Evidence of meeting #4 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was enforcement.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Clerk of the Committee  Mr. Marc-Olivier Girard
Jennifer Goldstone  Acting Head, National Anti-Drug Strategy, Department of Justice
Paul Saint-Denis  Senior Counsel, Criminal Law Policy Section, Department of Justice
Trevor Bhupsingh  Director General, Law Enforcement and Border Strategies Directorate, Department of Public Safety and Emergency Preparedness
Jean Cormier  Director, Federal Coordination Centres, Royal Canadian Mounted Police
Don Head  Commissioner, Correctional Service of Canada
Taunya Goguen  Manager, Serious and Organized Crime, Department of Public Safety and Emergency Preparedness
Luc Chicoine  National Drug Coordinator, Federal Coordination Centre, Federal and International Support Services, Royal Canadian Mounted Police
Denis Kratchanov  Director and General Counsel, Information Law and Privacy Section, Department of Justice

3:35 p.m.

The Clerk of the Committee Mr. Marc-Olivier Girard

Good afternoon, everyone.

As you know, the elected chair, Ms. Smith, resigned today, which means the position of chair of the committee has become vacant. So it will come as no surprise to you that your first task today will be to elect a new chair of the Standing Committee on Health.

As a reminder, pursuant to the Standing Orders, the chair must be a member of the government party.

I'm now ready to receive motions for the chair position.

3:35 p.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

If I might, sir, I'd like to nominate Mr. Ben Lobb.

3:35 p.m.

The Clerk

Are there any other nominations?

Is it your pleasure to adopt the motion?

3:35 p.m.

Some hon. members

Agreed.

3:35 p.m.

The Clerk

(Motion agreed to)

3:35 p.m.

The Clerk

I declare the motion carried and Mr. Ben Lobb duly elected chair of the Standing Committee on Health. I invite him to come and take the chair.

3:35 p.m.

Conservative

The Chair Conservative Ben Lobb

Ms. Davies.

3:35 p.m.

NDP

Libby Davies NDP Vancouver East, BC

First of all, congratulations on becoming chair.

I'd like to move a motion that we, as a committee, send a letter of thanks to Ms. Joy Smith. I know she has served on this committee for a long time, also as the chair. It would be nice to send her a letter thanking her for her years of service and interest in this committee.

3:35 p.m.

Conservative

The Chair Conservative Ben Lobb

Ms. Fry.

3:35 p.m.

Liberal

Hedy Fry Liberal Vancouver Centre, BC

I wanted to congratulate you on becoming chair.

I also wanted to concur with and second Ms. Davies' motion with regard to Joy Smith, who has had many years of service with this committee. If we could send that to her in a letter or in some other way, it would be perfect.

3:35 p.m.

Conservative

The Chair Conservative Ben Lobb

Thank you, Ms. Fry.

The clerk and I will put together a letter. We'll send it around for review by the committee, so they think it's appropriate, and then we'll forward it to Ms. Smith.

Good afternoon, ladies and gentlemen.

We have a full slate here today. We have four different groups that are going to be presenting. As you know—I'm sure you've been briefed—you each have 10 minutes to present. We'll carry right through. Once we get close to 10 minutes, I'll put my hand up so that you will know you're getting close. But I'm sure your notes are put together in such a way that you're going to be right on the 10 minutes.

We'll start with the Department of Justice. We have Mr. Saint-Denis and Ms. Goldstone. Whoever is presenting can start.

3:35 p.m.

Jennifer Goldstone Acting Head, National Anti-Drug Strategy, Department of Justice

Since the Department of Justice Canada heads the national anti-drug strategy, it's a pleasure for me, as the acting head, to be here today to say a few words about the strategy.

The strategy aims to contribute to safer and healthier communities through coordinated efforts to prevent use, treat dependency, and reduce production and distribution of illicit drugs. The strategy is a collaborative effort involving 12 federal partner departments and agencies, with $515.9 million allocated for this current five-year cycle of 2012-2017.

The strategy includes 22 programs that are delivered through three action, prevention and treatment plans, managed by Health Canada. Public Safety Canada is responsible for enforcing the act.

The strategy focuses on illicit drugs, as set out in the Controlled Drugs and Substances Act. Since the launch of the strategy in 2007, misuse of prescription drugs has emerged as a significant public health and public safety issue, resulting in addictions, overdoses, fatalities, and crime.

Prescription drugs are often obtained from the medicine cabinet of a friend or a family member. They're also being diverted and distributed through many of the same illegal channels that are used by illicit crime groups, that is, organized crime. Prescription drugs are obtained through armed robberies and break-ins of pharmacies, fraudulent use of the health care system, such as double-doctoring and forgeries, sales by individuals taking advantage of the lucrative street markets, and illegal Internet sales.

While some federal departments address misuse of prescription drugs as part of their mandates, it requires a policy authority expansion to use some of the national anti-drug strategy money towards addressing this important issue.

In the 2013 Speech from the Throne, the Government of Canada committed to expanding the NADS policy authority—I say NADS for national anti-drug strategy—to address prescription drug abuse. There's also been strong consensus among stakeholders, including first nations groups, medical and research communities, and enforcement and pharmaceutical communities, that collaborative action is needed.

Paul.

3:35 p.m.

Paul Saint-Denis Senior Counsel, Criminal Law Policy Section, Department of Justice

Thank you, Jennifer.

I have no presentation to make per se. If you have questions in the area of criminal law or in the area of offences and penalties with respect to the Controlled Drugs and Substances Act, I'll endeavour to answer those questions.

3:35 p.m.

Conservative

The Chair Conservative Ben Lobb

Okay, so that's the conclusion of your presentation, then. Thank you very much for your brevity. That allows for more questions at the end.

Next up is the Department of Public Safety and Emergency Preparedness. Forgive me if my pronunciation is incorrect, Mr. Bhupsingh; and we have Ms. Goguen as well.

Please, sir, go ahead.

3:35 p.m.

Trevor Bhupsingh Director General, Law Enforcement and Border Strategies Directorate, Department of Public Safety and Emergency Preparedness

I would like to thank the chair and committee members for inviting me to speak to you on prescription drug abuse and its impact on public safety.

My department is responsible for the Enforcement Action Plan, which is a part of Canada's National Anti-Drug Strategy. This responsibility means that we have to work in close cooperation with various partners, among them the Royal Canadian Mounted Police, the Department of Justice, and Health Canada, so as to ensure that government interventions in the fight against drugs are coordinated, in particular as regards marijuana grow-ops and clandestine laboratories that produce synthetic drugs such as ecstasy.

Within this role, Public Safety has sought to continuously address new and emerging issues impacting public safety with respect to drugs. In recent years, there is increasing evidence to suggest that the illicit use of prescription drugs is a major public safety concern in Canada.

From an enforcement perspective, the criminality associated with prescription drug misuse includes fraudulent use of the health care system, pharmacy robberies, drug-impaired driving, and more traditional drug-trafficking activities, both by criminal organizations and individuals looking to profit from a lucrative street market. Meanwhile, these licit drugs challenge traditional supply reduction approaches.

Public Safety has worked closely with the Canadian Association of Chiefs of Police drug abuse committee over the years to raise awareness about this issue impacting our communities. As many of you know, the illicit use and/or misuse of pharmaceuticals, in particular, narcotic opioids, has become an issue of increasing concern with the impacts on public safety and the community well-being. In fact, trends indicate rising rates of recreational misuse of prescription drugs by our youth, the majority of whom obtain these drugs from family medicine cabinets or from friends.

This is why, in June 2011, Public Safety hosted a national workshop on the illicit use of pharmaceuticals, in Vancouver, attended by over 100 participants representing federal, provincial, and municipal law enforcement, as well as health officials, including physicians and pharmacists. The goal was to facilitate multi-sectoral discussion and to increase the overall understanding of the issue of pharmaceutical misuse from a public safety perspective.

Following the workshop, Public Safety invested in a pilot project in the Niagara region to hold a prescription drug drop-off day in May 2012. The goal of the event was to safely dispose of unused or unfinished medications in order to limit the possible misuse of these medications. This initiative was very successful. In just one day, 4,000 kilograms of medications were collected, including 835 oxycodone pills, over 3,400 Percocet and Oxycocet pills, over 5,000 codeine pills, and 23 fentanyl patches.

Building on the success of this particular pilot, Public Safety supported the CACP in implementing their resolution to hold a national prescription drug drop-off day and to mobilize law enforcement efforts. Public Safety held a workshop and developed a handbook—I think copies of the handbook were given to members, Mr. Chair—targeting a new law enforcement to support them in their first national annual drop-off day held in May 2013, so earlier this year. This handbook, which has been shared internationally, highlights current prescription drug return initiatives in Canada and is available on both the PS website and the national anti-drug strategy website.

In line with this national day, Public Safety, in collaboration with Health Canada, put forth a resolution at the UN Commission on Narcotic Drugs, on behalf of Canada. This resolution was adopted on March 15, 2013, by the commission. It called on member states to promote initiatives for the safe, secure, and appropriate return for disposal of prescription drugs, in particular, those containing narcotic drugs and psychotropic substances under international control.

Public Safety has also worked closely with the Canadian Centre on Substance Abuse, the CCSA, in the development of the national framework on prescription drug misuse. Specifically, in collaboration with the Canadian Association of Chiefs of Police drug abuse committee, they led the development of the enforcement pillar for the CCSA's strategy, First Do No Harm: Responding to Canada's Prescription Drug Crisis. We are currently in the process of developing an implementation plan of this pillar.

I thank you for having given me this opportunity to give you an overview of the role my department plays in the National Anti-Drug Strategy, and for the work you have done up till now to manage the issue of prescription drug abuse.

I would be pleased to reply to your questions. Thank you.

3:40 p.m.

Conservative

The Chair Conservative Ben Lobb

Thank you very much, Mr. Bhupsingh.

Next up we have the Royal Canadian Mounted Police.

Mr. Cormier, I believe you are going to provide the speech today. Go ahead.

3:40 p.m.

Inspector Jean Cormier Director, Federal Coordination Centres, Royal Canadian Mounted Police

Good afternoon, Mr. Chair, and first of all congratulations on your election to the position of chair.

Honourable members of the committee, thank you for inviting the RCMP to participate in these proceedings. I am happy to be here today with my colleague and partners.

I am Inspector Jean Cormier, and I currently hold the position of director of the federal coordination centres within the RCMP's federal policing program at national headquarters. The federal coordination centres provide subject-matter expertise to many of the enforcement initiatives supported by federal statutes.

Today I am accompanied by Corporal Luc Chicoine, who is one of the RCMP's Drug Initiatives National Coordinator at RCMP National Headquarters.

Thank you for the opportunity to say a few words about the RCMP's engagement with this important issue, as well as our relationship with the different partners from the Canadian government involved in addressing the issue of prescription drug abuse.

Prescription drug abuse is a serious problem affecting citizens of our country. The misuse and abuse of prescription drugs has always been present, but recently it has become increasingly prevalent and therefore requires the attention of all of us. Non-medical use of prescription drugs is the third-most prevalent form of drug abuse among Ontario students. Information from Health Canada estimates that it is at 16.7% just behind cannabis at 22% and alcohol at 55%.

The misuse and abuse of prescription drugs has devastating impacts on the citizens of Canada. It is important to note that this issue is felt across all age groups, races, social classes, incomes, ethnic backgrounds and genders. The misuse and abuse of prescription drugs directly affects the Canadian population as a whole, our businesses, communities, and our international reputation.

One of the dangers posed by prescription drug abuse is the false sense of safety users have, as it is prescribed by doctors, manufactured in regulated facilities and provided by pharmacists. However, when these prescription drugs are misused, they come with the same devastating impact as other illicit drugs.

It is important for law enforcement to work collaboratively with domestic and international partners to identify, prevent, and detect the diversion and trafficking of prescription drugs by pursuing those who engage in such activity. The RCMP and other domestic police services are often the first responders to incidents of prescription drug abuse. Education and training of officers is an important step in properly addressing the situation.

We believe that information-sharing between different private and public partners is crucial in addressing this problem.

The National Anti-Drug Strategy promotes a three-pillar approach—prevention, treatment and enforcement. The RCMP is an active participant within the National Anti-Drug Strategy so as to deal with the problems related to prescription drug abuse.

The investigation of abuse or diversion of prescription drugs is complex and challenging. In spite of this, the RCMP in concert with its partners is focused on two of the national anti-drug strategy pillars—prevention and treatment.

All RCMP officers are technically responsible for investigating illicit drug-related activities. We do, however, have officers such as Corporal Chicoine here who have special training in drug investigation who are also considered subject-matter experts. These resources also have a responsibility to investigate illicit activities related to prescription drugs. There are some of these trained resources situated in all provinces and territories across Canada.

Although international cooperation has come a long way in establishing standards to prevent and detect prescription drug abuse, such as the elimination or further restriction of certain prescription drugs, continued effort and a sustained focus must be maintained.

The RCMP believes that everyone has ownership and a role to play in the prevention of prescription drug abuse.

It is our belief that focusing on prevention by raising the level of awareness within our communities, including our health care practitioners, of the misuse and abuse of prescription drugs will assist in conducting successful enforcement action that will suppress criminal activities. The RCMP is committed to efforts to detect and deter prescription drug abuse, which has a negative impact on Canada and the well-being of Canadians.

I thank you and look forward to answering your questions.

3:50 p.m.

Conservative

The Chair Conservative Ben Lobb

Thank you very much, Mr. Cormier.

Our final speaker of the afternoon is Correctional Service of Canada Commissioner Don Head.

Go ahead, sir.

3:50 p.m.

Don Head Commissioner, Correctional Service of Canada

Thank you, Mr. Chair.

Good afternoon, Mr. Chair, and members of the committee.

l'm pleased to have the opportunity to appear before you today to provide input into this committee's study on the government's role in addressing prescription drug abuse.

Mr. Chair, as Commissioner of the Correctional Service of Canada, or CSC, I oversee the operations of Canada's 53 federal penitentiaries, 16 community correctional centres, and 92 parole offices and sub-offices. On a typical day during the most recent fiscal year, CSC was responsible for 22,762 offenders, of whom 15,056 were incarcerated.

It will likely come as no surprise to this committee that substance abuse within the offender population is an ongoing problem. Our data indicates that approximately 80% of offenders arrive at federal penitentiaries with a history of substance abuse problems, many of whom have had issues with more than one substance. Equally concerning, it has been determined that drugs or alcohol were a factor in the crimes for which roughly half of the offender population were convicted. This statistic has remained constant over many years.

Within federal penitentiaries, my front-line staff have the responsibility of addressing the serious threat that drugs pose to the safety and security of institutions on a daily basis. Without question, reducing the supply of illicit drugs has been a priority of my organization. Through measures such as drug detector dogs and enhanced security intelligence, CSC has focused on preventing drugs from entering our institutions, and in turn created an environment that is both safer for our staff and inmates as well as more conducive to the effective rehabilitation of offenders.

In addition to initiatives that seek to reduce the supply of drugs, CSC has been equally determined to reduce demand for drugs. To this end, CSC provides drug treatment and substance abuse programs that assist offenders in their rehabilitation and in addressing the criminogenic risk of substance abuse. Indeed, CSC is widely considered to be an international leader with respect to its substance abuse programming and treatment.

Mr. Chair, CSC is certainly capable of providing insight into both illicit drug interdiction and treatment. However, where CSC may be most helpful to this committee is on the subject of actually administering prescription drug delivery in a very challenging institutional environment.

As this committee may be aware, CSC is mandated to provide essential health care services to all federal inmates. As part of this mandate, CSC must ensure that offenders are afforded reasonable access to required prescription medications. As this committee can no doubt imagine, managing the distribution and administration of prescription drugs to a client base of federal inmates presents a unique challenge due to the high risk that offenders pose in terms of abusing these medications.

Given this risk, CSC has created a system that limits the potential for these substances to be abused but maintains a high level of medical care. The most notable element of our policy framework is the Correctional Service of Canada's national formulary. This document, by which all federal penitentiaries must abide, provides a tool to physicians and pharmacists to encourage the selection of optimal and cost-effective medications. The formulary, which is produced by health care professionals and updated twice each year, provides a list of medications that CSC is prepared to provide to federal offenders when medically required.

By extension, any medications that represent a potential risk for an institutional setting are excluded from the formulary, and if that is not possible for medical reasons, restrictions are placed on how the drug is prescribed and administered.

Of particular relevance, the formulary also provides information for specific drugs in terms of available alternatives, how they are to be safely distributed to offenders, in what dosage and in what supply, for what duration, and under what circumstances.

I believe that the means by which CSC safely delivers prescription drugs to federal inmates is of direct relevance to this committee's study. Although consideration for time prevents me from providing specific details regarding these policies in my opening remarks, I'd be pleased to answer any questions this committee may have on this subject.

Thank you, again, Mr. Chair, for the opportunity to appear before you today.

3:55 p.m.

Conservative

The Chair Conservative Ben Lobb

Thank you, Mr. Head.

We'll start our first round of questioning. We'll start off with the NDP.

Ms. Davies, go ahead.

3:55 p.m.

NDP

Libby Davies NDP Vancouver East, BC

Thank you very much.

First of all, thank you to the witnesses for being here today. I'm interested to hear your presentations and what each of your departments is doing.

Mr. Bhupsingh, you mentioned in your brief that there's increasing evidence to suggest that illicit use of prescription drugs is a major public safety concern. Could you table any documents you have that actually give us that evidence? I don't know whether you're talking about polls or reports that have been done, or surveys. I'm not sure what you're referring to, but if you could table that with the committee, it would be very helpful.

The other thing that strikes me in hearing the presentations today is when we hear about what's taking place in terms of the drop-off day. I have no problem with the idea that there's a national drop-off day, and that we're involved in organizing it, and that there was a resolution at the UN, but it seems to me that to focus on a policy of appropriate return is sort of after the fact. I didn't hear any of you speak about what we do in a systematic way to prevent abuse in the first place.

In B.C., we have systems within our pharmacare program and through pharmacies where checks and balances are in place to ensure that people aren't shopping around for prescription drugs. It's hard to know whether any of your departments, or Health Canada for that matter, are involved in trying to promote something like that on a national level.

My question is, why are we focusing so much on after the problem has already happened, as opposed to putting systems in place?

Mr. Head, you said you do have systems in place. Maybe you can address that in terms of what we can learn from that, but I am concerned that we don't seem to have any systematic way of dealing with this issue. It seems to me that looking at it solely from a law enforcement argument is missing the boat. We need to look at how the system itself, in terms of the dispensaries, ensures that we're minimizing, as much as possible, any abuse from taking place.

Could any of you address that?

3:55 p.m.

Director General, Law Enforcement and Border Strategies Directorate, Department of Public Safety and Emergency Preparedness

Trevor Bhupsingh

Mr. Chair, thank you.

First of all, in my reference to the increasing trends we're seeing in pharmaceuticals, prescription drugs, a lot of that is just what we see in terms of investigations. In new cases coming before public prosecutions, etc., we see an increase. Those are the trends I'm talking about.

Mr. Chair, a number of studies referenced in earlier submissions, by Health Canada, by other members, are clear. We see a growing trend in this. What I'm suggesting is that we don't see anything different, at least from a public safety perspective, to counter that trend. With respect to systemic abuse, I would say that I'm from the law enforcement community, but I know Health Canada—and Health Canada was here last week—was talking about a number of systems they're attempting to put into place.

I am not the best placed to comment on an upfront, systematic approach to this. What I can speak to is that in addressing some of the law enforcement supply-reduction concerns, we're moving forward, and we think that, ultimately, take-back days and those types of initiatives can have an effect. I know that's not a systematic system such as you're talking about, but in terms of addressing some of the law enforcement concerns, we think that's an appropriate way to intercept some of the supply.

4 p.m.

NDP

Libby Davies NDP Vancouver East, BC

From a public safety point of view, wouldn't your first approach be to have a much better regulatory system in place? Whether they're deemed legal or illegal, we are dealing with substances that can be misused, that can be powerful, that can have a very negative impact if they're not used properly.

I haven't heard any of you speak of this. It seems to me we need to have a regulatory system up and running so that we do have those checks and balances.

4 p.m.

Director General, Law Enforcement and Border Strategies Directorate, Department of Public Safety and Emergency Preparedness

Trevor Bhupsingh

My only comment would be that there's a lot of collaboration. There are jurisdictional issues. My understanding is that the provinces have a large role in regulating controlled substances. I agree that we have a role. To the extent that we have a role putting in place systems, I think we're looking at and attempting to do that.

Again, from a health perspective and just in terms of responsibility, those would probably be good questions for colleagues at Health Canada.

4 p.m.

Conservative

The Chair Conservative Ben Lobb

Mr. Saint-Denis, did you want to add something?