Bill C-2 (Historical)

Respect for Communities Act

An Act to amend the Controlled Drugs and Substances Act

This enactment amends the Controlled Drugs and Substances Act to, among other things,
(a) create a separate exemption regime for activities involving the use of a controlled substance or precursor that is obtained in a manner not authorized under this Act;
(b) specify the purposes for which an exemption may be granted for those activities; and
(c) set out the information that must be submitted to the Minister of Health before the Minister may consider an application for an exemption in relation to a supervised consumption site.

Respect for Communities Act

[Mike Sullivan, NDP, York South—Weston, ON]

Mr. Speaker, I thank my colleague for that excellent question. That is precisely why community leaders, medical officers of health, and the medical community have rallied around the notion of finding a safe place for people who cannot control their addictions, whom we understand to be disabled Canadians, to inject their injectables.

Public health would be increased. We would have a better place to live. We would not have needles in parks. We would not have an increase in HIV and hepatitis C. We would not have individuals who are finding public places to inject themselves, leading to a lack of safety in communities. This is about public safety, not ideology.

[Robert Aubin, NDP, Trois-Rivières, QC]

Mr. Speaker, I want to thank my colleague for his presentation and, in the same breath, say that it saddens me that since the beginning of our debate on this topic, not a single government member has risen to present the government's position on this bill.

I would like know whether my colleague has noticed the same thing. In the bill on environmental assessments, for example, the government did everything it could to reduce the deadlines in order to allow party cronies to move forward with their projects as quickly as possible. However, when it comes to Bill C-2, the government puts up as many obstacles as possible in order to prevent projects from moving forward in communities that are prepared to welcome sites such as InSite. Has the hon. member noticed the same thing?

[Mike Sullivan, NDP, York South—Weston, ON]

Mr. Speaker, I too have noticed the lack of government members speaking on this bill, which leads us to wonder just how important it is to the government members.

It is very important to the people of Canada. It is very important to the people who live in the cities of Toronto, Ottawa, and Vancouver that they have the ability to have a safe injection place to reduce public harm, not just to the individuals who are injecting themselves but to the community at large. This bill would get in the way of that. It would defy the Supreme Court decision by putting in place huge obstacles to the creation of safe injection sites.

One would think that in a parliamentary democracy, we would have a robust debate, back and forth, between both the government and opposition members. However, to this point, there has been very little from the government members.

[Sana Hassainia, NDP, Verchères—Les Patriotes, QC]

Mr. Speaker, before I begin my speech, I would like to set the record straight. Are the Conservatives aware that, in September 2011, the Supreme Court ruled in favour of InSite? The court noted the effectiveness of the site and the very need for it in Vancouver's east side. I do not understand why we are still debating a law that will ensure that these kinds of organizations will not be able to exist in Canada.

Let us put this in context. We should begin by talking about what is happening in that Vancouver neighbourhood—and many other Canadian cities, I might add—and then try to understand why a place such as InSite is critical to the safety of the neighbourhood and why it is beneficial.

Vancouver's downtown east side is home to some of the poorest and most vulnerable people in our country. There are nearly 4,600 intravenous drug users there, which represents approximately half of the entire city's intravenous drug users. That is significant. That proportion is not at all reflective of the actual size of the neighbourhood, which is very small and has few houses. There are various factors that contribute to the high concentration of drug users in that area of the city. We could talk about the numerous rooming houses, the deinstitutionalization of people with mental health issues, the effects of drug policies throughout the years and, of course, the availability of illicit drugs on the street.

Before InSite came about, the things you could see on the streets were mind-blowing: people sitting on the ground or sitting on steps, putting on a tourniquet and shooting up. That was a common occurrence in this neighbourhood. Drug addicts come from all kinds of backgrounds, but the one thing they have in common is that they all had difficult childhoods or experiences that led them to drugs. Anyone walking through that neighbourhood, including children, would come across dirty needles.

The researchers who came up with the idea of InSite thought long and hard about how to create a site that would address all of these problems. InSite was developed as part of a public health project by the Vancouver Coastal Health Authority and its community partners, in response to a twelve-fold increase in overdose-related deaths in Vancouver between 1987 and 1993. At the time, the Vancouver area was seeing huge increases in the rates of communicable diseases, such as hepatitis A, B and C, and HIV, among injection drug users.

InSite first received an exemption in 2003 for conducting activities for a medical and scientific purpose, under the Controlled Drugs and Substances Act, so it could provide services and conduct research on the effectiveness of supervised injection sites. Section 56 of this act gives the minister the authority to approve facilities that use drugs for a medical and scientific purpose or for a law enforcement purpose. In 2007, the drug treatment centre OnSite was added to the facility.

In 2008, InSite's exemption under section 56 expired, and the Minister of Health rejected InSite's renewal request. This decision sparked a string of legal challenges leading to the Supreme Court of British Columbia ruling that InSite should be granted a new exemption. The federal government brought the matter to the B.C. Court of Appeal, which also ruled that InSite should remain open. Finally, in 2011, the Supreme Court of Canada ruled that the minister's decision to close InSite violated the charter rights of its clients and was “arbitrary, undermining the very purposes of the CDSA, which include public health and safety”.

The court based its decision on section 7 of the charter, which states: “Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice”. The court stated:

The infringement at stake is serious; it threatens the health, indeed the lives, of the claimants and others like them. The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored. These claimants would be cast back into the application process they have tried and failed at, and made to await the Minister’s decision based on a reconsideration of the same facts.

The Supreme Court ruled that InSite and other supervised injection sites must be granted a section 56 exemption when the opening of such sites “will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety”. After this decision was handed down, public health authorities and agencies in Toronto, Ottawa and Montreal began planning to open supervised injection sites.

Why are we here debating this issue when we clearly did not need to come back to it? We are doing so because once again the Conservatives decided to change a law so that it reflects their ideology. They came up with a deeply flawed bill that is based on an anti-drug ideology and false fears for public safety. This is another attempt to rally the Conservative base, as evidenced by their “Keep heroin out of our backyards” campaign that started mere hours after Bill C-2 was introduced in Parliament. This bill will make it almost impossible to open safe injection sites and will put heroin back in our neighbourhoods.

The NDP feels that decisions about programs that could benefit public safety should be based on fact and not ideology. Evidence has shown that supervised injection sites effectively reduce the risk of contracting and spreading blood-borne diseases, such as HIV and hepatitis C, and reduce deaths from overdoses. Evidence has also shown that these sites do not negatively affect public safety and that, in certain cases, they promote it by reducing the injection of drugs in public, the violence associated with such behaviour, and drug-related waste. Safe injection sites make it possible to strike the appropriate balance between public health and public safety. They also connect people in urgent need of health care with the services they need, such as primary health care and drug treatment services.

This bill imposes a far too heavy burden on communities, which would have to prove what the benefits of such a site would be and could then still be denied an exemption. As the Supreme Court pointed out, this bill brings us back to the arbitrary decision made by the minister against InSite in 2008.

The NDP believes that any legislation introduced by the Conservative government must respect the Supreme Court ruling and strike a balance between health and public safety.

This bill flies in the face of the 2011 decision, which ordered the minister to consider granting exemptions for supervised injection sites in order to strike a balance between public health and public safety. That decision ordered the minister to examine all the evidence in light of the advantages of supervised injection sites, rather than coming up with a long list of principles on which to base decisions.

In closing, I would like to add that the NDP believes that any new legislation regarding supervised injection sites must respect the spirit of the Supreme Court ruling, which this bill does not do. We believe that harm reduction programs, including supervised injection sites, should be granted exemptions based on evidence that they will improve public health and save lives, not on ideology.

[Laurin Liu, NDP, Rivière-des-Mille-Îles, QC]

Mr. Speaker, I thank my hon. colleague for her speech.

I wonder if she could provide some figures that support our position on Bill C-2. Can she talk about the fact that such sites reduce harm as well as the risk of people injuring themselves? Can she tell us about people who agree with our position?

[Sana Hassainia, NDP, Verchères—Les Patriotes, QC]

Mr. Speaker, there are numerous associations that I could name. For example, the Canadian Medical Association and the Canadian Nurses Association both criticized the fact that the government introduced this bill. They believe, as do we, that these types of organizations should be encouraged.

Pivot Legal Society, the Canadian HIV/AIDS Legal Network, and the Canadian Drug Policy Coalition issued this statement on the bill:

The bill is an irresponsible initiative that ignores both the extensive evidence that such health services are needed and effective, and the human rights of Canadians with addictions.... It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services.

I will provide some numbers that demonstrate how effective these sites are, just as my colleague asked. With regard to public safety, 80% of people questioned who work in Vancouver or who live in that part of Vancouver support InSite. They have come to realize that it is very effective.

I can also say that the rate of overdose-related deaths in east Vancouver has dropped by 35% since InSite opened. That is not an insignificant number. In addition, during a year-long study, there were 273 injections at InSite and none of them were lethal, thanks to the on-site nurses and doctors.

[Robert Aubin, NDP, Trois-Rivières, QC]

Mr. Speaker, I would like to thank my colleague for her presentation.

In this debate, people have mentioned InSite frequently for the past while, and that is understandable. Can my colleague can provide more information about how people in her own riding perceive these facilities that help people who are addicted to drugs? This bill seems to be the epitome of “not in my backyard” syndrome. I think there may well be many ridings where people are in favour of providing assistance to people who have these problems.

[Sana Hassainia, NDP, Verchères—Les Patriotes, QC]

Mr. Speaker, I thank my colleague for his question.

Yes, for the last little while, the members on the other side have been saying that the NDP wants to encourage people to take drugs. In fact, the only thing we want to do is keep people affected by this problem safer.

People who use drugs have a problem. We have to help them; we have to be proactive and set up agencies that will help them and allow them to use drugs safely, precisely in order to stop the spread of diseases transmitted by dirty needles. I am absolutely certain that the people in my riding would rather have a facility like InSite than see dirty needles when they are taking a walk in the park.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I want to quickly pick up on the one point the member referenced. There are many communities. I represent Winnipeg North, where there are many social needs. When we walk around our communities, we see there are back lanes around some of the community schools with drug-related issues and paraphernalia surrounding our facilities.

There is a need for the federal government to work with the different levels of government to ensure that we can make our communities healthier places to live by establishing and having proactive, solid social programs.

Would the member comment on that and how it would apply to all areas?

[Sana Hassainia, NDP, Verchères—Les Patriotes, QC]

Mr. Speaker, I would like to thank my colleague for his comment.

What I can say, in conclusion, is that the government is still using the same old strategies to cut back services to citizens. It is not concerned with health or with public safety. These are important issues. When dealing with these issues, we have to put partisanship aside and make sure our citizens, Canadians, have a safe place to live.

[Laurin Liu, NDP, Rivière-des-Mille-Îles, QC]

Mr. Speaker, I am happy today to talk about Bill C-2, formerly known as Bill C-65.

I am pleased to have an opportunity to denounce this bill, which is intended to terminate the operation of supervised injection sites: nothing more, nothing less. It is in direct opposition to a decision the Supreme Court handed down in 2011.

This is a bill that betrays the irrational ideology of the Conservatives, who believe that repression is the only way to deal with this scourge.

We are not the only people in the world to have considered this issue. There are more than 70 cities worldwide that have supervised injection sites. They are found mainly in Europe and Australia. In Canada, there is but one supervised injection site: InSite, which opened in 2003.

In order to use the services of InSite in Vancouver, users must be at least 16, sign a user agreement, comply with a code of conduct and not be accompanied by children. Users bring their own substances, and the staff provide clean injection equipment. Emergency medical aid is available if required, and expert staff are on site to provide health and social service support.

In addition to providing services to drug users in order to minimize the impact on their health and on public health, InSite conducts research on the effectiveness of supervised injection facilities.

This injection site has already demonstrated its effectiveness by significantly reducing deaths by overdose. It is estimated that overdose deaths in Vancouver have decreased by 35% since the site opened. In addition to reducing overdoses, the facility helps to reduce the rates of communicable diseases among injection drug users. I am referring to hepatitis A, B and C and HIV/AIDS, for example.

Ever since it was established by the Vancouver Coastal Health Authority and its community partners, this public health project has generated controversy. Those who believe only in repression saw it as an encouragement to use drugs.

At first, the site was able to open because it was given an exemption under the Controlled Drugs and Substances Act to operate for medical and scientific purposes. In 2008, the exemption for InSite expired and the health minister denied InSite's application to renew it. This decision triggered a series of court cases, which led to the B.C. Supreme Court decision that InSite should be granted a new exemption. The federal government then appealed this decision. One after the other, the B.C. Court of Appeal and the Supreme Court of Canada ruled that the closure of InSite violated the rights of its patrons under section 7 of the Charter of Rights and Freedoms, which provides that everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

I would like to quote from the 2011 Supreme Court decision effectively demonstrating the Conservatives' bad faith in this case, as follows:

[The minister's decision to close InSite] is arbitrary...because it undermines the very purposes of the CDSA—the protection of health and public safety.

I would also like to quote another excerpt from that decision:

The infringement at stake is serious; it threatens the health, indeed the lives, of the claimants and others like them. The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored.

Furthermore, the Supreme Court decision does not just concern InSite. It opens the door to new similar sites, and I quote:

On future applications, the Minister must exercise that discretion within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between achieving public health and public safety. In accordance with the Charter, the Minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.

This ruling by Canada’s highest court has led public health agencies throughout the country, including the Agence de la santé et des services sociaux de Montréal, to consider opening supervised injection facilities.

After being turned down twice by the courts, the Conservatives are now trying to get around the Canadian Charter of Rights and Freedoms, as well as the Supreme Court judges, by using Bill C-2 to amend the act.

The Conservatives are acting in a way that is just as reprehensible as the bill itself. Some people go so far as to say that this is hypocritical.

As we saw in this House during the previous session of Parliament, the Conservatives’ strategy is plain: to increase the number of requirements that supervised injection sites will have to meet before the department will grant an exemption. These many requirements will make it much more difficult for agencies to open supervised injection facilities in Canada. The Conservatives are so ideologically pigheaded that it is pathetic.

In this House, my colleagues have often heard me say how important it is to base political decisions on fact. Unlike the Conservatives, I have looked at the facts. I have found that 80% of the people questioned, who live or work in Vancouver’s Downtown Eastside, support InSite, primarily because there has been a significant drop in the number of needles discarded and the number of people injecting drugs on the street.

I can cite other figures and percentages. The rate of overdose deaths in East Vancouver has fallen by 35% since InSite opened. It has also been noted that injection drug users who go to lnSite are 70% less likely to share needles. In one year, 2,171 Insite users were referred to addiction counselling or other support services. Unlike repression, lnSite does not marginalize drug users and does not force them into isolation. These are figures that I think are pretty convincing.

There are more than 30 peer-reviewed studies, published in major scientific journals such as the New England Journal of Medicine, The Lancet and the British Medical Journal, that describe the benefits of InSite. Furthermore, there are other studies that show the positive impacts of more than 70 supervised injection sites that are similar to Insite.

In summary, I think that the science and the evidence are quite clear: supervised injection sites promote public health because they reach vulnerable groups and are accepted by the community. They make it possible to improve the health of their users and reduce high-risk behaviour, in addition to lowering the number of overdose deaths and reducing drug use in public places.

Above all, I believe that safe injection sites make it possible to strike the appropriate balance between public health and public safety. Furthermore, the sites give people who need help access to the necessary health services, such as primary health care and drug treatment services.

Front line workers have been clear: supervised injection sites are necessary. Pivot Legal Society, the Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition issued a joint statement about the bill, which reads:

This bill is an irresponsible initiative that ignores both the extensive evidence that such health services are needed and effective, and the human rights of Canadians with addictions.

It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services...

[Rosane Doré Lefebvre, NDP, Alfred-Pellan, QC]

Mr. Speaker, I thank my colleague from Rivière-des-Mille-Îles for her excellent speech on a bill I would describe as fairly controversial.

On the other side of the House, the Conservatives often talk about law and order, saying that we have to keep our streets and communities safe. It is all very well to talk that talk, but they should also walk the walk.

The fact is that supervised injection sites, such as InSite in Vancouver, exist in over 80 countries worldwide, including Australia, the Netherlands, Canada and Germany. Such sites exist all over the world.

In Montreal, not far from my colleague’s constituency, the Montreal police, the SPVM, is looking to work with community organizations to set up a supervised injection site on the Island of Montreal.

What does my colleague think about the fact that the SPVM wants to set up a supervised injection site and work with the communities involved on the Island of Montreal, and the fact that the Conservatives have a completely different take on the issue and are refusing to allow such sites to be set up in Montreal?

[Laurin Liu, NDP, Rivière-des-Mille-Îles, QC]

Mr. Speaker, that is an excellent question.

In my opinion, this shows that the NDP does not have the same approach as the Conservatives. On the NDP side, we look to facts and scientific studies, whereas the Conservatives rely on ideology.

Moreover, the Conservatives launched a campaign entitled “Keep heroin out of our backyards”, and used it to raise funds and fill their campaign coffers.

I believe that the Conservatives are creating an issue to help build up their campaign funds without really basing their ideas on facts and without adopting a science-based approach.

[Guy Caron, NDP, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, we have heard a number of comments by the government because it is not expressing its view on the question, of course. There has been neither debate nor comment, except for a few questions asked by members from time to time.

Moreover, most of the questions asked by the government focus on the dangers and the popular perception of supervised injection sites. Yet physicians, experts and street workers have shown that such perceptions were incorrect and that on the contrary, supervised injection sites helped improve neighbourhood safety and tackle substance and drug abuse directly.

What does the member think of the fact that the government is totally silent in this debate? Why is the government in no position to defend a public bill that is in fact going to be detrimental to public health?

[Laurin Liu, NDP, Rivière-des-Mille-Îles, QC]

Mr. Speaker, it is clear that this government has always governed with blinkers on and consults neither the public nor the appropriate experts.

We also know that Bill C-2 flies in the face of the Supreme Court's 2011 decision, which called upon the minister to consider exemptions for supervised injection sites as a way to reconcile public safety and health issues.

As we can see, the Conservatives have no respect even for the Supreme Court. We therefore hope that they will come to their senses, look at the facts and change their position on Bill C-2.