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

[Dennis Bevington, NDP, Western Arctic, NT]

Mr. Speaker, coming from the Northwest Territories, a small town, injection is not really a big issue in my community. However, where I live, and my hon. colleague happened to mention Sandy Hill, is very near what I call an unsafe injection site, the back side of a church in Sandy Hill, where addicts go on a regular basis to inject drugs.

Quite clearly, the community understands that. Quite clearly, people are trying to make a move to find a way to deal with this. By putting all these qualifications in place, the government is not helping the situation in Sandy Hill. The situation in Sandy Hill can be helped by the community, through its municipal ordinances, through the municipality coming to a decision that this a good idea.

I certainly do not want to walk out of my house in the next little while and find someone dead on the street from an overdose because of the delay that is going to be imposed upon getting any of these injection sites located into the communities. Will my colleague assure me that this terrible occurrence will not happen to me with this legislation delaying forever the introduction of a safe injection into this city, the capital of Canada?

[John Carmichael, Conservative, Don Valley West, ON]

Mr. Speaker, I guess the first important issue is that the people of Sandy Hill, the community of Sandy Hill, should have an opinion as to where they want that safe injection site. Whether it is in the back of a church, where it is illegal and where it is tolerated, does the community in fact have any say in that situation? Or will it in fact land in their own backyards when the population at the back of that church overflows and that is the only place to go?

We have to have a degree of consultation, conversation, about this issue. It is a serious issue. There is no doubt about it. However, we need to have families and communities engage so that we understand what the outcome can be. Certainly I understand his concern. I would caution him to vote with us and we will have this thing put together right.

[Cathy McLeod, Parliamentary Secretary to the Minister of Labour and for Western Economic Diversification, CPC]

Mr. Speaker, I have been listening to the debate for a good number of hours now. What I find absolutely stunning is hearing the opposition members referring to four pillars, but really, all they are talking about is one pillar. That is, of course, the harm reduction and the importance of InSite.

As a nurse, day in and day out I certainly had many experiences where I had people who were desperate for detox services, who were desperate for rehabilitation, and to be quite frank, those services were very sorely lacking. I find it a little odd that they would put so much energy and effort into one piece of the pillar but really have ignored the very important lack of resources for those people who want to leave a life of drug addiction behind. I think that is a funny feature of this conversation we have been having, especially from the opposition members.

I think the hon. member did answer my question a bit in his last response, and it sounds like this is what this legislation is intending to do. However, as a former mayor, I think we, local government, local communities, are in a very good position to have responsibilities in terms of the zoning bylaws, bylaws, consultation and community input.

I would like you to focus on how important the community engagement in this conversation should be.

[John Carmichael, Conservative, Don Valley West, ON]

Mr. Speaker, certainly the member's experience in her previous career, both politically and in nursing, gives her tremendous insight into this situation.

It is fair to say that the people of Canada expect our government to provide safe and healthy communities for their families and for their communities. This particular issue is an emotional one, and one that does need absolute care. I think your point of addicts wanting to get off drugs, that clearly has to be at the root of what they expect and I think that you—

[The Speaker, Conservative, Andrew Scheer]

Order, please. The hon. member is out of time for his response and I did hear the use of the word “you” quite a few times. I want to remind him and all members to address their comments to the Chair.

Resuming debate, the hon. Parliamentary Secretary to the Minister of Justice.

[Robert Goguen, Conservative, Parliamentary Secretary to the Minister of Justice]

Mr. Speaker, as His Excellency the Governor General put it so well in the Speech from the Throne earlier this week, “Canadian families expect safe and healthy communities in which to raise their children.”

Dangerous and addictive drug use has a major impact on public health and public safety in communities across Canada. The impact that these drugs have on our communities is often severe and the cost to our health and justice system significant. Our government takes seriously the harm caused by dangerous and addictive drugs. These drugs can tear apart families, lead to criminal behaviour and ultimately destroy lives.

The bill before us today addresses this challenge through, among other measures commented on by my honourable colleagues, ensuring that residents and parents have a say before drug injection sites open in their communities. In addition to this, I think all members of the House can appreciate that dangerous and addictive drug use requires a multi-pronged approach to be successful. That is why, as part of our national anti-drug strategy, our government has been focused on preventing our children and youth from using drugs in the first place and strongly deterring existing use of harmful and addictive drugs.

This strategy is our government's comprehensive response to fighting dangerous and addictive drug use in Canada. The goal of the strategy is to contribute to safer and healthier communities through coordinated efforts to prevent use, treat dependency and reduce the production and distribution of illicit drugs. This strategy has three pillars: prevention, treatment and enforcement.

Since its introduction in 2007, our government has invested significantly in this area. Under the prevention action plan, our government invested $30 million over five years in a targeted mass media campaign to raise awareness among youth aged 13 to 15 and their parents about the dangers of illicit drugs. The mass media campaign saw impressive results and 25% of parents who recalled one of our TV ads took action by engaging in discussions with their children about drugs. Results from the campaign also identified an increase in the proportion of youth who said they knew about the potential effects of illicit drug use on relationships with family and friends.

Also, under the prevention action plan, Health Canada delivers the drug strategy community initiatives fund. This contribution funding program supports Canadian communities in their collective efforts to address concerns related to health promotion and the prevention of illicit drug use among youth aged 10 to 24. This fund provides approximately $10 million annually in support of a wide range of provincial, territorial and local community-based initiatives to address illicit drug use among youth. It also promotes public awareness of dangerous and addictive drug use and its harmful impacts.

Another key impact is the drug treatment funding program. This program provides funding to provinces, territories and key stakeholders to initiate projects that lay the foundation for systemic change leading to sustainable improvement in treatment systems in their jurisdictions. This initiative is a great example of our government's commitment to reduce and prevent the use of illicit drugs across the country.

The bill that we are debating here today, the respect for communities act, is consistent with our government's approach to addressing dangerous and addictive drug use in the national anti-drug strategy.

At the federal level, there are several legislative tools that play an important role in maintaining public health and public safety, including the Controlled Drugs and Substances Act. This act has a dual role: to prohibit activities with controlled substances while allowing access to these substances for legitimate medical, scientific and industrial purposes. The amendments that we are proposing through the respect for communities act would help ensure that residents and parents have a say before drug injection sites open in their communities.

Section 56 of the Controlled Drugs and Substances Act gives the minister the authority to grant exemptions from the application of the act or its regulations for activities that, in the opinion of the minister, are necessary for a medical or scientific purpose or otherwise in the public interest. For applicants applying for an exemption for the use of controlled substances obtained from licit sources, the process to obtain a section 56 exemption would not change. Most applications reviewed by Health Canada are exemptions of this nature.

What is being proposed is a new approach to deal with the exemption applications involving the use of illicit substances, which are typically street drugs. Under this new regime for illicit substances, the proposed legislation includes a section specific to supervised injection sites.

These changes are in line with a Supreme Court of Canada decision handed down in 2011 and codify the court's ruling that community opinions must be considered by the Minister of Health with regard to supervised injection sites. The court stated that its decision is not a licence for injection drug users to process drugs wherever and whenever they wish, nor is it an invitation for anyone who so chooses to open a facility for drug use under the banner of a safe injection facility.

The Minister of Health must also verify that adequate measures are in place to protect the health and safety of staff, clients and also the surrounding area.

The court identified five factors the Minister of Health must consider when assessing any future exemption applications in relation to activities at a supervised consumption site involving illicit substances. The specific factors outlined by the court that must be considered in making the application under an exemption include evidence, if any, on the following factors: the impact of such a site on crime rates; local conditions indicating a need for such a site; the regulatory structure in place to support the site; the resources available to support its maintenance; and expressions of community support or opposition.

Our government respects the court's ruling on this matter and used these factors as a guide in drafting the bill before us today. Under the proposed approach, an applicant would have to address rigorous criteria when applying for an exemption to undertake activities involving illicit substances at a supervised consumption site. Demonstrating a benefit to an individual and public health is an important factor in making this decision. For example, the applicant would have to provide scientific evidence demonstrating that there is a medical benefit associated with access to the supervised injection site.

In addition, the applicant would have to provide a letter from the highest ranking public health official in the province outlining his or her opinion on the proposed site.

A letter would also be required from a provincial minister of health outlining his or her opinion on the proposed site as well as an explanation as to how this site fits into the provincial health care regime.

Understanding the potential public health impacts that a supervised consumption site might have on a community in which it exists is also important. Under the proposed approach the applicant would have to provide a report on the consultations held with the relevant provincial licensing body for physicians and nurses as well as those with local community groups. If any relevant concerns are raised by community groups with respect to impacts on public health or otherwise, the applicant would have to provide a description of the steps taken to address these concerns. Once all the information has been submitted, including, if applicable, an explanation of why there is a lack of information or evidence for certain criteria, the Minister of Health would consider the application.

The proposed changes clearly set out the criteria applicants must address when seeking an exemption to undertake activities involving dangerous and addictive drugs at a site. The information the applicant would have to provide in support of the criteria would directly relate to the public health and public safety considerations surrounding such activities.

In addition to all the information the applicants must provide, the respect for communities act would require that all applications that would seek to renew previously granted exemptions also include evidence of any changes in public health impacts and crime rates within the community since the first exemption.

I urge all members of the House to support this legislation that would help ensure that residents and parents have a say before drug injection sites open in their communities. This assurance is the least we can provide for Canadians who will be residing in areas that are set to see a rise in crime and addictive drug use.

Let the burden of proof lie on those who would seek to provide spaces for addicts to use these dangerous, illegal and addictive drugs.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Mr. Speaker, I would like to ask a very simple question.

Perhaps my colleague has already noticed this issue elsewhere, not just where safe injection sites are involved. Take the housing shortage in my region, for example. Everyone agrees that housing complexes need to be built. However, every time there are plans to build, people say that they do not want them to be built in their neighbourhood or in their backyard.

Similarly, even though everyone agrees that we need safe injection sites, which reduce risk in the neighbourhood, it is likely that no one will want a site at the location that is announced.

How do we fix that problem? How to we deal with that situation, when we know that these sites save lives? They keep people from injecting on the street and overdosing. They keep our children from witnessing that. We know there is a risk that no one wants this in their backyard. How do we negotiate that?

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, that is a very pertinent question. It is a dilemma that is not easily resolved. We recognize the importance of such a site. No one wants to live near it, that is for sure.

The only way to find the ideal location for such a site and to minimize the risk that children and other vulnerable people will be affected by the site is to proceed with the consultations required by this legislation. There is definitely not a good location for such a serious problem. Consulting and working with local authorities is paramount in identifying the ideal location.

[David McGuinty, Liberal, Ottawa South, ON]

Mr. Speaker, what this bill really does, and Canadians should know this, is make it now entirely a matter of the federal Minister of Health deciding whether or not an InSite location would be opened in the country.

That is the truth of it. The member knows it. The effect of this is actually quite dangerous. Here is how the government referred to this question in the Speech from the Throne. I think was difficult for the Governor General to even utter these words. It callously referred to the addiction question as “loopholes that allow for the feeding of addiction under the guise of treatment“.

That is more than disappointing. I am sure it is disconcerting for a lot of Conservative MPs who know the truth of the matter.

Here are a couple of facts I would like to introduce into the debate for the member to respond to. If we look at the Vancouver east InSite location, there were only 30 new cases of HIV in 2006, as compared to the 2,100 new cases of HIV in 1996. We know it costs $600,000 over a lifetime to treat HIV infection in the health care system. That is one thing I would like the member to address.

We also know that 87% of InSite's clients suffer from hepatitis C, another terrible, difficult chronic disease. It costs a fortune to treat these conditions.

Why would the government make it more difficult for us to act coherently in a public health fashion by taking this traditional partnership approach away from the provinces, taking it right up to the office of the Minister of Health, subject to the vagaries and ideology of a government that clearly does not subscribe to science?

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, we reject the premise of the comments that we do not rely on science. In fact we rely wholly on science.

The applicants who will make the application to the minister to prove that the location is suitable will have to base their determination on science, on the increase of crime rates, and it will be science that will determine whether it will be the best spot.

There is absolutely nothing that is mutually exclusive with diminishing the number of people who have HIV or other diseases contracted by virtue of using needles and placing it in a safe location where it has lesser effect on public safety and on vulnerable children and diminishing crime rates.

What is so incompatible with placing a location for a site in a spot where it is less disruptive to safe communities? Canadians expect safe communities. They do not have be subject to the placement of these sites when there are better places for it. That is what the whole consultation process is designed to elicit.

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

Mr. Speaker, I will be sharing my time with the hon. member for Esquimalt—Juan de Fuca.

This is the first time I have spoken in the House since Parliament was prorogued. I would therefore like to take a moment to say hello to my constituents and tell them that I am ready to return to the House and I look forward to participating in the debates. I am also pleased to speak about health because I am now a member of the Standing Committee on Health and this is an issue of particular interest to me.

That being said, I was very surprised this morning to see the Parliamentary Secretary to the Minister of Health give the first speech, since the government had decided to send this bill to the Standing Committee on Public Safety and National Security for review. There is a slight imbalance in that respect. Of course this bill is related to the health and public safety of Canadian communities; however, it would have made sense for it to be examined by the Standing Committee on Health. I wanted to take the time to say that.

I am pleased to speak to Bill C-2 or former Bill C-65 today. Bill C-2, An Act to amend the Controlled Drugs and Substances Act is a very thinly veiled attempt by the Conservatives to put an end to supervised injection sites. They want to give the minister more power, as we have already seen with immigration and other portfolios. This government wants to hold all the power.

If we add a long list of criteria that must be met in order for a supervised injection site to be opened, we will end up not having any more such sites. Right now, there is one such site in Canada called InSite, which I will talk about a little later. This bill shows that, sadly, we are still dealing with a very ideological government that puts its own thoughts and values ahead of scientific facts. We know that the Conservative Party is very anti-drug. Of all the Conservative bills, this one is aimed at pleasing the Conservative base by proposing to eliminate drugs in Canada.

It is unfortunate, because this bill will not have the effect they want. There was a big Conservative campaign this summer called “Keep heroin out of our backyards”. It is a shame, but heroin exists. Like all other Canadians, I am against it and I would love to be able to say that it no longer exists, but it does. There is a problem.

Deciding not to address this problem or not to create health centres to deal with it will not solve the problem. That is very irresponsible. By preventing communities from building supervised injection sites, the government is saying that instead of putting all injection drug users in one place so they can get clean syringes and be supervised, it would rather have them shoot up in churchyards, in parks where children play and in schoolyards. That is what the Conservatives are telling us.

Personally, I would rather know that there is a supervised injection site in my neighbourhood than know that these people who are unfortunately using drugs could be anywhere. That is what I understand from this bill. Supervised injection sites do not provide drugs. Earlier I heard a Conservative member say that they do, but that is untrue.

People who use these sites go there with their drugs and ask the people there to help them with their injections so that they can have clean equipment and access to experienced staff who can help if they overdose or if there is a problem.

This is a huge health problem. The government has made huge cuts to healthcare. We are talking about $31 billion in cuts. The government should take this seriously. I think these injection sites can help with prevention. We can try to prevent diseases and stop them from spreading instead of having hospitals treat countless cases of AIDS or hepatitis A, B and C.

Currently in Canada, there is one supervised injection site, namely InSite, in Vancouver. I would like to talk about what InSite does. Facts and figures can really help people understand what a supervised injection site does. People often have unfounded biases or preconceived notions about this.

To use these services, users must be 16 years old, sign a user agreement and follow a code of conduct. This is clearly not a place with a free-for-all philosophy. Not at all. There is a code of conduct and a focus on safety. Obviously, patients cannot have children with them.

InSite is open during the day, seven days a week, from 10 a.m. to 4 p.m. It has 12 injection stations. Users bring their own drugs. Drugs are not provided.

Nurses and paramedics who supervise the site provide emergency medical assistance if necessary. Overdoses can occur. Personally, I prefer that this be done in a supervised injection site with trained staff rather than out on the streets.

Once users have injected their drugs, their condition is assessed before they are sent to a post-injection room and before returning to the streets. If there is a problem, they will be treated by a nurse. Staff members also provide information on health care, counselling and referrals to health and social services. Users can then be referred to Onsite, which is located in the same building as InSite. This is a place that provides detox treatment.

Some of my family members have had to go to drug treatment centres, so I know that they are essential. When people are struggling with this problem, they often have no choice. I am not saying that 100% of addicts are going. There are those who, sadly, want to stay on drugs, and that is very unfortunate for them. However, there are some who want to try to get clean.

I find it very interesting that in one year, 2,171 InSite users were referred to addiction counselling or other support services. I think this is very positive. If the 2,200 people who were referred for drug treatment had injected their drugs on the street, they would not have received this service.

In 2006, Wood et al. published another interesting statistic: those who used InSite at least weekly were 1.7 times more likely to enrol in a detox program. Once again, this shows the influence that InSite has had on people who use the service.

In addition, the rate of overdose-related deaths in Vancouver East has dropped by 35%. This means that one in three lives were saved thanks to a centre like that.

I know that some Conservatives will say that they think it is bad for communities. My colleague just asked a question. Of course, no one wants this in their backyard. I live in a very cool little neighbourhood in Lachine. If someone told me that such a centre existed near my house, I might have some concerns at first, and that is only normal.

That being said, when asked, 80% of the people who live or work in that area of downtown Vancouver support InSite. Furthermore, the number of discarded needles and injection paraphernalia and the number of people injecting drugs in the street dropped dramatically one year after InSite opened. These are all positive aspects.

In closing, I do not have enough time to laud it properly, but an organization in my riding called Head & Hands in Notre-Dame-de-Grâce does some work with people who are unfortunately addicted, and it distributes injection paraphernalia. Once again, the entire Notre-Dame-de-Grâce community supports this. Since the organization's inception in the 1970s, crime has decreased and the number of people using detox services has increased. I think that is important.

Of course I will be opposing this bill, because I think we need these supervised injection sites in our communities in order to reduce crime and help people who are suffering from addiction.

[Cathy McLeod, Parliamentary Secretary to the Minister of Labour and for Western Economic Diversification, CPC]

Mr. Speaker, I listened with great interest and I heard many things about the safe injection site, how many lives it saved and a little about detox. However, does the member know how difficult it is for people who want to get into detox and rehabilitation? There are no beds available. There is no support. There are no services. I continue to be astounded about how those members want such money, effort and time put into one pillar of what is a four prevention strategy, and completely ignore the lack of opportunities for people who want to get off drugs through detox or rehabilitation.

The comment the member made that stunned me the most was the one about how it is NIMBYism if we do not want a safe injection in our area. I believe she said “I would not want one in my area”. I thought that was stunning to hear from the member. I would like her to explain why she believes that communities will not support them, if they are so important, and why she would not support one in her area.

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

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

I find it a bit odd to hear her say that she listened with great interest to my speech and then ask if I know about the difficulties with drug treatment programs. I said that people in my family have gone through detox programs. I wonder if she was really listening and where she was. Perhaps it was an issue with the interpretation.

In my speech, I also said that in one year, 2,171 InSite users were directed to drug treatment services, which, to my mind, is significant. In addition, approximately 30 peer-reviewed studies that were published in journals such as The New England Journal of Medicine, The Lancet and the British Medical Journal described the benefits of InSite. The Canadian doctors' association says that it has a positive effect on people's health and that it benefits the community because it puts all drug users in the same place. They receive support and are encouraged to check into a drug treatment program. I know that it is difficult. I am not saying that it is easy, but they need good services and a place to go.

In Notre-Dame-de-Grâce, I spoke to a street outreach worker who distributes injection kits. I heard how difficult it is to reach these people and convince them to check into a drug treatment program. I believe that InSite helps address that problem.

[Linda Duncan, NDP, Edmonton Strathcona, AB]

Mr. Speaker, the hon. member's speech on this bill was very honest and straightforward. It was very refreshing and very appreciated.

I wanted to build on my colleague's response to the former question. I have had discussions with doctors, particularly those who have been working in my city of Edmonton, on trying to deal with the problem of addiction and trying to seek safer places even within the community to deal with the problem of drug addiction, which is evident across the country. The member spoke to the issue of what the doctors are telling me, which is that it is pretty hard to create a path toward detox and better health alternatives if people are hiding in back alleys, getting HIV and avoiding prevention and rehabilitation.

Could she speak again to the issue of what the experts are finding in their analysis of B.C.'s Insight program that, in fact, it may well be the best path toward better health alternatives?

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

Mr. Speaker, that is precisely what I said and what I have been hearing in Notre-Dame-de-Grâce. It is a matter of building trust with the individual, which is difficult. A drug addict is not going to decide to go for treatment overnight after seeing the $2.7 million government ads urging them to do so. It is a process. A supervised injection site like InSite will attract them because they will know that they can get help there. Then, they can work towards getting treatment.