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

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I appreciate the question from the parliamentary secretary about the concerns she has about real property. I have concerns about real people's lives. I live in a community where people are dying every day on the streets. I am concerned about that. Residents of Victoria are concerned about that. On this side of the House, that weighs more heavily on us than the impact on property prices and investments, as she put it.

I point out that in Vancouver, 80% of people surveyed living or working in the Downtown Eastside support InSite. That is the community, too. People live there and 80% of them are in favour because they know the impact it has had on their community.

I live in a place where people often do not know that there is the possibility of treatment. We need to create, in partnership with local governments, what they did in Vancouver with InSite, which the Supreme Court celebrated in its decision. It is a coming together of the community. The police are in favour, I remind the House, as well as the community, the City of Vancouver and all of the partners.

They figured out that they could find a way to put this in an appropriate location. We are not talking about putting it in places where the community does not want it. We accept and respect the need for ample consultation with the community. That is what happened in Vancouver and that is what would happen here.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I think it is worthy to note that strong social programming in our communities, such as what we have seen in Vancouver with this particular facility, has a very strong benefit overall for all of the community. In fact, in response to the question that was just posed, the value of the community as a whole actually does improve.

I would ask the member to reaffirm what I believe to be the case, that when we bring in strong social programming, quite often what happens is that we will alleviate the concerns that many of the residents have. By centralizing or providing a service, for example, we can prevent individuals in this situation from using these illegal drugs in our schoolyards or back lanes, spread out throughout the community. The benefits far outweigh any sort of negatives that might be there by allowing facilities of this nature to exist.

As elected officials, what we should be doing is looking at creative ways in which we can start dealing with the social issues that are destroying many of our communities or that are extremely negative. This is just one of those tools, if I can put it that way, that can make a positive overall difference.

Could the member provide comment on that?

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I completely agree with my colleague's fundamental point that these strong social programs, as he puts it, do help alleviate community concerns.

Let me give the House some examples of that. In a study by Wood et al in 2004 about the Vancouver situation, there was a significant drop in the number of discarded syringes, injection related litter and people injecting on the streets one year after the InSite location had opened. That means, as the member points out, that people are not shooting up in alleys and dropping syringes by schools, they are going to a supervised site.

Secondly, I would point out that at those sites, there are trained nurses. If people are ready, willing and able to seek treatment and detox and get off drugs, that is what they are there for and they will help the addicted person to achieve that.

There are also all of the benefits that come from that, economically and otherwise. First of all, wasted lives, getting people off of drugs and getting into productive lives is certainly something that we really cannot put a price on. Secondly, the cost of less law enforcement, less hospitalization and so on are some of the benefits that, as the member said, clearly outweigh the costs.

[Anne-Marie Day, NDP, Charlesbourg—Haute-Saint-Charles, QC]

Mr. Speaker, I want to thank the hon. member for Victoria for his excellent speech.

The parliamentary secretary mentioned a potential decrease in the value of real property. Such a decrease could happen anywhere. The parliamentary secretary's use of the term says a lot about her living standards.

Cities like Toronto, Montreal, Charlesbourg and Limoilou all have back alleys. I used to own an apartment building. People would go to the alley behind the building to shoot up, and we would regularly find used syringes.

Would you agree it would be safer for the general public if people who are addicted to drugs and shoot up in back alleys were instead directed to supervised injection sites?

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I should point out, ironically, if there is any issue of real estate, I am from the west coast. We do not need to be told about real estate values. They have gone up in Vancouver. They have gone up in the Downtown Eastside. I think it is a rather specious argument.

I want to repeat that we would be working in partnership, if there were a bill that truly implemented the spirit and the letter of the Supreme Court of Canada's judgment. We would find a community partnership to address some of the concerns there.

Of course there are always benefits and costs in any public policy decision, but I am so persuaded, and all people on this side of the House in the New Democratic Party are persuaded, the benefits will clearly outweigh the cost. We need to move on the basis of public safety and health.

[The Deputy Speaker, Joe Comartin]

That brings to an end the debate on the bill for the time being. On resumption of debate we will have about two and a half minutes for questions and comments.

The House resumed consideration of the motion that Bill C-2, An Act to amend the Controlled Drugs and Substances Act, be read the second time and referred to a committee, and of the amendment.

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

Mr. Speaker, I will be sharing my time with the hon. member for Chicoutimi—Le Fjord.

First, I would like to go back to the legal aspects of this legislation. Bill C-2 creates so many legal complications that it is now virtually impossible for a safe injection site to meet all these obligations. Even if it did, the minister could still approve or reject the application.

I want to show that this really does not make sense. In fact, this is disguised legislation to convey the message that the government does not want such sites. However, instead of just saying so, the government prefers to make the legal obligations so complicated that none of these sites will be able to meet all of them. The hon. member for Gatineau demonstrated it very clearly in her speech.

I will restrict my comments to the legal aspects of this legislation. I am going to talk about what the safe injection sites do and about drug addiction.

First, we must understand that safe injection sites rely on an approach used by a number of health care professionals, namely the harm reduction approach.

Under this approach, we know that certain behaviours will be exhibited, even though we would prefer that they were not. Consequently, we deal with these behaviours as best we can to minimize their negative impact.

For example, in the case of sexually transmitted diseases, we realized that even if we told young people not to have sex, they still did. We then decided that since young people were still having sex, we would make condoms available in schools and ensure that young people had access to them. That is what this approach is based on.

It is the same with alcohol. If we tell people not to drink, it does not work. People will continue to consume alcohol. That approach is not effective. This is why we tell them that if they drink they should not drive, that they should drink moderately, or that they should have three of maybe four beers instead of a case of 24. We try to minimize the negative impact. We provide alcoholism treatment programs and support groups for those who need them. At least, we are not burying our heads in the sand and telling ourselves that since no one is taking action we are not going to do anything.

It is exactly the same with safe injection sites. We try to minimize the negative impact of this addiction. There are all sorts of consequences, including overdoses. People may die if they go too far. There is also the whole issue of blood-borne infections because people use dirty needles.

I should also mention that, unfortunately, some people who use these sites resort to prostitution to buy drugs. That is why we step in and hand out condoms. We try to minimize the harmful behaviour that may result from this lifestyle.

Safe injection sites prevent people from getting infections from dirty needles. For example, they prevent children from falling on needles in a park or a public area.

Safe injection sites also try to prevent other health problems. We are dealing with people whose hygiene is often a problem. If they go to a safe injection site, we can see whether they have an infection or the first symptoms of pneumonia, and we can encourage them to seek treatment. As for the rest, we can at least try to help these people live a healthier lifestyle.

In a safe injection site, we know that people will inject drugs anyway. Even if we try as hard as we can to prevent them from doing so, we know they will do it.

I searched high and low and, in my opinion, there is no strategy that is safer.

If we tell people to inject drugs at home, they might overdose without anyone around to help them. There are also some who will shoot up on the street. The discarded needles then become a problem because children can fall on them. Then there are people who will do it in apartments, in makeshift shooting galleries, where sanitary conditions are inadequate. I believe that a safe injection site is the best option.

Hon. members may not have noticed, but in hospitals, the yellow boxes containing discarded contaminated needles are locked. This may seem strange, but if they are not locked, people will steal them and use the contaminated needles to inject drugs. This happened to nurses whom I know. People just stole the boxes. Therefore, safe injection sites help prevent health problems that could be much more serious.

Moreover, it is not just in the big cities that people inject drugs. Unfortunately, this also happens in my area. I work with street nurses and I know that clean needles are handed out to prevent the spread of infection. Unfortunately, people are injecting drugs even in remote rural areas like Abitibi—Témiscamingue. We should not bury our heads in the sand when it comes to this issue.

I would also like people to understand that when people who inject drugs come into a safe injection site, the workers do not just show them where things are. An assessment can only be done when contact is made. Nurses assess them when they come in. This is what we always do, as nurses. We constantly assess people's health. It is something of an occupational hazard.

When people come in looking somewhat dishevelled, the nurses will ask questions to see whether those people have a place to sleep, for example. If they do not, workers will then be able to intervene. They will observe how their patients are doing and maybe even realize that they have some kind of untreated injury because they do not want to go to a hospital. There will be a health care intervention.

If the nurses observe increased confusion or symptoms of mental illness or depression, they will be able to intervene and advise the person. That only takes a few seconds. Experienced workers are able to notice these health problems rather quickly. They will talk with the person right away. If the patient has a persistent cough and has trouble breathing, then perhaps the nurse will realize that there is another health problem. If that person is getting a skin infection, someone will follow up.

This means that when people go there for injections, they get a regular health check-up, and a familiar nurse will be able to intervene quickly and provide advice. The individual may not listen to that advice, but at least action is being taken and no one is ignoring the problem. They detect risks and intervene socially, because there are risks associated with injecting drugs.

For example, if centre workers notice that overdoses are increasing in number, they will pass the message along to let people know that there could be drugs going around that may be impure or may be cut with dangerous products that are stronger than normal. They will caution people so that this information can get around. If some people who inject are also involved in prostitution and were in contact with violent or aggressive people, staff will be able to let others know to be careful, because other people have been attacked and they may be at risk.

These centres provide practical social intervention that cannot be found elsewhere. No one would truly rather have this happen in the street and to find someone who died from an overdose in the alley next to their home. That makes absolutely no sense. It should be done in a centre at the very least.

What is more, these centres can help in developing a trusting relationship with the individual.

That way, when an individual feels strong enough to quit doing drugs, someone at the centre can counsel them. Drug addicts will be much more likely to succeed in overcoming their addiction.

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

Mr. Speaker, I appreciated my colleague's speech and perspective on this issue, but I think, as a nurse, she has probably had many patients over the years who were absolutely desperate to get into detoxification services and rehabilitation services. To be quite frank, those services were not available. People who were ready to make changes in their lives were unable to get the help they needed.

As a nurse, how can the member support putting finances and funding into something when she has told many patients, “I'm sorry. I know you were looking for rehabilitation services and you would really like to have the opportunity to have a life free of drugs”.

How can she support that position without having the money spent where people really need it, on those who are looking for true changes in their lives?

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

Mr. Speaker, I would like to point out that there are services for people dealing with addiction. Up to this point, it has not been that difficult to access those services. The hard part is convincing people to go, especially by using a heavy-handed approach, saying that what they are doing is unacceptable. It would be better to tell them that what they are doing is dangerous and that we are there to help, to develop a relationship of trust. In the meantime, we do not want them to get sick or get AIDS because of their behaviour. When they are ready, they need to know that someone will be there to send them off to get help. The services are available. The hardest part is convincing people. If we judge them before trying to convince them to get help, it will often be completely ineffective and there will be no opportunity to develop a relationship of trust. The gentle nudge offered at safe injection sites to convince people to get help will not exist.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, it is important to recognize that there are many communities across Canada that have different challenges. One of these challenges is trying to deal with the infrastructure of many social injustices, such as drug abuse, which leads to all sorts of elements of crime, let alone social factors that are not very positive.

We need to develop good solid programming that would build on making our communities that all of us live in safe. When we look at injection sites, particularly the one site we have in Canada, I believe there are studies that would demonstrate that the community as a whole has benefited, not to mention the individuals themselves who have benefited.

The member might want to provide further comment in terms of how the community as a whole does benefit, obviously knowing that the individual in question benefits as well.

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

Mr. Speaker, I would like to say that the community does benefit. There will be fewer needles and overdoses in the streets. There are tangible benefits for communities. There are smaller communities that will not necessarily have a supervised injection site. However, they have gradually implemented concrete measures. That was not the case 10 years ago. Today, street nurses carry with them materials needed for a safe injection and condoms. They will use these types of interventions in areas where the number of people struggling with this problem is not sufficient to establish a supervised injection site.

These public health measures are extremely effective. However, they have to be implemented together with different social measures as part of a comprehensive solution. It is not enough to have just supervised injection sites. We must address access to education, poverty and different social measures that will help these people to do better. It is a package. This measure has to be part of a set of measures that a responsible government, one that does not look the other way, should adopt in order to fight these kinds of problems.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Mr. Speaker, I will be pleased to speak for 10 minutes to BIll C-2, An Act to amend the Controlled Drugs and Substances Act. Before prorogation, it also went by the name of C-65, for those who have been following this matter, which has after all been in the public domain for some years.

In 2007, unfortunately, the Conservative government sought to close the only supervised injection site in Canada, InSite in Vancouver. At each stage in the legal process, the government faced defeat. The courts—both the appeal courts of British Columbia and the Supreme Court—stressed that these sites served a purpose in Canada and that they followed the guidelines available to users in this country.

I deplore the ideology behind this. In Canada, after all, we do have an anti-drug strategy, like many other governments, except that an incident occurred in 2007. Before the Conservative government came into power in 2006, we already had an anti-drug strategy with four pillars. It was based on prevention, treatment, enforcement and, fourth, harm reduction.

I say “had” because in 2007, the government updated its national anti-drug strategy, and it mysteriously rested on just three pillars. Harm reduction had disappeared. That is where ideology comes in, because the InSite supervised injection site in Vancouver was intended precisely to reduce harm.

It is therefore understandable that the Conservative government should endeavour to make such a change by all possible means, both legal and legislative. The matter went as far as the Supreme Court of Canada. The Supreme Court informed the government that it had lost its case on three occasions. Under the law, people have a right to access a supervised injection site. A little later in my speech, I will explain why such sites can be a good thing for the public.

Obviously, the government has turned around and used the last card it held: changing the law so that it becomes illegal and unacceptable to have such sites in Canada, without even considering the studies done over the years.

InSite has been in operation for many years. It is the first, and the one and only supervised injection site to have been set up in Canada. Its purpose is to research ways of helping addicts who have reached the end of the road and who, unfortunately, use drugs. These are not people who use drugs recreationally, but people who have, for a variety of reasons, reached a point in their lives where they really cannot stop. Such people should not be left to their own devices. They need help.

In the NDP, we are really going to ensure that no Canadian is left behind. I thank my colleague from Timmins—James Bay for sharing our belief that the people of Canada deserve a government that cares about Canadians, and not just about their Conservative Party buddies.

This is a thinly veiled attempt by the Conservative government to put an end to supervised injection sites across Canada. Vancouver is not the only city that wants one; Toronto, Montreal and Ottawa do as well. Other Canadian cities have looked at the same scientific studies as we have and have concluded that it is a part of Canada’s anti-drug strategy to provide assistance for people who—let us face it—may continue to use drugs.

My colleague from Charlesbourg—Haute-Saint-Charles was speaking earlier about apartment buildings she owns in upscale suburban neighbourhoods in Quebec City, where people were unfortunately shooting up in the alleyways.

They left their potentially contaminated paraphernalia in the alleys, near places frequented by young and not-so-young members of the public.

It is therefore burying our heads in the sand to believe that the solution is to close injection sites in Canada and that our streets will be safer and our neighbourhoods less dangerous for our children. That is not true. It has actually been demonstrated that if these people are not using drugs in supervised injection sites, they will do so anywhere, even in places that cause concern. I am referring, for example, to playgrounds in this country.

I do not wish to oversimplify either, but I am genuinely convinced that my Conservative colleagues would prefer to have heroin addicts using drugs in a supervised injection site, with nurses and social workers who can help them overcome their difficulties, rather than in neighbourhood parks where children play.

I said that there had been studies on the subject, and it is true. More than 30 peer-reviewed studies have been published in such journals as the New England Journal of Medicine, The Lancet and the British Medical Journal. The writers describe the benefits of InSite in Vancouver. Moreover, studies of more than 70 similar supervised injection sites in Europe and Australia report similar outcomes. InSite constitutes one of the most important public health breakthroughs in Canada. We believe that this site and other sites in Canada can generate similar benefits and should be allowed to provide services under appropriate supervision.

The word “supervision” is really important here. I will provide some explanation of how InSite operates. First, it is open seven days a week, from 10 in the morning to 4 in the afternoon. There are 12 injection stations. Users bring their own substances. People at home should not get the idea that the government pays for people’s drugs through InSite. On the other hand, staff members provide injection equipment. It is this that is so important, because we know that there are many health risks if users use the same needles or share them around. People in utter misery are not overly careful.

People can develop and transmit blood-borne infections. I am talking about diseases such as hepatitis and HIV. This is a huge burden on the Canadian health care system. However, the Conservative government decided to cut $31 billion from health care transfers to the provinces. It will be harder and harder for the provinces to balance their health care budgets. Of course, it is even more difficult for the provinces to treat people with HIV or hepatitis A, B or C.

I really wonder whether the government has a heart. Where is its compassion? Does the idea of helping one's neighbour still exist? Helping one’s neighbour should be a universal value, but perhaps the Conservative members prefer helping their neighbours only if their neighbours can help them back or only if they have never in their life made a mistake.

However, people do find themselves on the street, they become prostitutes or they use drugs, if not both. Some of them have had a difficult life. Sometimes, they were abandoned by their family or they experienced violence and sexual abuse in their childhood. It is no secret that adults take drugs, and it is not surprising that children take drugs. People who find themselves on the street join together, and unfortunately sometimes they fall into the hell of drug use. We must do more to help them.

The Conservative government thinks that it will solve the problem by closing supervised injection facilities in Canada. In fact, the reverse is true.

I am going to end on this note. I really think the government’s anti-drug strategy—a strategy I hope it will soon change—should include the fourth pillar I mentioned: harm reduction.

Prevention is important, but I would like to stress the fact that treatment is just as important. It is important to punish drug dealers, but when people are needy and destitute, they need help finding a way out. They need help, and this help can come from supervised injection sites.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Mr. Speaker, I have listened with great interest to my hon. colleague and to the debate all this morning.

Twenty-five years ago, I was working on the streets of Toronto with the homeless men coming out of prison and dealing with issues of addiction. Twenty-five years later, my daughter is now doing similar work on the streets of Toronto. When we talk about what has changed, it is really dismal to see how conditions have actually become worse for people on the streets, thanks of course to actions such as the Harris government's cutting of social housing and mental health services.

What my daughter tells me in terms of addiction is that the biggest costs they are facing right now are in the emergency wards, with people getting sick and people dying, as well as the heavy cost of police, who actually have become the front-line social workers in many situations. When we talk to the police on the ground on inner-city Toronto, they are saying that it is a complete waste of their resources.

My Conservative colleagues are always talking about being tough on crime, but the real dangers of crime that we see in the inner cities are desperate addicts. It is the same even in smaller communities, where people who are not on methadone and are not able to have safe injection become dangerous criminals. Then the police and the emergency services are the ones who have to deal with these very sad cases.

I would ask my hon. colleague this question: why would the Conservatives once again choose a dumb-down approach when very straightforward systems that work with health care and police have been proven time and again to be effective?

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Mr. Speaker, I would like to thank my NDP colleague for his question, and I congratulate him on his understanding of the issue.

Many studies have shown that supervised injection facilities were good for the public, that they improved public safety and that they were less costly for taxpayers, who must pay for hospitals and emergency centres. Taxpayers also pay the salaries of police officers.

To explain how much these facilities help people, I will say that in one year, 2,171 InSite users were referred to addictions counselling and other support services in order to get off drugs. Those who used InSite at least weekly were 1.7 times more likely to enrol in a detox program than those who visited only rarely.

These statistics show that this kind of facility can help people get off drugs and become productive members of society.