The Recovery Capital: How Alberta is Reshaping Mental Health and Addiction Treatment

As Alberta moves to complete the build-out of its recovery model, it is clear the province is leading a movement that is reshaping addiction treatment and mental health care across the country. While it is too early to reach final conclusions, the early signs are encouraging. Alberta led the country with a 38% decline in opioid-related deaths in 2024, more than double the national average decline of 17%. The first five months of 2025 are also showing fewer deaths relative to 2024. However, the Alberta model is not without its critics, particularly among proponents of harm reduction who argue that supervised consumption sites and safe supply help save lives. 

Premier Danielle Smith and her United Conservative government’s Alberta Recovery Model is reorienting Alberta’s addiction treatment and mental health care system away from harm reduction toward a recovery-oriented system of care in response to the drug overdose epidemic sweeping the country. It is one example of many from a government that is quick to embrace big systemic changes and bold moves, such as creating new institutions and dissolving others. 

Since 2019, Alberta has created more than 10,000 new publicly funded addiction treatment spaces, increasing the supply by 55%, from 19,000 to more than 29,000 spaces. Alberta is also investing $350 million to build 11 Recovery Communities to provide comprehensive addiction treatment with a focus on helping people rebuild their lives, find stable jobs, and reintegrate into their community. Four of these communities are open in Calgary, Red Deer, Lethbridge, and Gunn. All 11 communities, which include five in partnership with Indigenous communities, are expected to be complete by 2027.  

In provincial correctional centres, Alberta is implementing correctional therapeutic living unit programs to help incarcerated people avoid relapse and a return to criminal activity after release. The province has also introduced on-demand access to opioid agonist therapies like Suboxone and Sublocade through the Virtual Opioid Dependency Program while working with Edmonton and Calgary’s police forces to increase the number of Police and Crisis Response Teams (PACT) in community. Navigation and Support Centres in downtown Edmonton and Calgary aim to help connect Albertans experiencing homelessness to a range of supports and services in recognition that a major contributing cause of their situation is often untreated addiction and mental illness.  

New institutions, such as a standalone Ministry of Mental Health and Addiction, develop policy and legislation, and Recovery Alberta, one of four new provincial health authorities, provides oversight of the addiction treatment and mental health supports and programs that the province delivers to Albertans. At the same time, the Canadian Centre of Recovery Excellence (CoRE) is tasked with evaluating programs and informing best practices. 

The Compassionate Intervention Act, 2025, otherwise known as involuntary treatment, creates a pathway outside of the justice system for parents and guardians, family members, health care professionals, and police or peace officers to request a treatment order or care plan for those who are likely to cause harm to themselves or others due to severe addiction. Alberta is investing $180 million over three years to build two compassionate intervention centres for adults in Edmonton and Calgary. The province is also investing in youth treatment beds, including a $23 million investment to establish the Northern Alberta Youth Recovery Centre in 2026, which will include space for care under the Act.  

Evaluation 

While it’s too early to reach final conclusions, the early signs are encouraging. Alberta led the country with a 38% decline in opioid-related deaths in 2024 compared to 2023, more than double the national average decline of 17%. The first five months of 2025 are also showing fewer deaths than the same period in 2024. 

Despite critics highlighting that supervised consumption sites and safe supply help save lives, deaths and drug use have gone up under that model. Municipalities have begun to show support for switching to Alberta’s model. For example, Red Deer’s City Council requested a transition of their supervised consumption site to recovery-oriented supports in 2024, including a Mobile Rapid Access Addiction Medicine clinic, a Dynamic Overdose Response Team, recovery coaches at the homeless shelter, and enhancements to existing medically supported detox capacity. While the Alberta government says that harm reduction has its place, they believe their approach will have better results in reaching the goal of long-term recovery. 

Likewise, a common refrain among prevention advocates is that an ounce of prevention provides a pound of cure, while noting that Alberta is investing significantly less in prevention than recovery. But with limited resources, the province is choosing to invest more in crisis response to those in need to address the epidemic that we currently face. Yet investments in prevention will be needed to prevent the next one. Part of the gulf in investment between prevention and recovery is that much of the investment in mental health supports such as counselling programs and school-based mental health classrooms are programs that rely on existing infrastructure whereas the expansion of treatment and recovery capacity requires upfront capital investment. A future challenge will be managing excess treatment and recovery capacity if the model is successful. 

Another criticism not easily batted away is the lack of integration with the primary care system at the same time the province has split up the single health authority into four new health care sectors. The danger of each care sector not effectively communicating with each other presents real risks to Albertans’ overall health and well-being. That being said, Alberta has been clear it is committed to seamless integration, but we know that is much easier said than done. As the recovery model and the health system refocusing are completed, it will be worth watching how effectively that can be accomplished. 

Other Provinces Take Notice 

Despite the criticism, the numbers are doing the talking, and other provinces are listening. When Alberta launched CoRE in April 2024, Saskatchewan and Ontario signed a memorandum of understanding to collaborate with Alberta on increasing access to recovery-oriented care, share best practices, advance partnerships with Indigenous communities, and advocate to the federal government for investment and policies that support recovery. Both provinces have started to follow Alberta’s lead. Perhaps more surprisingly, British Columbia and Manitoba – both led by NDP governments – have also started implementing elements of Alberta’s model. 

In Saskatchewan, the government has been implementing its own five-year Action Plan for Mental Health and Addictions, which moves towards a recovery-oriented system of care and creating 500 new supportive housing, detox, and substance use spaces by 2028. The province has cut off funding for some aspects of harm reduction, such as needle exchanges, and amended the Safer Communities and Neighbourhoods Act, 2024, to classify syringes and drug pipes as street weapons. Saskatchewan is also working to expand PACT teams and has established a Provincial Emergency Operations Centre in Saskatoon to help curb the wave of overdoses in the city. The province is also working to provide dedicated mental health youth homes in Regina, Saskatoon, and Prince Albert, as well as creating and expanding rapid access counselling. Last month, Premier Scott Moe signalled that, like Alberta, his government will explore implementing “compassionate care.” 

Ontario has taken its own steps towards a new approach. Ontario’s new policy under the Community Care and Recovery Act, 2024, places strict new requirements on safe consumption sites, prohibiting them from operating near schools or daycare centres. It also prohibits municipalities from applying for a federal exemption for a new site or seeking funding for prescription-based supply of safe drugs or supporting someone else’s application. Individuals experiencing addiction, mental health issues and lack of shelter will need to visit Homelessness and Addiction Recovery Treatment (HART) Hubs to request treatment services that will not provide supervised drug consumption, safe supply, or needle exchange services. HART Hubs intend to provide broader services, including primary care, mental health and addiction support, housing, and employment services.  Nine of the province’s 10 safe consumption sites were transitioned into HART Hubs at the start of April, with 18 more expected to open throughout the year. The province is also set to study involuntary addiction treatment for people in jail, on probation, and on parole.  

Even British Columbia (BC) – the leader of the harm reduction approach for more than two decades and the home of the first safe consumption sites – has recognized the need for a shift in direction.  Amid growing public concern, Premier David Eby announced plans in September 2024 to expand involuntary care for those with mental health and addiction issues and would open highly secure facilities to house people detained under the Mental Health Act throughout the province. In line with this commitment, the province has begun operationalizing new involuntary care sites. In 2025, British Columbia opened two new mental-health facilities that provide involuntary care: a 10-bed unit at the Surrey Pretrial Services Centre in April, and an 18-bed home-like facility called Alouette Homes in June. Since the NDP formed government in 2017, BC has added 7,066 new publicly funded mental-health and substance-use beds.  

Manitoba is also charting a new course. The province has signalled growing alignment with recovery-oriented care while balancing harm reduction approaches. Investments have been directed into expanding Rapid Access to Addictions Medicine (RAAM) clinics, strengthening community-based treatment, and supporting partnerships with Indigenous communities—particularly in northern regions where opioid-related deaths are rising sharply. Manitoba is also exploring how to integrate addictions treatment more directly with mental health and primary care, reflecting lessons from Alberta’s restructuring. The Manitoba government has been in active dialogue with both Alberta and Saskatchewan on how to embed recovery principles into its own mental health and addictions framework, while maintaining supervised consumption services in Winnipeg as part of its hybrid model. This positions Manitoba as a “bridge province,” adopting elements of Alberta’s bold recovery-first approach while maintaining aspects of harm reduction to meet local realities. Manitoba is testing whether this approach can deliver better outcomes in diverse urban, rural, and northern contexts. 

Conclusion 

As Alberta moves to complete the build-out of the Alberta Recovery Model, it is clear the province is leading a movement that is reshaping addiction treatment and mental health care across the country. Time will tell what kind of successes or failures it brings. In the meantime, CoRE will be evaluating, and the country will be watching.