Alberta NDP call for firing after minister wonders if naloxone may be 'enabler' of opioid abuse

Alberta's associate minister of mental health is facing a call for removal from his job after comments he made about an opioid antidote.

After an event Friday, Jason Luan told reporters that he had learned naloxone, an opioid overdose antidote, has been used as a way to push the limits of opioid dosing.

He said he was worried that youth were deliberately taking larger doses of opioids, knowing that naloxone can be used to reverse an overdose.

He also raised the concern that the distribution of naloxone kits might be enabling greater drug use — a suggestion strongly opposed by a top Calgary medical professional.

"You know the naloxone kit that we send as an emergency recovery for people with overdose? Actually, the kids take that, knowing they have the kit, because now you're safe," Luan told reporters.

"They want to push it to their limit, how far they can go to overdose, because they're safe, because the kit is there," he said. "Lots of times we're trying to make it easier, wanting to help, but it's a fine line. If you cross that line, you become an enabler."

Luan, who is a member of the governing United Conservative Party, made the comments after meeting with Albertans directly affected by addictions in Calgary on Friday for a roundtable discussion. The event was held ahead of, and to mark, International Overdose Awareness Day on Saturday.

NDP questions competence

The comments prompted backlash from the Alberta Opposition, the NDP.

Heather Sweet, the provincial NDP's mental health and addiction critic, called on Premier Jason Kenney to remove Luan from his portfolio at a press conference in Edmonton Saturday afternoon.

"There is a clear bias by this associate minister," she said. "The premier needs to fire him and needs to hire someone who's actually willing to work with Albertans and talk about addictions and mental health in a productive and solution-focused way."

Sweet said it's not the first time Luan has spoken callously about addiction, pointing to a controversial comment made earlier this summer. He deleted a tweet in which he wondered if research supporting supervised consumption sites was funded by big pharma. Through a spokesperson, Luan said he was misunderstood.

Petra Schulz co-founded Moms Stop the Harm, a national network of people whose loved ones died from drug-related harms. Her son Danny died from an accidental fentanyl overdose at 25-years-old, leading her to advocate for harm reduction strategies.  

Schulz said she was gravely concerned by the associate minister's comments and worried they would cast doubt over the life-saving power of naloxone. 

"He basically stigmatizes a proven public health intervention that has saved thousands of lives in this province," Schulz said at an Overdose Awareness Day event in Edmonton.

The latest statistics show Alberta Health Services has given out 146,892 naloxone kits for free across the province since 2016. People have self-reported 9,386 overdose reversals using the kits over the same period. 

"Comments like that make people hesitant, and that can cost lives and that upsets me so much," Schulz added. 

Minister repeated families, party says

When contacted, a spokesperson for the premier's office said "a simple review" of Luan's comments show he was stating what he had heard from families during the roundtable.

"It's disappointing, but not surprising, that the NDP is working to misrepresent the minister's words while ignoring what some families have said," spokesperson Harrison Fleming said in an email.

Luan's chief of staff, Marshall Smith, declined to comment on the NDP's request. He previously called CBC to note that two parents at the event believed their children had done this, and had told Luan this.

Smith said the provincial government remains committed to naxolone "100 per cent" and will continue to fully fund its distribution.

The roundtable was the first time Luan had heard about naloxone being used "in the wrong way," he told reporters after the event. He said it affected his thinking about the overdose-reversing agent.

"For me as a policy-maker, as a minister, my thinking is, 'Wow, this is interesting,'" Luan said. "We've got to find the balance. We can't just be one way of thinking, believing we are doing something good, when in fact that can be utilized in the wrong way."

ER physician disagrees

But Dr. Eddy Lang, an ER physician and head of emergency medicine at the University of Calgary's medical school, said he hasn't seen evidence that naloxone is being misused in the way Luan describes.

"I wouldn't agree necessarily with the idea that giving naloxone enables someone to pursue their addiction," Lang said.

"While that's a possibility and maybe that does occur, it's a really small proportion — a drop in the bucket of how naloxone is being used in the community," he said.

He said naloxone is a "life-saving opportunity."

"I've never gotten the sense from the patients coming to the emergency department that they had the naloxone at the ready, trying to push the limits on what they were using."

'Catastrophic' if naloxone not available

Lang said naloxone routinely saves lives and needs to be readily available. If distribution is limited, "the results would be catastrophic," he said. 

"I don't think that we're enabling or contributing to the problem by offering a life-saving intervention that can be used in a moment of crisis."

In emergency rooms, Lang said doctors are training overdose patients to use naloxone and sending them home with the overdose-reversing drug.

Luan told reporters naloxone is just one tool of many needed to combat the opioid crisis.