Public Safety Committee on Oct. 27th, 2014

[The Chair, Conservative, Daryl Kramp]

Thank you, Ms. Davies. You're over your time now. I'm sorry.

We will now go to Mr. Richards, please.

[Blake Richards, Conservative, Wild Rose, AB]

Thanks, Mr. Chair. I appreciate both the ministers being here today.

Minister Ambrose, I certainly appreciated in your opening remarks that you referred to our government's investments in the national anti-drug strategy. It was something that I was very pleased to see. I know many of my constituents were very pleased to see our government's investments in the expansion of that strategy when we introduced the economic action plan 2014.

I was hoping you might be able to provide the committee with some more detail on the activities that are included in our national anti-drug strategy, including how they are designed to work to reduce or eliminate the adverse social and health consequences of illicit drug use.

Of course, we recognize the importance of every health-related application that comes across your desk as health minister, but I do believe that supports for drug treatment need to remain priority investments, no question, especially with reports that we've heard recently of 16 people overdosing in a single day at Vancouver's injection site.

I'm wondering if you'd be able to provide the committee with a bit more detail on our government's current support for drug treatment.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Sure. I think your point underscores the fact that people have to recognize that what the health minister is being asked for is to make an exemption under the act to allow for the use of illicit drugs at an establishment. There is an impact on the community, and there is an impact on the health system, so by all means we should and we will consult with all relevant stakeholders, including the provincial health ministers, as well as the chief public health officers, and the communities for very common-sense, good reasons.

But of course your comment is more about illicit drug use and treatment, writ large. That is a very concerning issue because we see more and more young people's lives destroyed by drugs. I hear from more and more parents who talk to me about needing more national campaigns to communicate with kids about the concern around drugs. We know that drugs don't just affect the one family member who is using them. They affect the entire family and sometimes even the extended family and friends at school. Drugs have really torn the families of a lot of people apart, and communities apart.

We have been focused on investing heavily in the area of drug treatment and prevention. We have the national anti-drug strategy, which Minister Blaney is very much involved with and responsible for, and we do a little bit of that with him. But that is around prevention, treatment, and enforcement to make sure that especially kids are warned about the risk of using drugs, and trying to prevent them from using them, but if they do, getting them the treatment they need and getting them out.

Let's be frank, I'm sure that everyone here—including Ms. Davies—would hope that no one would have to use a harmful drug, and hope there is treatment available for those who find themselves addicted to an illicit drug or any drug, including a prescription drug.

We recently announced an expansion of our anti-drug strategy to do exactly that and not just deal with illicit drug use, but prescription drug use, which is really on the rise recreationally by young people. We now have nearly $45 million in new funding over the next five years that we're using to work with community groups and provinces and territories to put forward programs that will deal not just with prevention, but with treatment as well. There are a number of different things we're doing.

In terms of the treatment and support for first nations and Inuit people, which is something our department is integrally involved in, it involves supporting treatment programs for young offenders with drug-related problems. It enables the RCMP to refer youth with drug-related problems to treatment programs, and supports research on new treatment tools.

We have also been working the provincial and territorial governments and other stakeholders to make strategic system investments in key areas, including evidence-informed practice, strengthening the evaluation and performance measurement of activities, and really trying to take some of the programs that work and implement them in different parts of the country. Through this program alone we've now provided over $100 million in funding to the provinces and territories. That's resulted now in over 8,000 people being trained in delivering treatment initiatives, and over 27,000 people being reached via knowledge exchange, and over 20,000 youth being provided with programs or services.

So we are trying very hard to tackle the issue with our youth, and I think that's exactly where we need to be.

The results of these kinds of projects have really been very positive, and they resonate with communities. Of course, this kind of success really resonates with parents who, when faced with a child who has a drug addiction, sometimes really don't know where to go. We're providing them with phone numbers, support, information, how to have a conversation with their kid about this, and how to approach them. We're doing everything we can to support those who are working on the front lines dealing with drug abuse.

Minister Blaney might like to add to this, but at the end of the day I think this is one of the most horrible things that can happen to any family, to see someone descend into a drug addiction. We see more and more kids overdosing, not just from illicit drugs, but from prescription drug abuse. As health minister I feel very strongly about our being out front, communicating with young people, communicating with their parents, and offering prevention programs and treatment programs.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

If I may add, Mr. Chair, over the course of the last year I had the opportunity to talk to many police officers, and some of our own colleagues are former police officers. They've told me that to deal with drug issues and related mental health issues is very difficult. So this is putting a lot of burden and asking a lot of resources of our police officers to tackle those issues. I think we should be looking at the prevention measures the minister is putting forward instead of having to tackle these individuals, sometimes in a criminal matter.

[The Chair, Conservative, Daryl Kramp]

Thank you. Time is up.

Ms. Fry, you have seven minutes, please.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Mr. Chair, and I want to thank the ministers for coming here with the officials.

I find it very interesting that in both ministers' presentations, not a single word was mentioned about the addict, the patient, and what harms are being done to the patient. If you read the Supreme Court ruling, and I have it here in front of me, on page 147 it says that in six years, overdose deaths increased from 16 to 200 in the downtown eastside. Anybody would agree that this is a huge increase. The chief public health officer of the City of Vancouver also called “epidemic” the rise in HIV/AIDS, the rise in Hepatitis C, and the rise in endocarditis that went on in that neighbourhood for those users. It was because of this and because all of the other attempts to deal with drug addiction had failed that the three...and I quote from the Supreme Court ruling, “Insite was the product of cooperative federalism. Local, provincial and federal authorities combined their efforts to create it”. The Vancouver police supported InSite. In fact, the Supreme Court said, “Parliament has attempted to balance the two competing interests of public safety and public health.”

It surprised me that neither minister tried in their statements, nor in this bill, to balance those two competing interests.

The minister talks about the horrible life of drug addicts, and how we know no one wants to see their children.... I practised medicine for 21 years. Many of my patients came from the downtown eastside, and I know that so far we have not been able to do anything. InSite brought down deaths completely, and helped these people to be able to go to areas where they could get the care, the treatments, and the rehabilitation they needed.

So I would like to hear the Minister of Health tell me what she plans to do in keeping with good public health practices that have been proven, not only from InSite, but from the six European communities and Australia that now have between them about 70 safe injection sites because of evidence that it works. What does the minister plan to do to help all the addicted people who are currently facing huge public health issues and death?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

First of all, my last seven-minute answer was about what we're doing to support those who are—

[Hedy Fry, Liberal, Vancouver Centre, BC]

That's the old stuff you've been doing. It hasn't worked, Minister.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

It does work. Prevention—

[Hedy Fry, Liberal, Vancouver Centre, BC]

No, it hasn't worked.

[The Chair, Conservative, Daryl Kramp]

Let the Minister respond, please.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Drug prevention programs and drug treatment programs and rehabilitation programs do work, and that's why we continue to do them. That's why any stakeholders involved in this debate ask us to continue to fund. That's why the provinces and territories are thankful for the many hundreds of millions of dollars we've invested in these kinds of prevention, treatment, and rehabilitation programs, and we'll continue to do that because we want to help people get off drugs.

When it comes to the balance, when it comes specifically to an application for an exemption for a supervised injection site, the onus is on the applicant to make their case. The Supreme Court has set out that criteria, one of which is to offer evidence about the public health benefits and how resources and treatment would be available, there will be support for the applicant and the site, there will be appropriate funding to maintain the site. It's not for me to do. It's for the applicant to provide through the criteria of the application.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Minister, I'd like to differ very much with your saying that this works. Any—any—person who is a public health authority, any physician, any researcher, anyone who understands public health and addiction, will tell you that what you have mentioned are three elements of treatment, and you have missed the biggest one, and that is harm reduction. This is precisely what InSite did.

It is about treatment, yes, and it is about prevention, yes. But it is also about harm reduction and prevention of deaths and disease, which is really what harm reduction is. This is what InSite does. There's been evidence based in six European countries, 70 InSites, and in Australia, and been peer-reviewed by 24 international researchers on the whole InSite issue. The Supreme Court...and I could read it, but I don't have the time, Mr. Chair, all the areas where they agreed that this was working. I must say, Minister, the Supreme Court also said that when the minister has discretionary powers to grant this exemption or not, this discretion must conform to the charter. It is not absolute, and it must conform to the principles of fundamental justice for the person who is the patient in this instance, and I have not heard anything that helps the patient.

[The Chair, Conservative, Daryl Kramp]

Mr. Blaney, Ms. Ambrose, whoever. You have a minute.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Madam Minister, I'll let you answer.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

I'll just say again that the programs that Health Canada funds are evidence-based. They're widely supported by stakeholders to not only prevent addiction but treat and rehabilitate people who have suffered from drug addiction. It's not an easy area, and we'll continue to work with our stakeholders to fund these kinds of programs.

In terms of the evidence, that is for the applicant to make clear. When an application comes forward, the criteria are clearly set out by the Supreme Court. Evidence around the public health benefits of that application has to be made. That's in the criteria, so I assume it will be there.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Minister, you can't have evidence if you don't have a safe injection site to give evidence from in that particular region. There is a safe injection site in Canada and there are 70 around the world that have clear evidence of the facts that they prevent death, they prevent disease, and they help people to go to rehabilitation and treatment. So, Minister, the evidence is there about how it works.

I want to talk about the public health effects of this, not only about the policing and the “safer communities” part of this. I think the things people need to do, Minister, are too enormous for anyone to ever be able to meet the criteria you have given to set up a safe injection site in this country.

[The Chair, Conservative, Daryl Kramp]

The time is up.

We will go now to Mr. Garrison, please, for five minutes.

[Randall Garrison, NDP, Esquimalt—Juan de Fuca, BC]

Thank you, Mr. Chair.

Thank you to the ministers for being here today.

Minister Blaney, you threw out this kind of rhetorical question: would we want these in our neighbourhoods; would we want these in our riding? You have sitting at the table today one person who has a safe injection site and two members of Parliament who have applications coming up in our ridings because there is a severe need for harm reduction activities. In greater Victoria in a single year we had 16 deaths from overdose, yet at InSite in a single year they had 273 overdoses and zero deaths. So in my community there's a huge need for the harm reduction. I guess I have to say that, when you look at conditions from a to z, the most charitable comment is that you lack a sense of irony, when you have 26 conditions. It looks more like trying to frustrate the need to meet harm reduction than to facilitate and implement the Supreme Court decision.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Let me tell you of something I'm really proud to find in my riding. It is an institution that is offering a helping hand to young individuals who are vulnerable, who are sometimes drug addicts. What are they offered? They are offered a therapy. They are offered a therapy through the funding of Health Canada and the provincial government. It's called Portage, and those young individuals are going into a therapy that is giving them the tools that are needed to get out of their drug addiction

[Randall Garrison, NDP, Esquimalt—Juan de Fuca, BC]

That's exactly what a safe injection site does.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

This is what Portage is all about. At the end of Portage, we have young people who are going back to school. We have young people who are going back to work. What we see—and this is of public safety concern—and what is at stake for people today is this. What do you want in your community? Do you want a centre where you're helping the young to get out of this drug addiction and move on with their life and contribute to this society?

[Randall Garrison, NDP, Esquimalt—Juan de Fuca, BC]

That's exactly what a safe injection site is.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Or do you want to have a centre that is creating a public safety issue? What do you do when you want to buy drugs and you don't work? You do crimes, and this is what is happening around those vicinities. This what Tom Stamatakis has said.

[The Chair, Conservative, Daryl Kramp]

Thank you, Minister Blaney.

Do you have another question, Mr. Garrison?