I think it's just a matter of the evidence that is out there. The evidence on recovery-based non-pharmacotherapy treatments is just not as strong as the evidence on pharmacotherapy-based treatments. There's a reason that methadone and buprenorphine are on the WHO's list of essential medicines. It's because they are the most effective approaches we have to managing people who have opioid use disorders.
I share Dr. Humphreys' aspirational and optimistic sense of people's capacity and of helping people return to full lives after experiencing opioid use disorders. The fact is that these methadone and buprenorphine programs seem messy because people often will begin a program and will be enrolled in methadone and buprenorphine or another medication for opioid use disorder, and then they will stop the program. They will go back on. However, over time we don't see the scientific evidence out there suggesting that recovery is an effective approach. I think it can certainly be part of a comprehensive approach, but not at the expense of evidence-based pharmacotherapy clinical treatment.
I will say that one of the issues in Alberta is that the proportion of the population that actually has coverage for these types of medications—opioid agonist treatments or medications for opioid use disorder, or whatever term you want to call it—is actually quite a lot lower than in places such as B.C. and Ontario. When we're thinking about ways to prevent the overdose epidemic, I think we need to start with where the scientific evidence is and where the scientific consensus exists. That's not to say that recovery is not appropriate for some people; it's just to say that the scientific evidence—and that's what I follow—is much stronger with respect to these types of treatments versus recovery-based treatments.