August 27, 2025

The Right Honourable Mark Carney, Prime Minister of Canada

pm@pm.gc.ca

Prime Minister,

On the brink of another International Overdose Awareness Day, we are still being asked to mourn while politicians debate whether the lives of people who use drugs are worth saving. Tens of thousands of Canadians have died from preventable drug poisoning. Countless families are shattered. Direct care teams are exhausted. Indigenous, racialized, disabled, 2SLGBTQIA+ and low-income communities bear an unfair burden of suffering as their healthcare needs are moralized for political gain.

We do not have an awareness problem.

Across Canada, HRNA nurses working directly with people who use drugs have witnessed the evolution of the toxic drug supply and the devastating consequences of Canada’s drug laws. We are the health professionals providing life-saving care, conducting outreach in alleys and parks, and absorbing waves of grief as we lose community members.

Between 2016 and 2024, at least 52,544 Canadians have died preventable deaths during this crisis[1]. In recent years, we made measurable progress: scaling up innovative harm reduction approaches, expanding access to safe supply and supervised consumption, and challenging long-entrenched policies like criminalization[2]. Today however, we are in an era of moral panic, where policy is driven by rhetoric instead of evidence. Attacks on harm reduction are attacks on bodily autonomy, undermining the very principles of public health and human dignity that keep people alive.

We are concerned about recent policy directions.

  • At the federal level, your government advanced Bill C-2 (The Strong Borders Act)—anoutdated, xenophobic drug interdiction policy that prioritizes border theatrics overevidence and human rights. Research has shown that supply-side interventions increasethe toxicity and unpredictability of the illicit drug supply, contributing to more deaths[3].
  • At the provincial level, involuntary detention, coercive medical interventions, cuts to low-barrier not-for-profit and harm reduction programs and forced displacement of unhousedpeople drive up risk for more deaths because there are fewer safe places for people whouse drugs to go. A strong body of evidence demonstrates that involuntary “treatment” isineffective for preventing relapse and carries a high probability for harm, including death[4-7].
  • At the municipal level, stigmatizing political statements incite moral panic, underminepublic health guidance, and restrict access to life-saving services.

Strong leadership is not about cracking down on the vulnerable—it is, in your own words and commitments upon election, to care for them. The courageous leader stands up for Canadian sovereignty—our ability to make decisions for ourselves—not against marginalized communities.

Leadership means funding what is evidence-based, not what polls well. In the context of our drug poisoning crisis, this means re-directing funding from carceral approaches and investing in harm reduction.

We urge your government to take these actions before International Overdose Awareness Day:

  1. Rescind Bill C-2. It erodes our rights, our identity and our sovereignty.
  2. Reject involuntary detention and coercive interventions that violate Charter rights and lack evidence.
  3. Redirect enforcement funding to healthcare, housing, harm reduction, and voluntary, community-led treatment. Even one year of CBSA’s $1.3B budget could significantly expand housing, treatment, safe supply, and Indigenous-led healing[2].
  4. Legislate and fund a public health approach to harm reduction grounded in equity, autonomy, and evidence.
  5. Meet with the HRNA Board of Directors within the next 30 days to discuss urgent, evidence-based solutions and the role nurses can play in supporting national leadership on this issue.

HRNA’s members have attended more than a decade of memorials and vigils and done all we can to raise public awareness. We have data, coroners’ reports, and decades of evidence from harm reduction, housing-first models, safe supply, and supervised consumption. What is lacking is political courage.

International Overdose Awareness Day is not just a time to remember—it is a time to act. Lives are on the line. Please meet with us without delay.

Sincerely,

The Harm Reduction Nurses Association Board of Directors

cc:

The Honourable Marjorie Michel, Minister of Health

The Honourable Sean Fraser, Minister of Justice and Attorney General of Canada

  1. Health Canada. Opioid- and Stimulant-related Harms in Canada [Internet]. 2025. Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/
  2. Government of Canada. The Government of Canada’s Border Plan: significant investments to strengthen border security and our immigration system [Internet]. 2024. Available from: https://www.canada.ca/en/public-safety-canada/news/2024/12/the-government-of-canadas-border-plan-significant-investments-to-strengthen-border-security-and-our-immigration-system.html
  3. Beletsky L, Davis CS. Today’s fentanyl crisis: Prohibition’s Iron Law, revisited. Int J Drug Policy. 2017;46:156-9. https://doi.org/10.1016/j.drugpo.2017.05.050
  4. Ledberg A, Reitan T. Increased risk of death immediately after discharge from compulsory care for substance abuse. Drug Alcohol Depend. 2022;236:1-7. https://doi.org/10.1016/j.drugalcdep.2022.109492
  5. Pilarinos A, Kendall P, Fast D, DeBeck K. Secure care: more harm than good. CMAJ. 2018;15:E1219-20. https://doi.org/10.1503/cmaj.180700
  6. Werb D, Kamarulzaman A, Meacham MC, Rafful C, Fischer B, Strathdee SA, et al. The effectiveness of compulsory drug treatment: A systematic review. Int J Drug Policy. 2015;28:1-9. https://doi.org/10.1016/j.drugpo.2015.12.005
  7. Canadian Centre on Substance Use and Addiction. Involuntary Treatment Evidence Brief [Internet]. 2025 Feb. Available from: https://www.ccsa.ca/sites/default/files/2025-02/Involuntary-Treatment-Evidence-Brief-en.pdf