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We argue that Canadian Drugs and Substances Strategy (CDSS)’s focus on individualizing, bio-scientifically driven tools involving naloxone, opioid agonist therapy, supervised consumption sites, and surveillance of legal opioid prescribing do not fully explain why the opioid crisis has remained intact, disproportionately affecting vulnerable populations by not including social factors as a key component of the strategy. By examining contradictions inherent in these bio-scientific evidenced interventions, we call for a more holistic drug policy framework that considers broader structural conditions including a greater emphasis on engaging with those misusing substances to address underlying issues that affect them.