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.

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 co-ordinated 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.

Good Samaritan Drug Overdose Act

[The Speaker, Liberal, Geoff Regan]

The House will now proceed to the taking of the deferred recorded division on the motion at third reading stage of Bill C-224.

The House resumed from October 28 consideration of the motion that Bill C-224, An Act to amend the Controlled Drugs and Substances Act (assistance—drug overdose), be read the third time and passed.

[Kelly McCauley, Conservative, Edmonton West, AB]

Madam Speaker, I rise today to speak in support of Bill C-224, the good Samaritan drug overdose act. I thank the member for Coquitlam—Port Coquitlam for introducing this important piece of legislation.

In my riding of Edmonton West, similar to many parts of the country, we have seen a growing crisis with fentanyl and opioid use. According to the CBC, there have been 338 deaths from fentanyl overdoses in Alberta alone this year. If we think about that, it is equivalent to every member sitting in the House of Commons being wiped out since January. The numbers continue to rise, with no indication of its slowing down. It has become so bad that even the Alberta Health Services' web page cannot keep track of the number of fentanyl deaths. In Edmonton alone, there have been 102 overdose deaths since January. Even more deadly is the opioid W18, which is now showing up in Edmonton. Ironically, it was created at the U of A, but it is now hitting the streets. Recently, we have had a drug bust with enough W18 to wipe out half of the population if it were taken individually. Drugs like fentanyl and W18 are taking their toll on our cities and communities. Perhaps the most heartbreaking aspect of this crisis is that many untimely deaths could be prevented.

Dr. Charmaine Enns, chair of the Health Officers Council of British Columbia, has said, “Every year, psychoactive substances...are linked to greater than 47,000 deaths and many thousands more injuries and disabilities.... Sadly much of this carnage is preventable.”

I hope no Canadian is prevented from taking action when necessary because they fear the consequences of doing so. It is my hope that if anyone is ever in a situation in which they need to act to save someone's life, they can act without fear of repercussions, to spare a family the agony of losing a loved one, and to be able to act in the best interest of someone who needs help and in the best interests of their community. In a previous career, I experienced this first hand. I was a young hotel manager, and as I was living closest to the hotel, I would often get the first call when there was an emergency. I received a phone call from a frantic night auditor at four in the morning. I went the hotel and found four people suffering from overdoses. One had died. When the police arrived, once the people were revived, they said they had seen their friend writhing and dying but did not contact anyone for fear of being arrested. This is something that is still happening today. Therefore, I support this bill by our member.

As elected officials and lawmakers, we are obligated to take action in areas in which there is a clear and present need. In the case of unreported overdoses, it is my belief that the good Samaritan drug overdose act would fill this legislative gap.

Combatting drug-related crime requires a collaborative approach between municipal, provincial, and federal partners. Together, we must ensure that our levels of governments send a strong message to drug traffickers, while not penalizing users who are at their most vulnerable and in an overdosed state. While this bill will not change the rates of drug-related crime, something that our party has consistently taken a tough, clear stance on, it may help encourage people to take action and call emergency professionals in life-and-death situations, potentially saving the lives of hundreds, if not thousands, of Canadians from coast to coast.

As the member for Coquitlam—Port Coquitlam mentioned in committee, as I think has been noted more than once throughout the debate on this bill, there is often a barrier to accessing help in the time needed to prevent a potentially fatal situation due to fear of the consequences or legal ramifications for the person making the call. While these findings are indicative of a separate, albeit related, issue facing Canadians, namely access to banned substances, it is important that our efforts to remain tough on crime and drugs do not come at a human cost. We as lawmakers truly believe that life is worth protecting, and we need to ensure that the Canadians who need help get it.

According to the Waterloo Region Crime Prevention Council, “Fear of arrest weighs heavily on this life or death decision. People legitimately fear the police showing up, being criminally charged for drug possession, and for mothers, having their children taken away.” By removing the possibility of criminal charges against those who call emergency professionals, we are encouraging people to take life-saving action. This is especially true now, with deadly fentanyl and W18 on the streets, where ever moment's delay in receiving the miracle drug naloxone can literally lead to death.

On the issue of W18, this drug is reported to be 100 to 1,000 times more deadly than fentanyl. Oddly enough, it is just now being regulated as a controlled drug under the Controlled Drug and Substances Act, and until recently could be manufactured freely. Like others in the House, I would encourage the government to work faster on this and other W series drugs.

I would also urge the government to take steps similar to the Government of Alberta to restrict access to the pill presses used to make illegal drugs. By limiting the purchase of pill presses, table machines, and pharmaceutical mixers to only pharmacists and licensed professionals, we would take the necessary steps as Canadians to protect our communities.

Now as to the bill, it is not, as some critics have said, condoning drug use. This would ensure that drug users and addicts, in some regard the victims of drug trafficking, are provided with support and assurance that their lives still have value, and that a person acting in the injured person's best interest would not be penalized for saving a life.

I am pleased to support the bill and hope my colleagues in the House will support the bill as well.

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

Madam Speaker, I am proud to stand in the House today at third reading and support Bill C-224, the good Samaritan drug overdose act.

First and foremost, I want to thank the member for Coquitlam—Port Coquitlam for bringing this extremely important piece of legislation to the House. This is a piece of legislation that, if passed, would help to break down systematic barriers that deter people from calling 911 in the event of an overdose.

Evidence indicates that individuals are too often afraid to call for medical help in the event of an overdose. This is due to a number of concerns, one of which is fear of arrest or criminal charges. Bill C-224 would help to address this issue by providing those who experience or witness an overdose, call 911, and stay at the scene with immunity from minor drug possession charges. In other words, Bill C-224 is a harm reduction measure.

Our government is committed to protecting the health and safety of all Canadians. We recognize that problematic substance use can have devastating impacts on individuals, their families, and their communities. This is why our government is taking a balanced, comprehensive, collaborative, compassionate, and evidence-based approach to addressing the serious issue of problematic substance use. It is an approach that aims to protect both public health and public safety.

The term “harm reduction” often elicits strong reactions from people. I believe this is at least partly because it is misunderstood. I would like to take a moment to explain what it means to our government.

In general, harm reduction refers to policies, programs, or initiatives that aim to reduce the negative health and social impacts associated with problematic substance use on individuals and communities, without requiring abstention as an immediate goal. Our government has demonstrated strong support for evidence-based harm reduction measures that have been proven to help prevent the harm associated with problematic substance use, including overdose death.

However, I want to make it clear that this does not mean that harm reduction and abstention are mutually exclusive. In fact, while abstention is not the primary goal of harm reduction initiatives, harm reduction can act as a first step to meeting longer term goals such as reduced problematic use of drugs and full recovery. In other words, harm reduction measures can help pave a path to recovery by meeting people where they are in their lives right now.

Another common myth is that a focus on harm reduction is inconsistent with the objectives of drug control. Nothing could be further from the truth. It is our government's view that harm reduction is part of a comprehensive policy continuum and can complement and reinforce prevention, treatment, and enforcement initiatives. It is part of a holistic approach to addressing drug-related crime and problematic substance use.

Bill C-224 reflects these values. It melds public health and public safety interests and would provide an opportunity for law enforcement to build trusting relationships with individuals who use drugs, relationships that would help to reduce fears of calling 911 to save the life of someone experiencing an overdose.

I do not want to sell Bill C-224 as a solution that would prevent all overdose deaths. It will not. We do no favours to Canadians suffering from addiction when we debate a drug policy in black and white terms. Problematic substance use is a complex issue that requires a comprehensive response. Just like any other drug policy, Bill C-224 must work in conjunction with other initiatives to address the full scope of issues associated with problematic substance use.

That is why our government recently announced a new opioid action plan. The plan focuses on five key areas: better informing Canadians about the risks of opioids, supporting better prescribing practices, reducing easy access to unnecessary opioids, supporting better treatment options for patients, and improving the national evidence base upon which policy decisions are made.

Two of the action items under the plan were an expedited review of naloxone nasal spray, a more user-friendly version of the overdose-reverse drug, as well as an interim order to buy bulk stocks of the drug from the United States during the review process. I am pleased to say that Health Canada has completed its review and has authorized naloxone nasal spray for non-prescription use.

With federal market authorization, the manufacturer is now able to take the necessary steps to bring this drug to the Canadian market. This is a key step in helping to reduce overdose deaths, as the two crucial actions that can be taken to help save a life during an overdose are calling 911 and administering naloxone.

Also, 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 conclusion, Bill C-224 supports and complements our government's approach to drug policy and will help save lives. That is why we are supporting this extremely important piece of legislation.

As a registered nurse, I am extremely concerned about the opioid crisis occurring across Canada. We know that addressing this issue will require a comprehensive and evidence-based public health approach. Bill C-224 would be a welcome addition to our government's efforts, and I hope colleagues from all across the House will continue to support it. As many members have already stated, every life matters, and we have a duty to do what we can to help prevent these tragic accidental deaths from taking place.

This is an issue that requires a whole-of-government approach, and we are dedicated to working with our provincial and territorial counterparts, as well as experts across the country, to address this devastating crisis. As a country, we know we are facing an opioid crisis, and together, we will find a way to address this tragic situation.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, I am pleased to speak in support of Bill C-224, the good Samaritan drug overdose act. I thank the member for Coquitlam—Port Coquitlam for presenting this important piece of legislation. He has certainly worked very hard.

When I first read through the bill, I have to admit that I was a bit concerned. We are currently facing one of the worst drug epidemics that our nation has ever seen, and that is with regard to the opioid crisis. The combination of diverted pharmaceuticals, veterinary tranquillizers, and illicit drugs has created a very deadly mix of street drugs.

This past week in my riding of Lethbridge, 777 fentanyl pills were seized by the police in two separate drug raids. This is impacting every single nook and cranny within my community.

Having said that, many Canadians would agree that we need to tackle the root factors that are causing this epidemic. I agree with that. This is why we definitely need tougher laws to get drug dealers off the streets, and certainly not weaker ones. This legislation is part of a multipronged approach that should be taken in all communities across this country.

As a member of the Standing Committee on Health, I had the opportunity to examine the bill closely, and I heard from many expert witnesses from all corners of the country. Regardless of the geographical region or the sector from which they came, all of them agreed that Bill C-224 would save lives.

How exactly would this legislation do that? At the present time, when someone overdoses, there are barriers to that individual getting help quickly. For instance, young people often experiment with drugs with friends and family. In the event of an overdose, those who are with the person are often scared to call for help because they are afraid of the legal repercussions. As a result, they either do nothing, or they call 911 and then quickly flee the scene so they will not be prosecuted. As a result of this fear, young lives are lost.

When I was first made aware of this piece of legislation, I was concerned that it might allow dealers to go free or prevent police from being able to take action to shut down crack houses or illicit drug operations. After listening to the legal experts, it became clear that the bill would not provide another legal loophole for drug dealers to escape conviction. The exemptions provided in the bill only apply to those who are in simple possession.

Criminal Code offences, such as possession for the purpose of trafficking, would still apply to individuals at the scene of an overdose. Why is this important? It is important because it means that this legislation finds a balance between removing barriers to individuals having the courage to call 911, as well as preserving the power of law enforcement to convict criminals responsible for pushing these drugs on our streets. We see more than ever the organized crime rates in Canada, so it is important for me to discuss this. Again, the specific exemption within this legislation would apply to simple possession only. In this context, only those using the illicit drug, and not those who are trafficking the drug, would be exempt.

One of the heartbreaking stories we heard during my time on committee studying this legislation was from a mother who lost her 17-year-old son to an overdose. He was hanging out with his friends. There were about six people around him at the time, and they refused to call for medical assistance because they were afraid of the negative repercussions they might face. As a result, this young man's life was lost that day.

When it comes to opioid overdoses, there are simple and effective treatments such as naloxone, which can halt the effects of the opioid long enough to get a patient to hospital to receive the attention he or she needs. With the strength of illicit opioids, minutes matter in this endeavour. A few minutes can help spare a life. If bystanders were to wait for those few minutes to determine if an overdose was mild or life-threatening, that indecision could result in that person losing his or her life.

This is particularly true of young recreational drug users who have more to lose because of police involvement in an overdose. Young people who are experimenting with illegal drugs are more likely to try to keep their involvement with them a secret. As expert witnesses at committee repeatedly stressed, it is easier to deal with a drug addiction at the start of the addiction rather than caring for it later on.

Bill C-224 has the ability to facilitate early intervention and access to treatment, which I believe would serve our younger generation very well.

For addicts who are housing insecure or altogether homeless, the bill would simply puts in place what would already be common practice in many jurisdictions, and that is this. When front-line workers are called to an overdose situation, what often happens is the EMS will respond right away in order to care for that individual. Police officers will often hold back rather than going into the scene. The reason for this is because they will enter if there is a threat to medical staff or to the staff on site, let us say at a shelter. However, for r the most part they will hold back. The reason for that is because then it creates safety for concerned individuals to call EMS responders to the scene to react to the overdose.

Right now Canada is facing a significant crisis when it comes to deaths caused by opioid overdoses. In B.C., for example, the situation is so serious that public health within B.C. has declared a state of emergency. The truth is that we have been aware of this problem for a little more than a year now across our country, but there has been very little discernible action from the federal government on this file. At health committee, it was the NDP as well as the Conservatives at the table who put forward the motion to study the opioid crisis in Canada and to deliver recommendations to the health minister for consideration.

No steps have been taken to limit the import and the operation of pill press machines in Canada that enable criminal organizations to pump out hundreds of thousands of oxycodone knock-offs on a daily, monthly, and annual basis. The Liberal government reversed the Conservative regulations to move Canada toward a tamper-resistant prescription opioid, which is a very unfortunate decision. By reversing this direction, the Liberals allowed the easy conversion of legal pharmaceuticals to be used in a variety of street drugs, thus adding to the problem that we see today.

It took until last month for Health Canada to finally make naloxone a non-prescription drug and therefore accessible across Canada. Even after doing that, the provinces still need a few more months to loosen up their own restrictions to have this antidote make a real difference within streets.

The health minister finally decided that she would hold an opioid summit in mid-November. Although I am very thankful that this decision has been made, I am also disappointed with the amount of time it has taken just to achieve this. We do not need to wait for a summit this fall in order to start taking action on this file. We already know that border controls need to be ramped up. We know that Health Canada needs to make regulatory changes to limit prescription opioids that could easily be tampered with. We also know that stricter prescribing as well as tracking practices need to be implemented. We know that the over-prescribing of opioids on reserves needs to be addressed. We also need to provide treatment care for those who wish to get off of these addictions.

There is a saying on a reserve near my riding, which is “The drug dealers wear white coats”. This is made in reference to the availability of legal prescription opioids from doctors. The devastating effect this has for persons susceptible to drug abuse is tremendous. Dozens of people are dying each and every month. Dreams are being shattered. Potential is going unfulfilled and hope is disintegrating altogether.

I would contend that waiting to act on this national crisis is not an option. If we value human life, we must act now. I would contend that this requires a national strategy with regard to the opioid crisis we face in our country today. Bill C-224 is just one step, one very small step, in the massive puzzle that is needed to be put together in order to tackle this problem.

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

moved that the bill be read the third time and passed.

Madam Speaker, I want to thank all members of the House for their support of the good Samaritan drug overdose act. Members from all regions of Canada became co-seconders of Bill C-224, although the rules of the House did not allow for more than 20. It is a resounding call for the need for the legislation to be passed, and quickly. Members recognize that the bill would save lives.

In my speech at second reading, I spoke about two young men, Austin and Kelly. Austin, Kelly and countless others might still be with us today if the good Samaritan bill on drug overdose had been a law when they made that one, fatal mistake. However, we will never really know.

When I was researching the bill, even before I introduced Bill C-224, it was evident that this law is sorely needed. What I did not expect was the groundswell of support that came out shortly after the bill's first reading. Groups and individuals from every part of Canada called and emailed, telling me how much the legislation is needed. I thank them for that. Their support motivated me even more to make sure that the bill became law.

The House is steeped in democratic traditions. Our legislation process gives members the ability to scrutinize legislation. We are elected by and for our constituents to represent their values, beliefs, and desires. During second reading, I heard impassioned speeches from both sides of the House, some of which were very personal, making it clear that the good Samaritan drug overdose act had broad support.

Outside this chamber, it is the committees that continue Canada's democratic traditions. Committees give each piece of legislation more scrutiny, and the Standing Committee on Health did just that. The committee did its job well. They heard from many witnesses, from paramedics, front-line workers, Austin's mom, academics, and from drug users themselves.

For me, the most compelling testimony came from the drug-using community. That community does not feel safe and does fear law enforcement in an overdose situation. The committee heard that the bill would not go far enough, that exemptions from prosecution should be broadened beyond simple possession. I agree with that.

Studies show that fear of prosecution for possession is just one of the key reasons that people do not call 911 in the event of a drug overdose, but there are also other reasons, such as outstanding warrants and breach of probation. The bill is only one piece in the harm reduction tool kit. It is a tool kit that needs to be broadened and expanded over time.

I believe it would have been good to have broadened the scope of the bill to include outstanding warrants and breach of probation. However, that would have made the bill way too complex and controversial, lessening the chances of its passage.

If passed in its current form, the good Samaritan drug overdose act would still save lives.

I laud the Standing Committee on Health for their work on this bill and for referring the good Samaritan drug overdose act back to this House without amendment. The committee recognized the urgency of opioid deaths and how Bill C-224 is desperately needed in Canada.

The committee should also be commended for taking heed of the testimony they heard during the study of Bill C-224. The powerful testimony of witnesses led to a motion being introduced during the deliberations on the good Samaritan drug overdose act, a motion to study the opioid crisis in Canada. Now, the committee is doing just that, and I have been honoured to have participated in some of the committee's meetings on that study. We cannot delay taking action on the opioid crisis in Canada.

During the course of the deliberations on the bill, countless lives have been lost. I see it in the news every day. We do not know how many lives would have been saved if the Good Samaritan drug overdose act had been law.

Our government has been continuing to put more tools in that harm-reduction toolkit since the bill was introduced. That includes removing naloxone from the list of prescription drugs. The government is also listing the six essential ingredients that make fentanyl deadly as controlled substances.

In the coming weeks the Minister of Health will be arranging an opioid abuse summit, which will prioritize how we can start to get out of this mess.

I thank members of this House for their support of the good Samaritan drug overdose act.

I want to thank the Library of Parliament, the House of Commons legal department and the private members' business office for their incredible support on Bill C-224. There are several moving pieces to drafting and supporting legislation and without them this bill would not have happened.

Ultimately this bill needs to become law. I ask all members of the House to come together and support the good Samaritan drug overdose act to help save lives.

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

moved that Bill C-224, An Act to amend the Controlled Drugs and Substances Act (assistance — drug overdose), be concurred in.

The House proceeded to the consideration of Bill C-224, An Act to amend the Controlled Drugs and Substances Act (assistance — drug overdose), as reported (without amendment) from the committee.

[Réjean Leclerc, Chair, Syndicat du préhospitalier (FSSS - CSN)]

Thank you, Mr. Chair. Good morning, everyone.

Mr. Chair, members of the committee, I would like to thank you for having me here before you today. I am aware of what a privilege it is to appear before you so that I can contribute, however little, to the work concerning the opioid crisis.

My name is Réjean Leclerc. I have been a paramedic for over 20 years and I am currently the president of the Syndicat du préhospitalier, or FSSS-CSN, the union that represents almost 1,000 paramedics who work for Urgences-santé and provide emergency medical services to the populations of Montreal and Laval. The corporation is the only government emergency medical services body in Quebec. It has an annual budget of about $130 million and reports directly to the ministère de la Santé et des Services sociaux.

During fiscal 2015-16, the paramedics we represent were sent on 315,575 assignments serving a population of about 2.4 million people living in 744 square kilometres. This makes Urgences-santé one of the largest emergency medical services providers in Canada.

While a lot of information has already been given out about the work of this committee, we note that so far, there have been no presentations about the situation in Quebec here. Although the crisis is not comparable, at present, to what some other regions of Canada are experiencing, we are seeing a marked increase in opioid overdoses in Quebec. The Institut national de santé publique du Québec has said that the mortality rate attributable to overdoses associated with drugs and narcotics has increased in the years since 2000.

That increase primarily reflects the rise in fatal overdoses after taking opioids. From 2000 to 2012, a total of 1,775 deaths attributable to an overdose after taking opioids were recorded in Quebec, representing a rate of 2.97 deaths per 100,000 people. In addition, we have the article recently published in La Presse. According to the article, in summer 2014, Montreal was at the centre of an epidemic of overdoses linked to the use of street drugs. In the space of a few weeks, 233 cases were recorded and nearly 30 people died.

It should be noted that, according to the statistics published by the Régie de l'assurance maladie du Québec, between 2011 and 2015, opioid prescriptions had increased by 29%, rising from 1.9 million to 2.4 million. The Régie also said that the number of people who received prescriptions had risen by 10%, to 377,365 people in 2015.

In light of that information, some people will say there is a crisis and others will say there is not. But in any event, it is recognized that we have to continue collecting data on this subject, and even improve the work being done on that, in order to get a better picture of the situation and react better in real time.

It has also been brought to our attention that initiatives have been or are being proposed. Whether these consist of training and distributing naloxone kits to friends and family of people at risk of overdosing, wanting to set up supervised injection centres, creating watch groups to do a better job of identifying cases, or the wish expressed by the Collège des médecins du Québec to extend its members' investigative powers, the objective is the same: to significantly reduce the number of deaths attributable to opioid overdoses.

Because we are dedicated to our mission of reducing mortality and morbidity among our fellow citizens, we, as paramedics, support these initiatives, as well as Bill C-224, which was introduced by the member for Coquitlam—Port Coquitlam. We believe that the chances of survival of a person who is the victim of an overdose will be better once this bill is enacted, as long as the public is informed about it. The best thing is therefore to do it as quickly as possible.

Everyone agrees that paramedics provide the public with essential care. In Quebec, the responsibility for evaluating and maintaining the quality of that care rests with the physicians designated by the minister of health and social services. There is thus no professional order that governs paramedics in Quebec.

Because the paramedic profession is not officially recognized, which will be the case for another several years, does this mean that, if Bill C-224 provides for an exemption from possession of substances charges for persons present on the scene when health professionals arrive, the Quebec public would not be able to benefit from that exemption when only paramedics attend to a person who has overdosed? That is the question we have on this point.

Subject to interpretation by the experts, should Bill C-224 be amended to reflect this situation?

In addition, Mr. Chair, I would like to take advantage of the forum I am offered today to draw the attention of MPs and the public to a situation that we believe to be a matter of concern. Given the challenges inherent in the rising numbers of opioid overdoses, we would like to express our concern today about the way that Urgences-santé handles the training of paramedics in the naloxone protocol.

In November 2014, when the corporation was offered an opportunity to train all paramedics in the space of a few months, we made a proposal, following the usual procedure, to promote the rapid and uniform deployment of this antidote in Montreal and Laval. To our great surprise, Urgences-santé did not act on our request, claiming budget issues. The corporation preferred to adhere to the austerity vision imposed by the minister of health and social services and chose, in the middle of the opioid crisis, to train only a few dozen managers and paramedics. With only about 50 paramedics authorized to give this invaluable drug, that number being plainly insufficient, in our view, to meet rising demand, it was foreseeable that there would be unfortunate incidents, like the one that occurred and was recently described in La Presse by Dr. Marie-Ève Morin. In the case in question, an ambulance arrived urgently to find that when the paramedics arrived, they were not trained and also did not have the antidote with them that would have enabled them to rapidly reverse the effect of the drug ingested by the person suffering from an overdose.

What message are we, as an emergency service, sending the public when a large majority of paramedics are unable to do what is needed when they are called out to provide care in an emergency in the hope that they will make the difference between life and death?

Amending legislation to encourage the public to call 911 more often and faster is a fine thing, but if the luck of the draw results in the team of paramedics that are prepared to provide care not being authorized to act in overdose situations, we are failing in our objective and losing all credibility the first time out.

Is the public better served in Montreal and Laval today? According to the figures obtained by the CBC from the ministère de la Santé et des Services sociaux in September, only 35% of the thousand paramedics we represent have been trained to administer naloxone. We have to admit that this statistic is disturbing and seems to be incompatible with the efforts and policies supported by this committee and a number of other interested parties. In our view, this regrettable situation must be publicly denounced, until this training for Urgences-santé paramedics has been completed so that they are authorized to administer naloxone in order to save more lives.

Thank you for your attention.

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.