Bill C-224 (Historical)

Good Samaritan Drug Overdose Act

An Act to amend the Controlled Drugs and Substances Act (assistance — drug overdose)

This enactment amends the Controlled Drugs and Substances Act in order to exempt from charges for possession or charges related to the violation of certain conditions or orders a person who seeks emergency medical or law enforcement assistance for themselves or another person following overdosing on a controlled substance.

Opioid Crisis in Canada

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Chair, I have listened to this debate right from the very start and I appreciate our colleagues sharing their stories and coming at this from a point of respect.

It is interesting to stand here and talk about a national crisis, which is really truly what we have today.

I will gear most of my speech towards the impact that this crisis is having on my province of British Columbia. British Columbia has had a significant number of deaths each month, approximately 100 deaths per month. Last January our minister of health called on her federal counterpart for help with this issue. She asked the federal government to declare this a national health crisis.

I heard some of the arguments and talking points from our government friends. I listened intently to our friends in the NDP. I listened to the passionate speeches given by my friend from Sarnia—Lambton as well as my good friend from Barrie—Springwater—Oro-Medonte. It is clear that we are not there yet. We still have a crisis. People are still dying every day.

I listened to a comment by the government House leader. I hope she was not heckling me.

We cannot stand up and say we are winning this war. I get it. I understand this is an election year and government members are standing up and saying their government has pledged $350 million for this. This is a take-note debate. We should be listening. The government should be taking notes. We should be trying to move forward. We should be having a healthy discussion.

I will bring us back to the very first emergency debate that we had here in the House after the last election. It was on the suicide epidemic on Attawapiskat First Nation.

I do want to offer this before getting more heckles from anybody across the way. I have come to this debate with some personal experience in terms of a loss from an overdose.

I will bring members back to the debate that we had when our colleague from Coquitlam—Port Coquitlam brought forward his good Samaritan bill, Bill C-224. In that debate I talked about a day in 2008 when I received a call that my brother, who was not a drug user, was found deceased from an apparent overdose. It is still to this day hard to discuss. I strongly believe that our colleague's Bill C-224, the good Samaritan bill, will save lives. It allows people who are with someone who may overdosed or is struggling with some form of massive intoxication from some form of drug to dial 911 and ask for help knowing that they themselves will not be prosecuted.

Since 2016, over 8,000 Canadians have lost their lives because of this. In 2012, the death toll from fentanyl or opioids in British Columbia was 42, and right now we are sitting at over 1,000 in 2018 alone. This is a crisis like we have never seen before.

This past March was the worst month in B.C.'s five-year-old fentanyl crisis. There were 162 deaths. As a matter of fact, the week of July 23 was the worst week for Vancouver Fire and Rescue. It responded to 147 overdoses.

In preparation for this debate, I talked with a friend of mine who is with the RCMP. I also talked with a friend of mine who is with Vancouver Fire and Rescue. I asked if safe injection sites were helping. They did say that safe injection sites probably do help. However, they said that it probably helps those who are on the streets more so than the blue collar worker or the teenager, or the real estate agent that died recently of an overdose, who did not know what was in the drugs. They said the challenge that we have, and I do not think I have heard this brought up yet, is the drug is getting across our border. We are powerless.

People can say what they want about President Trump but at the G20 recently, he managed to get China to designate fentanyl as an illegal substance. I have to get the exact words. It is a controlled substance, “China agrees to make fentanyl a controlled substance after talks with the U.S. at G20 summit.” That means that people from China who sell fentanyl to the U.S. will be subject to China's maximum penalty under the law. We need to get tough on this ourselves.

To give an example of what we are dealing with here, fentanyl is 100 times more powerful than heroin. A dose the size of a grain of sand can kill. When prescribed by doctors, it is prescribed in the millionths of a gram. If someone takes ibuprofen for a headache, the dosage is usually around 400 milligrams. Imagine cutting that pill into 400 pieces. Fentanyl is 100 times more powerful than heroin.

It has been described as readily available to purchase on the Internet, that it is as simple as ordering a book from Amazon. That is how easy it is to get. A kilogram of fentanyl over the Internet costs around $23,000. A kilogram of fentanyl would be about the size of a cantaloupe, and on the streets that kilogram which costs $23,000 sells for $20 million.

That is the problem we have today. We need to be investing in things that will help us along the way, but we need to get people the treatment they need. Is a blue collar worker who is addicted to fentanyl going to check into a safe injection site? What about that real estate agent? What about a high school student who is at a rave or a party and ingests something, and he or she has no idea what he or she ingested?

It is now found in marijuana. It is found in cocaine. It is found in ecstasy. It is found in crack. It is coming across our borders, and we seem to be powerless to stop it. I would offer, respectfully, that our first line of defence is to make sure that this drug does not come into this country. We have to make it tougher for those who are importing it. We have to make it tougher for those who are selling it.

We have to educate Canadians that it could be found in anything they are trying. How many times do we have to pick up the newspaper and read about a teenager who went to a party or who was on a party bus and ingested a pop or a drink and overdosed? That is the reality. That is what we are hearing.

I do not have the answers. The people I have talked to who have been tasked to save lives, whether it is the RCMP or other police officers, say that safe injection sites may help, but we need to get people the treatment. We need to get beds. We need to stop the drug from coming into our country. When drugs the size of a grain of sand can kill, we have to do whatever we can to stop them from coming into our country. With that, I will cede the floor.

Health

[Ginette Petitpas Taylor, Liberal, Minister of Health]

Mr. Speaker, I would like to thank my hon. colleague for his work and his tireless efforts in this matter. Like him, I was extremely disappointed yesterday when I heard the opposition leader's outdated belief. Unlike the Conservatives, our government is actually supporting law enforcement where it matters. Rather than prosecuting those with mental health and addiction issues, we are disrupting illegal drugs at the border and diverting people out of the criminal justice system.

With Bill C-37 and C-224, our government is taking a compassionate, evidence-based approach to reduce barriers to treatment and encourage innovative measures to prevent overdoses and save lives.

Resuming Debate

[Jane Philpott, Liberal, Minister of Health]

Mr. Speaker, I am thankful for the wonderful opportunity to speak to the amendments adopted in the Senate relating to Bill C-37. This is an act, as we know, to amend the Controlled Drugs and Substances Act, and to make related amendments to other acts.

Before I begin, I thank my colleagues in the House and the Senate for their work on the bill to date, for reviewing this important legislation, and for recognizing the urgency of the issue. I particularly want to thank all my colleagues who supported getting the bill through the House as quickly as possible.

This bill, as proposed, will help our federal government and its partners to combat the existing opioid crisis and deal with the more general drug problem in Canada.

For that reason, I urge my colleagues to support the bill so it can be adopted without delay and to help protect the health and safety of Canadians and their communities.

It is clear that we are in the midst of a national public health crisis. Last year in British Columbia, more than 900 people died from illicit drug overdoses. If trends continue in 2017, we can expect 1,400 people in British Columbia to die this year as a result of overdoses.

However, British Columbia is not alone. In Alberta, close to 500 people died from overdoses in 2016.

We are also seeing signs that the opioid crisis is spreading to other parts of Canada.

For example, seizures of fentanyl have increased in almost every province over the last year.

Our government is responding. We are taking actions that are compassionate, collaborative, comprehensive, and evidence-based in our approach to drug policy. Our aim is to take a public health approach to addressing the opioid crisis and problematic substance use in general, while also ensuring law enforcement officials have the tools they require to keep communities safe.

That is why, last fall, the Minister of Public Safety and Emergency Preparedness and I announced the new Canadian drugs and substances strategy.

This new strategy replaces the previous approach by addressing problematic substance use as primarily a public health issue, restoring harm reduction as a key pillar of Canada's drug policy, alongside prevention, treatments, and enforcement, and supporting all those pillars from a strong evidence base.

Bill C-37 and the revised amendments our government proposed support this strategy by updating the law to focus on harm reduction measures.

Streamlining the application process for supervised consumption sites is central to this legislation.

Solid evidence shows that, when properly set up and maintained, supervised consumption sites save lives, and they do it without increasing drug use or crime in the neighbourhood.

To this end, Bill C-37 proposes to amend the current legislation in two ways. It will establish a streamlined application process that aligns with the five factors set out in the Supreme Court of Canada decision in 2011, in Canada vs. PHS Community Services Society. It will also improve the transparency by requiring decisions on supervised consumption site applications to be made public, including reasons for denying such an application.

We need to create an environment that encourages communities that want and need these sites to apply for them. I can assure the House that Bill C-37 and the revised amendments our government is proposing will ensure that communities that want and need these sites do not experience unreasonable delays in their efforts to save lives.

The first amendment specifies that should the Minister of Health choose to post a notice to seek further public input regarding an application, the public should have a minimum of 45 days to provide feedback.

Some members, and indeed members of the public as well, have questioned why we are accepting this Senate amendment. To be clear, the ministerial authority to post a public notice regarding an application for up to 90 days exists under the current legislation. Bill C-37, as introduced by our government, made that time period more flexible but retained the optional nature of the posting and the optional nature of an extra consultation. The only thing that would change with the Senate's amendment is that should a public notice for further consultation be posted, it must be posted for a minimum of 45 days.

Our government supports this amendment, as it would ensure that in the special cases where further community consultation was warranted, communities would receive a reasonable amount of time to provide comment on specific applications.

I will repeat that this consultation would not be required by legislation, and indeed, it would be the exception rather than the rule.

The second Senate amendment would give the Minister of Health the authority to establish citizen advisory committees for approved sites where deemed necessary.

Our government understands the intent of this amendment. It could be to bring together supervised consumption sites and community members. However, adding this oversight of supervised consumption sites, which is not used for any other health service as a legislated requirement, would further stigmatize their clients and potentially reduce the use of these critical facilities. As such, we respectfully disagree with this amendment.

The final amendment adopted by the Senate would require that clients of supervised consumption sites be offered an alternative pharmaceutical therapy before they consumed substances at the site. While the intention of this amendment may be to encourage the provision of evidence-based treatment options to people who use drugs, it is critical that the application process for supervised consumption sites not be hindered by additional federal requirements for immediate access to treatment services. This could impose an additional burden and make it more difficult to establish and operate supervised consumption sites.

As written, this amendment could result in charter challenges on the grounds that an individual's safety and security could be jeopardized if that person could no longer access the services offered at a supervised consumption site. It also represents significant jurisdictional issues, since it could be construed as regulating a health service or clinical practice.

In addition, repeated offers of pharmaceutical treatment could actually discourage people who are not yet ready to begin treatment from using supervised consumption sites. This would be counter to the aim of supporting communities that need these sites to save the lives of their community members.

For these reasons, our government proposes that we amend the wording to say “may” instead of ”shall” and remove subsection 2 of this amendment.

For all the reasons I just outlined, our government does not support the amendment to the motion moved by the member for Oshawa.

I also want to remind the House that this bill includes other important initiatives, because the opioid crisis is a complex problem that requires a comprehensive response.

The pathways to addiction are numerous, but they are connected through their origin in personal pain, whether that be mental or physical pain. These issues are all too often exacerbated by multiple social determinants of health, including poverty, homelessness, and lack of access to economic resources, making the reality of addiction and the path to recovery all the more difficult to navigate.

To add to this complexity, the drug environment in Canada has changed drastically in recent years. Strong drugs like fentanyl, carfentanil, and other analogs have made their way into Canada, and they are often being disguised as prescription drugs like Percocet or oxycodone, or they are mixed with other less potent street drugs, such as heroin or cocaine.

With that in mind, l would like to take this opportunity to specifically discuss the Senate amendments with respect to establishing supervised consumption sites.

This crisis is impacting high-risk, long-term drug users as well as recreational drug users who do not expect that the drug they are using could contain fentanyl. As we all know from the devastating local news reports across this country, the crisis is also affecting young people who are experimenting with drugs. That is why, in addition to important provisions regarding supervised consumption sites, Bill C-37 also includes proposals that would modernize the current legislative framework and create new law enforcement tools to confront the ongoing crisis.

For example, Bill C-37 proposes legislative measures to prohibit the unregistered import of pill presses to Canada. If passed, it would allow border officials to open international mail of any weight should they have reasonable grounds to suspect that the item may contain prohibited, controlled, or regulated goods. As well, it would grant the Minister of Health the necessary powers to quickly temporarily schedule and control a new and dangerous substance.

It is important to point out that Bill C-37 and the revised amendments our government is proposing are part of a suite of vital measures that our government has taken to combat the opioid crisis. For the benefit of the members, I think it is worth mentioning some of our government's other initiatives.

We have made naloxone available without prescription, and we have expedited the review of naloxone nasal spray to ensure that multiple formats are available to Canadians. We have granted exemptions to Insite and the Dr. Peter Centre to operate supervised consumption sites in Vancouver, and we have now issued exemptions for a total of three supervised consumption sites at fixed locations in Montreal and are expediting reviews for the approval of 18 additional sites in 10 cities: Montreal, Toronto, Vancouver, Surrey, Ottawa, Victoria, Edmonton, Calgary, Kelowna, and Kamloops.

Our government has also rescinded the prohibition on access to an important treatment option, prescription heroin, to treat more serious addictions.

We have finalized new regulations to control chemicals used to make fentanyl, making it harder to manufacture illegal substances in Canada, and we have supported the passage of the important Bill C-224, the Good Samaritan Drug Overdose Act, which I am pleased to say achieved royal assent on May 4. Finally, we are providing $100 million in federal funding to support the Canadian drugs and substances strategy, as well as an additional $10 million in emergency funding to British Columbia and $6 million in emergency funding to Alberta.

It is important that members understand that there is no single action that will end this opioid crisis immediately. There is no single law or policy that will do so. It requires comprehensive, urgent action. The adoption of the amendment our government is now proposing and making Bill C-37 law would be, however, a very important step forward in supporting a new approach to drug policy in Canada.

As proposed, this legislation would give our government and law enforcement agencies more effective tools to fight problematic substance use and provide more support to communities that are battling this crisis locally.

The amended legislation would also help our government work with partners to implement an evidence-based approach that is comprehensive and collaborative. Therefore, I encourage all members to support Bill C-37 and our approach to the Senate's amendment in order to protect Canadians and save lives. I thank my colleagues for their important work in this regard, and I thank you, Mr. Speaker, for the opportunity to discuss it.

Royal Assent

[The Speaker, Geoff Regan]

I have the honour to inform the House that a communication has been received as follows:

Mr. Speaker:

I have the honour to inform you that the Right Honourable David Johnston, Governor General of Canada, signified royal assent by written declaration to the bills listed in the schedule to this letter on the 4th day of May, 2017, at 11:30 a.m.

Yours sincerely,

Stephen Wallace

The schedule indicates that the bills assented to were Bill S-201, an act to prohibit and prevent genetic discrimination, and Bill C-224, an act to amend the Controlled Drugs and Substances Act (assistance — drug overdose).

Now I believe the hon. opposition House leader has the usual Thursday question.

Controlled Drugs and Substances Act

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of National Revenue]

Mr. Speaker, I am very pleased to rise in the House today to speak in support of Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.

As members are aware, Canada is facing an opioids overdose crisis across this country. We have seen very troubling figures and have heard many tragic stories. As stated earlier in the House, British Columbia alone saw 916 illicit drug overdose deaths in 2016, an almost 80% increase from the year before. The majority of these overdoses are due to opioids. Other parts of the country have been impacted as well, with Alberta reporting 343 apparent overdoses related to fentanyl in 2016, which is an over 30% increase from the year before. While some areas have been more acutely affected that others, drug use is not unique to one part of the country, and the potential for this crisis to spread is very real.

Our government is committed to addressing this complex public health issue through a comprehensive, collaborative, compassionate, and evidence-based approach to drug policy in Canada. To that end, the Minister of Health with support from the Minister of Public Safety and the Minister of Justice announced the new Canadian drugs and substances strategy on December 12 of last year.

This new strategy replaces the previous national anti-drug strategy with a more balanced approach for restoring harm reduction as a core pillar alongside prevention, treatment, and enforcement, and supporting these pillars with a strong evidence base. The Canadian drugs and substances strategy formalizes our government's commitment to taking an evidence-based and more appropriate health-focused approach to addressing problematic substance abuse in our country.

The bill before us would ensure a sound and modernized legislative base to support this new strategy. This comprehensive bill aims to balance protecting public health and maintaining public safety. It is designed to better equip health professionals and law enforcement with the tools they need to address this issue.

Specifically, this bill would improve the government's ability to support the establishment of supervised consumption sites as a key harm reduction measure in communities. It would address the illegal supply, production, and distribution of drugs, and reduce the risk of controlled substances used for legitimate purposes being diverted to the illegal market by improving compliance and enforcement tools.

In addition to introducing this new strategy, proposing this bill, and building on our five-point action plan, our government has taken and continues to take concrete steps to address problematic substance use. Since coming into office, our government has used all the tools available to address this issue.

One of the first steps our government took, as expressed by experts, was calling for an increase in availability of naloxone, a drug that temporarily reverses an opioid overdose. We acted quickly in this regard to remove the requirement to have a prescription to facilitate access to naloxone in March 2016. Further, our government completed an expedited review of an easier to use nasal spray version of naloxone, which, as of October 2016, is now approved for sale in Canada.

In the meantime, our Minister of Health used the extraordinary legal authorities available to her under the Food and Drugs Act to issue an interim order to allow the emergency import of naloxone nasal spray from the United States. This significant step has increased access for emergency responders and helps to address the growing number of opioid overdoses.

We have also demonstrated our support for the establishment of supervised consumption sites, a key harm reduction measure. Through a thorough and rigorous review in January 2016, Health Canada granted an exemption from the Controlled Drugs and Substances Act for the Dr. Peter Centre to operate as a supervised consumption site.

Not long after that, in March 2016, Health Canada granted Insite an unprecedented four-year exemption to continue its extremely important work in the Downtown Eastside neighbourhood of Vancouver. Insite has demonstrated time and again through a countless number of peer-reviewed research studies that it saves lives without increasing drug use and crime in the surrounding area. This four-year exemption is a positive shift from the previous annual exemptions. Just last week, Health Canada issued three new exemptions for supervised consumption sites in the city of Montreal, the first such exemptions outside of the province of British Columbia.

I do want to briefly touch upon a concern that was raised in this House by the opposition, that the views of communities would no longer be important in the assessment of an application to establish a supervised consumption site. Let me be very clear; this was actually determined by the Supreme Court of Canada. The Supreme Court of Canada determined that the Minister of Health must consider expressions of community support or opposition when reviewing such applications.

Our government is respecting the Supreme Court of Canada's decision by proposing to include these factors in this legislation. We support the need for community consultation in the application process for considering the establishment of supervised consumption sites. We understand and respect that communities may have valid concerns about a proposed site, and that these concerns deserve to be heard and should be adequately addressed by applicants in their applications. The proposed amendments would demonstrate that respect for communities is a multi-faceted issue. It means that the concerns of communities must be considered and addressed by the applicants. However, it also means that the federal government should not place any unnecessary barriers in the way of communities that need and want to establish supervised consumption sites as part of their local drug harm reduction strategy.

In order to combat this crisis head on, our government is also supporting private member's bill, Bill C-224, the good Samaritan drug overdose act, a bill that would help encourage individuals who witness an overdose to call for emergency help. It would provide immunity from minor drug possession charges for individuals who experience or witness an overdose and call for emergency assistance.

The opioid crisis is something we know we cannot fix alone. We need collaboration with all levels of government, experts, and professionals. This is why we are committed to working with our colleagues across Canada to address the opioid crisis, from medical professionals to law enforcement partners.

In November last year, the Minister of Health co-hosted an opioid summit and conference along with the Ontario minister of health. The summit and conference brought together governments, experts, and key stakeholders to address the opioid crisis and to determine a path forward. Participants heard a number of perspectives on this crisis from people who use drugs, families devastated by opioid misuse, health care providers, first responders, educators, and researchers. Provincial ministers and heads of organizations with the ability to bring about change committed to a joint statement of action to address the opioid crisis. This joint statement of action reflects a combined commitment for each participant to work within respective areas of responsibility to improve prevention, treatment, and harm reduction associated with problematic opioid use by delivering on concrete actions. We will publicly report on the progress of these actions, starting in March 2017.

In conclusion, Bill C-37 is a key example of our government's commitment to establishing a comprehensive, collaborative, compassionate, and evidence-based approach to drug policy in order to reduce the harms caused by drugs that are currently being experienced by individuals. One life lost to an opioid overdose is one too many. We need to take action now. As this bill would help save lives, I strongly encourage all the members in this House to support this very important piece of legislation.

Motions in amendment

[Joël Lightbound, Liberal, Louis-Hébert, QC]

Mr. Speaker, I think the government is doing all it can to respond to this crisis. The question allows me to point out a few things that this government has done.

Health Canada has issued a necessary exemption to Centre intégré universitaire de santé et de services sociaux to provide three supervised consumption sites in Montreal, which took nearly two years under the previous government's 26 criteria in Bill C-2, and now we are moving forward with Bill C-37.

We have made the overdose antidote naloxone more widely available. We have provided an emergency interim order to allow the importation of bulk stocks of naloxone nasal spray from the United States. We have scheduled W-18 under the Controlled Drugs and Substances Act. We have scheduled precursors to fentanyl. We have supported Bill C-224, the good Samaritan drug overdose act. We have enabled access to diacetylmorphine via Health Canada's special access program.

In addition, we have launched a five-point action plan to address opioid misuse, which focuses on better informing Canadians about the risk of opioids, supporting better prescription practices, reducing easy access to unnecessary opioids, supporting better treatment options, and improving the national evidence-based strategy. We also held a summit on opioids, resulting in 42 organizations bringing forward 128 concrete commitments to address the crisis. Also budget 2016 provides $50 million over two years, starting in 2016-17, to Canada Health Infoway to support short-term digital health activities in e-prescribing and telehomecare. That is just to name a few.

We have done a lot to respond to this opioid crisis, and Bill C-37 is one of the steps we are taking to respond to this crisis. I appreciate the member's support and work on Bill C-37.

Controlled Drugs and Substances Act

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Madam Speaker, I will be splitting my time with the hon. member for Edmonton Centre.

I am pleased to rise today to speak in support of Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts. My private member's bill, Bill C-224, the good Samaritan drug overdose act, is currently in the other place. Just like Bill C-37, it is just one piece in the harm reduction tool kit that would help to save lives.

Protecting the health and safety of Canadians is a key priority for this government. That is why on December 12, 2016, the Minister of Health, with support from the Minister of Public Safety and Emergency Preparedness, introduced Bill C-37 in the House of Commons.

This bill makes several amendments to the Controlled Drugs and Substances Act and the Customs Act in support of the government's efforts to respond to the current opioid crisis and problematic substance abuse in general.

This comprehensive bill aims to balance the important objectives of protecting public health and maintaining public safety. It is designed to better equip both health professionals and law enforcement with the tools they need to address the issue.

Over the last decade, the harms associated with problematic substances abuse in Canada have become more complex and have been changing at a rapid pace. The line between licit and illicit substances has blurred with the opioid crisis, prescription drug misuse, and the rise of new designer drugs.

The government has committed to helping Canadians affected by these problematic substances and their use. Legislative and regulatory controls are certainly an important part of this approach. However, as we know, drug use and dependency pose significant risks for individuals, families, and communities. Our approach to addressing problematic substances abuse must include preventing and treating addiction, supporting recovery, and reducing the negative health and social impacts of drug use on individuals and their communities through evidence-based harm reduction measures. This must also be a part of our approach to addressing problematic substances abuse.

Harm reduction is viewed by experts as a cost-effective element of a well-balanced approach to public health and safety. Harm reduction connects people to other services in the health and social systems related to treatment and recovery. It recognizes that individuals and whole communities benefit when people with substance misuse and addiction issues can obtain the support and services they need rather than being marginalized or stigmatized. The evidence regarding harm reduction is absolutely clear. Harm reduction measures are a critical piece of a comprehensive approach to drug control.

That is why the government is determined to take a balanced, evidence-based approach that supports rather than creates obstacles to harm reduction.

To that end, on December 12, 2016, in addition to introducing Bill C-37 in the House, the Minister of Health announced that a national anti-drug strategy would be replaced with a new, more balanced, and health-focused approach, called the Canadian drugs and substances strategy. The new strategy will strengthen Canada's approach to drug policy by providing a comprehensive, collaborative, compassionate, and evidence-based approach to the protection of public health and safety and the reduction of harm from misuse of licit and illicit substances. To reflect the new health-focused approach, the strategy will be led and coordinated by the Minister of Health, in close collaboration with her colleagues.

Canada has had successive drug strategies in place since 1987 that have aimed to balance public health and public safety. In 1992, the government launched Canada's drug strategy, which was intended to reduce the harms associated with alcohol and other drugs to individuals, families, and communities. In 1998, harm reduction was added as a pillar alongside prevention, treatment, and enforcement.

However, the balance between public health and public safety in Canada's approach to drug policy shifted in 2007, with the release of the national anti-drug strategy. This strategy reflected the previous government's priorities of public safety, crime reduction, and safe communities.

The national anti-drug strategy focused primarily on youth and illicit substance use and did not retain harm reduction as a pillar. This shift brought Canada out of step with other like-minded countries, most of which include harm reduction in addressing problematic substance abuse.

The new strategy will retain and build upon the aspects of the national anti-drug strategy that worked well and, specifically, the new strategy will maintain the existing and well-established areas of prevention, treatment, and enforcement. These pillars, respectively, aim to prevent problematic drug and substance use, support innovative approaches to treatment and rehabilitation, and address illicit drug production, supply, and distribution.

However, perhaps the most important aspect of the new strategy is that it will improve upon the national anti-drug strategy by formally restoring harm reduction as a pillar. This shift to a more health-focused approach has been welcomed by stakeholders, including the Centre for Addiction and Mental Health, and our provincial partners.

Our government is committed to ensuring that its policies under the new strategy will be informed by a strong foundation of evidence, including data related to harm reduction policies, programs, and interventions. This will enable the government to better identify trends, target interventions, monitor impacts, and support evidence-based decisions. It will help ensure that Canada has a comprehensive national picture of drug use and drug-related harms and can fully meet our international reporting requirements.

Even before the new strategy was announced, our government included harm reduction measures in our efforts to reduce the negative health and social impacts associated with problematic drug use, including the transmission of infectious diseases, overdose deaths, and stigma.

For example, under federal legislation, we have improved access to naloxone, an overdose reversal drug, by making it available without a prescription specifically for emergency use in cases of opioid overdose outside of hospital settings.

This important measure broadens access for emergency workers and will help address a growing number of opioid overdoses.

We have also demonstrated our support for the establishment of supervised consumption sites, a key harm reduction measure.

After a thorough and rigorous review, in January 2016, Health Canada granted an exemption from the Controlled Drugs and Substances Act for the Dr. Peter Centre to operate a supervised consumption site.

Not long after, on March 16, 2016, Health Canada granted Insite an unprecedented four-year exemption.

If passed, Bill C-37 would go further to support the implementation of evidence-based harm reduction measures. In particular, it would reduce the burden on communities that wish to apply for an exemption to operate a supervised consumption site.

The proposed amendments would streamline and simplify the application criteria, while ensuring that community consultation continues to be an integral part of the process. By streamlining the application and renewal process and adding a new transparency provision, applicants could be assured that the process would not cause unreasonable burden or delay.

In conclusion, our government's approach to drug policy strives to balance the important objectives of protecting public health and maintaining public safety.

The Canadian drugs and substances strategy will restore harm reduction as a pillar, alongside prevention, treatment, and enforcement, and will formalize our commitment to a comprehensive, collaborative, compassionate, and evidence-based approach to Canada's drug policy.

It would mean that harm reduction-focused policies, such as support for properly established and maintained supervised consumption sites and increased access to naloxone, would now officially be part of Canada's drug strategy.

Implementing measures proposed in Bill C-37 would be a key step in realizing the objectives of the Canadian drugs and substances strategy.

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

Mr. Speaker, I am truly honoured to stand today and talk about Bill C-307. I want to thank the member for Battle River—Crowfoot for allowing me to second this bill, for supporting me in terms of the debate, and for bringing forward this incredibly important issue. He did an excellent job talking about what the bill is about, what it will do, and why he has moved it forward. However, I will talk about a few areas that I do not think have been covered yet in this debate.

We have a record. Often when we hear we are number one or number two, it is something that we are very proud of. However, we are not and should not be proud of this particular record. Canada and the U.S. are the world's heaviest opioid users, with the rate of overdoses and deaths increasing dramatically. In 10 months in British Columbia alone we had 622 deaths. I wrote these notes yesterday. I had to revise that. It is now 623. This is in British Columbia alone. Of those, 322 have been related to fentanyl. Over 2,000 naloxone kits have been handed out, which is the antidote. Therefore, there were 2,000 potential overdoses and death might have been prevented with the use of the naloxone kits.

Back in September, I spoke in favour of the member for Coquitlam—Port Coquitlam's bill, Bill C-224, the good Samaritan drug overdose act. At that time, I talked about a young man and his wife I knew. They had both died from an overdose, leaving behind a young baby. However, I want to give another face to this crisis. I think it is important to give faces to the crisis and that it is important for the government to hear this if there is any way that it will help. I will talk about some of the evidence later, but I hope the bill will at least go to committee to get the most up-to-date evidence and to really have it looked at.

There was a young man who lived in Kamloops named Paul. I knew Paul as a very young boy. He had the cutest little smile, and he was a hockey player. I watched him grow up from someone who tottered around on skates to someone who was very skilled in the arena. He was a very fine young man. I saw Paul in September. I was at a golf tournament. I had not seen him for a long time, and I chatted with him for a while. I asked him what he was up to. He had graduated from university, he had a job with the Investors Group, he had a girlfriend, he was smiling, he was happy, and he seemed to have the world by the tail. That was in September. In October of this year there was a wedding. Paul was a groomsman at this wedding and did his duties for the day. Then he made a fatal error. He kissed his mom, and he and four friends went upstairs to the hotel room and decided to ingest some drugs. That was a fatal mistake, a silly mistake, and the wrong thing to do. The groom noticed that his friends were missing and decided to go and find out what had happened to them. He went upstairs and five of them had overdosed on fentanyl. They were unconscious. What had been a joyous occasion ended in panic, mayhem, and tragedy. There were four who lived after being given the antidote naloxone. However, Paul's mom and dad had to come and say goodbye to him. This is our neighbour.

Today, we have the premier of British Columbia, we have the health minister here, and we have this conference happening. They have said that we are the face, the whole face, of this tragedy—and people need to recognize it is a tragedy. If it has not impacted members yet, we can only hope that it does not, because in the community where I am there is Ryan's mother, there is Jordan's mother, there are way too many who have tragically made a mistake that has ended in tragedy.

I do recognize that Bill C-307 is just one tool. We have talked about its tamper resistance and abuse deterrence. It is strictly one tool in the tool box, but it is a tool that could make a difference.

We have to have many strategies and I noted that one of the questions from the Liberals was about the importance of an overall strategy. Absolutely, we need an overall strategy, and I hope the conference over the next two days will get us to a better place with an overall strategy.

However, I want to point out that it did not stop the Liberals from moving forward with Bill C-224, which they recognized made sense. Again, I would suggest that it should not stop them from moving forward with Bill C-307 or at least taking it to the next step. We moved forward on naloxone, in terms of the nasal spray. We have moved forward in many ways. Just because there is a need for a comprehensive strategy does not mean that we should not move forward with this particular bill.

I heard the Parliamentary Secretary to the Minister of Health talk about the evidence and the balloon effect. To be quite frank, the evidence is actually contradictory. She talked about the worry about a balloon effect, but she did not cite references. I will follow up to see what her sources were.

The New England Journal of Medicine, which is a very respected publication, had a study where the new formulation decreased abuse from 35% down to 12.8%. That is one piece of evidence that needs to be taken into account.

A lot of work has happened in Australia, which has shown a significant decrease. The study focused on 606 people who had regularly misused opioids and due to the tamper-resistant and abuse-deterrent formulation, there was a significant decrease in the misuse, without the balloon effect that Liberals talked about as their reason for not supporting this legislation. The balloon effect was not there. There was not a shift, in this particular study, to using other drugs. There are a number of studies that have shown that is not an issue.

There was another study done by the National Drug and Alcohol Research Centre at the University of New South Wales. Opioids were used 3,500 to 4,000 times a month and once they established the tamper-resistant and abuse-deterrent formulation, it went down to 500 in terms of usage.

What I would tell the Liberals is this is such an important issue and they need to look at this very carefully. They need to vote for it, at least at second reading, because when it gets to committee, they will be able to review the evidence. When the Americans made their decision, they had a lot of evidence and moved forward. The previous minister of health for the Province of Ontario regularly asked for Canada to move forward with this.

We would be missing an opportunity to review the latest evidence. Concerns have been expressed around pricing. Again, things have changed over the last couple of years. As a result of studies done by the House of Commons and the Senate, they recommended we move forward. Those studies are a couple of years old now, so it would give us the chance to review this in light of new evidence.

To sum up, this is not the be-all and end-all and I am hoping the conference tomorrow and much of the other work will help us at least get a handle on this. The tamper-resistant and abuse-deterrent formulation has a very important role to play and we should not miss this opportunity. This is for Jordan, Hardy, and Ryan. Today the premier, with one of the mothers, laid out 54 pictures for the minister to see. These are 54 of the 600-plus who have died in British Columbia in the last few years, deaths that can be prevented.

I support this bill. Let us check the research and evidence and send it to committee to see where we are at.

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, before I begin my remarks on this piece of legislation, I would first like to take a moment to discuss the current crisis that is facing our nation.

Across this country we are facing a national emergency that has cost lives. This tragedy is something that I think all members agree is completely unacceptable and one that we need resources and initiatives to address.

Earlier today the Minister of Health, along with the Minister of Public Safety and the Parliamentary Secretary to the Minister of Justice , met with the premier of British Columbia and her cabinet colleagues to discuss the crisis in British Columbia. The province's delegation provided parliamentarians and Canadians with a glimpse of the real human impact of this crisis. This meeting built on a trip that the Minister of Health made to Vancouver last week where she met with local first responders, the mayor, provincial ministers, and the provincial task force addressing the crisis.

How we go about addressing this crisis is incredibly important. We do not want to create potential harm or unintended effects with well-intentioned ideas. This is why any action that the federal government takes must be based on sound evidence. With this thought in mind, I would like to speak to Bill C-307, an act to amend the Controlled Drugs and Substances Act, tamper resistance and abuse deterrence.

Insofar as the intention behind the bill is to address the opioid crisis, I share the member's concerns. The minister, I, and our government commend the member for wanting to work to address this crisis; however, while I appreciate my hon. colleague speaking about this, unfortunately our government cannot support Bill C-307.

As a brief reminder to members, in the case of pills intended to be swallowed, tamper-resistant properties could, for example, make them more difficult to be crushed or dissolved. If tamper-resistant regulations were put in place, it would mean that only tamper-resistant versions of certain drugs or classes of drugs could be sold in Canada.

I would like to make the point that we strongly support tamper-resistant products and continue to encourage pharmaceutical companies to continue to make progress and invest in this technology. We also know that any strategy to address opioids needs to be comprehensive and that there is no silver bullet to address this issue.

Our government acknowledges that making tamper-resistant products mandatory has an intuitive appeal. However, Health Canada's review of the evidence concluded that the introduction of tamper-resistant versions of one drug does not reduce the overall harm of opioid misuse. This is a concern that was also echoed by many witnesses studying the opioid crisis who appeared before the Standing Committee on Health.

These conclusions came about due to a number of factors, and the minister's decision not to move forward with these regulations at this time was not taken lightly.

I should make the point here that the minister already has the ability to do what this legislation intends, under regulation, and at this time the risks outweighs the benefits. Regardless of this legislation, if evidence changes, the Minister of Health will already have the ability to take regulatory action.

However, the evidence today points to several things that do not make it possible to support the bill. First, tamper-resistance has not been shown to prevent the most common form of misuse, which is swallowing intact tablets. Second, the small number of individuals who choose to crush or dissolve a drug are more likely to switch to non-tamper-resistant drugs, including illicit drugs, than to stop misusing drugs altogether. This is also known as the balloon effect. These people may even be at increased risk of harm or death if they switch to using street drugs such as heroin or illegal fentanyl.

Beyond the minimal impact that requiring tamper-resistance would have on opioid misuse, such regulations could also negatively impact patients who legitimately need access to these drugs. I would also stress that mandatory tamper-resistant formulations primarily benefit the patent-holder. New tamper-resistant formulations can be patented and sold at substantially higher costs than their generic equivalents. Passing regulations requiring pharmaceutical companies to only produce tamper-resistant forms of their products would increase the cost to patients and provincial governments, which in many cases pay for their prescription drugs.

These extra costs are estimated to run into millions of dollars if only one drug, OxyContin, is legally required to be tamper resistant. Therefore, the minimal potential benefits simply do not outweigh the risks and the costs.

I would also like to note that tamper-resistance technology is not sufficiently developed to cover the entire class of opioids, some of which come in the forms of patches, sprays, or injectable liquids.

As members can see, it simply is not in the public interest to move forward with regulations requiring drugs to have tamper-resistant properties.

This is not to say that Health Canada is not supportive of drug companies voluntarily including tamper-resistant features in their products. That is why Health Canada released a guidance document for all opioid manufacturers that will help guide them in making their products tamper resistant, should they desire to do so.

As I said earlier, over the next two days, the Minister of Health will be hosting a summit on opioids to bring together experts, patient groups, governments, and regulators to discuss the current crisis and identify actions for moving forward, building on our five-point plan announced earlier this year.

Other actions to save lives have also been taken. We are switching the status of naloxone and improving a user-friendly nasal spray version of naloxone following an expedited review. We will also be proposing a variety of regulatory changes, including requiring both a prescription for low-dose codeine products and new warning stickers to be placed on dispensed opioids. We will be approving properly established, managed, and community-led supervised consumption sites. We will be proposing regulations to control the precursors of fentanyl. We will be allowing physicians of certain patients to apply for special access to heroin-assisted treatment under the special access program. Also we will be supporting the private member's bill, Bill C-224, the good Samaritan drug overdose act, proposed by the member for Coquitlam—Port Coquitlam, a bill that would save lives, as Bill C-224 would encourage people witnessing an overdose to call 911 by providing immunity from minor drug possession charges.

In conclusion, I would like to once again reiterate our government's support of any measures grounded in sound evidence that would help address this troubling public health crisis, and once again, I want to thank the hon. colleague for raising this issue.

As previously stated, if forthcoming evidence demonstrates that there would be a positive net benefit impact from requiring drugs to be tamper resistant, there are already existing authorities within the Controlled Drugs and Substances Act to move forward with regulations.

Health

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I would like to begin by stating that both I and our government are deeply concerned about the misuse of opioids.

Misuse causes considerable harm to families and communities. However, we also know that patients need to have access to these drugs for legitimate medical treatment of pain. This is why the Government of Canada is supporting a comprehensive approach to addressing this issue and reducing harm associated with problematic opioid use.

To do this, we are supporting properly established and managed supervised consumption sites. We are proposing regulations to control six precursors that can be used in the production of fentanyl, once again allowing physicians of certain patients to apply for access to heroin-assisted treatment under the special access program, improving access to naloxone, and supporting private member's Bill C-224, the good Samaritan drug overdose act. This bill would encourage people witnessing an overdose to call 911 by providing immunity from minor drug possession charges.

These actions are part of our five-point action plan to address opioid misuse. The plan focuses on informing Canadians about the risks of opioids, supporting better prescribing practices, reducing easy access to unnecessary opioids, supporting better treatment options, and enhancing the evidence base upon which policy decisions are made.

Other specific actions under the plan include, for example, an expedited review of easy-to-administer naloxone nasal spray, proposing regulatory changes that would require a prescription for low-dose codeine products, new warning stickers to be placed on dispensed opioids, and mandatory risk management plans for all high-potency opioids.

Within the context of our comprehensive and evidence-based response to the opioid crisis, we will not be proceeding with new regulations on controlled-release oxycodone at this time. Ultimately these regulations would not have been in the public interest.

Health Canada's review of the evidence concludes that the introduction of tamper-resistant versions of one drug would not reduce the harms associated with opioid misuse writ large. This is because the small number of people who choose to tamper with a drug are more likely to switch to another non-tamper-resistant opioid rather than stop misusing this highly addictive class of drugs. These people may even be at increased risk of harm or death if they switch to using street drugs such as heroin or illegal fentanyl, which are often being disguised as other drugs.

Further, the regulation would have increased the costs to patients that are prescribed oxycodone, because they would have been unable to purchase a lower-cost version of the drug. It would have made no sense to penalize patients with a policy that would not have the intended effect of reducing the harms of opioid misuse.

That being said, the Government of Canada is supportive of tamper-resistant features. Health Canada has published guidance for drug manufacturers that will allow them to request the review and approval of tamper-resistance claims.

I want to be clear. Our government takes the exponential growth in opioid misuse and the rising numbers of overdose deaths very seriously. Next month, the Minister of Health will be hosting a summit on opioids to bring together experts, patient groups, governments, and regulators to discuss the current crisis and identify actions for moving forward.

In closing, I would like to reiterate our commitment to improving public health and safety for Canadians. I look forward to continued collaboration with all my colleagues from across the floor on this extremely important issue.

[Bill Casey, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, I have the honour to present, in both official languages, the third report of the Standing Committee on Health in relation to Bill C-224, an act to amend the Controlled Drugs and Substances Act (assistance — drug overdose).

The committee has studied the bill and has decided to report it back to the House without amendment.