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Opinion: Flawed study on Red Deer OD prevention site closure could put lives at risk

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Last week, a study led by Dr. Nathaniel Day and colleagues from the Alberta-based Canadian Centre of Recovery Excellence (CoRE) received a lot of attention, reporting that closing the Red Deer overdose prevention site (OPS) in 2025 was associated with increased treatment seeking, with no impacts on mortality or overdose.

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An accompanying CoRE press release described it as a “landmark” study with international policy significance. Minister of Mental Health and Addiction Rick Wilson issued a statement that read, in part, “the findings are clear. The closure of the Red Deer site did not lead to an increase in mortality, emergency department visits, or EMS (ambulance) calls for site users,” suggesting elsewhere that the study may be used to justify future closures. However, a closer look at the paper reveals limited support for these claims.

The authors compared outcomes between Lethbridge OPS clients (where the OPS remains open) and Red Deer OPS clients (where the OPS closed). They acknowledge that their study had low statistical power, owing to a short follow-up period and the relative rarity of some of the study outcomes.

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As a result, they warn readers that “the present study cannot … establish causality” and that an observed lack of statistically significant increases in opioid-related ambulance calls or mortality should be interpreted as “inconclusive” and not “as clear evidence of safety.” This caveat is especially important given that first responders in Red Deer and Alberta’s substance use surveillance system report increases in opioid-related events, including deaths, in the Red Deer area following the OPS closure on April 1, 2025.

Further, while the study described a small but significant increase in the number of Red Deer OPS users seeking treatment, some media framed this as a definitive surge. Columnists have described a “statistically significant increase in the number of people wanting to turn their lives around.”

Yet, these conclusions minimize the efforts made to reduce negative impacts of the OPS closure. Specifically, the Government of Alberta funded a new 24/7 overdose-response team to patrol the area around the closed OPS, and a new mobile clinic was placed in the OPS parking lot to connect people to treatment. The study made no mention of these targeted interventions despite the fact they are likely to have directly impacted the findings.

If you take away a safety net, like an OPS, and replace it with more people standing below to catch the fallout, you haven’t proven the net was useless, only how hard you have to work to compensate for its absence. Further, we cannot view this study in isolation. A wealth of research from multiple jurisdictions supports that supervised consumption services, like Red Deer’s OPS, save lives. Ignoring this evidence in favour of one early study is premature and ill-advised.

The study authors disclose Alberta government funding and almost all report an affiliation with CoRE. But their readers are likely unaware that CoRE is a provincial Crown corporation founded and solely funded by the Alberta Ministry of Mental Health and Addiction.

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In addition, the study’s first and second authors occupy positions appointed by the minister himself. This conflict of interest matters because it increases the risk of decision-based evidence-making, where research data and analysis are curated to justify pre-determined policy decisions.

Prior UCP government-commissioned reports have been critiqued for their methodological bias and flawed science. By nature of its relationship to the government, CoRE has broad access to OPS and other health data. It is imperative that CoRE or the minister provide the same access to independent researchers to counter perceptions of bias and ensure findings are replicable.

CoRE’s study provides an incomplete picture of the impacts of Red Deer’s OPS closure. The authors themselves acknowledge that their study was exploratory and further research is needed. Unfortunately, we are already seeing this study used to justify closing OPS in Ontario.

Basing decisions about the future of OPS on a single, inconclusive study puts lives at risk. Albertans deserve evidence-based substance-use services and systems grounded in data transparency and robust analysis, not sensational headlines or predetermined policy agendas.

Emily Berg, PhD student, University of Alberta

Elaine Hyshka, associate professor and Canada Research Chair in Health Systems Innovation, University of Alberta

Kathryn Dong, associate professor, University of Alberta

Rebecca Haines-Saah, professor, University of Calgary

Katarina Bogosavljević, Killam Postdoctoral Fellow, University of Alberta

Ginetta Salvalaggio, professor, University of Alberta

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