipeg’s only overdose prevention site (a retrofitted RV that travels around the city offering support to people who use substances, run by people with lived experience) about what they want to see in a site.

Smith said the facility should be more than just a place where people can use drugs under the supervision of trained staff. She wants it to include access to primary care, treatment and housing support, goals that align with the very language of her department — housing, addictions and homelessness.

“These are all interconnected,” she said of her portfolio.

Her vision for a multi-purpose supervised consumption site is influenced by facilities she’s visited in other parts of the country, including Insite, North America’s first supervised injection site, located in Vancouver’s Downtown Eastside.

“It’s a one-stop kind of shop,” she said of Insite, which has access to detox and transitional housing.

Smith said she’s in talks with Indigenous organizations in the city about running the community-led facility.

The people who use drugs are the experts in what they need and will remain key players in planning discussions, she said.

She did not provide a timeline for the creation of a facility, instead saying the government is putting a priority on getting things right.

Smith also committed to sharing timely data with the Public Health Agency of Canada for its quarterly national report on opioid toxicity deaths. Under the previous government, Manitoba was routinely the only province not providing timely data.

The Free Press revealed in June that Manitoba’s reliance on paper files to record overdose deaths may have been a factor in not getting data to PHAC sooner.

The government aims to share data with PHAC for its next report, Smith said.

She wouldn’t say if she supports safer supply programs, which allow people at high risk of overdose to access prescribed medication as an alternative to toxic street drugs.

Proponents argue such programs keep people to alive and help them them stabilize their lives, while critics raise concerns about diversion — people selling their supply — and government “enabling” drug use.

When asked about her stance on safer supply, Smith pivoted back to the need for a supervised consumption site (which would not provide drugs to users).

One project well underway is the purchase of more drug-testing machines. She said her department is in talks with various organizations about which groups could best benefit from access to drug testing.

Sunshine House’s mobile overdose prevention site currently has one — called a mass spectrometer, the machine cost $65,000. It allows users to determine what substances are in their drug supply.

Sunshine House raised funds to buy the equipment last summer. Smith said the province will be purchasing “a couple” for local organizations.

The province will also expand access to detox beds and treatment options, something the previous government was also committed to, but often framed harm reduction as mutually exclusive of treatment.

“We want to take a different approach than the last government took, which is supporting people where they’re at and making sure that folks get the support that they need,” she said. “We don’t want to see any more deaths in this province.”

In the first seven months of this year, at least 243 people in Manitoba have died from overdoses — nearly all being accidental from toxic drugs, also called “drug poisonings.”

In 2022, at least 437 people died from overdoses, and in 2021 the number was 436, according to updated numbers from the office of the chief medical examiner.

Smith said helping people who use substances is a priority “near and dear” to her heart. Her own family members and loved ones have been impacted by substance use and addiction, leading, in some cases, to deaths.

Smith said she thinks the public feels a sense of “hope” about the government’s plans on the addictions file.

“They know it’s going to take some time, but they know that something is coming,” she said.

katrina.clarke@freepress.mb.ca