Health Committee on March 23rd, 2023

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Sorry, Laila...?

[The Chair, Liberal, Sean Casey]

Go ahead and finish your answer, Dr. Bennett. That's the last question.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

In a comprehensive assessment of all these safe supply projects, diversion has always been something that people have looked at. It is being tracked.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Goodridge.

Next is Dr. Hanley, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

Thank you, Minister, for appearing, and thanks to all the officials for being here.

I'm going to continue on some similar themes, but perhaps in a slightly different frame.

In the Yukon, as you know, drug overdoses and deaths continue at alarming levels. Mayo, Yukon is one community that has been hit particularly hard in the last three years. There have been numerous deaths in this small community of a few hundred. They were also tragically hit by a double homicide in the community—it's currently under investigation—just a week and a half ago.

They have called an emergency in order to take some extraordinary measures to reinforce community safety and to address addictions and drug trafficking on a more urgent level.

Just so you know, one of the asks brought from the community is that supports for private treatment that were provided during the pandemic be extended so that people can have short-term access to addictions treatment in the absence of other options at the moment.

Clearly, the spectrum of supports needs to be brought to bear. They are preventative measures, including access for children and youth, recreation, mental health support, cultural connection, early intervention and harm reduction with social and medical supports, including, as you mentioned earlier, opioid agonist treatment, clinical substitution and the possibility of safe drug supply for those who can't benefit from clinical OAT treatment and other measures adapted to where that individual is on their substance use journey, which I think is really the essence of harm reduction. It's one of those pillars of support. Of course, it would also be access to treatment options, including clinical treatment, counselling, social supports and aftercare.

In light of that, I wonder if you could comment on how the current funding and committed funding from our federal government can be utilized to answer the needs of communities. We know the ire across the country. Mayo is in a bad state at the moment, but we know there are many in a similar situation around the country.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

The substance use and addiction program across Canada that Shannon supervises is doing extraordinarily good work, and the work it's doing is also researched as we go by CIHR and CRISM, so we are able to show what works in all of the harm reduction modalities—certainly at Blood Ties in Whitehorse—and to see drug testing, safe injection and safe inhalation, where we know we are able to reverse overdoses and keep people alive.

The SUAP money is mainly for proof of concept. When we can prove that something works, then we hope that the provinces and territories will pick that up and put it into their comprehensive approach to their drug policy and programs.

In terms of treatment, whether they be healing lodges or on-the-land programs, we're very interested in being able to follow the science on how effective those are.

I think, as you said, Doctor, the aftercare piece of this is so important—that people have the kinds of supports and services they need through their primary care teams or with community organizations.

We need more primary care practitioners. Nurse practitioners and family doctors could have more confidence dealing with mental health and substance use problems, and that's why I think we're very pleased to see the College of Family Physicians expanding its program for an extra year, so that people will come out being much more confident. It is going to be at that front line that we can prevent people from falling through the cracks.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

Just going back to—and you mentioned it—land-based treatment, maybe you can elaborate a bit on what that means to you through your experience as Minister of Mental Health and Addictions in particular, but also what avenues there are for northern indigenous communities to pursue land-based care and develop programs on land-based care, including aftercare.

[The Chair, Liberal, Sean Casey]

Be as concise as possible, Minister, as we're trying to get a couple more rounds in.

Thanks.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

On-the-land programming has been shown to be very successful throughout COVID and even before. I think you know that my brother-in-law runs a land-based program in Alberta, which has been hugely successful because of the quality of its aftercare as well. To be out on the land is important to all Canadians, but for indigenous people, to actually have that language and culture and to be proud of who they are, and to have that secure personal and cultural identity is so important. To be good at stuff on the land and on the water is really important in building self-esteem and having people be able to see that they can live their best lives.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Mr. Thériault, you have the floor for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I'd like to come back to the lax budgetary expenditures.

In one of her reports, the Auditor General stated that the government had paid $5 billion for 169 million doses of COVID‑19 vaccine between December 2020 and May 2022. She said that, of those 169 million doses, 13.6 million had expired before they could be shipped and administered. After that, 11 million more doses expired.

According to the Auditor General, 32.5 million doses were going to expire before the end of 2022. How many of those 32.5 million doses did we manage to use? Whatever the case may be, how many of those doses were thrown away, on top of the 24.6 million doses that had already expired?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Before I hand it over to Heather, I think this is a time for people to understand that COVID is not over, and that we want people to get out and get their shots. This is a hugely important time and a teachable moment—

[Luc Thériault, Bloc, Montcalm, QC]

That's not my question.

[Heather Jeffrey]

The number of doses that have expired to date is 25.6 million.

A dose could be considered expired for many reasons. Sometimes the expiry date has been reached. Sometimes the container has been opened. Sometimes it's related to the refrigeration process. In a few cases, containers had been damaged during transportation.

We're working very closely with our global partners to transfer doses between provinces, and we're working with manufacturers to extend shelf life in consultation with Health Canada.

Regarding donations abroad, we have donated 196 million doses to be used abroad.

[Luc Thériault, Bloc, Montcalm, QC]

A total of 24.6 million or 24.5 million doses represents a lot of money and a lot of health care we can't provide.

How do you plan to rectify the situation?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

First of all, I believe the priority was to have enough vaccines for Canadians.

[Luc Thériault, Bloc, Montcalm, QC]

Yes, we know that and I agree, Madam Minister. I want to know how you plan to rectify the situation.

[The Chair, Liberal, Sean Casey]

That's all the time you had, Mr. Thériault.

I will give you enough time to provide a brief response, if you want.

[Heather Jeffrey]

To keep doses from expiring, we transferred them between the provinces and territories, worked with manufacturers, expanded vaccine requirements and promoted active international vaccine donations.

We're taking a number of steps to minimize the number of vaccines that expire. However, as the minister mentioned, in order to be prepared and to ensure that all Canadians have access to doses, we procured a wide variety of vaccines in significant quantities to make sure that everyone would have access.

I would also add that ensuring we promote vaccine take-up and combat misinformation and hesitancy is an important part of ensuring that all doses can be used as effectively as possible.

[The Chair, Liberal, Sean Casey]

Thank you.

Mr. Johns, you have two and a half minutes, please.

[Gord Johns, NDP, Courtenay—Alberni, BC]

We've heard from the Conservatives that in British Columbia they're blaming decriminalization and safe supply for the root of the problem of the toxic drug crisis. The reality is that decriminalization didn't start until January 31.

Six people a day have been dying. It's been mounting for six years. Out of the 100,000 people in British Columbia with substance use disorder, literally hundreds might have access to a truly safer supply of substances. The problem is that its drug policy, Minister, has failed.

We've heard from the police chiefs association. They can't police their way out of this problem. It won't matter how many resources they get; they can't solve it.

It's easier to get the toxic concoction of drugs almost anywhere in this country than it is to get a prescription at a pharmacy. You can fill it faster. This is a problem.

It's the police chiefs who have suggested a safer supply to get people away from the toxic drug crisis and to stop criminalizing people who use substances. This is also reflective of the expert task force on substance use.

My problem with your government is the delay and lack of rapid response in terms of a safer supply getting out to communities. It's not a diversion of safer supply that's killing people; toxic street drugs are killing people.

When are you going to scale things up? I keep asking the procurement minister if you've reached out and asked her to procure a safer supply of substances so you can scale things up. When will that happen?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

I think that it's really important to understand that they're off the drugs, that the community of safe supply practice are using....

There's not an insufficient supply of Dilaudid, diacetylmorphine or the drugs that safe supply practice uses. The problem is that there aren't enough practitioners comfortable enough to use it, so we have to move differently and—

[Gord Johns, NDP, Courtenay—Alberni, BC]

Minister, I have only 10 seconds.

It's the stigma that's causing the delay, Minister.

[The Chair, Liberal, Sean Casey]

Mr. Johns, please allow the minister to finish. You took a minute and a half to ask the question.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

My concern is that in the coroner's report, only 30% of the deaths were of people with diagnosed opioid use disorder who would go to a doctor. The people who are dying are the people in the trades, using alone and dying alone. They're the people who aren't going to go to the doctor for safe supply.

We have to find another way to keep people safe.