An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts

Sponsor

Jane Philpott  Liberal

Status

This bill has received Royal Assent and is, or will soon become, law.

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment amends the Controlled Drugs and Substances Act to, among other things,

(a) simplify the process of applying for an exemption that would allow certain activities to take place at a supervised consumption site, as well as the process of applying for subsequent exemptions;

(b) prohibit the importation of designated devices — unless the importation is registered with the Minister of Health — as well as prescribed activities in relation to designated devices;

(c) expand the offence of possession, production, sale or importation of anything knowing that it will be used to produce or traffic in methamphetamine so that it applies to anything that is intended to be used to produce or traffic in any controlled substance;

(d) authorize the Minister to temporarily add to a schedule to that Act substances that the Minister has reasonable grounds to believe pose a significant risk to public health or safety, in order to control them;

(e) authorize the Minister to require a person who may conduct activities in relation to controlled substances, precursors or designated devices to provide the Minister with information or to take certain measures in respect of such activities;

(f) add an administrative monetary penalties scheme;

(g) streamline the disposition of seized, found or otherwise acquired controlled substances, precursors and chemical and non-chemical offence-related property;

(h) modernize inspection powers; and

(i) expand and amend certain regulation-making authorities, including in respect of the collection, use, retention, disclosure and disposal of information.

It makes related amendments to the Customs Act and the Proceeds of Crime (Money Laundering) and Terrorist Financing Act to repeal provisions that prevent customs officers from opening mail that weighs 30 grams or less.

It also makes other related amendments to the Criminal Code and the Seized Property Management Act.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Votes

May 15, 2017 Passed Motion respecting Senate amendments to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts
May 15, 2017 Failed Motion respecting Senate amendments to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts (amendment)
May 15, 2017 Passed Time allocation for Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts
Feb. 15, 2017 Passed That the Bill be now read a third time and do pass.
Feb. 14, 2017 Passed That Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts, {as amended}, be concurred in at report stage [with a further amendment/with further amendments] .
Feb. 14, 2017 Passed That, in relation to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts, not more than one sitting day shall be allotted to the consideration of the report stage of the said bill and not more than one sitting day shall be allotted to the consideration of the third reading stage of the said bill and, fifteen minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration of each stage of the said bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and in turn every question necessary for the disposal of the report stage or the third reading stage, as the case may be, of the bill then under consideration shall be put forthwith and successively without further debate or amendment.
Feb. 1, 2017 Passed That the Bill be now read a second time and referred to the Standing Committee on Health.
Feb. 1, 2017 Passed That, in relation to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts, not more than one further sitting day shall be allotted to the consideration at second reading stage of the Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at second reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and, in turn, every question necessary for the disposal of the said stage of the Bill shall be put forthwith and successively, without further debate or amendment.

Controlled Drugs and Substances ActGovernment Orders

May 15th, 2017 / 4:55 p.m.
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Conservative

Dianne Lynn Watts Conservative South Surrey—White Rock, BC

Madam Speaker, I will be splitting my time with the member for Foothills.

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

As a member of Parliament from the Lower Mainland of British Columbia, I certainly can say that we have seen this crisis for a very long time. I am glad that the health minister has come forward to look at this issue. I would say that the community does want more to be done. This is an epidemic and I feel very strongly that we as legislators must do something. We must to anything we can to protect our kids, to protect our communities, and to protect the life of these individuals who are affected by this public health emergency. When there are close to 1,000 people dying from opioid overdoses in a single province in a single year, we need everyone involved to assist in mitigating that crisis.

When Bill C-37 came before the House in December 2016, it was tabled two days before the House rose for Christmas. I remember thinking that this piece of legislation should have been tabled months earlier, because there were some extremely important tools and changes in the bill that needed to be implemented immediately. Those had to do with the banning of the importation of unregistered pill presses, providing CBSA officers with more powers to open suspicious packages to stop the flow of fentanyl and carfentanil into Canada from China, and broadening the penalties to apply to the production, sale, importation, or transportation of anything intended to be used in the production of a controlled substance, including fentanyl.

There were other parts of this legislation that were more problematic and needed to be given more time for debate and more time for the opportunity for some amendments to come forward. I am talking about the legislative changes included in Bill C-37 that facilitated easier access to opening the injection and consumption sites in communities. In particular, there was the lack of community, police, and municipal consultation or notice in the legislation. That is why we as the Conservative opposition put forward a motion to separate the bill into two bills. One bill would have addressed all of the urgently needed measures and had unanimous support of the House and the other bill would allow parliamentarians and Canadians to have a bit more time to gather data and have a look at our communities to determine what we need to do and to look at the legislation and amendments.

It was absolutely astonishing that unfortunately, politics came into play and that motion was voted down. We could have had all of those measures in place right now.

We also wanted to hear from some expert witnesses on this issue at committee. Again, the Liberals opted not to hear from any witnesses whatsoever on the legislation and proceeded straight through to clause-by-clause study. Again, the Conservative opposition put forward amendments to the bill. They were common sense amendments, such as, obtaining letters indicating support or opposition from a municipality or a local police force, that all households within a two kilometre radius of a proposed site be notified and given the ability to offer up opinions whether they are in support or opposition, and information to be provided regarding schools, hospitals, day care centres, recreation facilities within that two kilometre radius. A defined period of time for public input and consultation, a minimum of 40 days and maximum of 90 days, would be given. Again, all of those amendments were voted down by the Liberal-dominated health committee.

The bill passed and went to the upper chamber, where amendments were made and the legislation was sent back to this House. It is now May 2017. It has been six months since the Liberals tabled this legislation and here we are debating the legislation that could have been passed through the Senate.

What part of the bill did the Senate take issue with? It was the lack of community consultation regarding injection site rule changes. That means none of the measures that had received unanimous consent from all sides of this House and the Senate have been passed.

I want to highlight the fact that had the Liberals put politics aside earlier and voted in favour of splitting the bill, those proposed pieces of legislation would be in place now, and CBSA would have the additional powers to stop fentanyl and carfentanil from coming into Canada. As well the ban on the importation of unregulated pill presses would be in place. However, these measures are still not in place and because of the importation of pills and powders, dozens of Canadian lives are being taken each and every day.

Today we are talking about three amendments made by the Senate to Bill C-37, after the Senate held five committee meetings and heard from 22 expert witnesses on this legislation.

The first amendment would ensure that there is a minimum community consultation period of 45 days prior to the approval of an injection site.

The second one would set up a citizens advisory committee of five to 10 volunteers who would be responsible for advising the approved injection site of any public concerns, including public health and safety. This is something that every community would want to support. The committee would also provide the minister with yearly updates on these matters.

The third amendment would direct those working at the site to offer users alternative pharmaceutical therapy rather than their consuming street drugs.

I was very pleased to see these amendments come from the Senate. Clearly it showed the upper chamber listened to the concerns around the issues and the lack of community consultation regarding the injection site and attempted to address some of these concerns yet again.

I am glad to hear that the Liberal government is supporting the first amendment from the Senate. I was a mayor for almost a decade, and I can say that if we do not consult with the community and do not have community buy-in on these very difficult issues, then it is doomed to fail. There must be a minimum amount of time for consultation, the gathering of information, and for input.

I am, however, very disappointed that the Liberals oppose the second amendment from the Senate. We have to look at the community as a whole and support those in need, as well as ensure that the community has a voice. Establishing an advisory committee, such as the one proposed by the Senate, would ensure that the community is engaged in an ongoing way, that it has a mechanism to voice its concerns, its support, any developing issues, and whether the site is actually working in that particular area of the community or not. It is not clear why the Liberals are so against giving communities a voice that would no doubt be very significant in any community, whether it is a large community or a small community.

On the third amendment, I find the Liberals' position somewhat baffling, because any injection or consumption site absolutely must offer an alternative to those who are using its services. Again, it is helping the individual. However, the Liberal government has changed the wording in this amendment. This has to be about saving lives.

These amendments would save lives. They would help the communities come together. This is an issue affecting all of us.

The motion put forward by the member for Oshawa to accept these amendments would provide legislation that really could have assisted, but again, the Liberals continue to refuse to allow communities a voice.

Thousands of Canadians have died from opioid overdoses. The families are affected, as are the schools, the friends, the children, the first responders, and the community at large. I look at this list. There is a mother who lost her two children within 20 minutes of each other. They were both in their twenties. Jordan was 21. Ryan was 23. Kelsey was 24. David was 21. Danny was 25. Scott was 21. Tyler was 23. These are young kids. There have to be alternatives. There has to be a community coming together and looking at this in a very holistic way. On this side of the House, that is all we want.

Controlled Drugs and Substances ActGovernment Orders

May 15th, 2017 / 5:10 p.m.
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Liberal

Sukh Dhaliwal Liberal Surrey—Newton, BC

Madam Speaker, I am pleased to address the House today with respect to amendments adopted in the Senate to Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts. I will take this opportunity to thank the Senate, the House, and their committees for their hard work in studying this bill.

I will never forget last summer, when over one weekend in July, the city of Surrey had more than 60 fentanyl overdoses within a 48-hour stretch. This was a wake-up call for residents of Surrey—Newton and many across all of Surrey, as it shed light on how bad the opiate addiction crisis had become.

Following that horrible 48-hour stretch, my office called for an immediate emergency summit. The summit was attended by representatives of all three levels of government, including Surrey-based members of Parliament and members of the Legislative Assembly, irrespective of their political stripes. We gathered together front-line workers, such as Darlene Bowyer of the Surrey Association of Sustainable Communities, Shayne Williams of Lookout Emergency Aid Society, and Brenda Locke and Mike Musgrove of Surrey Urban Mission.

We had health care officials, such as Dr. Mark Tyndall of the UBC Centre for Disease Control; Shovita Padhi representing Fraser Health authority; and Clayton Pecknold, director of police services, representing the law enforcement community; and Tonia Enger, B.C. Ministry of Public Safety and Solicitor General.

We listened that day to the stories of those who were dealing with this crisis first-hand, every day of the week. We heard about how fentanyl is an opiate narcotic that is prescribed for cancer patients to treat their pain. I learned about how it is 100 times more toxic than morphine and how it was responsible for more than half of the overdoses that occurred in British Columbia in 2015.

There is an ongoing crisis of opioid-related overdose deaths and the devastating impact that this is having on individuals and their families. Canadians are dying from drug overdoses in record numbers, with the majority of those overdoses associated with opioids. In a number of provinces, including my own British Columbia, opioid overdoses are surpassing motor vehicle accidents as a cause of death. It is evident that Canadians across the country are feeling the impact of this crisis. People from all walks of life are affected.

Substance use is an extremely complex issue, and effectively responding to it requires a comprehensive, coordinated approach. On that note, this bill was introduced in the House of Commons on December 12, 2016 by the Minister of Health. It is aligned with one of our government's key priorities, which is protecting the health and safety of Canadians. The legislation is driven by our government's goal of adopting a comprehensive, collaborative, compassionate, and evidence-based approach to drug policy.

Bill C-37 would improve our government's ability to support the establishment of supervised consumption sites, a key harm reduction measure; address the illegal supply, production, and distribution of drugs; and reduce the use of controlled substances to the illicit market by improving compliance and enforcement tools.

Today, we are here to discuss amendments proposed by the Senate in three areas of the bill, to address the following issues: the period of time dedicated to public consultation as part of an application for a new supervised consumption site, the creation of a citizen advisory committee for supervised consumption sites, and the requirement that users of supervised consumption sites be offered alternative pharmaceutical therapy.

All aspects of this legislation are important, and we must act to pass Bill C-37 without delay. My comments today will focus on key legislative proposals to modernize the Controlled Drugs and Substances Act through a strengthening of law enforcement, and the government's ability to monitor, promote, and enforce compliance. These measures would reduce the risk of diversion of controlled substances used for legitimate purposes, such as prescription opioids, to the illegal market, which contributes to problematic substance use in Canada.

The Controlled Drugs and Substances Act has been amended over the years since it came into force in 1997. However, it has not kept pace with changes seen in both the controlled substances industry and the illicit drug market.

A specific measure that this bill would employ to modernize compliance and enforcement is the alignment of inspection authorities with other federal legislation. More than 600 licensed dealers are regulated under the Controlled Drugs and Substances Act, conducting activities with controlled substances for legitimate purposes.

Health Canada inspectors are currently only able to inspect sites where authorized activities with controlled substances or precursors take place. This legislation would allow Health Canada inspectors to enter places where they have reasonable grounds to believe there are activities with controlled substances. With these new powers, inspectors will also have the power to conduct follow-up visits with establishments whose licences have been suspended or revoked. These changes would not allow inspectors to enter private residences without consent of the occupant or a warrant. Cases would continue to be referred to law enforcement officers if Health Canada's inspectors believe that illicit activities are taking place.

Bill C-37 would further improve compliance and enforcement by providing the Minister of Health with the power to compel regulated parties to provide information regarding their activities with controlled substances. This authority could only be used to verify compliance with the act, to prevent non-compliance, and to address a public health or safety threat. Access to timely information would be of great benefit to the decision-making process when responding to public health or safety risks. This is the approach in other modernized legislation, for example, the Food and Drugs Act.

The bill would also provide the Minister of Health with the ability to establish an administrative monetary penalties scheme as a way of addressing non-compliance with the Controlled Drugs and Substances Act. For example, the department would be in a position to issue fines in cases where regulated parties do not follow required protocol, which would be a valuable addition to the tool kit at Health Canada's disposal in compliance promotion. These amendments would place the act in line with other Canadian regulatory frameworks, like the Canada Consumer Product Safety Act, and the Pest Control Products Act.

Currently, Health Canada's options for compliance promotion include the sending of a warning letter, which is often ineffective, or the suspension or revocation of a licence, which may be too severe a penalty, since it could lead to a shortage of drugs used for legitimate medical purposes.

In addition, not all regulated parties are issued licences under the Controlled Drugs and Substances Act. Some are simply subject to requirements established in regulations under the act. While this legislation would allow an administrative monetary penalty scheme to be put in place, regulations would be required to exercise this power.

Another aspect of Bill C-37 would be to modernize the disposal process for seized controlled substances or any property related to a chemical offence. Current handling and disposition rules are cumbersome and complex. Law enforcement agencies are required to follow the time-consuming process of obtaining a court order and Health Canada approval before disposal can take place, which results in longer storage times. The storage and handling of seized materials of this type poses a risk to the health and safety of Canadians and is very costly. With the increase in seizures of dangerous, illicit opioids, these changes are more important now than ever before. To reduce the burden on courts, government, and law enforcement agencies, this bill introduces an expedited process for the disposal of seized materials. The proposed improvement would eliminate the need for a court order or Health Canada authorization.

Bill C-37 would also allow military police to be designated a police force under the Controlled Drugs and Substances Act. This amendment would provide military police with a greater set of tools when investigating drug-related crimes on military bases.

Military police currently have the authority to enforce offences of a criminal nature within the jurisdiction of the Department of National Defence. However, they are not covered by the Controlled Drugs and Substances Act (Police Enforcement) Regulations. The regulations allow the use of a full set of techniques, such as the possession and trafficking of drugs as part of an investigation. Without that authority, tools and techniques at the disposal of military police in the course of an active investigation are limited. RCMP support currently fills this gap, which is both inefficient and costly.

All these legislative proposals would contribute to the modernization of the Controlled Drugs and Substances Act, aiming to better balance the key objectives of protecting public health and maintaining public safety. This would be accomplished by better equipping health and law enforcement officials with the tools and authority needed to reduce the risk and harm linked to substance use in Canada.

The ultimate goal of Bill C-37 is to decrease the diversion of controlled substances to the illicit market, which is a significant contributor to Canada's opioid crisis. The problematic substance use situation we are facing as a country is an immense concern, and I stress the urgent need for the passage of this bill to help address it. I therefore urge all members of Parliament to support Bill C-37 and the amendments as a step towards ensuring the continued protection of the health and safety of Canadians.

I have been out on the ground talking to people, health professionals, and first responders. I want to thank all of them for the input they have provided over the past many months. People say that knowledge is power, and my knowledge comes from the grassroots that have brought this issue to this level.

All parliamentarians feel, whether they sit on this side or the other side of the House, that the opioid crisis a health crisis, and we have to deal with it immediately. I ask all members in the House to support the bill, and let us do it on a non-political basis.

Controlled Drugs and Substances ActGovernment Orders

May 15th, 2017 / 5:25 p.m.
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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

Madam Speaker, Bill C-37 was introduced in the House in December, and here we are in May. I think questions about the delay of this legislation coming forward are quite legitimate.

My friend and colleague, the member for Vancouver Kingsway, has stood in this House as the NDP health critic, and in public, on numerous occasions and has asked the health minister and the Liberal government why they have not used the resources of the federal government to declare a national health emergency under the Emergencies Act. We still have not received a good answer. If we had 40 to 50 Canadians a week dying from Ebola or Zika viruses, there would be no hesitation in this House or by the government in mobilizing the resources it has at its disposal.

I would like to know why the government has not entertained the idea of enacting a national health emergency to give this crisis, and he has referred to it as a crisis, the resources it needs and demands.

Controlled Drugs and Substances ActGovernment Orders

May 15th, 2017 / 5:35 p.m.
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NDP

Don Davies NDP Vancouver Kingsway, BC

Madam Speaker, last month brought with it a grim reminder for those struggling on the front lines of Canada's opioid crisis. April 14 was the one year anniversary of British Columba provincial health officer Dr. Perry Kendall's decision to declare the overdose epidemic a public health emergency in British Columbia. Unfortunately, despite a year of amplified efforts from municipalities, health professionals, and community volunteers, the overdose epidemic is getting worse across Canada, not better.

The first week of May marked the second time in less than a month that Vancouver Fire and Rescue Services reported more than 150 overdose calls in a week, responding to 168 calls. Vancouver police reported seven suspected overdose deaths for the same period.

That brings Vancouver's total to 148 lives lost to overdose so far in 2017, with 41 alone in April. Only January, with 47 suspected overdose fatalities, was deadlier in the history of British Columbia. The city is on pace to reach 400 overdose deaths this year, double the 2016 number, which was in itself a record. Overall, the province of British of Columbia is on pace for 1,400 overdose deaths in 2017; that again would be a 50% increase over last year.

In April, B.C.'s first responders once again broke the record for suspected overdose calls in a single day. BC Emergency Health Services says it responded to 130 suspected overdoses in the province on Wednesday, April 26, mere weeks ago. The previous record was 121, and that was on November 20, 2016.

Early in 2015, Downtown Eastside fire Hall No. 2 answered about 50 overdose calls a month. By December 2016, that had jumped to 438 as the opioid crisis deepened, according to data released by the city of Vancouver.

In total, Vancouver Fire and Rescue Services reported 688 overdose calls in April, the highest on record this year and a 22% increase from March. Vancouver Fire and Rescue Services has now capped the time spent by firefighters at Hall No. 2 at one year to limit their emotional and physical burnout.

Vancouver's mayor Gregor Robertson has said he feels “incredible frustration and anger” at the preventable loss of life, and directed his comments at the federal and provincial governments. He said, “This crisis is B.C.’s most tragic public health emergency in decades, and yet urgent health-care interventions that could immediately save lives are not being facilitated.” City councillor Raymond Louie has described the situation as a disaster.

As the death toll increasingly mounts, it is difficult to understand exactly what the federal government is waiting for or how it can claim progress is being made. It is time for Ottawa to stop overstating this progress and start responding to this crisis with the urgency and resources that it deserves.

Despite repeated NDP attempts to fast-track Bill C-37, the Senate delayed this critical life-saving legislation for three months. That is unacceptable in the midst of a national public health emergency.

In Canada, we had over 2,000 overdose deaths last year. That is an average of six Canadian lives lost every day. This means that in the past three months, while this bill has languished in the Senate, we should expect that at least 500 Canadians have died, perhaps preventable deaths, due to overdoses. However, given the escalation in fatal overdose rates so far in 2017, that number is likely even higher.

On the first day that the Vancouver-based facility Insite opened, it reversed 15 overdoses. Not all of those people would have died of course, but odds are that some of them would have if those overdoses had happened out on the street. Indeed, we have over a decade of clear and overwhelming evidence that supervised consumption sites save lives. There is not a shred of credible evidence to substantiate the baseless fearmongering that has shrouded this debate for too long.

Today, there will be 600 supervised injections at Insite and not one of them will result in a fatal overdose. No one has ever died of an overdose at Insite since it opened in 2003. In the immediate area around Insite, the 40 block area surrounding the facility, there has been a 35% decline in overdose deaths. People who use Insite on a regular basis are 30% more likely to enter addiction treatment.

The three months this bill unnecessarily was held up in the Senate has cost lives in our country, and that should be condemned.

In the end, I cannot imagine a more irresponsible way to respond to a health crisis than by wasting our time rehashing a settled debate on the efficacy of supervised consumption sites, when every day we delay their approval means more overdoses and more lives lost. Yet, after three months of delay, the Senate has now returned the bill to the House with three problematic amendments, motivated by those who, based on a narrow ideology, are opposed to supervised consumption sites, reject the clear evidence they save lives, and really want to obstruct or delay their opening.

These amendments, and the concepts behind them, were specifically raised, debated and rejected at the House of Commons Standing Committee on Health. They are not evidence based, they represent poor public health policy, and they are contrary to the very intent of the legislation.

I will deal with amendment 1.

Before it was amended, the bill set out a maximum 90-day consultation period with the public in order to allow the public to have its say on the site and location of the supervised consumption site. The amendment by the senators proposes to put in a minimum 45-day public consultation for these applications. There is only one reason someone would want to put in a minimum time for public consultations, and that is to slow down an application for a supervised injection site.

There is no doubt that this amendment, were it to pass, will slow down the approval process and hinder quick action in the case of emergency where we may have to open supervised consumption sites very quickly, as have volunteers and activists on the ground in Vancouver as we speak. Some people in Vancouver have opened what are called “overdose prevention clinics”, right now operating courageously outside the law because they know they are saving lives. They are risking their professional credentials. They are risking being arrested. They are risking running afoul of the law. However, they are not waiting around for an application to be approved by the minister. We have had none approved over the last several years, other than this weekend when finally two were approved in Montreal. They are opening these sites to save lives now, yet this amendment, which the Conservatives have put in, would delay the opening of a site even in an emergency basis. I will get to this in a moment, but to their everlasting disgrace, the Liberal government will support that.

Amendment 2 proposes that the minister may appoint a citizen advisory committee for each supervised consumption site. This is unnecessary and redundant because community consultation is already a core criterion in the main part of the bill. The amendment is an attempt to delay supervised consumption sites and try to create public opposition to them. Last, site decisions should be health based. Community input, as I have already stated, is already provided for in the body of the bill.

Finally, amendment 3 would require a person who is operating a safe injection site to offer what is called “alternative pharmaceutical therapy” to each person entering that facility before the person consumes a controlled substance. First, that provision is very likely unconstitutional and outside the power of the federal government. Second, it is unnecessary because treatment options are already part of harm reduction facilities. Had any of those senators bothered to go to Insite and tour that facility, they would have been told that all over that facility anyone entering it is exposed to treatment modalities of all types. Third, such an amendment would be counterproductive because it could have the effect of discouraging some clients from entering and using supervised consumption sites.

Do not take my word for it. When Bill C-37 was being debated before the House of Commons Standing Committee on Health, the Liberal members of that committee said what I just said.

The Liberal member for Oakville cautioned the committee. He said:

...it's really important that we remember what we're doing here. This isn't designing the treatment programs and the whole care model around people with drug addictions. That's the province's responsibility.... What we're doing here is deciding who would be exempted from the Controlled Drugs and Substances Act because of medical conditions.

On the 45-day minimum consultation, the Liberal member for Charleswood—St. James—Assiniboia—Headingley told the committee:

I have a very quick point to the question that was asked about what the harm would be in 45 days [as a minimum consultation period] and whether it would matter.

The question I would ask in return is if there's an urgent enough need....the day that Insite opened, they reversed 15 overdoses. Multiply that by 45 potential deaths. Does that matter? I would say it does.

The Liberal member for Calgary Skyview reminded the committee of this. He said:

Time is of the essence when we are setting up these clinics. This amendment will constrain or tie the minister's hands for 45 days in terms of taking any action. Look at all the lives that may be lost in that delay.

Those are my comments.

It will be interesting to see if those members of the health committee, who sat with me when we heard from witnesses about the opioid overdose crisis due to a New Democrat amendment to study that very issue, will stand and vote with the New Democrats in opposing these three amendments that are contrary to the intent of the bill and actually make opening supervised consumption sites more difficult or more difficult for clients to access.

Those on the front lines of this crisis are unanimously opposed to these amendments because they know that they will delay the opening of critical public health facilities. Canada's New Democrats will stand with them, because we support sound, evidence-based health policy. We support these critical public health facilities that save lives. We therefore oppose these ill-advised amendments and we are deeply disappointed that the Liberal government would ignore evidence-based decision-making by agreeing to support any of them.

There is no reason to believe that this crisis is over, under control, or indeed will not continue to get worse with the proliferation of carfentanil in our communities. We need to fast-track the opening of supervised consumption sites and expand opioid substitution programs. We need better pain management regimens and substantial investments in addictions treatment across the board. These are needed to start the tectonic shift to transform how we think about addiction and to create better policies to address it after a decade of moralizing and criminalizing what is a public health issue.

First we must make long-term investments in mental health programs and addictions research. Canadian mental health experts, including the Public Health Agency of Canada, do not yet have an explicit understanding of the relationship between drug and mental health issues. Research identifying these associations will aid in defining the upstream mental health factors contributing to substance misuse. These factors can form the foundation of targeted and proactive mental health strategies, including community-based treatment and support programs for youth, indigenous people, women, and any other group that requires special support. Research shows that 70% of mental illness begins in childhood or adolescence, and those suffering are twice as likely to have a substance use problem.

In addition, national tracking of co-morbidity of mental illness and drug-related fatalities, similar to what is done in the U.S. and Australia, would enable faster access and a better understanding of trends for use in the development of targeted solutions.

In short, we need to know more, we need to invest more, and we need to devote more efforts to acquire the science and knowledge to address this public health crisis.

Second, we need substantial investments in addictions treatment across the board, and by that I mean significant new funding by all levels of government, in a myriad of modalities, for all distinct populations.

I will stop and point out that my Liberal colleague mentioned the $10 million given by the Minister of Health to British Columbia. That was in 2016. The current 2017 budget tabled in this House devotes zero dollars to address the emergency opioid overdose crisis in this country.

There is currently an unacceptably narrow portal for access to detox services and an appalling lack of publicly funded longer-term treatment beds. In Vancouver, where I have the privilege of representing a riding, it takes an average of eight days to access detox services. That is directly contrary to everything we know about addiction. If someone is willing to get treatment, we have to get them into treatment right away. If we wait even a day, that moment is usually lost.

In truth, effective treatment is really only available to those who can pay or are desperate enough to go into debt to access it. It is not unusual to have to pay $10,000 or more a month to receive timely access to quality addiction treatment facilities in Canada, a shocking gap in our so-called universal heath care system.

This has to change, and we must start building the infrastructure to provide universal access to essential health services for everyone suffering from substance use disorder. Different treatment modalities are needed for different populations, including treatment centres for youth, women, men, and indigenous Canadians. They must be built like any other health care facility and cover treatment for existing ones. It is time to start treating addiction as a bona fide health issue, and that means public coverage for effective treatment universally delivered.

Third, much of the opioid dependence and addiction phenomenon has been driven by millions of Canadians who cannot find effective treatment for chronic pain. This must be acknowledged and addressed.

Access to multidisciplinary pain management programs such as physiotherapy, weight loss, nutrition, massage, and counselling have been shown to improve pain treatment outcomes, as well as reduce the inappropriate use of pain medications, including reliance on opioids, which are highly addictive. Multidisciplinary management of chronic pain also has the potential to produce significant cost savings in health care expenditure by restoring lost workplace productivity and reducing hospitalization.

Access to effective interdisciplinary chronic pain treatment currently varies widely by province and territory, is particularly lacking in rural areas, and wait times are long. The cost is often prohibitive, as visits to non-physician health professionals are paid through private sector insurance or usually out of pocket. Therefore, we must prioritize the development of these chronic pain centres by supporting provincial and territorial efforts to establish and expand these programs.

Fourth, we must expand alternative treatments for people with chronic opioid addictions who are not benefiting sufficiently from available treatments such as oral methadone. For example, the SALOME study found that patients receiving medically-prescribed heroin, or diacetylmorphine, are more likely to live longer than someone receiving methadone maintenance therapy, more likely to stabilize their lives, and more likely to seek long-term treatment. Despite this, Vancouver's Providence Crosstown Clinic remains the only harm reduction treatment centre in North America where diacetylmorphine is used for treating long-term users.

This has to change, and change now. We need to encourage the opening of medically prescribed diacetylmorphine facilities across the country and ensure access to this phenomenally successful program to everyone who qualifies for and wants it. Let us be realistic. These policy initiatives will require a substantial allocation of resources after being chronically underfunded, indeed some actively opposed, by successive federal governments.

I have returned to the House day after day, month after month, and now year after year to push the Prime Minister and the Minister of Health to see the shocking scale of human suffering involved with this crisis, each time with news of a new horrifying record-breaking number for overdose deaths in my home city, province, and now across the country. On this point, I feel I must be blunt. Canadians' patience with the Liberal government has become exhausted. They no longer wish to listen to platitudes while Canadians continue to die.

Prior to the release of the last budget, the Prime Minister travelled to Vancouver and promised the crisis would no longer be ignored. He pledged, “There are no barriers to the federal government being able to do exactly what it needs to do. We will ensure resources are available”. Shockingly, budget 2017 fails to allocate the resources necessary. As former vice-president Joe Biden used to say, “Don't tell me what you value, show me your budget, and I'll tell you what you value.”

While the Liberals may pay lip service to progressive values, their funding decisions do not back them up. That is why at a recent town hall forum the Prime Minister was called out by harm-reduction worker Zoe Dodd, who accused his government of not going far enough to combat this epidemic, saying, “We need millions of dollars. I am a frontline worker who has not been on the job for the last six weeks because people keep dying around me, and I'm completely traumatized.”

These overdoses are not merely statistics. They are someone's son, daughter, sister, or brother. They are someone's mother or father, aunt, uncle, cousin, or colleague. They may even be someone we know. It is time the House came together and gave them the support they need.

Controlled Drugs and Substances ActGovernment Orders

May 15th, 2017 / 6:05 p.m.
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Liberal

Ken McDonald Liberal Avalon, NL

Mr. Speaker, we are here today to discuss the amendments to Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.

I would like to start my remarks by thanking the Standing Committee on Health, and the Standing Senate Committee on Legal and Constitutional Affairs, as well as members of both Houses of Parliament for their time and expertise in the review of Bill C-37.

This bill proposes a number of amendments to the Controlled Drugs and Substances Act and other acts, to support our government's efforts to address the current opioid crisis, as well as problematic substance abuse more generally. I will focus my remarks on Bill C-37 and the opioid crisis in Canada.

Canada is in a public health crisis due to an increasing number of opioid-related overdoses and deaths. The reality is that individuals, families, and communities across Canada are losing loved ones to this crisis, and it is more and more likely that the majority of Canadians know someone, directly or indirectly, who has been impacted.

Until very recently, only British Columbia and Alberta regularly reported on opioid overdoses and deaths. While I cannot speak about a national picture of overdoses and deaths due to drug substances, it is clear that the numbers we do have are rising. For example, in British Columbia, 931 people died of drug overdoses in 2016, an increase of 80% from 2015. In Alberta, 343 fentanyl-related deaths occurred in 2016, an increase of 33% from 2015.

According to Ontario's chief medical officer of health, approximately one in every 170 deaths in Ontario is related to opioid overdose. Furthermore, we all see the severity, through daily news articles that outline the number of overdoses and deaths from the night before. The news cannot be ignored. People are suffering and people are dying.

Our government has already taken many actions to date to address this crisis. These actions include commitments in the areas of prevention, treatment, harm reduction, and enforcement, all supported by strong evidence-based and targeted public health emergency response.

In addition, recognizing that provinces, territories, and other stakeholders have an important role to play, the Minister of Health co-hosted an opioid conference and summit in November 2016, which brought together a broad range of stakeholders for a national dialogue on actions to address and reduce the harms related to opioid use in Canada.

In December 2016, the Canadian drugs and substances strategy was introduced, replacing the national anti-drug strategy with a balanced and health-focused approach. Also, Health Canada funded the Michael G. DeGroote National Pain Centre, at McMaster University, to lead a project to update the Canadian guideline for safe and effective use of opioids for chronic non-cancer pain, which was published this May. The goal of the updated guidelines is to maximize the benefits of opioid therapy for chronic non-cancer pain, while reducing the risk of harm.

Bill C-37 was introduced on December 12, 2016. As mentioned, it proposes a number of amendments to the Controlled Drugs and Substances Act and other acts to support our government's efforts to address the current opioid crisis, as well as problematic substance use more generally. For example, it makes important proposed changes to the establishment of supervised consumption sites. Currently, supervised consumption sites are governed by the Respect for Communities Act. This act requires that applicants interested in establishing supervised consumption sites address 26 criteria in their application. Further, to renew an exemption for an existing site, the same 26 criteria must be addressed, as well as information related to two additional criteria.

Many experts agree that this administrative burden makes it difficult for supervised consumption sites to be created in communities that need them.

Evidence guides our government's current approach to drug policy, and Canadian and international research shows that when properly established and maintained, supervised consumption sites can and do save lives and indeed improve health. Without compromising the health and safety of those operating the site, its clients, or its surrounding community, Bill C-37 proposes to relieve the administrative burden on communities seeking to establish a supervised consumption site.

Rather than 26 criteria, Bill C-37 proposes five factors to be included in applications. These factors examine the impact on crime rates, the local conditions indicating need, the regulatory structure in place to support the facility, the resources available to support its maintenance, and the expressions of community support or opposition. Streamlining the application and renewal process and adding in a new transparency provision means that applicants can be assured that the process will not cause unreasonable delay. If assented to, Bill C-37 would support the establishment of supervised consumption sites by showing communities that their voices would be heard and that each application would be subject to a comprehensive review.

Also, for renewals, a new application would no longer be required. Instead, a renewal would simply be requested by informing Health Canada of any changes to the information that was submitted as part of the site's last application. If a community is benefiting from an existing supervised consumption site, then why would the federal government make it burdensome for their application to be renewed?

The Senate has adopted amendments to Bill C-37 that focus on further involving the public in their input regarding supervised consumption sites. Our government supports one of those amendments fully, the amendment to establish a minimum consultation period of 45 days when the minister chooses to post a public notice of consideration in cases where there may be extenuating circumstances.

However, our government does not support the second amendment, which is to allow for citizen advisory committees for supervised consumption sites. By setting out a mechanism for oversight that does not apply to any other health service, this would add stigma to the use of harm reduction services at a time when the focus needs to be on saving lives.

Finally, our government seeks to amend the provision requiring an offer of alternative pharmaceutical treatment at supervised consumption sites. While we share the goal of improving access to treatment, the mandatory wording could pose an additional burden to applicants seeking to establish supervised consumption sites. I repeat that this cannot be risked during such a time of urgent need.

Bill C-37 also contains additional provisions to reduce the availability and harm of street drugs. Another pressing aspect of the opioid crisis is that street drugs are being made more and more potent as they are being laced with fentanyl. Illegal fentanyl, often imported, is increasingly available, and overdoses are occurring when individuals are not aware of the potency of the substances they are using. This includes counterfeit pills made using pill presses and encapsulators. Currently, these devices can be and are legally imported into Canada by anyone, with no specific regulatory requirements.

HealthAdjournment Proceedings

May 15th, 2017 / 6:55 p.m.
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NDP

Tracey Ramsey NDP Essex, ON

Mr. Speaker, earlier this year in question period, I asked the government for immediate action on the opioid crisis. I said that we cannot afford to wait for Bill C-37 to wind its way through the parliamentary process. Ironically, months later, while this legislation has made progress, it has not yet received royal assent.

At the time, I asked the government to provide immediate and direct support to communities like those I represent in Essex which continue to grapple with this public health emergency. Unfortunately, this crisis continues to spiral. Front-line workers do not have the resources that they need. People in my community are frustrated and angry by the lack of response from the government.

Earlier today, the Minister of Health spoke about emergency funding to B.C. and Alberta. I would like to remind her that communities across Canada need emergency funding. Small communities especially are struggling to deal with this issue when there is not a holistic plan. We need care in this country that sees people from detox through transition and into rehab. That is very difficult to find in small communities. We need the government to step up with the resources necessary to bring this crisis under control.

In my riding of Essex, youth addiction is a significant issue. In fact, our county has the seventh highest rate of youth addiction in the province. People in law enforcement feel that their hands are tied and they are stuck in the cycle as well. They pick up the same person, bring him or her to the hospital, and then the person is back on the street again. They want to be part of the solution, but there is currently no way for them to participate in that.

Families are feeling desperate. When a loved one experiences an addiction, the parents and the family struggle so much. It is life or death. They try to support their loved one in getting help, but there are so many gaps in the system that it often feels like the system is working against them. Families are doing all they can to help each other.

This morning I spoke with a woman from my riding who was trying to help another family save their child. Fortunately, she was able to get her daughter into treatment and her daughter is healthy today, but this is not the case for everyone. If it were not for Narconon and family support systems that are popping up, we would have no formal way for people to be able to find out what treatment is available to them.

When someone with an addiction is ready to detox and then go to rehab, it is often the beginning of a frustrating experience of running up against the common problems of lack of beds, long wait lists, and a complete lack of resources. People with addictions simply cannot get the help they need and sadly, this can have tragic consequences. People not being able to get into help is heartbreaking.

I have met with some of these families. They have visited me in my office. It is a very emotional conversation with people who are struggling to get their loved ones the help that they need. I have heard their pain and sorrow, and more often, their frustration and anger. When families tell me that their only hope is that their loved one will somehow end up in jail so that their loved one can get the treatment that he or she needs, this tells us how incredibly broken our system is.

Since I held a round table several months ago, seven more people have died in our region due to opioid addictions. I implore the government to revisit its five point plan and reconsider the level of resources that this public health crisis deserves. I would like to ask what the government can offer to rural communities like those in Essex to assist with strengthening the response to the opioid crisis.

Controlled Drugs and Substances ActGovernment Orders

May 12th, 2017 / 10:05 a.m.
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Louis-Hébert Québec

Liberal

Joël Lightbound LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, I am very pleased to rise in the House of Commons 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 and to discuss the amendments adopted by the Senate. This is an important bill, as all members know, a bill that will save lives.

First, I would like to thank the Senate, the House of Commons Standing Committee on Health, and the Standing Senate Committee on Legal and Constitutional Affairs for their swift but thorough consideration of Bill C-37.

It is clear from the discussions and debates that have taken place that, while we may not always agree on a way forward, we all understand the urgency of the situation and share the same goal of saving lives and reducing the growing number of opioid overdoses.

The Senate has adopted three amendments to Bill C-37, all of which deal with the proposed application process and requirements to obtain an exemption under the Controlled Drugs and Substances Act for a supervised consumption site.

The first amendment adopted by the Senate modifies the ministerial authority to post a public notice and solicit input concerning a specific application.

The version of Bill C-37 adopted by the House of Commons proposed allowing the minister to determine an appropriate length of time for public comment, up to a maximum of 90 days. The amendment adopted in the Senate requires that any consultation must be a minimum of 45 days, and retains the previous maximum of 90 days. Our government supports this amendment.

I understand that there have been some questions from public health stakeholders on whether setting a minimum consultation period could delay applications. I want to reiterate that this consultation period is not required, but rather that a public notice can be posted, if there is a need. Such an authority would likely be used if there were concerns that community consultations were not sufficient. Further input would be helpful in making a decision in such instances, ensuring a reasonable amount of time is provided to the public to comment on a specific application. We think it makes sense. Therefore, we support this amendment.

The second amendment adopted by the Senate specifies that the Minister of Health may establish citizen advisory committees for approved supervised consumption sites where it is deemed appropriate.

While such committees could be seen as a way to maintain an open and ongoing dialogue with the surrounding community, it also represents a level of citizen oversight and influence that is not in place for any other health care service. We know that people who use drugs already face discrimination and stigmatization that can prevent them from accessing the services they need to stay alive. By including a process that could further add to the stigmatization faced by people who use drugs, this amendment runs against the intent and the spirit of Bill C-37. For this reason, our government respectfully disagrees with the second amendment.

Finally, the last amendment adopted by the Senate would require staff who supervise the consumption of substances at a site to offer clients access to an alternative pharmaceutical therapy before they consume illegal drugs at a supervised consumption site.

I would like to explain some of the concerns that our government has with this amendment as it is currently written. I want to make it very clear that our government is entirely supportive of providing immediate access to evidence-based treatment options for people living with addictions who are ready and willing to enter treatment. This would be the ideal situation. However, the situation in practice at a supervised consumption site is far more complex than simply writing the words into legislation. There are a number of factors that must be considered.

First, as I have already mentioned, people who use drugs already face significant barriers in accessing the health and social services they need, often due to stigmatization and discrimination. Supervised consumption sites are meant to be low-threshold, easily-accessible services. The more requirements or rules that are added to the process for accessing supervised consumption sites, the less accessible this service becomes to the vulnerable population it is meant to serve. Further, if this amendment is included in the legislation, I want to make it clear that none of the supervised consumption sites operating in Canada, nor most of the 18 applications that are currently before Health Canada for consideration, would meet the legislated criteria for operation. If the single word “shall” is kept in the amendment, additional requirements and burdens are automatically imposed upon supervised consumption sites and those who operate them.

This would make it more difficult to establish new supervised consumption sites in communities where they are wanted and needed. As such, requiring staff to offer immediate access to treatment could cause significant delays in the opening of any new supervised consumption sites. The purpose of Bill C-37 is to reduce burden and streamline the application process so that communities can open supervised consumption sites as part of a comprehensive plan to reduce harms associated with illegal drug use, including deaths. Given the current opioid crisis, these considerations raise major concerns for our government.

Finally, except in certain specific circumstances, regulating health care services is generally the responsibility of the provinces and territories. Our government has taken concrete action to pave a path forward towards improving treatment, for example, by removing barriers at the federal level and undertaking knowledge-exchange activities to improve awareness of the options available in Canada. However, at the end of the day, the provinces must make health care decisions based on the needs of their citizens. There are also costs associated with offering access to immediate treatment. This is something that would have to be considered by the provinces and weighted against their other health priorities.

The fact is that Canadians are dying every single day, and communities are urging us to set up supervised consumption sites to stop the overdoses and the deaths. I do not want the federal government to be what stands in the way of communities saving lives here and now. Improving access to treatment is a goal that our government will continue to support. I can assure the House that our government will continue to support future supervised consumption sites in developing a strong link with treatment services. We will encourage all potential sites to work closely with their respective provincial governments to make this happen. However, for the reasons I have just outlined, our government submits that the word “shall” in this provision must be changed to the word “may”.

By now, everyone in this room is well aware of the critical and urgent nature of the opioid crisis that has been devastating communities across the country. The rising mortality rates and drug overdoses are deeply concerning. These are real communities where real people are dying, communities where front-line workers are exhausted, and friends and families are losing loved ones. We are facing a public health crisis, and we need to work together to stop it from claiming more lives. In order to do so, our actions must be collective, comprehensive, and aimed directly at protecting the health and safety of our communities. This is a complex issue that requires a comprehensive approach.

The Minister of Health has been clear that Canada’s drug policy must be comprehensive, compassionate, collaborative, and evidence-based, and use a public health approach when considering and addressing drug issues.

To that end, on December 12, 2016, the Minister of Health announced an updated drug strategy for Canada. The Canadian drugs and substances strategy would replace the current national anti-drug strategy. This strategy formally restores harm reduction as a core pillar of Canada's drug policy, alongside prevention, treatment, and enforcement. All pillars are supported by a strong evidence base. The minister further supported this approach when she introduced Bill C-37, a bill that proposes many important legislative changes to address the opioid crisis. Problematic opioid use involves an intricate web of intersecting issues that must be addressed simultaneously, using different tactics.

Today I would like to underline the importance of continuing to move quickly through the legislative process.

First, the proposed changes contained in the bill would provide the law enforcement community with the tools needed to better address the supply of illicit opioids and other drugs in Canada and to reduce the risk of the diversion of controlled substances. The sharp rise in opioid-related overdoses and deaths has been intensified by an increase in illicit fentanyl coming into Canada. Bill C-37 would ensure that law enforcement is better equipped to keep deadly drugs like illicit fentanyl out of our communities, in a number of ways, such as making it a crime to possess or transport anything intended to be used to produce or traffic a controlled substance, allowing temporary scheduling of new psychoactive substances, and supporting faster and safer disposal of seized chemicals and other dangerous substances.

It is critical that we support members of the law enforcement community who work on the front lines of the opioid crisis. It is critical that this bill be passed quickly so we can prevent illicit opioids and other drugs from reaching our communities.

Our government is also committed to working with its partners to help reduce the harm to citizens and communities associated with problematic substance use. Evidence has shown that supervised consumption sites, when properly established and maintained, have the potential to save lives and improve health without increasing drug use and crime in the surrounding area. Bill C-37 proposes to support communities seeking to operate supervised consumption sites by streamlining the application process, as well as the renewal process for existing sites, to align with the five factors set out by the Supreme Court of Canada, without compromising the health and safety of the surrounding community.

A key component of this legislation involves ensuring that the voices of communities are heard by being more flexible and supporting the ability to tailor consultations to each community as appropriate. This improved approach preserves the requirements for community engagement. Each application would be subject to a comprehensive review, without delaying the implementation of these life-saving sites in the communities that need them the most.

We all have an important role to play in overcoming this crisis. We must support the efforts of all community members, from the volunteers, civil society organizations, health professionals, legal professionals, and of course law enforcement groups, if we are going to tackle this crisis.

The legislative changes proposed in Bill C-37 demonstrate our government's concrete support for communities grappling with this crisis by increasing law enforcement's ability to respond to the evolution of the illicit drug market and to take early action against suspected drug production operations. Furthermore, the changes proposed in the bill to remove unnecessary barriers to establishing supervised consumption sites and to emphasize community engagement would support communities by ensuring that these sites ultimately met the objectives of saving lives and reducing harm.

Our government will continue to work collaboratively with communities, provinces, territories, and key stakeholders through a comprehensive approach to drug policy.

I want to thank every one of you for your work on Bill C-37 and for your commitment to this urgent matter. We cannot turn our backs on the communities being affected by this crisis across the country.

I urge all members of the House to move forward with the proposed legislative changes, which would support communities, and ultimately, save lives.

Controlled Drugs and Substances ActGovernment Orders

May 12th, 2017 / 10:15 a.m.
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Liberal

Joël Lightbound Liberal Louis-Hébert, QC

Mr. Speaker, as the member pointed out when he talked about how we got here, one of the reasons we got to Bill C-37 is that initially, the Conservatives' Bill C-2 established 26 criteria, which were very burdensome for communities that need and want safe consumption sites, which science demonstrates save lives.

Our idea was to come back to the five criteria established by the Supreme Court and to get closer to those criteria so we could move more swiftly, because we know that every single day Canadians are dying from opioid use in this country. We need to take swift action and act decisively, with respect for the communities where they would be established. We need to make sure that where they are needed and wanted, these safe consumption sites are established.

Controlled Drugs and Substances ActGovernment Orders

May 12th, 2017 / 10:20 a.m.
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Liberal

Joël Lightbound Liberal Louis-Hébert, QC

Mr. Speaker, I thank the hon. NDP member for the question and the entire NDP party for its response to the opioid crisis and all its work in committee and in the House of Commons on Bill C-37. We know that this bill will save lives. It probably should have been introduced sooner, by the previous government perhaps, but so be it.

As far as the member's question on the amendment is concerned, it should be noted that this amendment requires a 45-day minimum consultation, if necessary. Not every request is subject to a 45-day minimum consultation. In cases where this is necessary, where there might be a need for community consultation, there would be a consultation period of no less than 45 days and no more than 90 days. In these cases, we think it is only right to give the public time to be heard.

As I said in my speech, this will only happen if there is a need for such consultation. It will be determined on a case-by-case basis.

Controlled Drugs and Substances ActGovernment Orders

May 12th, 2017 / 10:25 a.m.
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Conservative

Colin Carrie Conservative Oshawa, ON

Mr. Speaker, today we are debating a motion put forward by the Minister of Health. The motion addresses the amendments proposed by the Senate in regard to Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.

First, I want to stress that the opioid crisis continues to be an absolute tragedy. People across the country are still dying at an alarming rate, and there is no one solution to this. In fact, I think most Canadians would agree that there are many factors that have contributed to and continue to contribute to this serious issue.

When Bill C-37 was first introduced in the House, I made a point to let the minister know that my colleagues and I were very much in favour of the majority of the bill. I had the chance to take part in a health committee study that had taken place prior to the tabling of the bill which looked specifically at the opioid crisis in our country and what we were facing.

Taking part in the study allowed me to truly learn and empathize with struggling addicts, communities, first nations, health professionals, and families that have had to endure an opioid-related death. We learned that there were many factors that contributed to this crisis. While one cause of the crisis results from illegal substances and organized crime, many people are battling addiction because of the practice of over-prescribing of painkillers. Some of these causes have yet to be addressed, but I definitely think the right steps are being taken, at least for the most part.

I stated earlier that I was in favour of most of the bill, and that is because the minister recognized that tackling the production, distribution, importation, and consumption of deadly drugs needs to be made a priority. She listened to the advice of Conservatives on the health committee and in the Senate, and I commend her for that. I will not get into details about Bill C-37 as I have already had the opportunity to do so twice now, but I do think it is important to acknowledge and point to the bill's attempt to weaken public consultation in the approval of injection sites.

That is why, when I had the chance to review the Senate's amendments to Bill C-37, I was glad to put my support behind them. I will summarize the Senate's amendments.

The first amendment ensures that there is a minimum consultation period of 45 days prior to the approval of an injection site. The second amendment looks to establish a citizen advisory committee responsible for advising the approved injection site of any public concerns, including public health and safety. The amendment also looked to have the committee provide the minister with a yearly update on these matters. The third amendment directs those working at the site to offer the person using the site legal pharmaceutical therapy before that person consumes illegal drugs obtained illegally.

Unlike here in the House where the Liberals rammed the bill through with minimal debate, the Standing Senate Committee on Legal and Constitutional Affairs was able to hold five meetings and hear from 22 witnesses. That is in contrast to the health committee, which only scheduled one meeting on the bill, with only four witnesses appearing, and none of whom was the Minister of Health.

The Senate's amendments are well thought out and take into consideration communities and those battling addiction. I must admit that I was surprised to see the minister agree to the first amendment, as her colleagues voted against the same amendment brought forward by the Conservatives. I am happy that she made the right choice in ensuring that communities at least will have some chance to be involved, if only in a small way.

I do, however, want to acknowledge my disappointment with her rejection of a voluntary community committee. The minister's refusal to include community involvement in regard to injection sites goes against the majority of testimony we heard. Over and over again, witnesses at committee stated that injection sites would not be successful without community support. Community support goes beyond harm reduction advocates. It includes mothers, fathers, law enforcement, and of course the local government. The minister knows that by passing the Senate's amendment to establish a citizen advisory committee, it would demonstrate and respect the fact that not everyone wants an injection site in his or her backyard.

I want to talk about the reasons I support a community committee. By establishing a community committee, it would ensure that the injection site remains clean, and that it operates in a way that prioritizes the health and safety of Canadians. It would ensure that the minister of health, the individual who is responsible and who ultimately approves the site, remains in the loop about the community's concerns with regard to the site. It would ensure that he or she, along with the actual operators of the site, would be held accountable and to a high standard. That should be the goal. The health and safety of those battling addiction and the health and safety of all citizens should be a priority.

That is why I was shocked that the minister's motion looks to change the wording of the Senate amendment that would improve the bill. The third amendment seeks to offer pharmaceutical therapy as a substitution to an illegally obtained and possibly deadly poison. I realize that the minister's concerns lay in the fact that these sites may range in different services such as an injection site within a hospital to mobile injection sites, but what strikes me as odd is that we would discourage the use of a legal substitution for heroin such as methadone.

For those who may not know, methadone is a maintenance treatment which, according to the Centre for Addiction and Mental Health, CAMH, prevents opioid withdrawal and reduces or eliminates drug cravings. It is by offering substitutions that are legal and of pharmaceutical grade such as methadone that could lead a serious drug dependent individual to seek treatment and get the help he or she needs to get clean. Again, should that not be the goal?

The CAMH also states that an individual who is physically dependent on opioids such as heroin or fentanyl is kept free of withdrawal symptoms for 24 hours after a single dose of methadone. In contrast, a person who uses heroin or other short-acting opioids must use three or four times a day to avoid withdrawal. There is no argument here. By ensuring that users are offered legal substitution, crime rates will decrease and the likelihood of seeking detoxification treatment will go up.

I would like to read testimony from the Senate's hearing in which the minister was actually a witness.

I will quote Senator White:

I spent last Sunday night and Monday night in East Hastings with police officers and health officials walking up and down those streets and visiting some of the facilities. The biggest concern raised by community members who aren't addicts and by police officers and health officials is the use of illegal drugs.

I notice that we did see a regulatory change that will allow for the use of medical-grade heroin, but we did not see any regulatory changes that will allow for the medical use of other than medical-grade heroin.

My perspective and that of most people around supervised injection sites is that they move to the relationship between a doctor and an addict, not organized crime, a drug dealer and an addict who is committing crimes but an addict and the doctor which is where it is now. Will we see regulatory change that will allow for greater use of prescriptive pharmaceuticals rather than illegal and illicit poison? I don't want to call them drugs because they're not that.

At that time, the Minister of Health responded. She said:

Thank you for the question. It is a very good one. I encourage honourable senators to work with us in ensuring that access to all range of treatments and responses to this health problem are there. Some of this requires the decisions of provinces and territories as well as medical practitioners who obviously make decisions about what appropriate treatments are.

There is nothing in the bill and nothing in the law that would prevent provinces from expanding a treatment centre associated with a supervised consumption site to be able to allow these kind of treatments to which you are referring to work closely. I think it is an outstanding model and it's a model that we have to perhaps talk about a little more in public.

I know, senator, you are well aware of the work done in other countries. Switzerland is perhaps the best example of that. When people are determined to have opioids use disorder and/or have legal problems associated with their substance use disorder they are introduced to the possibility of being able to be prescribed medications. It certainly has been effective in decreasing crime rates in those areas, very dramatically decreasing overdose rates and treating this as a health issue.

That is what the minister said when she was a witness. Why the change? In Switzerland, they do in fact offer drug substitution as proposed in the Senate amendment, and as stated, it has led to a dramatic reduction of illegal drugs, has reduced crime rates, and has lowered overdose rates. This model has seen high levels of acceptance because rather than an addict illegally obtaining illegal drugs, the individual is able to get pharmacological help from a doctor with the goal of leading to seeking proper treatment. That is why this is so important.

This amendment would allow an individual to enter a site and be offered a legal drug by a medical practitioner as opposed to a dangerous and potentially deadly drug, a poison bought from a drug dealer. This, as I have stated, removes the potential of overdosing and eliminates criminal activity. If the Liberals really wanted to treat addiction as a health problem, they should be encouraging doctors and nurses to be at these sites administering alternatives that many addicts do not even know about.

We should not be encouraging irresponsible administering of illegal drugs that are manufactured and mixed in a drug dealer's basement lab. We know that they are being laced with fentanyl, carfentanil, and much more. We have an overdose crisis in this country. I will not object to the assertion that injection sites can temporarily save lives, as it is always better when an individual is revived, but we need to be looking at ways to prevent the overdose from happening in the first place.

I believe this amendment that would guarantee that the drug user is offered an alternative pharmaceutical therapy prior to putting something poisonous and potentially deadly into his or her body would do just that. That is why it is crucial that the Liberal government take initiative and ensure that injection sites do not become a place for people simply to get high. If injection sites are wanted in communities, they should be used to ensure that addicts are offered legal, safer alternatives to dangerous and illegal street drugs that have been obtained illegally from drug dealers, alternatives that would decrease overdose rates and decrease crime rates, which I believe should be the overall goal.

I realize that the minister has not flat-out rejected the amendment, but by changing the words “shall offer” to “may offer”, we would guarantee that the majority of users would not be offered a legal, safer alternative. We would not force diabetic Canadians who rely on insulin to commit a crime or numerous crimes to find an illegal insulin supply and to buy their treatment from drug dealers, would we?

Canadians expect their government, if it truly feels that addiction should be treated as a health problem, to provide safe treatment options and detoxification programs for those suffering from addiction. The Liberal plan, unfortunately, provides none of that. The response to this crisis has been horribly slow. We are still debating a bill that was tabled in December and communities are still seeing an increase in overdose deaths. Our country has seen no progress in increasing access to detox treatment, which is another issue that must be addressed but has failed to be addressed by the current Liberal government. We know that not all addicts are willing to go into treatment, which is why I believe that, with the certainty of many new injection sites opening up in the near future, we should at a bare minimum be ensuring that users have a choice between a poisonous street drug or a legal alternative.

In conclusion, this is how I view the situation. The motion put forth by the minister leaves out communities and eliminates the likelihood of reducing crime and overdose rates by offering legal substitution. The approval of an injection site will have a profound impact on any community. Perhaps some will be successful and some will not, but the individual approving the site, the minister of health, should be putting the health of Canadians first. He or she should be encouraging the use of pharmaceutical alternatives over illegally obtained street poison. He or she should be held accountable for the success or failure of approved sites, and not just be the individual responsible for rubber-stamping them. The minister has not even stated how she will measure that success. Will she keep statistics on how many addicts get referred to treatment and on how many are referred to detox programs?

This is why I would encourage all parties and members of this House to review very carefully the Senate amendments. They would not make the application process any more difficult and they would not slow down the approval process. All they would do is give citizens within a community that has an approved site a voice, and give those who are addicted to deadly drugs a safer alternative. In a caring country such as ours, should that not be what it is all about?

The Senate amendments were well thought out and put the health and safety of Canadians first. I challenge the Liberals to do the same. Therefore, I move:

That the motion be amended by deleting all the words after the word “That” and substituting the following: “the amendments made by the Senate to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and to make related amendments to other Acts, be now read a second time and concurred in.”

Controlled Drugs and Substances ActGovernment Orders

February 15th, 2017 / 3:25 p.m.
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Markham—Stouffville Ontario

Liberal

Jane Philpott LiberalMinister of Health

moved that Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts, be read the third time and passed.

Mr. Speaker, it gives me great pleasure to rise on the third reading of Bill C-37. I am particularly gratified at the speed with which the bill has moved through the House of Commons. I want to thank all members, including all parties, who have been very helpful in agreeing to time allocation, agreeing to expediting the committee process, and the fantastic work at the committee level to move the bill along. This demonstrates the serious nature of the bill, and recognizes the ongoing opioid crisis and the need for urgent action.

Bill C-37 is one of a range of comprehensive responses to this very challenging issue. We are eager to advance the bill through Parliament to help protect the health and safety of Canadians and their communities.

It has been said before in the House that problematic substance use is an issue that affects Canadians of all ages. It affects people from all socio-economic groups. We should also point out that there are, however, particular groups that are excessively vulnerable to the risks associated with problematic substance use, people living in poverty, people who have experienced trauma in their lives, and indigenous peoples of Canada.

We are facing nothing short of the greatest drug crisis our country has faced. It is a national public health crisis related to opioids. For example, one may draw attention to the fact that in British Columbia last year more than 900 people died from overdoses. That was an 80% increase over 2015. The majority of those deaths were related to the rapid spread of the drug fentanyl.

Elsewhere in Canada, we are hearing from law enforce officials that there are increasing numbers of seizures of fentanyl and carfentanil.

Last week, we heard about the distressing number of deaths linked to opioids in Alberta. For example, in 2016, 343 people died in Alberta from fentanyl overdoses. That was an increase over 257 the previous year.

It is necessary that the Government of Canada use every single tool at our disposal to help turn the tide on this crisis. We need a policy approach that is comprehensive, collaborative, compassionate, and evidence-based.

Bill C-37 would further strengthen our government's response to the opioid crisis.

Lest there be any doubt that we are pulling out all the stops to respond to this crisis, let me review what we have done over the past year. It includes things like ensuring naloxone, which is the antidote to overdose, is available on a non-prescription basis across the country. That involved me ensuring that we had naloxone nasal spray available on an emergency order so it would be available to Canadians, and expediting the approval of naloxone nasal spray.

We also launched Health Canada's opioid action plan. This is a plan to improve access to education for both the public, as well as prescribers, to ensure that we support better treatment options, that we reduce access to unnecessary opioids, and that we expand the evidence base.

In the matter of expanding the evidence base and getting better data, we supported McMaster University to produce guidelines for prescribing opioids in situations of chronic pain. Those new guidelines are now available for consultation.

We overturned a ban on prescription heroin so doctors might use it through Health Canada's special access programs to treat the most severe cases of addiction.

We have supported the good Samaritan drug overdose act, which offers immunity against charges for simple possession for individuals so they will call 911 if they witness an overdose and they will stay at the scene to help.

We have also put in place a number of regulations to schedule fentanyl precursors for controlled substances, making it harder for illicit substances to be manufactured in Canada.

I co-hosted, along with the minister of health for Ontario, the opioid conference and summit. At that summit, we had nine provincial and territorial health ministers. We also had 30 other organizations. We produced a joint statement of action that had 128 commitments.

In addition, in collaboration with the provinces and territories, we have put together a special advisory committee that includes the Council of Chief Medical Officers of Health. This committee is very active at ensuring we have better access to data that is up to date about the state of the circumstances.

We also have a task force within the federal health portfolio to work with all federal departments in a comprehensive response to the crisis.

We funded the Canadian research initiative on substance misuse. It is providing now evidence-based guidelines for medication-assisted treatment.

In December, I joined the Minister of Public Safety and Emergency Preparedness in introducing Canada's new drugs and substances strategy. We reintroduced at that time harm reduction as a key pillar in drug policy.

I would like to talk now a bit about what we have done to support the establishment of supervised consumption sites. Early on, we granted an exemption to the Dr. Peter Centre in Vancouver to operate a facility, and we provided an unprecedented four year exemption to Insite to continue the good work it was doing.

For communities that have demonstrated a need and desire to have such a site in their community, we want to create an environment that will encourage applicants to come forward. That is why, pending passage of the bill, we have adjusted operational procedures in the interests of removing unnecessary barriers to the review and approval of supervised consumption sites.

Just last week, I was very pleased that we were able to issue exemptions for three new supervised consumption sites at fixed locations in Montreal. The time frame to approve these sites was unacceptable. It took a year and a half, and that was due to the onerous 26 criteria that existed under the previous legislation. However, finally we were able to get an exemption for them. These new sites, located in Hochelaga, Maisonneuve and Ville-Marie districts and operated by the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, will be able to provide care for people in those areas.

Health Canada has expedited a review of 10 pending requests for approval in other communities. There is an additional site in Montreal, three sites in Toronto, two in Vancouver, two in Surrey, one in Ottawa and one in Victoria.

Even while doing this, we have maintained the key essential criteria to ensure we protect the health and safety of staff, people who use drugs, and the neighbours who are in the areas of the proposed sites. We are working with all applicants to ensure that those applications are complete and that the department has received the necessary information.

Passing Bill C-37 will be so helpful to streamline the application process and it will be a big step forward for these communities.

Some have wondered why we have not declared a public health emergency. What I have said for months is that clearly we are in the midst of a national public health crisis of unprecedented proportions related to a growing number of opioid overdose deaths. However, the Federal Emergencies Act, which was formerly called the War Measures Act, is a tool of last resort. It is there to ensure public safety and security when a national emergency cannot be addressed by any other law. This act was not used in the case of SARS, H1N1 or Ebola. It is not the right instrument, but as I have already noted, we will make use of every tool at our disposal. We have already taken extraordinary steps at the federal level, and Bill C-37 is another essential step.

Bill C-37 needs to be passed without delay. This is not a political matter or an ideological matter; it is a matter of saving lives.

With the current growing rates of opioid overdoses and deaths, we have recognized there are gaps and weaknesses in the current federal legislative framework as it relates to controlled substances. To address those under Bill C-37, we will provide the government with the ability to more easily support the establishment of supervised consumption sites, a key measure in harm reduction.

We will also address the illegal supply, production and distribution of drugs. We will reduce the risk of diversion of controlled substances that are used for legitimate purposes to the illegal market by providing improved compliance and enforcement tools.

Bill C-37 would simplify and streamline the application process for communities that want and need supervised consumption sites. It would replace the 26 application criteria with the five factors that were identified by the Supreme Court in its 2011 decision regarding Insite.

It is important for all members to understand that Bill C-37 retains the need for community consultation, and it also adds increased transparency, making it a requirement for the Minister of Health to make public decisions on applications, including any reasons for denial.

To support these proposed changes, Health Canada will post information online about what is required in applications, how the process works, and the status of applications.

Supervised consumption sites are an essential part of a harm reduction measure. There is a vast abundance of international and Canadian evidence that shows that when they are properly established and maintained, they save lives and improve health without increasing drug use or crime in surrounding areas, they prevent infection, and, best of all, they provide a safe, non-stigmatizing, non-judgmental way for people to be introduced to the health care system.

Harm reduction measures in Bill C-37 complement a number of other actions that the government is taking to protect community safety. For example, the RCMP is working with the Chinese ministry of public safety to combat the flow of illicit fentanyl and other opioids into Canada.

Bill C-37 is proposing to prohibit the unregistered importation of pill presses and encapsulators, which would make it more difficult to produce illicit drugs and, in turn, keep these illicitly produced opioids and other substances off our streets. Bill C-37 would also give border services officers greater flexibility to inspect suspicious incoming international mail. As has been said before, just a standard-sized envelope can contain enough fentanyl to cause thousands of overdoses.

Before I conclude, I want to say a few words about treatment. It is absolutely essential to understand that we will not turn this crisis around by harm reduction alone. People need to have access to the broadest range of treatment options. Delivery of health services, including the treatment of addictions, falls largely under provincial and territorial jurisdiction. That is why I am very pleased to say that this fiscal year the federal government is transferring $36 billion to the provinces and territories to support the delivery of care. With the support of the Prime Minister, we identified new funding for the provinces and territories, in the order of $5 billion for mental health over the next decade, which will help people facing mental illness, including addiction.

We need to address the social drivers of the opioid overdose crisis. That includes things like poverty, social isolation, unresolved trauma, sexual abuse, and mental illness. It is widely understood that untreated mental illness is a common cause of addiction and early intervention is absolutely essential if we are going to counter such addiction.

I want to emphasize in the House that we need to include all four pillars in our Canadian drugs policy: prevention, treatment, harm reduction, and law enforcement. Prevention is so essential, as we understand that issues like social equity are absolutely important, cultural continuity, people having the opportunity to have healthy and safe childhoods, and making sure people heal from any unresolved trauma and grief in their lives, which might drive them to problematic substance use.

There is no single action that, on its own, is going to end this opioid crisis immediately, but Bill C-37 is an absolutely essential step in the process of moving to that end. We need a balanced approach. We need to work collaboratively with all other levels of government and civil society organizations. All Canadians need to work together. We need to have partnerships across the country, including, as I said, with provinces, territories, and municipalities that are very much engaged on this matter and, of course, indigenous leaders. We need to protect Canadians, to save lives, to address the root causes of this crisis, to give people hope, and to make sure that all matters are addressed in order to turn the tide of the opioid overdose crisis.

I encourage all hon. members to recognize the importance of this bill and to support its speedy passage through the House. I look forward to working with all members to that end.

Controlled Drugs and Substances ActGovernment Orders

February 15th, 2017 / 3:40 p.m.
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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Madam Speaker, I want to thank my colleague, the Minister of Health, for her work on the health file. There is no question in my mind that she has the best interests of Canadians at heart. However, we may agree to disagree on a couple of facts.

First, we agree on this side of the House that the opioid crisis needs attention quickly and forcefully. There is no question about that. The other part of Bill C-37 refers to supervised injection sites. I think we would find on this side of the House, and, indeed, probably within each party, that there are differing opinions on that. In fact, some of the opinions are supported, clearly, by front-line police officers in terms of their safety and efficacy and public safety.

My question for the minister is this. Why did her party not allow the bill to be split into two component parts, which would have clearly allowed fulsome debate on both issues, and then, more importantly, why are Liberals shutting down debate and minimizing the amount of time that members of Parliament, who were elected to represent their communities here in the House, can debate this issue?

Controlled Drugs and Substances ActGovernment Orders

February 15th, 2017 / 3:45 p.m.
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NDP

Tracey Ramsey NDP Essex, ON

Madam Speaker, the NDP will be supporting Bill C-37. It is so incredibly important to my riding of Essex. I am holding an opioid round table this Friday with stakeholders, and very concerned families who are desperate for help for their family members, and for those in their community who are suffering under this crisis.

As a member of a committee of this House, it is incredibly important that we honour the work that is done at committee. Therefore, my question to the minister revolves around the health committee and the emergency study that it conducted into the opioid crisis. The very first recommendation that was made with all-party support was to declare opioid overdoses a national public health emergency. This would give the public health officer of Canada extraordinary powers to act immediately while Bill C-37 works its way through Parliament.

My question to the minister is this. In the face of this mounting death toll across our country, will the minister stand today and declare a national public health emergency so we can start saving lives in Canada?

Controlled Drugs and Substances ActGovernment Orders

February 15th, 2017 / 3:45 p.m.
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Liberal

Bill Casey Liberal Cumberland—Colchester, NS

Madam Speaker, I am pleased to rise on this bill because I was a member of the health committee that studied it. We heard from doctors, nurses, scientists, and police, but the most compelling testimony was from paramedics. I want to mention the paramedics from Vancouver especially, because they deal with this issue day in, day out, all day long. I do not know how they can do it repeatedly. They told stories about finding young people unconscious in alleys with needles still in them, how they would bring them back to life, and then two days later they would get another call and come back to the same situation with the same person. It was an incredible story. What we are dealing with is an incredible emergency, and Bill C-37 is designed to deal with that emergency.

I want to ask the minister this. How can passing Bill C-37 help those paramedics especially, because I do not know how they can do it, day in, day out? It must have a tremendous effect on them and their families.

Controlled Drugs and Substances ActGovernment Orders

February 15th, 2017 / 3:45 p.m.
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Liberal

Jane Philpott Liberal Markham—Stouffville, ON

Madam Speaker, I want to thank the member for his excellent leadership role on the committee, which has done such outstanding work on this crisis. He draws attention to something that is very important, which is that we need to recognize the incredible work of first responders, in particular, paramedics. The pressure on these paramedics is remarkable, and I have heard similar stories.

Bill C-37 would allow the increasing availability of supervised consumption sites so that these paramedics would have somewhere to take people where they would be welcomed, where people would know that they can be introduced safely into the health care system, and where we can prevent death from overdose. They might have an opportunity as well to be introduced to treatment when they are ready for that. Therefore, we encourage the availability of these sites, and encourage all players to make sure that we increase access to treatment so that lives will be saved, so that people will find that there is a way to find hope for their future, and so that we can also make sure that first responders are respected and do not have to go through this terrible ongoing crisis.