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.

[Don Davies, NDP, Vancouver Kingsway, BC]

I may have the singular advantage on this committee of being the only MP from Vancouver. I've lived there for the last 26 years, and Insite has been operating for—jeez, I want to say 12 years. I drive through the Downtown Eastside every week. I've been on the Downtown Eastside literally hundreds and hundreds of times, and I want to tell you something: prior to Insite opening, the rate of vacancy of businesses and the general atmosphere on the street was worse. Do you know why? People were injecting drugs on the street, in the doorways, in the alleys. Right in front of businesses, people would inject drugs and collapse in front of the door.

When Insite opened, it was in a very discreet way. I have to tell you that it was several years before I actually knew where they were. That's how discreet they are. They have taken the street drug use that would have been happening on the streets, in the alleys, and in front of businesses, and they've moved a significant amount of it indoors. I talked to members of the Chinese business association—this is located in historic Chinatown—and they had a lot of issues with this site when it first opened. If you go and talk to those businesses now, they are absolutely convinced that the opening of Insite has helped the general environment and atmosphere around Chinatown because it has moved this activity indoors.

You know, supervised consumption sites are specialized health care facilities. They provide a range of services to mitigate the harms associated with substance use. Their core functions are to connect people who use drugs with sterile injection equipment, to supervise people while they are using psychoactive drugs, and to provide overdose reversal, first aid and wound care, and referrals to other health care services. In many cases they also provide referrals to addiction treatment programs, something that I think should be part of every supervised consumption site. I really like the fact that Insite has OnSite upstairs, where there are treatment beds. Every time someone goes into Insite, they have an opportunity to go there.

I want to say that to me, the challenge before this committee is to make sure that the criteria that go before the minister before a section 56 exemption is granted should be guided by the health perspective. We don't ask the community if they are in agreement if an abortion clinic gets opened. We don't ask the community if methadone treatment should happen in a pharmacy in their community. Those are core health services. While it may impact a community, so do hospitals and so does putting in a local fire station, with trucks going in and out of the station at three in the morning. These all have an impact on the community, but we know that these are core public services. Our job here is to make sure that an applicant can get an application in and the proper factors can be taken into account, not extraneous factors that serve only one purpose.

I'll say it here: the only reason that the Conservatives passed Bill C-2, with their 26 criteria, was that they were ideologically opposed to supervised consumption sites and wanted to put up a lot of barriers to opening them. That's why, yes, three sites in Montreal were approved this week, 16 months after they applied. I mean, every stakeholder in the country is telling us that those criteria are making it take an extremely long amount of time. Toronto has been waiting for months. Victoria has been waiting for months and months.

Again, this is a public health emergency. I'm glad to see Dr. Carrie uses that term. The Liberals are using that term. The New Democrats encourage the use of this term. This is a national public health emergency. People are dying, and when people are dying, I think it behooves us as a committee to get a process that is fair, medically based, and science-based, one that can expedite the opening of these life-saving facilities while taking into account the proper criteria.

I think the criteria proposed by Dr. Carrie are just a continuation, in a truncated form, of Bill C-2. Putting up additional barriers by consulting groups that really don't have any particular stake in the health care aspect of this problem will simply delay the process, make it more difficult, and make it more time-consuming. In the meantime, we will see more people die even as we know that these sites could be up and running.

On the first day that Insite opened, they reversed 15 overdoses. Not all of those people would have died, but I bet that some of those people would have died had those overdoses happened out on the street. Those are the stakes that we're dealing with here.

[Don Davies, NDP, Vancouver Kingsway, BC]

I speak in great support for this. Twenty months ago, I was in the House when Bill C-2 was introduced, and although perhaps we have different views around the table on that bill, the bill came before the committee. There were five meetings and 20 witnesses, who all discussed and debated all of the issues around supervised consumption sites. There was significant testimony on the issue of what criteria ought to be considered in determining an exemption. It was well-canvassed, under 24 months ago. Four months ago, we had the opioid overdose crisis study. We, in this room, heard evidence from a number of witnesses on a wide range of issues concerning the opioid crisis, including the need for supervised consumption sites and their impact.

We know that 40 to 50 Canadians are dying every week from overdoses in this country. I pointed out before that when SARS hit this country, the total number of deaths across the whole country was 40. We are losing that many people every week. We all now agree that this is a national public health emergency. All parties are using that term now, if not the declaration. Bill C-37 provides essential measures to address the crisis—not only supervised consumption sites, but necessary legislation regarding interdiction for CBSA and limits on the production of illicit opioids with respect to pill presses.

I am fully in support of expediting this bill. I don't think this committee can move fast enough.

I just want to end by saying that yesterday someone sent me an article about the situation in Estonia, which suffered from a very similar outbreak over the years. They had a fentanyl overdose crisis in that country. What it says here is that they were asked about the advice they would give Canada and what they said was, “The most important thing is you don't waste time. If you really want to learn from us, that's the mistake we made.... Don't look for some new solutions, because you have them.”

I know there are a lot of issues to debate, but it's not the time to debate and waste time when Canadians are dying and we know that we can take measures that will save lives. I'm asking all my colleagues to support this.

Second reading

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, let me begin by saying a few words about how this affects the people of Victoria who sent me here to speak on their behalf. Where I come from this is not an academic debate; it is a crisis across our community.

In the first 11 months of last year, my community lost 60 people to overdoses. I personally know families who have lost loved ones. None of us remain unaffected. We have been robbed of far too many people who might still be our friends, our neighbours, and coworkers today if we had the services to prevent overdoses and provide the treatment that is so desperately needed in our community. Still, people in Victoria and across British Columbia have taken what action they can in the absence of leadership from their federal government.

Last April, British Columbia declared the first public health emergency in our history. In December, the provincial health minister authorized temporary overdose prevention sites. There are now three such sites in my city of Victoria.

On January 4, thanks to the hard work of so many in our community, the Vancouver Island Health Authority submitted an application for the first full service safe consumption site in Victoria, and there will be more. That application is now before the Minister of Health, and I hope that she will do everything in her power as I will do everything in mine to see that this life-saving community initiative is approved without further delay.

The hard work of those who are fighting to save lives on the streets of Victoria has not been in vain. Because of their efforts, we have three small overdose prevention sites in place. In its first month, one such site reported an overdose nearly every day. But because the right services were available, not a single life was lost. That is the difference these services make in the real world. That is why we called for this legislation a year ago. That is why we will not allow it to be delayed any further.

To understand the scale and urgency of this crisis, we need to look beyond our own communities. My home province, British Columbia, lost 914 citizens to illicit drug overdoses just last year. That is not only the deadliest year on record for us, it is on par with the highest overdose rates among the American states. Last year, Ontario lost two citizens a day. That many lives are now lost each and every day in the city of Vancouver alone.

Some 2,000 Canadians died of this in 2015. We know that many more died in 2016 as powerful opioids like fentanyl spread across the country. I know it can be hard to give meaning to numbers like that unless we know some of the victims by name.

Consider what my colleague from Vancouver Kingsway, our NDP health critic, reminded us of yesterday. In 2003, we lost 44 Canadians during the SARS crisis. During the opioid crisis, we are now losing that many fellow citizens every week. If 40 or 50 Canadians were dying of an infectious disease every week, this House surely would not stand idly by. So let me address something head-on.

There are some in this place who think there is nothing we can do to stop the crisis, who think that addiction represents a moral failure, that it has always existed on the margins of society, and all that has changed is that the drugs just get stronger.

For too long, that outdated view guided government policy, and refused to bend to evidence from doctors, courts, and front-line workers. So let us be clear. What we are facing today is unlike anything Canada has ever experienced before.

This is not just about Downtown Eastside Vancouver. It is about suburban kids experimenting with recreational drugs that turn out to be laced with opiates 100 times stronger than heroin, and then they die. It is about athletes and office workers becoming dependent on prescription painkillers, folks who have never struggled before with addiction, but now have nowhere to turn but the street.

It is about firefighters and paramedics who have to wear masks to stop inhaling drugs so powerful that a dose no bigger than a grain of salt can be deadly. Opioid use disorder is a disease and it should be treated as such. One of those firefighters is Chris Coleman. He came from Vancouver to testify before the House health committee. He said this:

It takes a toll...to work extremely hard but to feel that you are having little or no impact on a problem that is growing exponentially, like a tidal wave, on the streets of your city.

...our brothers and sisters who work in the Downtown Eastside are in trouble. They feel abandoned and they feel hopeless.

It has taken the government far too long to act, but now we have a bill before us that can begin to help. By passing this bill we can lift the barriers, some of them at least, that prevent communities from establishing life-saving safe consumption sites. We can send a signal to provinces, like British Columbia, that the federal government will step up and do its part. We can show people like Chris Coleman, and the thousands of firefighters and paramedics, police officers, and front-line workers like him, that they are not abandoned, that their work does matter, that we do care, and that their community has their back.

We have to be realistic. This bill alone will not solve the opioid crisis. We are here because government after government has failed to invest in detox, treatment, education, and prevention. The government has failed to put in place that foundation of services that would save lives and connect drug users to the support they need to stabilize and begin the long journey out of addiction.

Hundreds of Canadians are now dying in the gaps that governments have let grow year after year. For more than a year, we have been calling for a bill to repeal the Conservatives' Bill C-2 and lift the barriers that the previous government erected to make it harder for communities to open life-saving safe consumption sites. When I spoke to that bill, I called it the “24 ways to say 'no' act”.

It has taken far too long to get here. I regret that the government took so long to come around to our point of view and accept that legislative action repealing Bill C-2, or replacing it, was necessary. Thankfully, here we are.

Bill C-37 would save lives. We must pass it as soon as possible. For that reason, the NDP moved in December to fast-track the bill right to the Senate. It was blocked. I want to make sure that does not happen again and that we get this done.

I will continue to urge the minister to declare a public health emergency and allow emergency overdose prevention sites to operate legally across the country. I will continue to call on the government to use the powers it already has and expedite applications from cities like Montreal, Victoria, and Toronto, that have been gathering dust as Health Canada sits around and looks at them for months at a time. I will continue to ask why the government continues to ignore the recommendations from major cities, medical authorities, and even Parliament's own health committee, on other steps to turn the tide on this crisis.

In conclusion, passing this bill is not sufficient, but it is necessary. Therefore, on behalf of a Canadian community at ground zero in this crisis, I urge all members to support this life-saving bill and pass it now before more Canadians are lost to this preventable crisis.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, everyone in the House wants to do the right thing and recognizes that we have a real issue, especially my colleagues from British Columbia who are really at the coal face of this issue.

We just had a motion that would actually facilitate the vast majority of the bill going right through the system and up to the Senate. We do have some legitimate debate that can happen around community consultations. Perhaps what was in Bill C-2, the Respect for Communities Act, has now been completely gutted.

I know that communities can provide much wisdom. We thought having a methodical process around how communities engaged about a safe consumption was worthy of more debate.

How can the member justify taking the vast majority of the bill, on which we all agree is very important, and delay it? To be quite frank, this will perhaps create a number of weeks of additional delay.

[Jenny Kwan, NDP, Vancouver East, BC]

Mr. Speaker, there is no doubt that the opioid crisis unfolding right now in our communities, big and small, right across Canada, is nothing short of a national emergency. The suffering and damage this crisis is causing, not just in Vancouver's Downtown Eastside, the epicentre of the crisis, but in Vancouver East and cities across British Columbia and Canada, is absolutely devastating.

I am very grateful for the Herculean efforts of first responders, front-line workers, medical practitioners, family members, advocates, and activists who have and are continuing to work tirelessly to save lives in the midst of this terrible crisis.

People are dying in our communities. Both the city of Vancouver's chief medical health officer, Dr. Patricia Daly, and the provincial health officer, Dr. Perry Kendall, have declared this crisis a medical health emergency. In fact, this is the first time in the history of British Columbia that a health emergency has been declared.

It was noted by Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto, that the number of overdose deaths across Canada has vastly outpaced the toll during the 2003 SARS crisis that gripped this country and was declared an emergency by the Ontario government. He stated, “Forty-four people died of SARS. We lose 70 people a week to opioids in Canada”.

Still, the federal Minister of Health has refused to declare this a national health emergency.

From the beginning of 2016 to October 2016, 338 Albertans died from an apparent drug overdose related to opioids. Fentanyl was involved in 193 of them. Two Ontarians die from opioid overdoses a day. An average of 79 people die of drug overdoses every year in Montreal. If this is not a national health emergency, I do not know what is.

Today I am here once again urging the government to do what is right and what is necessary: declare a national public health emergency. Let us remember as we debate Bill C-37 that people in communities across the country are still dying.

Bill C-37 came on the heels of an announcement by the B.C. government, which was no longer willing to wait for federal approval and decided that it would take “the extraordinary measure” of signing a ministerial order making the provincial operation of temporary overdose prevention sites legal.

For those who want to put up roadblocks to harm reduction initiatives, including supervised injection facilities, I say this. It has been more than a decade since Insite, the first supervised injection facility in North America, was established. There has not been one single overdose death in that facility. Insite has saved countless lives. It has reduced the spread of diseases. The evidence is clear, and it is irrefutable.

Van East led the way, and I am so proud of the progressive forces and the movement in a community that cares so deeply that it took this issue and drove it until we had the first supervised injection facility in North America.

I still recall vividly the imagery of 1,000 crosses planted at Oppenheimer Park in our community, what we call the killing fields. Each one of those crosses bears a name, the name of a person who somebody loved in our community, a daughter, a son, an aunt, an uncle, somebody's child. I still recall how family and friends came together and mourned those preventable deaths. It was a call to action, and we drove the issue and eventually Insite was established.

It is sad to me that despite this irrefutable evidence-based outcome, there are still those who want to block this critical health measure.

The former government took every step possible to undermine the work of Insite. Even after the Supreme Court of Canada's 9-0 decision that ordered the government to exempt Insite from prosecution, stating clearly that the government cannot close Insite because of its ideology, the Harper government passed Bill C-2, the ill-named Respect for Communities Act, which introduced near insurmountable barriers to opening new supervised injection sites in Canada. The roadblocks have been widely condemned and no doubt have contributed to preventable deaths.

After more than a year of foot-dragging, thousands of overdoses, and hundreds of needless deaths, the Liberal government today is finally bringing in measures to address the ideological relic of the years past.

While I support Bill C-37, to be clear, I would much rather that the bill was about repealing Bill C-2. Nonetheless, this is a move in the right direction. It is a step forward, so I am here to support it.

Bill C-37 has to get through the House, then it has to be sent to committee, then has to go to the Senate. It will be some time before the bill passes. I want to applaud my colleague, the member for Vancouver Kingsway, the NDP's critic for health. His proposal to try to get the bill through all stages as quickly as possible, sadly was rejected.

Many concerned citizens and organizers are so frustrated by the glaring absence of substantive action on this that they have felt compelled to act unilaterally with pop-up supervised injection sites. Extraordinary times call for extraordinary measures. This is a testament to those individuals' courage and dedication to saving lives in our community.

Let me take a moment to thank them and acknowledge the numerous volunteers and activists; the leadership shown by Ann Livingston and her peers at VANDU; Sarah Blyth, the former Vancouver Park Board chair; and many others for their incredible dedication and caring. Were it not for their efforts, I can say with confidence that many more people would have died.

In going forward, as we wait for Bill C-37 to become law, what action can be taken to save lives? Let me start with a shout-out to all the tireless first responders for their incredible efforts.

I heard first-hand from firefighters about their experiences in this crisis, particularly from those men and women at Fire Hall No. 2, with the incredible overload of calls that came into that hall and the stresses firefighters had to face each and every day as they had to witness death. Imagine that as their work every single day.

It is not limited to Fire Hall No. 2 in my riding. In fact, all the other fire halls in my community across East Van have had an increase in calls with respect to overdose challenges and issues. I heard from firefighters who told me that during their shifts, sometimes they would have two, three, four, or more calls to go out and try to save lives. That is what they are faced with. Imagine the stress.

The BC Coalition of Nursing Associations hosted an emergency forum on the nursing response to the opioid crisis. Like so many, they are devastated by this medical health emergency, and they themselves are suffering from stress, trauma, and exhaustion. All first responders, nurses, health care workers at emergency rooms, and front-line workers with NGOs are overextended, and they deserve our support.

While the Minister of Health said that the Liberals would take action and provide support to first responders, we are still waiting. Let us get on with it.

I want to say that we need to do much more. We need to move to a longer-term resolution. Real effort needs to be made to provide addiction treatment. For some, traditional treatment works; for others, not so much. We need to move forward with providing treatment that deals with the addiction, including opioid prescriptions and opioid substitutes. The goal of stabilizing people and getting them away from the illegal market saves lives.

We also need to look at the issues around the social determinants of health. We need safe, secure, affordable housing. We need to address poverty. We need to look at the issue of breaking that cycle. We need to address aboriginal child apprehension.

We need a comprehensive approach so that we can move forward once and for all and save lives.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Mr. Speaker, I will be sharing my time with the excellent member for Vancouver East.

I thank the House for allowing me to speak today on Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts. Before I get into the substance of Bill C-37, I would like to remind the House of some of the events that occurred before it was introduced.

In 2011, the Supreme Court of Canada ruled that the federal government must grant Vancouver's safe injection site, Insite, and other such sites section 56 exemptions under the Controlled Drugs and Substances Act in order to uphold the fundamental right of all people to life and security. The Supreme Court added that safe injection sites will “decrease the risk of death and disease, and there is little or no evidence that [they] will have a negative impact on public safety”.

In response to this decision by Canada's highest court, the then Conservative government finally tabled Bill C-2 in 2015. With the thinly veiled intent of not allowing new supervised injection sites to open, the government put in place 26 conditions for obtaining a legal exemption, making it virtually impossible to open new centres.

As if that were not enough, the bill also gave discretionary power to the minister responsible to refuse to grant the legal exemption even if the 26 conditions were met. I always maintained that it would not be possible to obtain an exemption given the number of requirements already imposed by the law. However, this discretionary power proves that the Conservatives were not going to allow, under any circumstances, new centres to open.

I sat on the committee and heard witnesses, with supporting evidence, describe the benefits of injection sites, including harm reduction and public health, and tell us that public safety would not be jeopardized.

By refusing to consider clear and compelling evidence that supervised injection sites save the lives of many very vulnerable people, the Conservatives and their ideological approach only continued to marginalize and criminalize people suffering from addiction. This unfortunately also resulted in overdoses and deaths that could have been prevented.

A serious opioid crisis is plaguing the country, particularly the west coast, as my colleague, the member for Vancouver Kingsway, our health critic, has repeatedly stated here in the House.

In 2016, in British Columbia alone, opioid overdoses took the lives of 914 people, 80% more than in 2015. In April, the situation prompted B.C. public health authorities to declare a state of emergency for the first time in the province's history.

Although we do not have statistics for the number of overdose-related deaths in Canada, it is estimated to have been over 2,000 across the country in 2015. It is easy to imagine the death toll in 2016 being much higher because of the rapid spread of extremely powerful opioids across the country.

Overdoses and drug-related deaths are on the rise in every part of the country, and the crisis is expected to hit Ontario and Quebec this year. The opioid crisis in Canada is now officially out of control.

One of the main reasons the crisis is mounting is that fentanyl is cheap and easy to transport, and just a small amount can be used to make thousands of doses. Because this drug is so cheap, and because too few resources are invested in raising awareness and prevention, young and inexperienced users are overdosing. In many cases, they do not even know that there is fentanyl in the drug they are using.

In February 2016, when the crisis was emerging, the New Democratic Party called for the repeal of Bill C-2 to make it easier for organizations to get legal exemptions to open supervised consumption sites.

Last fall, the NDP got the Standing Committee on Health to study the opioid overdose crisis. In its report, the committee made 38 recommendations to the federal government.

We were also the first to request that a national public health emergency be declared in order to give the Chief Public Health Officer of Canada the authority to take extraordinary measures in order to coordinate a response to the opioid crisis, including the creation of injection sites on an emergency basis. Last December, after Bill C-37 was introduced, we also tried to have the bill fast-tracked in order to resolve the crisis as quickly as possible.

The Liberals say they support supervised injection sites, and yet their government has not approved a single new facility since coming to power. In fact, the Minister of Health initially argued that legislative changes to Bill C-2 were not even necessary, even though the real problem was with the bill itself, with its 26 separate requirements acting as effective barriers to any new sites, as had been pointed out by stakeholders and the NDP.

Faced with the growing crisis across the country and mounting pressure from stakeholders and the NDP, the Minister of Health finally gave in and, on December 12, 2016, introduced Bill C-37, which we are debating here today. Specifically, the bills seeks to simplify the process for applying for a legal exemption so that communities dealing with the opioid crisis can actually open supervised injection sites.

In the preamble, the bill states:

Whereas harm reduction is an important component of a comprehensive, compassionate and evidence-based drug policy that complements prevention, treatment and enforcement measures;

It is in the context of harm prevention that the City of Montreal and the public health authority officially submitted their application for legal exemption in May 2015 for three fixed services in three neighbourhoods and one mobile service. They are still awaiting. It is not surprising. Not a single supervised consumption site has opened in Canada since Bill C-2 was passed.

We are not the only ones calling for the government to move forward with implementing injection services. In summer 2015, the mayor of Montreal, Denis Coderre, who wanted to get moving on this by the fall, said the following to The Montreal Gazette.

“What are we waiting for? People are dying”.

One year later, in July 2016, Sterling Downey, municipal councillor and Project Montréal critic, asked the mayor a question:

“How do you go into the media and announce over a year ago that you're going to open these sites and back off and go radio silent?”

Then, concerned organizations also tired of waiting. Jean-François Mary, executive director of the Association québécoise pour la promotion de la santé des personnes utilisatrices de drogues, had this to say to the Montreal Gazette.

The organizations that are supposed to host the sites don’t even dare set opening dates anymore. We’re stuck in a grey area where, every year for the last three years, we’re told they’ll be open in the spring. But it doesn’t happen.”

We need to move forward quickly. Many groups, such as Anonyme and Dopamine in Montreal, have been waiting for too long to establish services that have been proven to save lives.

In the meantime, in Montreal alone, 70 people on average die every year as a result of drug overdoses. As I have already said, the crisis in western Canada will be coming to Quebec this year. Even without this crisis, and if only for the sake of harm reduction and public health, the services provided by supervised injection sites are vital.

In Montreal, 68% of injection drug users have hepatitis C. Opening these centres could do much to decrease the incidence of disease related to the use of syringes. Speaking of syringes, Hochelaga, the riding I represent, is the second largest area in Montreal after the downtown area, which has the largest number of injection drug users. A supervised injection site could help get needles out of parks where our children play.

I will support this bill in the hope that it will come into effect quickly.

Controlled Drugs and Substances Act

[John Oliver, Liberal, Oakville, ON]

Madam Speaker, it is a pleasure to serve with the member on the health committee. We have worked together to make some really good recommendations and directions in our report.

With respect to supervised consumption sites and harm reduction, we heard from many witnesses how important these sites are as part of early treatment and early intervention and better management for people who are consuming.

We also heard from witnesses that the previous government's Respect for Communities Act, Bill C-2, introduced such stringent rules and 26 application criteria that we have not been able to open a new safe consumption site across Canada since Bill C-2 was introduced. The Supreme Court has ruled on this and Bill C-37 would simply enshrine the court's ruling.

I would note that one of the five criteria is support and expressions of community support for the centre. I do believe there is appropriate response to community concerns and that part of the process of approval deals specifically with hearing from and looking for communities' expressions of support or their expressions of opposition.

[John Oliver, Liberal, Oakville, ON]

Madam Speaker, I will be sharing my time with the member for Brampton East.

The emergence of fentanyl and its analogues, an opioid at least 100 times more potent than morphine, has given rise to a public health crisis in Canada that requires urgent action.

Bill C-37 proposes to amend the Controlled Drugs and Substances Act in a number of ways to address this crisis. In terms of harm reduction, it proposes to simplify the process of applying both for a supervised consumption site and for the exemptions that would allow certain activities to take place at a supervised site. I am pleased to see an evidence-based health-centric focus on harm reduction return to our health policy and legislation.

With regard to law enforcement and border security, amongst many changes, it would prohibit the importation of designated devices, unless they are registered with the Minister of Health. This would specifically prohibit unregistered importation of pill presses and encapsulators. It would expand the offence of possession, production, sale, or importation of anything with the knowledge that it will be used to produce or traffic in methamphetamines.

The bill would authorize the minister to temporarily add to a schedule substances that the minister has reasonable grounds to believe pose a significant risk to public health and safety. It would modernize inspection powers allowing border officers to open mail weighing 30 grams or less in order to stop drugs like fentanyl from entering Canada illegally through the mail system.

I would like to add my support for this bill and the proposed amendments to the CDSA. I would frame my support with particular reference to the recommendations from the December 2016 report by the House of Commons Standing Committee on Health, entitled “Report and Recommendations on the Opioid Crisis in Canada”. I am pleased to be a member of the standing committee.

My following remarks draw heavily on this report and the excellent summation of the witnesses' testimony and the committee's deliberations, as provided by the committee's members and supporting staff. The members of the standing committee agreed to undertake an emergency study of the opioid crisis in Canada. During the course of its study, the committee held five meetings, where it heard from a range of stakeholders, including federal and provincial government representatives, health care professionals, addiction experts, emergency front-line responders, representatives of first nations communities, and individuals with lived experience in substance abuse and addiction.

These witnesses outlined specific ways to address the opioid crisis and implored the committee to make recommendations that would lead to concrete action. I cannot emphasize enough the powerful, emotional, and compelling testimony that we heard from all witnesses urging the government to take action on this crisis.

The committee heard from witnesses that this situation began reaching crisis proportions in July 2013, when fentanyl, a prescription opioid 100 times more potent than morphine, became increasingly available on the illicit drug market. The assistant commissioner for federal policing special services with the Royal Canadian Mounted Police advised the committee that, because of the high demand for this drug, organized crime groups began importing illegal fentanyl from China. These are then transformed into tablet forms in clandestine labs in Canada using pill presses and are disguised as legal prescriptions, such as OxyContin, or are used in powder form as cutting agents for other illicit drugs.

The unknown potency of illegal fentanyl and other synthetic opioids, coupled with the fact that users are often unaware that they are taking the drug, has resulted in a dramatic increase in drug deaths in Canada. British Columbia has become the epicentre of the crisis because of its maritime ports and relative proximity to China.

According to the chief coroner for British Columbia, the percentage of drug deaths involving fentanyl increased from 5% in 2012 to 60% in 2016, with the involvement of fentanyl doubling the rates of drug deaths in the province. According to the coroner, the province had experienced—and this at the date of the testimony—488 illicit drug deaths at the end of August 2016, or approximately 61 deaths a month.

In addition—and again, I am drawing from the text of the my committee's report—the committee heard that the RCMP is collaborating with law enforcement agencies in China to combat international drug trafficking networks, as well as to gain support for regulatory control of fentanyl analogues to prevent their distribution in Canada.

In terms of federal efforts at the border, the committee heard that Canada Border Services Agency is using innovative technologies and dogs to detect fentanyl at borders and maritime ports, resulting in more than 115 seizures since 2010.

However, the vice-president of the operations branch of the CBSA explained to the committee that the agency faces challenges detecting and intercepting fentanyl sent through the postal system. Fentanyl powder and equivalent substances are most often smuggled into Canada through the postal stream. Due to the increased volume of packages sent through postal and courier services, it can be a challenge for the CBSA to identify and intercept all shipments of concern. Postal and courier shipments are often accompanied by false declarations or are intentionally mislabelled. The RCMP further elaborated that these shipments are disguised or labelled in a variety of ways, such as printer ink, toys, and DVDs. To address this issue, Canada Border Services was reviewing the Customs Act to see if it could remove the restrictions on the agency's ability to open packages weighing less than 30 grams.

With respect to harm reduction strategies, the committee heard that supervised consumption sites are an evidence-based harm reduction measure. A number of witnesses expressed the opinion that changes to the CDSA, introduced in 2015, through Bill C-2, were a barrier to establishing new supervised consumption sites across the country and should be repealed or significantly amended.

After much deliberation, the committee made a number of recommendations.

Specific to harm reduction measures is recommendation number eight: “That the Government of Canada repeal or significantly amend the Controlled Drugs and Substances Act where it creates barriers to communities in establishing supervised consumption sites...”. Bill C-37 addresses this recommendation specifically.

Specific to law enforcement and border security, the committee made the following recommendations:

Recommendation 33 says:

That the Government of Canada take measures to grant authority and lawful privilege to Canada Border Services Agency officials to search and/or test suspect packages that weigh under 30 grams.

Recommendation 34 says:

That the Government of Canada develop a federal enforcement and interdiction strategy around the importation of illicit opioids.

Recommendation 35 says:

That the Government of Canada adopt measures to regulate commercial pill presses to limit their possession to pharmacists and others who hold an appropriate licence.

Recommendation 36 says:

That stronger criminal penalties for having a production machine be established.

Finally, recommendation 37 says:

That the Government of Canada provide more resources for drug testing packages and other shipments.

I am pleased to see that Bill C-37 addresses these recommendations and is consistent with the cited findings of the committee.

Looking beyond Bill C-37 and the amendments to the Controlled Drugs and Substances Act, the committee heard that this crisis should be considered a public health crisis, and the committee produced many other recommendations related to harm reduction, addictions prevention including prescribing practices and public education, addictions treatment, the need for mental health supports, and issues unique to first nations.

The Minister of Health has already responded to this crisis through a five-point action plan that includes better informing Canadians about the risks of opioids, supporting better prescribing practices, reducing easy access to unnecessary opioids, supporting better treatment options for patients, improving the evidence base and improving data collection, and also by making naloxone available as an emergency treatment.

Progressive action was also initiated by the minister through a pan-Canadian opioid summit held in November 2016.

Further, the minister has responded to every request that the provinces have raised with the government, and she continues to work with the provinces.

Finally, while this public health crisis must be addressed through the measures proposed in Bill C-37, and while as Canadians we battle the addictions brought on by opioid usage, it is important to remember that some Canadians, like Christina in my riding of Oakville, suffer from unrelenting and incurable pain. My thoughts are with her today. We must always ensure that their needs are addressed and that appropriate pharmaceutical care remains available to them.

I want the residents of my riding of Oakville to be protected from the opioid crisis and illicit fentanyl distribution. I will be supporting Bill C-37, and I encourage all members of the House to support this bill and to work to address this terrible public health crisis. Let us get this bill through the House and the other place as quickly as we can to help these Canadians.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Mr. Speaker, I will be splitting my time with the member for Pitt Meadows—Maple Ridge.

We can, and should, treat drug use and abuse as a health issue and not as a crime. Our government has committed to a sensible and evidence-based approach to drug policy; that approach is emphasized by the recent task force report on cannabis regulation, and it is emphasized by our health minister's actions. Those include restoring harm reduction as a key pillar of Canada's drug strategy, permitting physicians to prescribe heroin to severe drug addicts, and introducing Bill C-37, effectively repealing the previous Conservative government's attack on evidence and supervised consumption sites.

The story of that attack and how we have ultimately come to Bill C-37 begins with Insite and the former Conservative health minister's refusal to renew its exemption from the Controlled Drugs and Substances Act.

Insite is a supervised injection clinic in Vancouver. It is North America's first government-sanctioned such facility, having receiving a conditional exemption in September 2003. Since that time, it has been open seven days a week; users are provided with clean injection equipment to use; they are monitored by staff during injection; health professionals provide treatment and support in the event of overdoses; and users are provided with health care information, counselling, and referrals to health authorities and service providers.

In the fall of 2007, a detox centre opened above Insite, named Onsite, to provide detox on demand. It is a drug-free environment, supported by addiction specialists, physicians, nurses, and peers.

Since opening, Insite has saved lives and improved health outcomes, with the support of local police as well as municipal and provincial governments.

The benefits of Insite and supervised injection facilities and the lack of any related negative impacts have been well documented in leading scientific journals, including The New England Journal of Medicine, The Lancet, and the British Medical Journal.

An expert advisory committee's report to the former Conservative health minister concluded that there was no evidence of increases in drug-related loitering, drug dealing, or petty crime around Insite; there was no evidence that Insite increased the relapse rate among injection drug users; the police data showed no changes in rates of crime recorded in the area; and a cost-benefit analysis was favourable.

Despite all of this, that minister refused to grant a continued exemption and stated that Insite represents a failure of public policy.

Contrary to the claims of that Conservative minister, Insite did not represent a failure of public policy, but the Conservative minister's actions did represent a failure of decision-making in the public interest.

In fact, it was such a failure that the Supreme Court of Canada, in a unanimous nine to nothing decision in 2011, ordered the minister to grant an exemption to Insite and stated, as follows, at paragraph 133:

Insite saves lives. Its benefits have been proven. There has been no discernable negative impact on the public safety and health objectives of Canada during its eight years of operation. The effect of denying the services...to the population it serves is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.

At paragraph 153, the Supreme Court held that a minister must consider a number of factors in exercising discretion to grant an exemption from the CDSA, including:

...[one] evidence, if any, on the impact of such a facility on crime rates, [two] the local conditions indicating a need for such a supervised injection site, [three] the regulatory structure in place to support the facility, [four] the resources available to support its maintenance, and [five] expressions of community support or opposition.

Yet, in the face of that landmark decision, the previous Conservative administration remained wilfully blind to the evidence and continued to attack safe injection facilities.

With the introduction of then Bill C-2, the previous government ignored our Supreme Court and, in the words of the Canadian Nurses Association, created “unnecessary and excessive barriers to establishing supervised injection facilities”.

Bill C-37 would remove those unnecessary and excessive barriers. Bill C-37 would simplify the process of applying for an exemption from the CDSA for supervised consumption sites, as well as the process for subsequent exemptions.

Specifically, Bill C-37 would replace the excessive 26 criteria imposed by the Conservatives with the five factors I have reiterated, as set out by our Supreme Court. It would simplify documentation, it would require reasons for a minister's decision, and it would remove the moralizing principles regarding illicit substances.

Bill C-37 would save lives, and one need not condone drug use to want to save lives.

This is a good beginning to a modern drug policy, with public health and harm reduction front and centre.

In addressing the United Nations last year on April 20, our Minister of Health said:

I am proud to stand up for drug policy that is informed by solid scientific evidence and uses a lens of public health to maximize education and minimize harm.

That commitment to evidence is important, but it also demands that we go further. Fentanyl and illicit drug overdoses killed hundreds of Canadians in 2016. B.C. health officials and medical experts have called it a public health emergency. It is so serious that the B.C. government opened two new supervised consumption sites without waiting for federal approval. We need new solutions. The current approach, the so-called war on drugs of criminal sanctions and preaching abstinence, is not working.

In 2011, the Global Commission on Drug Policy called for an end to drug prohibition stating that government expenditures on futile supply reduction strategies and incarceration displace cost-effective and evidence-based instrument investments in demand and harm reduction.

That commission included former presidents and prime ministers of Brazil, Colombia, Greece, Mexico, and Switzerland, former UN Secretary-General Kofi Annan, and former Supreme Court of Canada judge and UN High Commissioner for Human Rights, Louise Arbour. Prohibition has failed to effectively curtail the supply or consumption of illicit drugs, and its unintended consequences can be devastating, creating a lucrative and violent black market and shifting resources from public health to law enforcement instead.

Those enforcement efforts only serve to divert problems to new geographic areas or to inadvertently promote the use of alternative and potentially less safe drugs, and the use of the criminal justice system marginalizes those who are already often at society's margins, diminishing the likelihood that they seek treatment.

Prohibition treats the very people we want to help, the victims, the users, the addicts, as criminals. Looking outside of Canada, we know there is a better path.

In 2001, Portugal decriminalized low-level possession and use of all drugs. Those caught with drugs are sent before dissuasion commissions, which include representatives from law, medicine, and social work. More than 80% of cases are dismissed without sanction, and the number of people arrested and sent to criminal courts declined by more than 60%. There has been no major increase in drug use. In fact, the level of drug use is below the European average. Adolescent and problematic drug use has decreased, and the number of deaths from drug overdoses has dropped significantly.

As Donna May, a woman who lost her daughter to overdose on August 21, 2012, said that we have to get ahead of this crisis and the fastest and most effective way of successfully accomplishing this may well be done by taking away the profit from the black market and dangerously produced counterfeit opioids by legalizing and regulating all substance use. She said that at the very least following the lead of other countries which have decriminalized drugs and substituted criminalization with a health protocol needs to be seriously considered.

I am not suggesting that I have all of the answers, but I am asking our government and this House to consider additional public health and harm reduction measures. I am asking us to work together to save lives.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, we created Bill C-2. There are 26 criteria, which include things like the mayor and council having consultations, the chief of police knowing what is going on, and letting the community know. In Kamloops, I had someone come to me who would have really liked to have had some input in terms of Kamloops and the locations. Under even the current system, the comment period had already closed.

What I am saying is that the Liberals have gutted a lot of reasonable processes around community decision-making on consumption sites. Something that really needs a good conversation in this House is Bill C-2, the Respect for Communities Act, and those 26 criteria. Maybe one or two were overdone, but there were a whole bunch that were great, and the current government has gutted those.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, I will be sharing my time with the member for South Surrey—White Rock.

I am rising to speak to Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.

As we all know, addiction issues have been a challenge throughout the history of mankind. As noted by the Canadian Centre on Substance Abuse, addiction touches everyone. As of 2013, one in five Canadians, or six million people, met the criteria for substance use disorder, causing harm and heartache among families and communities throughout the country. Today, however, we are facing an unprecedented crisis: the casual or addictive use of drugs now includes a much higher risk of death.

I would note there were some questions in the previous exchange where the government talked about how it worked very hard with the provinces in terms of moving forward, but what the Liberals did not say is that they worked hard with the opposition.

There are many pieces of the bill that are very supportable and should move forward in a rapid and timely way, but the Liberals know very well that there is one component that we have a few concerns with, and I will articulate the reasons a little later. If the Liberals are talking about being concerned about this crisis, they should have proposed something that would allow us to immediately move forward with all the things we know we can agree on, and take a little bit more time for the conversation over the one piece that is giving us a bit of a challenge. This is a big concern.

The other big concern which people who are listening and watching need to be aware of is that on April 14, 2016, B.C. declared a public health emergency in response to this rise in drug overdoses and deaths. Now it is months later, at a time when pill presses and encapsulators, and border issues have been identified, but what did the government first talk about in its call for debate yesterday? It was a bill on Statistics Canada. It is absolutely shameful. The government had the opportunity to move forward on some important issues, but Statistics Canada was more important on our first day back. They presented a bill that the Liberals knew there were some challenges with instead of presenting something that we could all immediately support and move forward in a timely way. I think the Liberals should look at how they have dealt with this issue.

An emergency was declared in April, and it was recognized. Maybe it has not hit some of the other provinces, but it is interesting that it was a Liberal member, the member for Vancouver Centre, who said that if this crisis was happening in Ontario or Quebec, action would have been taken much sooner. That was said by a Liberal member, a family physician, who called out her own party on how it responded to this particular crisis. That is absolutely shameful.

The recent epidemic is characterized by an increasing proportion of death related to fentanyl, which is an illicit opioid substance. Back in 2012, fentanyl was seen in about 5% of the illicit drugs, and in 2016 it was seen in 60%. Fentanyl is dramatically increasing in use. In British Columbia in 2016, there were 914 deaths, with 142 in December alone.

Many might have read the Facebook page of the grandmother who was grieving for her young granddaughter saying that she just needed some help. She felt that maybe she could have dealt with her granddaughter who died a couple of days before Christmas.

In Kamloops, a community I represent, there were 40 deaths over the year. It typically had 10 deaths, steady over years and years, but in 2016, 40 people died in Kamloops from a drug overdose. With SARS, there were 40 deaths across Canada, and H1N1 had 400 deaths across Canada. I was on the health committee when H1N1 was happening. I remember that we had daily briefings from the chief public health officer of Canada. It was Dr. Butler-Jones at the time. He kept parliamentarians up to date every day on what was happening. That was for 400 deaths across Canada. We are talking about 900 deaths in British Columbia alone.

We do have in Bill C-37 a partial response to this crisis. As I indicated earlier, there are measures in the bill that are very supportable, such as the prohibition of designated devices, encapsulators, and adding to the schedule of substances reasonable grounds to represent health risks. There are more powers proposed for Canada Border Services Agency. We knew a year ago those were some of the things that could have been done to avert this crisis. The addition to broaden the prohibition and penalties to now apply to the possession, sale, importation, or transport of anything intended to be used is an important measure.

However, if the government had been concerned, it could have dealt with this many months ago instead of debating a bill about Statistics Canada. This is about people who are dying in British Columbia, and soon across the country.

I want to talk about the areas in which I have what I think are reasonable concerns. That is the part we need to be debating as parliamentarians. There is one area where there is a bit of a difference of opinion and it has to do with the process that should be in place for what they call safe consumption sites, or what are more commonly known by the public as injection sites, to move forward. That is a reasonable discussion.

Our Conservative government brought in the Respect for Communities Act. Certainly, there are some people who felt it made it too difficult, but it is a valid place for us to talk about what that should look like. We originally had 26 criteria that were to be addressed when people applied for a safe injection site. This bill changes it from 26 criteria to five factors. That is a little vague.

When I talked to the minister at committee, I tried to go through the 26 criteria. I asked her what objection she had to them, but I really did not get an answer. None of them said they were really concerned about any one piece, “I don't think the RCMP should be able to have a say”, or “I don't think municipal council should have a say”. Those are the criteria that are in place. What is being proposed now is a few factors.

The other thing the government has done is there were six principles that should be part of the thinking around whether the minister would approve a site or not. These principles have been totally removed and there are no principles left. Those are principles that recognize the issue of crime profits or criminal activity that is supported with illicit substances. We have gone from 26 criteria to five and there are no other checks and balances.

Using Kamloops as an example, the mayor and council voted unanimously to support a safe injection site. They have talked to the RCMP. They are having a consultation process under former Bill C-2, which is now the Respect for Communities Act. That process allows the mayor and council to have input. They supported the safe injection site. I am not sure how they would feel if they were told they would not even be talked to about it, that it was just going to happen. They can write a letter and say whether they like it or not. They endorsed it unanimously. Interior health will be looking at it. That is important. As we know, Ottawa has not endorsed it. Those are pieces of public consultation that the government is looking to replace with vague references to talking to the community, but it really does not matter because communities do not tend to like these things. Kamloops council voted 100% for it. Why does the government not trust the community process that is specific and methodical?

There are some good pieces in the bill. We should move forward on those important pieces immediately. We should have done it a year ago. We should have a reasoned and appropriate debate around the changes to the safe injection sites. However, there are some pieces that are missing when it comes to the government's response to the crisis.

My colleague from South Surrey—White Rock and I both have said to listen to British Columbia. Let us call a state of emergency to raise the elevation so that people know about what is happening, because it is happening in B.C. now, and it will be going across the country. Youth councils are saying that there should be a national education campaign. Moms and dads need to be having that conversation. They will not have the conversation if they do not know.

In conclusion, let us look at the pieces, move forward on those critical ones, then look at doing those additional recommendations.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Madam Speaker, the Liberals have been in power for more than a year now and we have been asking that the Conservatives' Bill C-2 be withdrawn and reworked in order to consider the possibility of opening injection sites to help reduce the number of overdoses and overdose-related deaths.

We know that it is often the young, inexperienced users who end up overdosing. Some do not know that certain drugs contain fentanyl. Why have the Liberals still not reinvested in awareness and prevention? There is a desperate lack of resources for this. Front-line workers are saying that they need more resources to work on prevention.

What is the Liberal government doing to save lives and ensure that young people are not the primary victims of its inaction?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, sometimes Liberals say that the New Democrats are Liberals in a hurry. The corollary to that is that Liberals are New Democrats who will not take action.

My hon. colleague brings up something that I made a central point of my speech, which is that when Liberals were in opposition, they stood in the House and told Canadians that they opposed Bill C-2, that they believed that supervised consumption sites save lives, and that Bill C-2 was deliberately designed to prevent the opening of supervised injection sites in this country. In fact, the member for Vancouver Centre, the senior Liberal in British Columbia and the Liberal critic for health at the time, called the bill unconstitutional.

That is why New Democrats, as soon as the Parliament changed back in October of 2015, at first opportunity, called on the government to introduce legislation to amend or repeal Bill C-2. New Democrats started the call in February of last year. Why? It was because we saw that there was a crisis. People were dying every week.

What did the Liberals do? They told the NDP they did not think, while in government, that there was any problem with the legislation, that they just thought it was an administrative problem. Every month, New Democrats stood in the House and told Liberals they had to act to change it because supervised consumption sites save lives and the bill was a barrier. Month after month, Liberals stalled and did nothing while Canadians died. It took them until December, after over a year in office, before they actually introduced legislation, which will now take months to pass.

I am going to give the Liberal government no credit for its inaction and delay on introducing legislation that is so critical to saving lives in this country, and New Democrats will continue to push the government to take the dozens of recommendations that are necessary to continue to do so.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I support many of the comments the member made in reference to Bill C-2, especially his reflections on the Conservative government at the time. I was here, like him, and I like to think it was not only the NDP. The Liberals were also in great opposition to Bill C-2 and made commitments to look at making changes. What we are talking about today addresses some of the issues that were raised during the debate on Bill C-2 by both opposition parties.

I agree, in good part, with the beginning of the member's comments. Where I take some exception, and where the member needs to get a better appreciation, is on the statement that the national government has not demonstrated leadership. The Minister of Health and the Prime Minister have demonstrated leadership on the opioid crisis here in Canada.

The Minister of Health has been very proactive. The member himself made reference to a series of things the Minister of Health has done. We have to take into consideration an enormous amount of work with the different stakeholders, whether they are provincial administrations, indigenous people, first responders, and so forth. It has to be a coordinated approach.

My question for the member is this. Does he not recognize the importance of working with others, since it will not be just Ottawa that resolves this particular problem? Maybe he could comment further on how the House today can assist in expediting the passage of this legislation.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, Canada is currently in the grips of an unprecedented opioid overdose crisis. According to David Juurlink, one of Canada's leading drug safety experts:

This is the greatest drug safety crisis of our time, and it's not hyperbole to say that every one of you knows somebody with an opioid use disorder. Whether you realize it or not, you do, and it's quite possible that you know someone who's lost a loved one to these drugs.

He went on to say:

The scope of the problem in Canada is completely unknown. We know that in the U.S., the CDC estimates that over the last 20 years, about a quarter of a million people have died from opioids, more than half of them from prescription opioids.... We have no corresponding numbers in Canada. I speculate that somewhere in the order of 20,000 Canadians have died over the last 20 years from these drugs. The fact that no federal politician can tell you that number is a national embarrassment.

In my home province of British Columbia, illicit drug overdoses claimed the lives of at least 914 people last year, making it the deadliest on record for overdoses. This places it at the same level as Alabama, the worst state in the United States in terms of overdose rates.

Last year two Ontarians died every single day from drug overdoses, with one of every eight deaths of young adults due to opioids, and 338 Albertans died last year. Quebec overdose deaths have increased by 140% over the last 10 years.

Although Canada does not track overdose deaths at the national level, which again is an inexcusable deficiency in national health policy, it is estimated that in 2015 alone, 2,000 Canadians died from overdoses. That number is certainly much higher for 2016 due to the rapid proliferation of extremely potent illicit opioids throughout Canada.

It is patently clear that drug overdoses and deaths are increasing in every region of the country and will continue to do so without extraordinary and effective action. The significant increase in overdoses in 2016 prompted B.C.'s provincial health officer, Dr. Perry Kendall, to declare a public health emergency last April for the first time in the province's history. Notwithstanding this extraordinary step, the crisis has deepened.

December saw another record spike in deaths in B.C., with Vancouver alone now registering 15 overdose deaths per week. This is truly a crisis of epidemic proportions.

Fentanyl, an opioid 100 times more potent than heroin, has been called a game-changer for drug overdose deaths in Canada, and now we are seeing overdoses caused by carfentanil, an opioid so powerful that it poses overdose risks to those exposed to it simply through inhalation or contact with their skin. These drugs are so dangerous that a dose the size of a grain of salt can cause overdose or death.

I think we can all acknowledge that there are many aspects to this complex crisis. Fentanyl is strong, cheap, easy to transport, and small amounts can be made into thousands of doses. For $10,000 or $20,000, manufacturers can obtain a kilogram of fentanyl, an amount so compact it can fit in a shoebox, and turn it into $20 million in profit.

Many overdoses are being caused by inexperienced young people experimenting with non-opioid recreational drugs, unaware that they are contaminated with fentanyl. For example, this past fall in Vancouver, there were nine overdoses recorded within 20 minutes in people who were using cocaine that was unknowingly laced with fentanyl.

Opioids have been overused and over-prescribed by doctors for pain management, leading to many patients becoming dependent and addicted. Canada has among the highest per capita volume of opioids dispensed in the world, totalling 19.1 million prescriptions in Canada in 2015, up from 18.7 million the year before. That is about one opioid prescription written for every two Canadians.

Even though there are no credible peer-reviewed studies that demonstrate that opioids afford more benefit than harm for chronic pain, opioid use has been marketed beyond palliative and cancer patients for regular use for people experiencing back pain and other common ailments. Prescribers were incorrectly taught that addiction was a rare consequence of using prescription opioids long term, that less than 1% of patients would become addicted.

In reality, the addiction rate is estimated to be 10%, with 30% suffering from opioid use disorder. This misuse of opioids reveals the absence of broad and effective treatment for chronic pain in Canada. Critically, there is an alarming lack of public detox and treatment facilities available across Canada, caused by underinvestment for decades at both provincial and federal levels, and even less resources dedicated to education and prevention.

Bluntly, our health care system has an appalling lack of publicly covered treatment options for Canadians suffering from substance use disorder, a pox on both Liberal and Conservative governments over the last number of decades.

In indigenous communities, inconsistent federal support for community governed and culturally based treatment has made addressing the opioid crisis a particular challenge. Nurses employed by Health Canada do not possess the scope of practice to support indigenous people in addressing opioid addiction in their own communities beyond 30 days by federal edict.

As Dr. Claudette Chase, a family physician at the Sioux Lookout First Nations Health Authority recently told our health committee:

I tear up every time I think about this, because our workers are putting themselves on the line to hear the stories of incredible trauma. We have little funding to train them. These are community members who, because Health Canada has refused to step up, have stepped up themselves. They do this and they get traumatized daily, and I have little or no means to support them other than being their family doctor. It's not acceptable.

Addiction is a complex psychosocial disease with genetic, environmental, and social determinant influences of every type. Although this crisis has been garnering increased media attention in recent months, make no mistake that it has been allowed to escalate for years, recently under a Conservative government blinded by superficial ideology and now under a Liberal government paralyzed by timid expediency.

What both Conservative and Liberal governments have in common, however, is a refusal to act on evidence in a timely fashion, and decades of history of failure to make the investments necessary to provide Canadians with essential health options to treat substance use disorder.

Over the last 10 years, the previous Conservative government slashed Health Canada's addiction treatment budget, removed harm reduction as one of the four pillars of Canadian drug policy, and spent nearly a decade trying to discredit the clear and overwhelming evidence that supervised consumption sites save lives.

Indeed, this crisis has undeniably been exasperated by barriers erected by a Conservative government that prevented supervised consumption sites from opening across Canada. Despite an abundance of research that conclusively established that Vancouver's supervised consumption facility, Insite, significantly reduced overdose deaths, the Conservative government obstinately refused to accept that evidence.

In 2011, it took the Supreme Court of Canada to rule that Insite and other supervised consumption sites must be granted a section 56 exemption from the Controlled Drugs and Substances Act because they “decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety”.

In response, in 2015, the Conservative government introduced Bill C-2, which sets out a lengthy and arduous list of criteria that supervised consumption site applicants must meet before the minister would grant them an exemption. In practice and by design, these criteria made it effectively impossible for organizations to open new supervised consumption sites in Canada.

For example, Montreal has had applications pending Health Canada approval since May 2015, almost two years, for three fixed services in three neighbourhoods and one mobile service. Indeed, not a single supervised consumption site has opened in Canada since Bill C-2 was passed. Of course, that was exactly the Conservatives' intention.

Only an hour after Bill C-2 was initially introduced, in a move so vile it would impress Donald Trump, Conservative campaign director Jenni Byrne issued a fundraising letter stating that the Liberals and NDP wanted addicts to shoot up in the backyards of communities all across the country. This went beyond a juvenile refusal to accept evidence that ran contrary to their moralizing ideology. It was a clear and utterly disgraceful attempt to campaign on the backs of the most vulnerable Canadians, sick Canadians.

For those Conservative MPs who now claim to have found religion on the issue, who have recently echoed the NDP's long-standing call to declare a national public health emergency, I must remind them that it was Conservatives who blocked my attempt to move this bill swiftly through the House in December, to save lives faster.

Though the Liberals claim to support the expansion of supervised consumption sites, their government has not approved a single new facility since coming to office. In fact, the Minister of Health initially and stubbornly argued that legislative changes to Bill C-2 were not even necessary, since she had directed Health Canada officials to facilitate the application process under the existing law. She refused to acknowledge that the problem was the act itself with its 26 separate requirements acting as effective barriers to any new sites, as had been consistently pointed out by stakeholders, the NDP, and even some of her own colleagues. This tepid response stood in stark contrast to the view espoused by the member for Vancouver Centre, the Liberal member for Vancouver Centre, when she was the Liberal health critic in opposition.

When Bill C-2 was introduced, the member for Vancouver Centre publicly stated that the bill was deliberately written in a way that would ensure no supervised consumption sites were approved in Canada. She also questioned the constitutionality of the bill. It has frequently been observed that Liberals campaign from the left and govern from the right, that they talk progressively in opposition, but act conservatively when in power. I am afraid their conduct on the opioid crisis is yet one more example of this unfortunate truism.

Unacceptably, it took a mounting death toll and universal pressure from medical experts, public health officials, provincial governments, municipal leaders, and the federal NDP before the Minister of Health finally relented and outlined legislative changes she was willing to make to Bill C-2, on December 12, 2016. This came on the heels of an announcement from the B.C. government that it was no longer willing to wait for federal approval and would take the extraordinary measure of signing a ministerial order making the provincial operation of temporary overdose prevention sites legal. This was in turn a response to the unsanctioned, makeshift supervised consumption sites that were being established throughout B.C. by activists like Ann Livingston and Sarah Blyth, who founded the Overdose Prevention Society last September with crowdfunding, due to the severity of the crisis.

While the current government was waiting, while people were dying, people in British Columbia and on the street were acting. Thus, the bill is an overdue acknowledgement that this is, in fact, a crisis and contains some important steps to address it.

I do want to credit the government for taking some positive measures.

The Liberals hosted an opioid summit, where they committed to better informing Canadians about the risks of opioids, supporting better prescribing practices, and improving the evidence base. They made naloxone available in a non-prescription status. They reversed the federal prohibition on the use of pharmaceutical heroin for treatment. They scheduled fentanyl precursors. They reinstated harm reduction as one of the four pillars of drug policy. Now the government has introduced amendments to the Controlled Drugs and Substances Act and other acts, to streamline supervised consumption site applications.

These changes are all welcome, if overdue, and New Democrats are in agreement with all of them. However, they do not go nearly far enough, fast enough. There is much more that we can and must do. That is why I must take serious exception to comments made by the Minister of Health in a recent interview. The minister said:

I would argue with the fact as to whether or not there's been progress made. I know that the number of deaths are rising, but we have been extremely active on this file....

I do not know how the minister measures progress, but I do know one thing. When Canadians are dying at unprecedented rates, when month after month we see increased death tolls from opioid overdoses, there can be no legitimate talk of progress. We in the New Democratic Party will measure progress by one factor and one factor only: when the death toll of Canadians goes down, not up. However by that standard, the crisis is getting dramatically worse, not better. Annually since 2012, the number of fatal overdoses in B.C. has increased significantly: 273 deaths in 2012, 330 in 2013, 366 in 2014, 510 in 2015, and now 914 in 2016.

Last month alone, we recorded the highest number of overdose deaths in B.C.'s history, with 142 lives lost. That is more than double the monthly average of overdose deaths since 2015 and a sharp increase from the fall. There were 57 overdose deaths in B.C. in September, 67 in October, and 128 in November. That is not progress.

To understand the scale of this epidemic, I would remind the House that during the SARS crisis in 2003, 44 people died in an outbreak of the disease across all of Canada. We are losing that many people every week to opioid overdoses.

I would suggest to members of the House that if 40 to 50 Canadians were dying every week from SARS, Ebola, or any other infectious disease, the House would not rest until it saw a response from the federal government that matched the severity of the crisis. Every life lost to overdose is a heart-wrenching tragedy that leaves devastated loved ones in its wake. The lives cut short by overdose matter just as much as anyone's, and this epidemic deserves the same attention and urgency as any other disease.

Moreover, we must remember that the consequences of inaction are felt severely by those on the front lines of this crisis. As Chris Coleman, a firefighter who works on Vancouver's Downtown Eastside, told the health committee:

...it takes a toll on an individual's mental health to see such helplessness and suffering up close on a daily basis; to work extremely hard but to feel that you are having little or no impact on a problem that is growing exponentially, like a tidal wave, on the streets of your city. There is mental strain in watching a population repeatedly harming itself and in ultimately witnessing death and deceased persons who have succumbed to this human tragedy....

I must stress that our brothers and sisters who work in the Downtown Eastside are in trouble.... In conversations with these firefighters, I hear a lot of “It's driving me nuts” and “I can't take it”. I'm told stories of their being in an alley with 20 or 30 drug users. They're unprepared and untrained for that. Part of their hopelessness comes from having to deal with the same particular overdose patient who has a needle in their neck, who's rolling around in urine and feces, more than once on the same shift. They feel abandoned and they feel hopeless

We must not condemn our courageous first responders to the fate of Sisyphus, rolling an immense boulder up a hill over and over again for eternity. They need the Government of Canada to have their backs.

Indeed, the federal government's failure of leadership on the opioid crisis has led to renewed pleas for help from public officials from all across Canada. These include the mayors of Calgary, Toronto, Ottawa, and Vancouver, B.C.'s health minister, and health professionals from every discipline.

I know that the Minister of Health has repeatedly stated in public that the federal government is doing everything it can. Of course, that is utter nonsense. There are literally dozens of measures and recommendations made by health experts and stakeholders across Canada that remain unimplemented by the government.

Recently, the City of Vancouver sent a list of nine recommendations to the federal government to help address this crisis, including calling for a central command structure, daily meetings with Health Canada, and improved treatment services. A coroner's jury in British Columbia recently issued a list of 21 recommendations for action, and the Standing Committee on Health in December issued a report detailing 38 recommendations for the government alone, most of which remain unimplemented.

To demonstrate this leadership and illustrate the federal government's understanding of the scope of this crisis, the New Democrats have been calling on the federal Minister of Health to declare a national public health emergency for months. We are now joined in this call by municipal, provincial, and federal politicians of all stripes, including, recently, the Conservatives.

A declaration of a national public welfare emergency under the Emergencies Act would empower Canada's top doctor with the authority to take extraordinary measures to coordinate a national response to the crisis. This could include an allocation of emergency funding on the scale required to actually address the mounting death toll, as well as sanctioning the operation of temporary supervised consumption sites on an emergency basis.

Inexplicably, the minister continues to claim that a national public welfare declaration is unnecessary and untimely. With respect, she is utterly and demonstrably wrong. For example, such a declaration would allow overdose prevention sites across the country to open and operate legally, something they cannot do now. Not only are such sites needed desperately in every major city in Canada, but they would start saving lives today.

New Democrats have worked in good faith with successive federal governments to address the crisis with the urgency it deserves. We led the fight against the Conservatives' Bill C-2 from the day it was introduced, and then pressed the Liberal government to repeal or amend it. Last fall, we moved a motion at the standing committee to conduct an emergency study on the crisis. We tried to expedite this bill through the House in December; and we were the first to call for a declaration of a national public health emergency to address the crisis.

The New Democratic Party will support this bill and work in committee to improve it. We will continue to press the government to take every action it can to address this national public health crisis.