Madam Speaker, Canada is currently in the grips of an unprecedented opioid overdose crisis. According to David Juurlink, one of Canada's leading drug safety experts:
This is the greatest drug safety crisis of our time, and it's not hyperbole to say that every one of you knows somebody with an opioid use disorder. Whether you realize it or not, you do, and it's quite possible that you know someone who's lost a loved one to these drugs.
He went on to say:
The scope of the problem in Canada is completely unknown. We know that in the U.S., the CDC estimates that over the last 20 years, about a quarter of a million people have died from opioids, more than half of them from prescription opioids.... We have no corresponding numbers in Canada. I speculate that somewhere in the order of 20,000 Canadians have died over the last 20 years from these drugs. The fact that no federal politician can tell you that number is a national embarrassment.
In my home province of British Columbia, illicit drug overdoses claimed the lives of at least 914 people last year, making it the deadliest on record for overdoses. This places it at the same level as Alabama, the worst state in the United States in terms of overdose rates.
Last year two Ontarians died every single day from drug overdoses, with one of every eight deaths of young adults due to opioids, and 338 Albertans died last year. Quebec overdose deaths have increased by 140% over the last 10 years.
Although Canada does not track overdose deaths at the national level, which again is an inexcusable deficiency in national health policy, it is estimated that in 2015 alone, 2,000 Canadians died from overdoses. That number is certainly much higher for 2016 due to the rapid proliferation of extremely potent illicit opioids throughout Canada.
It is patently clear that drug overdoses and deaths are increasing in every region of the country and will continue to do so without extraordinary and effective action. The significant increase in overdoses in 2016 prompted B.C.'s provincial health officer, Dr. Perry Kendall, to declare a public health emergency last April for the first time in the province's history. Notwithstanding this extraordinary step, the crisis has deepened.
December saw another record spike in deaths in B.C., with Vancouver alone now registering 15 overdose deaths per week. This is truly a crisis of epidemic proportions.
Fentanyl, an opioid 100 times more potent than heroin, has been called a game-changer for drug overdose deaths in Canada, and now we are seeing overdoses caused by carfentanil, an opioid so powerful that it poses overdose risks to those exposed to it simply through inhalation or contact with their skin. These drugs are so dangerous that a dose the size of a grain of salt can cause overdose or death.
I think we can all acknowledge that there are many aspects to this complex crisis. Fentanyl is strong, cheap, easy to transport, and small amounts can be made into thousands of doses. For $10,000 or $20,000, manufacturers can obtain a kilogram of fentanyl, an amount so compact it can fit in a shoebox, and turn it into $20 million in profit.
Many overdoses are being caused by inexperienced young people experimenting with non-opioid recreational drugs, unaware that they are contaminated with fentanyl. For example, this past fall in Vancouver, there were nine overdoses recorded within 20 minutes in people who were using cocaine that was unknowingly laced with fentanyl.
Opioids have been overused and over-prescribed by doctors for pain management, leading to many patients becoming dependent and addicted. Canada has among the highest per capita volume of opioids dispensed in the world, totalling 19.1 million prescriptions in Canada in 2015, up from 18.7 million the year before. That is about one opioid prescription written for every two Canadians.
Even though there are no credible peer-reviewed studies that demonstrate that opioids afford more benefit than harm for chronic pain, opioid use has been marketed beyond palliative and cancer patients for regular use for people experiencing back pain and other common ailments. Prescribers were incorrectly taught that addiction was a rare consequence of using prescription opioids long term, that less than 1% of patients would become addicted.
In reality, the addiction rate is estimated to be 10%, with 30% suffering from opioid use disorder. This misuse of opioids reveals the absence of broad and effective treatment for chronic pain in Canada. Critically, there is an alarming lack of public detox and treatment facilities available across Canada, caused by underinvestment for decades at both provincial and federal levels, and even less resources dedicated to education and prevention.
Bluntly, our health care system has an appalling lack of publicly covered treatment options for Canadians suffering from substance use disorder, a pox on both Liberal and Conservative governments over the last number of decades.
In indigenous communities, inconsistent federal support for community governed and culturally based treatment has made addressing the opioid crisis a particular challenge. Nurses employed by Health Canada do not possess the scope of practice to support indigenous people in addressing opioid addiction in their own communities beyond 30 days by federal edict.
As Dr. Claudette Chase, a family physician at the Sioux Lookout First Nations Health Authority recently told our health committee:
I tear up every time I think about this, because our workers are putting themselves on the line to hear the stories of incredible trauma. We have little funding to train them. These are community members who, because Health Canada has refused to step up, have stepped up themselves. They do this and they get traumatized daily, and I have little or no means to support them other than being their family doctor. It's not acceptable.
Addiction is a complex psychosocial disease with genetic, environmental, and social determinant influences of every type. Although this crisis has been garnering increased media attention in recent months, make no mistake that it has been allowed to escalate for years, recently under a Conservative government blinded by superficial ideology and now under a Liberal government paralyzed by timid expediency.
What both Conservative and Liberal governments have in common, however, is a refusal to act on evidence in a timely fashion, and decades of history of failure to make the investments necessary to provide Canadians with essential health options to treat substance use disorder.
Over the last 10 years, the previous Conservative government slashed Health Canada's addiction treatment budget, removed harm reduction as one of the four pillars of Canadian drug policy, and spent nearly a decade trying to discredit the clear and overwhelming evidence that supervised consumption sites save lives.
Indeed, this crisis has undeniably been exasperated by barriers erected by a Conservative government that prevented supervised consumption sites from opening across Canada. Despite an abundance of research that conclusively established that Vancouver's supervised consumption facility, Insite, significantly reduced overdose deaths, the Conservative government obstinately refused to accept that evidence.
In 2011, it took the Supreme Court of Canada to rule that Insite and other supervised consumption sites must be granted a section 56 exemption from the Controlled Drugs and Substances Act because they “decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety”.
In response, in 2015, the Conservative government introduced Bill C-2, which sets out a lengthy and arduous list of criteria that supervised consumption site applicants must meet before the minister would grant them an exemption. In practice and by design, these criteria made it effectively impossible for organizations to open new supervised consumption sites in Canada.
For example, Montreal has had applications pending Health Canada approval since May 2015, almost two years, for three fixed services in three neighbourhoods and one mobile service. Indeed, not a single supervised consumption site has opened in Canada since Bill C-2 was passed. Of course, that was exactly the Conservatives' intention.
Only an hour after Bill C-2 was initially introduced, in a move so vile it would impress Donald Trump, Conservative campaign director Jenni Byrne issued a fundraising letter stating that the Liberals and NDP wanted addicts to shoot up in the backyards of communities all across the country. This went beyond a juvenile refusal to accept evidence that ran contrary to their moralizing ideology. It was a clear and utterly disgraceful attempt to campaign on the backs of the most vulnerable Canadians, sick Canadians.
For those Conservative MPs who now claim to have found religion on the issue, who have recently echoed the NDP's long-standing call to declare a national public health emergency, I must remind them that it was Conservatives who blocked my attempt to move this bill swiftly through the House in December, to save lives faster.
Though the Liberals claim to support the expansion of supervised consumption sites, their government has not approved a single new facility since coming to office. In fact, the Minister of Health initially and stubbornly argued that legislative changes to Bill C-2 were not even necessary, since she had directed Health Canada officials to facilitate the application process under the existing law. She refused to acknowledge that the problem was the act itself with its 26 separate requirements acting as effective barriers to any new sites, as had been consistently pointed out by stakeholders, the NDP, and even some of her own colleagues. This tepid response stood in stark contrast to the view espoused by the member for Vancouver Centre, the Liberal member for Vancouver Centre, when she was the Liberal health critic in opposition.
When Bill C-2 was introduced, the member for Vancouver Centre publicly stated that the bill was deliberately written in a way that would ensure no supervised consumption sites were approved in Canada. She also questioned the constitutionality of the bill. It has frequently been observed that Liberals campaign from the left and govern from the right, that they talk progressively in opposition, but act conservatively when in power. I am afraid their conduct on the opioid crisis is yet one more example of this unfortunate truism.
Unacceptably, it took a mounting death toll and universal pressure from medical experts, public health officials, provincial governments, municipal leaders, and the federal NDP before the Minister of Health finally relented and outlined legislative changes she was willing to make to Bill C-2, on December 12, 2016. This came on the heels of an announcement from the B.C. government that it was no longer willing to wait for federal approval and would take the extraordinary measure of signing a ministerial order making the provincial operation of temporary overdose prevention sites legal. This was in turn a response to the unsanctioned, makeshift supervised consumption sites that were being established throughout B.C. by activists like Ann Livingston and Sarah Blyth, who founded the Overdose Prevention Society last September with crowdfunding, due to the severity of the crisis.
While the current government was waiting, while people were dying, people in British Columbia and on the street were acting. Thus, the bill is an overdue acknowledgement that this is, in fact, a crisis and contains some important steps to address it.
I do want to credit the government for taking some positive measures.
The Liberals hosted an opioid summit, where they committed to better informing Canadians about the risks of opioids, supporting better prescribing practices, and improving the evidence base. They made naloxone available in a non-prescription status. They reversed the federal prohibition on the use of pharmaceutical heroin for treatment. They scheduled fentanyl precursors. They reinstated harm reduction as one of the four pillars of drug policy. Now the government has introduced amendments to the Controlled Drugs and Substances Act and other acts, to streamline supervised consumption site applications.
These changes are all welcome, if overdue, and New Democrats are in agreement with all of them. However, they do not go nearly far enough, fast enough. There is much more that we can and must do. That is why I must take serious exception to comments made by the Minister of Health in a recent interview. The minister said:
I would argue with the fact as to whether or not there's been progress made. I know that the number of deaths are rising, but we have been extremely active on this file....
I do not know how the minister measures progress, but I do know one thing. When Canadians are dying at unprecedented rates, when month after month we see increased death tolls from opioid overdoses, there can be no legitimate talk of progress. We in the New Democratic Party will measure progress by one factor and one factor only: when the death toll of Canadians goes down, not up. However by that standard, the crisis is getting dramatically worse, not better. Annually since 2012, the number of fatal overdoses in B.C. has increased significantly: 273 deaths in 2012, 330 in 2013, 366 in 2014, 510 in 2015, and now 914 in 2016.
Last month alone, we recorded the highest number of overdose deaths in B.C.'s history, with 142 lives lost. That is more than double the monthly average of overdose deaths since 2015 and a sharp increase from the fall. There were 57 overdose deaths in B.C. in September, 67 in October, and 128 in November. That is not progress.
To understand the scale of this epidemic, I would remind the House that during the SARS crisis in 2003, 44 people died in an outbreak of the disease across all of Canada. We are losing that many people every week to opioid overdoses.
I would suggest to members of the House that if 40 to 50 Canadians were dying every week from SARS, Ebola, or any other infectious disease, the House would not rest until it saw a response from the federal government that matched the severity of the crisis. Every life lost to overdose is a heart-wrenching tragedy that leaves devastated loved ones in its wake. The lives cut short by overdose matter just as much as anyone's, and this epidemic deserves the same attention and urgency as any other disease.
Moreover, we must remember that the consequences of inaction are felt severely by those on the front lines of this crisis. As Chris Coleman, a firefighter who works on Vancouver's Downtown Eastside, told the health committee:
...it takes a toll on an individual's mental health to see such helplessness and suffering up close on a daily basis; to work extremely hard but to feel that you are having little or no impact on a problem that is growing exponentially, like a tidal wave, on the streets of your city. There is mental strain in watching a population repeatedly harming itself and in ultimately witnessing death and deceased persons who have succumbed to this human tragedy....
I must stress that our brothers and sisters who work in the Downtown Eastside are in trouble.... In conversations with these firefighters, I hear a lot of “It's driving me nuts” and “I can't take it”. I'm told stories of their being in an alley with 20 or 30 drug users. They're unprepared and untrained for that. Part of their hopelessness comes from having to deal with the same particular overdose patient who has a needle in their neck, who's rolling around in urine and feces, more than once on the same shift. They feel abandoned and they feel hopeless
We must not condemn our courageous first responders to the fate of Sisyphus, rolling an immense boulder up a hill over and over again for eternity. They need the Government of Canada to have their backs.
Indeed, the federal government's failure of leadership on the opioid crisis has led to renewed pleas for help from public officials from all across Canada. These include the mayors of Calgary, Toronto, Ottawa, and Vancouver, B.C.'s health minister, and health professionals from every discipline.
I know that the Minister of Health has repeatedly stated in public that the federal government is doing everything it can. Of course, that is utter nonsense. There are literally dozens of measures and recommendations made by health experts and stakeholders across Canada that remain unimplemented by the government.
Recently, the City of Vancouver sent a list of nine recommendations to the federal government to help address this crisis, including calling for a central command structure, daily meetings with Health Canada, and improved treatment services. A coroner's jury in British Columbia recently issued a list of 21 recommendations for action, and the Standing Committee on Health in December issued a report detailing 38 recommendations for the government alone, most of which remain unimplemented.
To demonstrate this leadership and illustrate the federal government's understanding of the scope of this crisis, the New Democrats have been calling on the federal Minister of Health to declare a national public health emergency for months. We are now joined in this call by municipal, provincial, and federal politicians of all stripes, including, recently, the Conservatives.
A declaration of a national public welfare emergency under the Emergencies Act would empower Canada's top doctor with the authority to take extraordinary measures to coordinate a national response to the crisis. This could include an allocation of emergency funding on the scale required to actually address the mounting death toll, as well as sanctioning the operation of temporary supervised consumption sites on an emergency basis.
Inexplicably, the minister continues to claim that a national public welfare declaration is unnecessary and untimely. With respect, she is utterly and demonstrably wrong. For example, such a declaration would allow overdose prevention sites across the country to open and operate legally, something they cannot do now. Not only are such sites needed desperately in every major city in Canada, but they would start saving lives today.
New Democrats have worked in good faith with successive federal governments to address the crisis with the urgency it deserves. We led the fight against the Conservatives' Bill C-2 from the day it was introduced, and then pressed the Liberal government to repeal or amend it. Last fall, we moved a motion at the standing committee to conduct an emergency study on the crisis. We tried to expedite this bill through the House in December; and we were the first to call for a declaration of a national public health emergency to address the crisis.
The New Democratic Party will support this bill and work in committee to improve it. We will continue to press the government to take every action it can to address this national public health crisis.
