When Evidence Erases Recovery: A Response to Lisa Lapointe

In response to:
“BC’s Drug Response Isn’t Following the Evidence: Former Coroner” – The Tyee

Former B.C. chief coroner Lisa Lapointe argues that British Columbia is responding to the toxic drug crisis in the wrong way. Her core claims are clear:

She says the province is spending too much money on treatment and recovery beds and not nearly enough on safer supply, decriminalization, housing and harm reduction. She asserts that these approaches are the only ones supported by evidence. She further claims that decriminalization was a success, and that abstinence-based treatment increases the risk of overdose.

These are strong claims. They deserve equally strong scrutiny.

Where Is the Evidence?

Lapointe states that decriminalization reduced deaths, arrests and ambulance calls. Yet the article itself admits that Health Canada data does not clearly support this, and that she did not provide the data she was relying on when asked.

That matters.

When someone says, “the evidence proves this works,” but cannot point to that evidence, we are no longer in science. We are in ideology.

Even more troubling is the fallback logic offered:

Even if nothing improved, decriminalization would still be a success because criminalization doesn’t work.

That is not evidence-based reasoning. It is a philosophical position.

The Framing of Treatment as the Villain

Lapointe portrays treatment centres — particularly abstinence-based ones — as dangerous and exploitative. She claims abstinence increases overdose risk and that opioid agonist therapy is the “gold standard.”

Medication-assisted treatment clearly helps many people. That is not in dispute.

What is in dispute is the claim that abstinence-based recovery is inherently harmful or unsupported by evidence.

There are tens of thousands of people in Canada and millions worldwide who recovered before methadone and buprenorphine were even available — and who remain well today. They rebuilt families. They returned to work. They stopped dying.

Yet in Lapointe’s framework, they barely exist.

A Critical Blind Spot: Who Counts as “Lived Experience”?

Throughout her work, “lived experience” is treated as synonymous with people who are still using.

But what about people who used to use — and don’t anymore?

If the only voices we listen to are those still in addiction, then recovery itself disappears from the policy conversation. Addiction becomes permanent. Management replaces change. People become patients for life.

That is not compassion. It is resignation.

Addicted people deserve better than a palliative model of care.

What Is Missing From This Discussion

There is no comparison between:

• long-term abstinent individuals

• safer-supply participants

No serious question is asked about:

• who eventually stops using

• who rebuilds relationships

• who regains purpose

• who leaves the system entirely

There is no acknowledgment that recovery itself reduces overdose risk.

There is no discussion of transformation, agency or identity change — all well-documented features of recovery.

Only pharmacology and housing remain.

That is not a full picture of addiction. It is a narrow one.

Where We Actually Agree

Criminalization alone does not solve addiction.
Housing matters.
Mental health care matters.
Treatment should be regulated.
Outcomes should be reported.

On those points, Lapointe is right.

But it does not follow that recovery should be sidelined, or that abstinence should be portrayed as dangerous.

The Real Problem

This debate has been reduced to a false choice:

Either:

• safer supply and harm reduction

or:

• recovery and treatment

That is a policy failure.

Addiction is not a single-path problem.
There should be multiple routes out, not just one route in.

Medication is part of the solution.
It is not the only solution.

People who recover should not be erased from the evidence base.

A Final Question

If public policy cannot recognize that some people actually leave addiction behind, what does that say about our expectations for those still trapped in it?

Are we offering them hope —
or merely maintenance?

Because those are very different futures.

And the difference matters.

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— Dr. Larry Smith