Hon. Jane Philpott (Minister of Health, Lib.)
moved that Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts, be read the third time and passed.
She said: Mr. Speaker, it gives me great pleasure to rise on the third reading of Bill C-37. I am particularly gratified at the speed with which the bill has moved through the House of Commons. I want to thank all members, including all parties, who have been very helpful in agreeing to time allocation, agreeing to expediting the committee process, and the fantastic work at the committee level to move the bill along. This demonstrates the serious nature of the bill, and recognizes the ongoing opioid crisis and the need for urgent action.
Bill C-37 is one of a range of comprehensive responses to this very challenging issue. We are eager to advance the bill through Parliament to help protect the health and safety of Canadians and their communities.
It has been said before in the House that problematic substance use is an issue that affects Canadians of all ages. It affects people from all socio-economic groups. We should also point out that there are, however, particular groups that are excessively vulnerable to the risks associated with problematic substance use, people living in poverty, people who have experienced trauma in their lives, and indigenous peoples of Canada.
We are facing nothing short of the greatest drug crisis our country has faced. It is a national public health crisis related to opioids. For example, one may draw attention to the fact that in British Columbia last year more than 900 people died from overdoses. That was an 80% increase over 2015. The majority of those deaths were related to the rapid spread of the drug fentanyl.
Elsewhere in Canada, we are hearing from law enforce officials that there are increasing numbers of seizures of fentanyl and carfentanil.
Last week, we heard about the distressing number of deaths linked to opioids in Alberta. For example, in 2016, 343 people died in Alberta from fentanyl overdoses. That was an increase over 257 the previous year.
It is necessary that the Government of Canada use every single tool at our disposal to help turn the tide on this crisis. We need a policy approach that is comprehensive, collaborative, compassionate, and evidence-based.
Bill C-37 would further strengthen our government's response to the opioid crisis.
Lest there be any doubt that we are pulling out all the stops to respond to this crisis, let me review what we have done over the past year. It includes things like ensuring naloxone, which is the antidote to overdose, is available on a non-prescription basis across the country. That involved me ensuring that we had naloxone nasal spray available on an emergency order so it would be available to Canadians, and expediting the approval of naloxone nasal spray.
We also launched Health Canada's opioid action plan. This is a plan to improve access to education for both the public, as well as prescribers, to ensure that we support better treatment options, that we reduce access to unnecessary opioids, and that we expand the evidence base.
In the matter of expanding the evidence base and getting better data, we supported McMaster University to produce guidelines for prescribing opioids in situations of chronic pain. Those new guidelines are now available for consultation.
We overturned a ban on prescription heroin so doctors might use it through Health Canada's special access programs to treat the most severe cases of addiction.
We have supported the good Samaritan drug overdose act, which offers immunity against charges for simple possession for individuals so they will call 911 if they witness an overdose and they will stay at the scene to help.
We have also put in place a number of regulations to schedule fentanyl precursors for controlled substances, making it harder for illicit substances to be manufactured in Canada.
I co-hosted, along with the minister of health for Ontario, the opioid conference and summit. At that summit, we had nine provincial and territorial health ministers. We also had 30 other organizations. We produced a joint statement of action that had 128 commitments.
In addition, in collaboration with the provinces and territories, we have put together a special advisory committee that includes the Council of Chief Medical Officers of Health. This committee is very active at ensuring we have better access to data that is up to date about the state of the circumstances.
We also have a task force within the federal health portfolio to work with all federal departments in a comprehensive response to the crisis.
We funded the Canadian research initiative on substance misuse. It is providing now evidence-based guidelines for medication-assisted treatment.
In December, I joined the Minister of Public Safety and Emergency Preparedness in introducing Canada's new drugs and substances strategy. We reintroduced at that time harm reduction as a key pillar in drug policy.
I would like to talk now a bit about what we have done to support the establishment of supervised consumption sites. Early on, we granted an exemption to the Dr. Peter Centre in Vancouver to operate a facility, and we provided an unprecedented four year exemption to Insite to continue the good work it was doing.
For communities that have demonstrated a need and desire to have such a site in their community, we want to create an environment that will encourage applicants to come forward. That is why, pending passage of the bill, we have adjusted operational procedures in the interests of removing unnecessary barriers to the review and approval of supervised consumption sites.
Just last week, I was very pleased that we were able to issue exemptions for three new supervised consumption sites at fixed locations in Montreal. The time frame to approve these sites was unacceptable. It took a year and a half, and that was due to the onerous 26 criteria that existed under the previous legislation. However, finally we were able to get an exemption for them. These new sites, located in Hochelaga, Maisonneuve and Ville-Marie districts and operated by the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, will be able to provide care for people in those areas.
Health Canada has expedited a review of 10 pending requests for approval in other communities. There is an additional site in Montreal, three sites in Toronto, two in Vancouver, two in Surrey, one in Ottawa and one in Victoria.
Even while doing this, we have maintained the key essential criteria to ensure we protect the health and safety of staff, people who use drugs, and the neighbours who are in the areas of the proposed sites. We are working with all applicants to ensure that those applications are complete and that the department has received the necessary information.
Passing Bill C-37 will be so helpful to streamline the application process and it will be a big step forward for these communities.
Some have wondered why we have not declared a public health emergency. What I have said for months is that clearly we are in the midst of a national public health crisis of unprecedented proportions related to a growing number of opioid overdose deaths. However, the Federal Emergencies Act, which was formerly called the War Measures Act, is a tool of last resort. It is there to ensure public safety and security when a national emergency cannot be addressed by any other law. This act was not used in the case of SARS, H1N1 or Ebola. It is not the right instrument, but as I have already noted, we will make use of every tool at our disposal. We have already taken extraordinary steps at the federal level, and Bill C-37 is another essential step.
Bill C-37 needs to be passed without delay. This is not a political matter or an ideological matter; it is a matter of saving lives.
With the current growing rates of opioid overdoses and deaths, we have recognized there are gaps and weaknesses in the current federal legislative framework as it relates to controlled substances. To address those under Bill C-37, we will provide the government with the ability to more easily support the establishment of supervised consumption sites, a key measure in harm reduction.
We will also address the illegal supply, production and distribution of drugs. We will reduce the risk of diversion of controlled substances that are used for legitimate purposes to the illegal market by providing improved compliance and enforcement tools.
Bill C-37 would simplify and streamline the application process for communities that want and need supervised consumption sites. It would replace the 26 application criteria with the five factors that were identified by the Supreme Court in its 2011 decision regarding Insite.
It is important for all members to understand that Bill C-37 retains the need for community consultation, and it also adds increased transparency, making it a requirement for the Minister of Health to make public decisions on applications, including any reasons for denial.
To support these proposed changes, Health Canada will post information online about what is required in applications, how the process works, and the status of applications.
Supervised consumption sites are an essential part of a harm reduction measure. There is a vast abundance of international and Canadian evidence that shows that when they are properly established and maintained, they save lives and improve health without increasing drug use or crime in surrounding areas, they prevent infection, and, best of all, they provide a safe, non-stigmatizing, non-judgmental way for people to be introduced to the health care system.
Harm reduction measures in Bill C-37 complement a number of other actions that the government is taking to protect community safety. For example, the RCMP is working with the Chinese ministry of public safety to combat the flow of illicit fentanyl and other opioids into Canada.
Bill C-37 is proposing to prohibit the unregistered importation of pill presses and encapsulators, which would make it more difficult to produce illicit drugs and, in turn, keep these illicitly produced opioids and other substances off our streets. Bill C-37 would also give border services officers greater flexibility to inspect suspicious incoming international mail. As has been said before, just a standard-sized envelope can contain enough fentanyl to cause thousands of overdoses.
Before I conclude, I want to say a few words about treatment. It is absolutely essential to understand that we will not turn this crisis around by harm reduction alone. People need to have access to the broadest range of treatment options. Delivery of health services, including the treatment of addictions, falls largely under provincial and territorial jurisdiction. That is why I am very pleased to say that this fiscal year the federal government is transferring $36 billion to the provinces and territories to support the delivery of care. With the support of the Prime Minister, we identified new funding for the provinces and territories, in the order of $5 billion for mental health over the next decade, which will help people facing mental illness, including addiction.
We need to address the social drivers of the opioid overdose crisis. That includes things like poverty, social isolation, unresolved trauma, sexual abuse, and mental illness. It is widely understood that untreated mental illness is a common cause of addiction and early intervention is absolutely essential if we are going to counter such addiction.
I want to emphasize in the House that we need to include all four pillars in our Canadian drugs policy: prevention, treatment, harm reduction, and law enforcement. Prevention is so essential, as we understand that issues like social equity are absolutely important, cultural continuity, people having the opportunity to have healthy and safe childhoods, and making sure people heal from any unresolved trauma and grief in their lives, which might drive them to problematic substance use.
There is no single action that, on its own, is going to end this opioid crisis immediately, but Bill C-37 is an absolutely essential step in the process of moving to that end. We need a balanced approach. We need to work collaboratively with all other levels of government and civil society organizations. All Canadians need to work together. We need to have partnerships across the country, including, as I said, with provinces, territories, and municipalities that are very much engaged on this matter and, of course, indigenous leaders. We need to protect Canadians, to save lives, to address the root causes of this crisis, to give people hope, and to make sure that all matters are addressed in order to turn the tide of the opioid overdose crisis.
I encourage all hon. members to recognize the importance of this bill and to support its speedy passage through the House. I look forward to working with all members to that end.
Mr. Garnett Genuis (Sherwood Park—Fort Saskatchewan, CPC):
Madam Speaker, it is a pleasure for me to rise and address Bill C-37, certainly a very important discussion as we confront what is a national crisis around drug use. However, we have seen a funny pattern from government members, where they draw our attention to a significant problem yet actually refuse to collaborate in a non-partisan way to move these things forward. That is very clearly on the record. Members can laugh, but this is not a funny topic, and it is not funny that we tried to move this forward quickly and the Liberals got in the way.
Let us review the record of what happened. The bill contains certain provisions that are vital for addressing the challenges we face. It also, though, contains a provision that would remove effective community engagement on supervised injection sites. We have a big problem with that, and I will talk about why that is later on in my speech.
It is important for people to understand what the government has done here. Recognizing the need to move quickly on certain provisions but also the need to have thorough debate on this one particular provision on community consultation, our very hard-working member for Oshawa, our health critic, brought forward a request for unanimous consent to split the bill.
What he proposed was very reasonable, and it would have effectively addressed this issue. What he proposed was to split the bill into two sections. The sections on which we all agreed there be urgent action, and I will talk about what those are, he and all of us would agree to immediately deem adopted at third reading, fully adopted by the House, and sent to the Senate. Very likely the Senate would have moved quickly on that as well. Those provisions could already be law today and already addressing this problem right now as we speak. That was our proposal brought forward by the member for Oshawa.
However, the government said no. Why? It insisted that removing an effective voice for communities in the process had to be tied to these other important life-saving measures. It was the Liberals' decision to slow this down by refusing to split the bill. In fact, the offer we proposed in our unanimous consent motion was not just to expedite the provisions on which we agreed. It was also to immediately deem referred to the Standing Committee on Health the provisions on which we disagreed. We were even willing to move that immediately to committee for study while immediately adopting those things on which we agreed. This is how we proposed to work in a non-partisan fashion to move quickly on the things we could move quickly on to get this done.
The government, while pleading about the need and the urgency of this crisis, actually refused to give unanimous consent to our proposal to expedite those sections. Given the strong words coming from the health minister and other members of the government, it is utterly shameful that they refused to work to move this forward.
I would like to highlight the sections of the bill we agree on and the sections of the bill that could today already be law had the government been willing to work in a non-partisan manner. They will still become law eventually, but it is unfortunate that we were not able to move on the timeline we wanted.
The bill proposes to regulate the import of pill presses. Currently, pill presses, which are used for putting together illegal drugs, can be imported freely. The bill contains important provisions that would have any pill press imported registered with Health Canada and that would give our border services officials the authority to detain unregistered pill presses at the border. This is a very important measure that we have strongly supported. It could be law today if the government had been willing to work to expedite this in a non-partisan manner.
Another great provision in the bill would increase prohibitions against certain actions related to controlled substances. This would enhance the ability of the government to stop, in this instance, the transportation of illicit substances. It would enhance the power to do that under the relevant legislation. Again, it is a very positive provision. It would be making a difference if it were law today. It is something we could have moved forward on more quickly.
The bill would grant increased powers to the Canada Border Services Agency to open and inspect packages entering Canada, packages that it suspects may contain contraband such as drugs. Again, it is an important provision that CBSA be given the power to move forward and open packages that it believes contain illicit substances. Again, there is no reason anyone should oppose that. That is why it should have been done by now. It should have been passed quickly. It would have been passed quickly had the government agreed to work with the opposition and split the bill, as we proposed.
In terms of the category of things we agree on, the bill proposes temporarily accelerated scheduling, essentially allowing the Minister of Health to quickly, but temporarily, schedule and control new drugs and substances under the relevant legislation. This is important, because we have seen new drugs coming to the fore on a regular basis. These powers are important.
Four out of the five changes that we would say yes to on this side of the House could already have been law today had the government been willing to work with us.
Why was it so important for us to raise concerns and to insist on further debate on the one provision on which we disagree? The government is proposing to change the community consultation process on supervised injection sites. I have talked before about broader concerns about supervised injection sites. I know that there are many Canadians who do not believe we should have legal islands that allow people to use drugs legally. If we want to send the strongest possible message about the dangers of drug use, we may want to be optimistic in our compassion instead of pessimistic in our compassion. Many Canadians reflecting on that have broader concerns about these supervised injection sites.
Let us be very clear. That is not the question in this legislation. The question in this legislation is the degree to which, and the nature of how, communities should be engaged in the conversation about that.
The original provisions that were put in place under the previous government established some key requirements with respect to how communities had to be engaged. There had to be strong engagement with the community to maximize the chances that these types of facilities would be successful. The previous legislation put in place a reasonable process to get that done.
The government is proposing in this legislation to significantly pare down any kind of engagement. Previously, there was a requirement that the period of consultation be at least 90 days. The new provisions would allow a period of consultation of up to 90 days. There would actually be no minimum. They could spend two days undertaking the consultation. The requirements in the legislation they put forward are pared down. It says:
|| An application for an exemption under subsection (1) shall include information, submitted in the form and manner determined by the Minister, regarding the intended public health benefits of the site and information, if any, related to (a) the impact of the site on crime rates; (b) the local conditions indicating a need for the site; (c) the administrative structure in place to support the site; (d) the resources available to support the maintenance of the site; and (e) expressions of community support or opposition.
They have to provide some of that basic information.
They would satisfy the provisions of the new bill if applicants simply said that they talked to a few people in the community about opening a supervised injection site and no one liked it, but at least they talked to some people. That would be sufficient under the proposed legislation.
Let us talk about what the Liberals took out. We hear a lot from the government about the importance of scientific evidence. Actually, the existing application requirements we put in place require “scientific evidence demonstrating that there is a medical benefit to individual or public health associated with access to activities undertaken at supervised consumption sites”. Among other things, the previous legislation actually requires that scientific evidence be presented on what the impacts would be in the context of the application. That would be removed by these new requirements.
We put requirements in place for consultation with local law enforcement and local governments, which are going to be called upon to respond to the challenges and situations that are in place. Those were things that were in place before and would now be pulled back.
One of the defences we hear often from the government and the NDP about supervised injections sites is that there are actually some drug treatment services available at the sites. I know that still does not allay many people's concerns, but the consultation process that currently exists, that we put in place, requires that a description of drug treatment services available at the site be provided with the application. If people are going to apply to open a supervised injection site, they actually have to provide information to the government about the kind of drug treatment services that would be available.
If that is one of the key arguments for allowing supervised injection sites, because it seems that it is, listening to the comments that have been made, then it should be particularly emphasized and required that the person who is applying to open a supervised injection site actually provide some information to the government about what is going to exist in that space vis-à-vis drug treatment. That should be there.
The existing legislation requires, for example, that we have criminal record checks for those who are going to be involved with these facilities. There are a lot of important requirements the existing legislation has in place, and these are basic things, like consultation and engagement with the community and providing information about what is going to be in place in terms of support for people who are trying to get off drugs.
All these things should be there, but we have this vastly pared down proposal in terms of what would actually be required for the application. It is going to be so much easier for people to apply to open these supervised injection sites, and there are no requirements to ensure that we will have the due diligence in place.
Again, members can debate the merits of supervised injection sites, but the existing legislation at least ensures that they are doing the kinds of things they are supposed to be doing. The new proposed legislation by the government completely turns the page on that by not engaging communities and not requiring the kind of due diligence we included in that application at all.
I will conclude by saying again that we had an opportunity to move forward with those provisions on which we all agree. Those could be law today, but instead, we are still debating the entire bill, because the government refused to split it. The Liberals brought in closure on these important community consultation measures.
I say that we move forward with the things that will save lives now, but let us continue an important conversation about whether communities should be engaged when these types of injection sites are opened.
I think it is important that communities be engaged in conversations. I believe that communities are compassionate and that they care about these issues. It is not only the federal government that cares. If we engage communities, if we engage local law enforcement, we will get better solutions that will be more responsive to the needs of the community and will be more likely to solve this problem.
The government needs to know that it cannot fix this problem on its own. It needs to work with the opposition. It needs to work with other levels of government. It needs to work with communities. If we are going to address this problem, we need more voices at the table and more collaboration. That is what we are standing for in the opposition, and that is why, in its current form, I have to oppose the bill.
Mr. Don Davies (Vancouver Kingsway, NDP):
Madam Speaker, for any Canadians who are watching, I am glad that they can see that the Liberal Party, the New Democratic Party, the Green Party, and I am not sure about the Bloc, are willing and ready to move quickly on this legislation and not sit here and debate and slow down legislation when Canadians are dying every day.
It has been well established that Canada is currently in the grips of an unprecedented national public health emergency. I am glad to hear both my Liberal and Conservative colleagues increasingly using that term to describe the opioid crisis. The New Democratic Party started using the term back in November, and that is because this is a national public health emergency and our fellow Canadians are suffering and dying every single day.
Fifty Canadians are dying every week from opioid overdoses in this country. That is a national crisis. It also bears repeating that this crisis has become dramatically worse in recent months.
In 2016, in my home province of British Columbia alone, there were 914 drug overdose deaths. That is an 80% increase from the year before. In December, just a couple of months ago, we recorded the highest number of overdose deaths in B.C.'s history with 142 lives lost. That is more than double the monthly average of overdose deaths since 2015 and a sharp increase over September, October, and November. There were 57 overdose deaths in B.C. in September, 67 in October, 128 in November, and 142 in December. I can only guess that the number will be even higher for January. While the Conservatives want us to debate and consult, New Democrats want to act and save lives.
In December, the B.C. Coroners Service announced that morgues in the city of Vancouver were frequently full as a result of the unprecedented number of overdose deaths, forcing health authorities to store bodies at funeral homes.
This crisis is in large part the legacy of Canada's now defunct anti-drug strategy. Decades of a misguided criminal approach to drug policy has proven to be counterproductive, fuelling Canada's unregulated illegal drug market and leaving a scarcity of evidence-based health services, including harm reduction and treatment programs for people suffering from substance use disorder.
The Conservatives cut 15% from the addiction service budget in their last year in office. International research demonstrates that the criminalization of drugs increases rates of drug production, consumption, availability, and adverse drug-related health effects, but that is the evidence, and for the last 10 years our drug policy in this country was not based on evidence. It was based on ideology.
Because this crisis has been years in the making, it will not be solved by any one action or piece of legislation. I think we all know that. The passage of Bill C-37 must be the beginning of a much deeper examination of how we understand and respond to drug use and addiction in Canada.
For many years, New Democrats have been advocating for an evidence-based and health-focussed approach to drug use and addiction. Our party understands that substance use is not a moral failure. We also understand that criminal approaches that aim to punish or isolate those with addiction issues only serve to compound the suffering of those already experiencing tremendous pain.
As Dr. Gabor Maté, a Canadian physician who specializes in addictions has said:
|| Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the center of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden — but it’s there.
That is why New Democrats have pushed the federal government to reinstate harm reduction as one of the four pillars of Canadian drug policy ever since it was removed by Stephen Harper. That is why New Democrats led the fight against the Conservatives' Bill C-2 from the day it was introduced. That is why we have pressed the Liberal government to repeal or amend Bill C-2 since February 2016, one year ago, when the opioid overdose crisis was in its earliest stage.
Last fall, the NDP successfully moved a motion at the Standing Committee on Health to conduct a study on the opioid overdose crisis. This led to a report with 38 recommendations to the federal government, most of which have not yet been implemented, I would point out.
We were the first to call for a declaration of a national public health emergency. Such a declaration would empower Canada's Chief Public Health Officer to take extraordinary measures to coordinate a national response to the crisis, a measure the Liberal government, still to this day, refuses to take.
Last December, we attempted to fast-track Bill C-37 because of the dire need to deal with this crisis as quickly as possible, but that, again, was blocked by the Conservatives.
Indeed, Bill C-37 continues to be delayed because the Conservatives refuse to acknowledge the crucial importance of harm reduction, and the evidence that supervised consumption sites save lives now.
Today, I am saddened to see that the Conservatives still have not learned from their mistakes, and I am deeply troubled that they continue to liken supervised consumption sites and the approval of same to pipeline approval processes.
After their bizarre offer to trade supervised consumption site approvals for pipelines, at the health committee, the Conservative member for Lethbridge argued that these health facilities should require the same social licence as energy projects before they are permitted to save lives. The member argued that we must maintain Bill C-2's unnecessary barriers because the placement of a site will impact the communities in which they are located.
For once, I agree with the member for Lethbridge. It is absolutely correct that these sites do indeed impact communities: by saving lives, by reducing crime, and by providing opportunities for recovery to people suffering from a disease.
The Conservative Party likes to imagine that supervised consumption sites might be imposed on communities by the federal government. The opposite is true. Supervised consumption sites only exist in Canada due to the tireless efforts of advocates and community members who contribute their time and talent to provide evidence-based, life-saving health services. Sometimes, they have even done so at the risk of their own liberty.
Vancouver's Dr. Peter Centre provided supervised consumption services, in violation of federal law, for over a decade, since 2002, before the federal government finally granted it a legal exemption.
Vancouver's Insite had to fight the federal government all the way to the Supreme Court of Canada to keep its doors open. Even then, instead of complying with the spirit of the ruling, the Conservative government of Stephen Harper passed Bill C-2 as a thinly veiled attempt to prevent any new site from opening in Canada.
Today, as we speak, at least three overdose prevention sites are operating in the open in Vancouver without a legal exemption, against the law, exposing the staff who work there to criminal sanction because they are answering a higher call. They are answering the call of saving lives. That is why they are doing it.
The truth is supervised consumption sites do not harm communities; they help them. The evidence from Insite has been overwhelming and crystal clear.
By the way, the Conservatives talk about the negative impact of supervised consumption sites on communities. They never quote a single piece of evidence, not a shred, from any operating supervised consumption site because there are only two in Canada. Those two in Canada have been studied and written up in periodicals as respected as The Lancet and the evidence is crystal clear. They save lives. They reduce crime around the area. They stop open drug use. They reduce the spread of disease, and they stop the detritus of used needles in consumption sites from being out in the community where they can harm our community members and our children. That is the evidence.
When the Conservatives say that these sites impact communities, darn right they do, and they do so by helping the community. There is not an iota of evidence to the contrary.
Perhaps the Conservatives should listen to Edmonton's Mayor Don Iveson who recently said, “This is not a homeless, addicted issue. This is in pretty much every neighbourhood.”
The opioid crisis is here. It is already affecting our communities. Every day, it is claiming the lives of our friends, our family members, our neighbours.
The Conservative Party's argument that supervised consumption sites will somehow introduce opioid addiction to unaffected communities is baseless fearmongering, and it is deeply stigmatizing to Canadians with substance use disorders.
The truth is communities across Canada have been asking to open supervised consumption sites for years. It was by refusing to grant section 56 exemptions that the federal government was overruling both my home city of Vancouver and my home province's repeated requests. Indeed as Vancouver's Mayor Gregor Robertson has said: “Factors such as the impact of the site on crime rates and expressions of community support or opposition should not be relevant to the federal government's approval process. Those issues are local matters, and as such, are best dealt with by local officials, such as municipalities, health authorities, and local police agencies, who understand the issue.”
I will leave it to the Conservative Party to explain why it does not trust local authorities to make those determinations.
It has been community heroes, not the federal government, who have been on the front lines showing leadership throughout the current crisis. The efforts of these selfless people have undoubtedly saved lives and although there are too many to name individually here, I would like to specifically acknowledge the Herculean efforts of a few people.
The are: Ann Livingston and Sarah Blyth, founders of B.C.'s Overdose Prevention Society; Hugh Lampkin, long-time member of the Vancouver area network of drug users; Daniel Benson of the Portland Hotel Society; Gregor Robertson, mayor of Vancouver; Kerry Jang, city councillor of Vancouver; Maxine Davis, executive director of Vancouver's Dr. Peter AIDS Foundation; Katrina Pacey, executive director of Vancouver's Pivot Legal Society; Dr. Perry Kendall, B.C.'s Chief Medical Officer, the first and only medical officer in the country who has declared a public health emergency in British Columbia because he recognizes the extent of the crisis facing our community; and Dr. Gabor Maté, who is an internationally-renowned expert in addictions.
Having repeated requests for a declaration of a national public health emergency ignored by the current federal Liberal government, these front line organizations and the Government of British Columbia were forced to take the extraordinary measure of disregarding federal law by opening non-exempt pop-up supervised consumption sites which are operating right now as I speak. These sites have operated for months despite the daily risk of prosecution faced by those working at them as staff and volunteers.
Here is what the College of Registered Nurses of B.C. said to its membership last month.
|| This crisis may be prolonged and continue to worsen; as these overdose prevention services are being established across our province, in any place there is a need, we are being asked by nurses, “Is my licence at risk if I provide nursing care in these sites and conditions that can be less than ideal?”
Our courageous front line health workers should never be forced to ask that question.
That is why the NDP introduced an amendment at the health committee that would have allowed provincial health ministers to request in writing from the federal health minister emergency approval for supervised consumption sites in response to a local crisis.
Such an exemption would bypass the normal application process, and go into effect immediately for up to a year with the possibility of renewal. The federal minister would be required to post a provincial request online and post the response within five days.
This change was aimed at removing the potential for distant political considerations in Ottawa, many of which we hear expressed by members of the House today, to undermine or impede timely evidence-based decision responses to provincial public emergencies.
In the unusual situation where a province has declared a provincial health emergency, instead of forcing it to go through the application process which takes time, and time in a crisis like this costs lives, it gives the federal health minister the ability to grant a temporary approval quickly.
The Liberal government has repeatedly claimed that, with this legislation, it is now doing everything in its power to address this crisis, but that is demonstrably false. The government has failed to take many actions. There are literally dozens of them that are open to the government to take to respond to this crisis which it seems reluctant to do.
Recently, the City of Vancouver sent a list of nine recommendations to the federal government to help address this crisis, including calling for a central command structure, daily meetings with Health Canada, and improved treatment services.
A coroner's jury in British Columbia recently issued a list of 21 recommendations for action and the Standing Committee on Health in December issued a report detailing 38 recommendations for the government alone, again most of which remain unimplemented. The Liberal government is not doing everything it can to address the opioid crisis. It is taking some measures, but not all the measures it needs to.
When the health committee conducted the emergency study last fall into the crisis, the first recommendation made with all-party support was to declare opioid overdoses a national public health emergency. This call was echoed by Dr. David Juurlink, the keynote speaker at the health minister's own opioid summit last fall and now by B.C. Health Minister Terry Lake, a Liberal, and stakeholders across the country. In the face of a mounting death toll, a declaration of a national public health emergency would allow us to start saving more lives today.
Furthermore, during our study, the health committee heard that access to treatment for opioid addiction is almost nonexistent in indigenous communities, and where there is access, it is short-term access. That is because nurses employed by Health Canada do not have the scope of practice to support indigenous people in addressing opioid addiction in their own communities beyond 30 days. Yet, the Liberal government has made absolutely no commitment to ensuring full access to long-term, culturally appropriate addictions treatment in indigenous communities.
Finally, the health committee's recent report on the crisis made three separate and specific recommendations, calling for significant new federal funding for public community-based detox and addictions treatment. But the federal government will not commit to making any new funding available for detox and treatment in budget 2017, so far.
The health minister continues to recycle money dedicated to mental health, and claims that money can be used for addictions treatment. We are looking for new, specific, targeted funds for addictions treatment in this country. Mental health is a huge area, and there are many needs in this country. We all know that. We wanted targeted money from the government, and the government has refused to make that commitment so far.
I believe it behooves this House to be honest with itself. Would the federal government be so noncommittal and cautious in its approach if these deaths were caused by any other disease? As we look to the future, we must let go of our prejudices in order to hold on to our loved ones. Donna May, the founding member and facilitator of mumsDU, moms united and mandated to saving drug users, lost her daughter Jac to addiction at the age of 35. She said:
|| Most people would think that the hardest thing I’ve ever had to face was her death; the death of a child; the death of my only girl. However, that’s not it at all.
|| The hardest thing I’ve had to face in my life is realizing how my ignorance towards my daughter’s addiction cost me years with her that I will never get back. There are no ‘do-overs’ when your child is dead! Now I can only share my experience and what I’ve learned since, so that other parents can take something from it.
In many respects, substance abuse is one of the last remaining acceptable targets for health care discrimination. With all the evidence available to us, we should know better. If we are to succeed in treating addiction as a disease, which it is, we need to acknowledge that fear, stigma, and ignorance about those who suffer from addiction are widespread and in many respects have framed our approach to this crisis.
That is why, although these legislative changes are long overdue, they do not go far enough, fast enough. We need federal coordination and funding to address the crisis right now and over the long term. Canada's failure to treat addiction and substance use disorders by successive federal governments as a medical condition was explained to the health committee by Dr. Evan Wood from UBC.
|| I'll just ask you to imagine a scenario of somebody having an acute medical condition like a heart attack. They would be taken into an acute care environment. They would be seen by a medical team with ex1pertise in cardiology. The cardiovascular team would then look to guidelines and standards to diagnose the condition and to effectively treat it. Unfortunately, in Canada, because we haven't traditionally trained health care providers in addiction medicine, we have health care providers who don't know what to do, and routinely do things that actually put patients at risk.
|| In addition to the lack of training for health care providers, the overall lack of investments in this area has meant that there aren't standards, guidelines [or beds] for the treatment of addiction.
Dr. Mark Ujjainwalla, medical director of Recovery Ottawa, said:
|| The problem we face here is that the real issue with addiction is not opiates. The real issue is the inability of the present health care system to treat the disease of addiction. An addiction is a biopsychosocial illness that affects 10% of society, probably more if you include families, and it is the most underfunded medical illness in our society.
|| The problem is that it's also a highly preventable and very highly treatable illness. It's very unfortunate that people don't see that. When it affects your family or you, you can feel the pain and suffering, and you watch the tragedy unfold in front of you.
I would like to conclude my remarks by imploring this House to take a lesson from Estonia, a country that recently overcame an opioid crisis very similar to Canada's. The head of Estonia's drug abuse prevention department said, “I think the most important thing is you don't waste time. If you really want to learn from us, that's the mistake we made. Don't look for some new solutions, because you have them.”
We could say that history does not look kindly on those who dither in times of crisis. To put it bluntly, it is not the history books that should keep us up at night; it is the lives that we continue to lose every single day to entirely preventable causes.
Canadians are looking to us to provide leadership in a crisis. It is time for us to deliver.
Mr. Darrell Samson (Sackville—Preston—Chezzetcook, Lib.):
Madam Speaker, I will be splitting my time with the member for Brampton South.
The bill before is an extremely important one. We have a health crisis, and we need to respond quickly. Our government, with the support of many members in the House, is doing just that.
I would like to begin by extending my sympathy to all those who have lost a friend, neighbour, family member, or co-worker through this crisis.
In the past eight years in Nova Scotia alone there have been over 800 overdoses, and half of those have been due to the use of opioids. This is the situation in Nova Scotia, but the situation is much greater in other provinces. For example, in British Columbia, 900 people lost their lives through overdose in the last year, which is 80% more than in 2015. At a national level, overdoses now outnumber the deaths due to motor vehicle accidents. This gives us an interesting comparison, and shows how sad this crisis is.
This crisis has no boundaries. There is no age, gender, or income factor. This is an addiction; it is an illness. All governments need to respond to this crisis. We have to find the root causes and then find solutions through the most current evidenced-based policies to support that. Addictions can take hold of someone trying to cope with physical or emotional pain.
The tragic thing about fentanyl is that the drug is so powerful, a minuscule amount can have dramatic effects and even cause death. As little as 30 grams, enough to fill a regular envelope, can cause as many as 15,000 people to die of an overdose.
That is why our government and all members of the House must pass a bill quickly, because every moment counts.
This legislation would roll back changes made by the previous government, the so-called Respect for Communities Act. That legislation added an unnecessary burden on provinces, local governments, and communities in applying for an exception under the Controlled Drugs and Substances Act to establish a safe consumption site. Bill C-37 would accomplish this by simplifying and streamlining the previous process and its 26 application criteria. That is why only three sites in the last two years have been established under those criteria.
Our government is applying the wisdom of the Supreme Court of Canada, which indicated five important factors: one, evidence on the impact of such facilities on crime rates; two, local communities indicating that there is a need for those types of sites; three, establishing regulatory structures and making sure they are in place to support the sites; four, having the necessary resources; and, five, having communities express support or opposition. That is what is important and what the bill would provide. In addition, whichever applications are denied or approved, the decisions would be made public. It is important that they be public.
The fact is that supervised consumption sites save lives. That is the important thing here: they save lives. The Vancouver sites help integrate people with addiction problems into the health system in an environment where they are not judged or stigmatized.
Harm reduction is not our government's only strategy. Our government has made it clear that we will invest $5 billion in mental health as part of the health agreement.
Prior to 2006, the Government of Canada had a federal drug strategy that had a balanced approach between public health and public safety that included the four key pillars: prevention, treatment, enforcement, and harm reduction. The previous government removed harm reduction as a pillar in our national drug strategy. This was unfortunate, because evidence has shown time and time again that harm reduction strategies are needed to ensure good public health outcomes.
As part of this government's commitment to evidence-based policy-making, the Minister of Health has reinstated harm reduction as a pillar of our strategy.
Along with harm reduction, our government has also eased access to the life-saving overdose treatment naloxone. Canadians can now access this drug antidote without a prescription and we have ensured emergency supplies are available for all Canadians.
In terms of enforcement, the RCMP has been diligently working to try to stop the flow of fentanyl. An agreement was recently reached with China on this issue. Furthermore, under this legislation, the Canada Border Services Agency would have more flexibility to inspect suspicious mail which it believes may contain prohibited goods. This measure would only apply to incoming international mail from areas of the world where prevalence of illicit drugs is greater.
In closing, I would like to commend the Minister of Health for her hard work in combatting this crisis and working toward a solution, and her leadership in bringing this legislation forward. I also want to thank members in all parties in the House for their contribution to this debate, as well as the NDP, the Bloc, and the Green Party that have directly supported this bill.
Ms. Sonia Sidhu (Brampton South, Lib.):
Madam Speaker, I am grateful for the opportunity to speak in support of Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.
While I am supporting this positive move, I must say I am still deeply troubled by this crisis that continues to hit communities. On a personal note, I was deeply touched after hearing from those affected. As a member of the Standing Committee on Health, I, with my colleagues from all parties, studied this crisis. In fact, we chose to pass a motion to undertake an emergency study of the crisis.
We were all in lockstep with the minister, trying to make a positive difference and to make choices that would save lives. That motivation drove us to work hard, and work together. We worked collectively and openly on this. That is something I am quite proud of and something I have valued in my time as the MP for Brampton South, and as a fellow parliamentarian of all who serve together in this place.
In committee, we heard from wide-ranging front-line perspectives, experts, and from the Minister of Health directly on this. I would like to make particular note of the testimony the committee heard from indigenous peoples on October 25, which I feel was compelling, honest, and a real wake-up call about what we need to do to ensure we address the needs of indigenous communities. For starters, improving access to naloxone treatment, the life-saving medication used in the case of an opioid overdose, was needed for rural and remote first nations in particular. That was a key part of the minister's action plan coming out of the summit, and goes to show what we can do when we consult all communities.
In looking at the bill, I see that Bill C-37 addresses what we heard from the Canada Border Services Agency about practical changes that would help prevent drug-making materials from entering the country. I applaud the minister's work also to check suspicious international mail packages that are 30 grams or less, which could be used to smuggle in any amounts of substances that may cause harm. This is a good precaution to benefit Canadians.
I want to remind colleagues that the bill is the product of hundreds of voices coming together. Our committee members were graciously invited to join in the health minister's summit on this as well. Coming out of the summit, we saw action. In fact, the joint statement of action by 42 organizations to address the opioid crisis was a broad but concrete approach that includes all those involved, from health care providers, to first responders, to educators, to researchers, and to families as well. I want to applaud our Minister of Health, and Ontario's minister of health as well, for leading that conference, which focused on concrete steps and delivering clear results.
Our government has taken action from day one, building on our five-point action plan to address opioid misuse. We have taken concrete steps, such as granting section 56 exemptions for the Dr. Peter Centre and extending the exemption for lnsite for an additional four years. We made the overdose antidote naloxone more widely available in Canada. Our government recently approved three safe consumption sites in Montreal that the community asked for.
Further, at the local level, we have seen action already undertaken. In the city of Toronto, the mayor met with the mayor of Vancouver and other officials in order to plan a proactive not reactive response for Ontario as the crisis drifts eastward. The mayor of Hamilton held a discussion about this as well, and other municipalities have been doing the same. I hope more municipalities will reach out, learn from one another, and take proactive measures in their communities.
The numbers and the experts support this as the right way to public health, and it also delivers cost savings. I see how various aspects of the bill address a lot of the concerns we heard at committee and at the opioids summit. While many members have made note of the urgency of passing the bill, I think the majority of members showed time and time again in recent weeks that they were willing to collaborate to move quickly on this.
I want to reassure members that I believe the bill is an extremely collaborative and well-thought-out bill that responds to experts in the field as well as front-line needs. It gives me comfort to know that this bill would make a difference.
As others have said before, and I agree, we are in a national public health crisis in Canada. In 2016, thousands of Canadians tragically died of accidental opioid overdoses, and more will die this year. Our government and its partners must work together aggressively to save lives.
If people have friends or neighbours who are hearing the Conservatives' argument that facilities like Insite are the wrong approach, I would encourage them to contact me or other members on the health committee who would be happy to provide non-partisan, evidence-based information on why that does not reflect the safe consumption site model we see working already in Canada. All members of this House can agree that our hearts go out to the families and friends affected personally when a loved one has lost his or her life instead of having another chance. Last year in British Columbia alone, more than 900 people died from a drug overdose, an 80% increase from 2015.
This legislation simply proposes to ease the burden on communities that wish to open a supervised consumption site, while putting stronger measures in place to stop the flow of illicit drugs and strengthening the system in place for licensed controlled substances facilities. Experts and stakeholders told the previous government and then told our government that Bill C-2 as it stood was not helping this crisis. That is why we took action to reverse the barriers that were holding back communities that have long been asking for the ability to save their citizens' lives.
We know there is more to be done as we move forward. We know that sadly the situation is getting worse. The deaths from overdoses will now be greater than deaths caused by car accidents. This tragic crisis continues to move eastward in Canada, with increasing drug seizures of fentanyl and carfentanil across the country. We will continue to work with our partners across the country to continue bringing forward evidence-based solutions to save lives and ensure that 2017 is the year that will mark a turn in this national public health crisis.
Many people in Brampton South have asked me about my work on the health committee, and I have mentioned over and over that we all agreed we should turn our focus to this study due to the emergency at hand. They ask me why and they are always engaged when hearing about how we can work together at committee to address real problems and issues that our fellow Canadians face. Again, the way our committee worked together is one of the cherished moments I have of being an MP, and I hope we get more chances to work collaboratively again. This crisis called on us as leaders in our communities and as parliamentarians to take action.
In October 2016, I put forward a motion that the health committee call upon the Minister of Health to move as quickly as possible to conduct a review of the laws and regulations in place with regard to safe injection sites. I suggested that the review have an end goal to improve the health and safety of Canadians, using a strong evidence-based approach. With Bill C-37, I feel the minister and government have responded fully to the motion that the health committee passed in October of last year.
I am proud to be supporting this legislation that would save the lives of Canadians who need our help.