Health committee  Thank you. I'm Dr. Peter Selby, and this is Dr. Sproule on my left. I'm the division chief of the addictions program at CAMH. CAMH, as you may or may not know, is the largest mental health and addiction treatment and research centre in Canada, affiliated with the University of

Health committee  Thank you.

Health committee  I think this idea of separating treatment from harm reduction is a bit odd. As a physician, I can tell you that western medicine is entirely about harm reduction. We do not cure hypertension. We do not cure diabetes. We do not cure depression. We do not cure heart failure. We sim

Health committee  Yes. I'd like to add that there are some more technological advances that can be done in our data collection systems. They've actually automated the collection of data that can be done through the cloud, off people who are coming and seeking treatment. For example, when they de

Health committee  Call it what you will, at the end of the day what we are here for is we want to make sure that Canadians live good, healthy lives, so you want to call it reducing harm while not using the term. The issue is, does the term become divisive, as opposed to integrative. If it is becom

Health committee  No, you didn't, actually. We've got some models here on primary care whereby we've been able to deploy very rapidly—like a rapid prototype—the program. It would mean getting the program from the U.S. so that it's on a Canadian server. It would mean being able to have it available

Health committee  The national opioid use guidelines for chronic non-malignant pain are now housed in the national pain centre at McMaster University, and every national college of physicians was part of it. Work is ongoing in trying to help disseminate and implement this. The real focus there i

Health committee  I want to concur with you. As a physician, I actually have seen that happen. When you've given people Narcan, they wake up. Here's where we have to manage what the risk is. The issue is that I'd rather have somebody a bit agitated, as opposed to dying. From that perspective, in

Health committee  In Ontario, we have a youth survey of drug use. It has been going on for the last 15 or 20 years, and we're beginning to see the recreational use of opioids come in. To answer your question about what determines whether people get addicted or not, it's not only availability. The

Health committee  Yes. That's exactly right. People end up resorting to using medicines or pain medication like opioids in the belief that this will fix the problem, and they don't have access to covered services like physiotherapy, massages, or relaxation. There are those kinds of issues, and the

Health committee  First of all, thank you so much. It's an honour and a pleasure to present to this committee again. I am speaking on the use of electronic nicotine delivery devices, commonly known as e-cigarettes. We have sent some speaker's notes to you. I'm sorry they came at the last minute,

Health committee  Yes, thank you so much for your questions. They are important ones. We at CAMH really try to be the honest brokers around bringing the science to bear to what our recommendations are and point out where there are gaps. So I want to make sure that we are clear about that as well.

Health committee  Oh, yes. How feasible would it be to replace combustible cigarettes. I think that's an aspirational one. Of course, whenever we talk about changing something...society has been rife with these things. When you want to make a big, bold idea most people want to have the status qu

Health committee  To do research in Canada is hard. To do experimental research with the actual product is hard. We can do population trends. We can look at people doing that, absolutely. But trying to do the study where we give one group e-cigarettes with nicotine and one group without nicotine i

Health committee  That's exactly right. We need to study it from that perspective. I'm sorry, your third question was...? You had a third question as well.