Bill C-45 (Historical)

Cannabis Act

An Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts

This enactment enacts the Cannabis Act to provide legal access to cannabis and to control and regulate its production, distribution and sale.
The objectives of the Act are to prevent young persons from accessing cannabis, to protect public health and public safety by establishing strict product safety and product quality requirements and to deter criminal activity by imposing serious criminal penalties for those operating outside the legal framework. The Act is also intended to reduce the burden on the criminal justice system in relation to cannabis.
The Act
(a) establishes criminal prohibitions such as the unlawful sale or distribution of cannabis, including its sale or distribution to young persons, and the unlawful possession, production, importation and exportation of cannabis;
(b) enables the Minister to authorize the possession, production, distribution, sale, importation and exportation of cannabis, as well as to suspend, amend or revoke those authorizations when warranted;
(c) authorizes persons to possess, sell or distribute cannabis if they are authorized to sell cannabis under a provincial Act that contains certain legislative measures;
(d) prohibits any promotion, packaging and labelling of cannabis that could be appealing to young persons or encourage its consumption, while allowing consumers to have access to information with which they can make informed decisions about the consumption of cannabis;
(e) provides for inspection powers, the authority to impose administrative monetary penalties and the ability to commence proceedings for certain offences by means of a ticket;
(f) includes mechanisms to deal with seized cannabis and other property;
(g) authorizes the Minister to make orders in relation to matters such as product recalls, the provision of information, the conduct of tests or studies, and the taking of measures to prevent non-compliance with the Act;
(h) permits the establishment of a cannabis tracking system for the purposes of the enforcement and administration of the Act;
(i) authorizes the Minister to fix, by order, fees related to the administration of the Act; and
(j) authorizes the Governor in Council to make regulations respecting such matters as quality, testing, composition, packaging and labelling of cannabis, security clearances and the collection and disclosure of information in respect of cannabis as well as to make regulations exempting certain persons or classes of cannabis from the application of the Act.
This enactment also amends the Controlled Drugs and Substances Act to, among other things, increase the maximum penalties for certain offences and to authorize the Minister to engage persons having technical or specialized knowledge to provide advice. It repeals item 1 of Schedule II and makes consequential amendments to that Act as the result of that repeal.
In addition, it repeals Part XII.‍1 of the Criminal Code, which deals with instruments and literature for illicit drug use, and makes consequential amendments to that Act.
It amends the Non-smokers’ Health Act to prohibit the smoking and vaping of cannabis in federally regulated places and conveyances.
Finally, it makes consequential amendments to other Acts.

[The Chair, Liberal, Bill Casey]

We'll reconvene our meeting number 67.

As we ended our last session, we learned that our colleague, Mr. Arnold Chan, has passed away. We're going to take just a moment in consideration and remembrance of Arnold. He put up a long fight and passed away last night. Arnold never stopped. He worked right until the last minute. He never slowed down. He was always present. He put up a good fight.

[A moment of silence observed]

Here we are on meeting number 67. We're studying Bill C-45. We welcome our guests and our panellists. We're pleased to have you. I think we're somewhere near the 80th panellist we've had so far. They've just been incredible panellists. They have brought great knowledge, background, and experience to us.

I'm going to introduce our panellists here today. From Brazeau Seller, we welcome Trina Fraser, partner. From the Department of Employment and Social Development, we welcome Brenda Baxter, director general, workplace directorate, labour program, and Eric Advokaat, senior director, occupational health and safety, workplace directorate. From Fasken Martineau, we welcome Norm Keith, partner.

Thank you very much.

The way we do this, each organization has a 10-minute opening statement, and then we go to questions after that. We'll start with Trina Fraser.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

You know, on our fourth day of hearings, it's quite apparent that one of the major focuses of the testimony and the attention of committee members has been the impact of cannabis and cannabis legalization on young people, on youth. We've heard that Canadian youth are among the highest users of cannabis in the world, perhaps the second highest. We've heard about the impact on their health and their career prospects and the impact of legalization and criminalization on them. We've heard about brain development. We've heard that they apparently suffer from holding myths and misinformation about cannabis. We've heard advice from people about how to effectively talk to young people about cannabis. We've heard different thoughts about their access to cannabis and whether they do or don't have easier access to cannabis than liquor. We've heard about their attitudes towards cannabis, yet we haven't heard from a single young person at this committee.

Millions of Canadians use cannabis and have acknowledged it. They use it today, have used it, and will continue to use it. The parliamentary budget officer has estimated that somewhere between five million and seven million Canadians will use cannabis once this legislation comes into force, and of course, millions of Canadians, I think, voted very clearly last election for a legalized approach to cannabis, yet we haven't heard from a single, ordinary Canadian at this committee.

We have large, established producers of cannabis in this country right now that have been responsible, for I think a decade, for producing cannabis for the medicinal market. Dispensaries across this country, both in Ontario and British Columbia, and maybe in other provinces, have been very actively serving the market, mainly while politicians and police forces have quietly ignored them. We haven't heard from a single producer of cannabis or the dispensaries about their experience over a decade.

Finally, this legislation, we've heard, also seems, by design, to be excluding edibles and concentrates and non-smokable cannabis products, despite the health concerns and despite the obvious contradiction that the very purpose of this bill is to bring products out of the illicit market, to get rid of organized crime, and to regulate these products for the health and safety of Canadians, yet we haven't heard from a single producer of those products.

I think these are very important stakeholder groups, and I believe that it's important to hear from them for the committee's full consideration of the most comprehensive evidence on this legislation. Therefore, colleagues, I wish to serve notice that I am going to be moving the following motion, to be debated at some convenient point later in the day, because I want to give my colleagues a chance to think about it. The motion will read as follows:

“That pursuant to Standing Order 108(2), this Committee meet for an additional two days for the purpose of the consideration of Bill C-45, An Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts, and that the chair be empowered to coordinate the witnesses, to a minimum of 32 witnesses (eight per stakeholder group), the resources, and scheduling necessary to complete this task in accordance with the following guidelines: (1) Witnesses are to represent the following stakeholder groups in four two-hour panel blocks per day: (i) existing Canadian licensed producers and dispensaries; (ii) producers of edible cannabis products and other non-smokable forms of cannabis; (iii) ordinary Canadians who made a written submission to this committee regarding Bill C-45; (iv) young Canadians, 15 to 24 years; (2) That witnesses for each panel block be allotted as follows: two Liberal, one Conservative, one NDP; (3) That witnesses be directed to prepare oral remarks for 10 minutes in length, and that the witnesses be invited to submit written statements prior to appearing; (4) That the meetings be held prior to September 30, 2017.”

Colleagues, to conclude, the purpose of this is not to hold up these hearings. I'm mindful of the government's timeline. It is September 14. I believe that we are meeting next week to hear from ministers. I want to give the clerk and the chair and the parties time to put their witnesses in, but I think extending these hearings for another week and a half to hear from these important groups would be very important.

I'm going to conclude by saying that I've heard from no one but 50-year-olds and 60-year-olds about how to talk to young people. I think it's time we heard from young people about their thoughts on this bill.

[Michael DeVillaer]

I think there are some positive aspects of Bill C-45 arising from the task force report. For example, it looks as if the direction we're going in is that advertising for cannabis products will only be allowed in places frequented by adults. That would include cannabis retail outlets, perhaps alcohol retail outlets, gambling casinos, maybe in promotions before adult-rated films. There are a number of possibilities there.

I think that presumes that only young people are affected by advertising and marketing, and yes, absolutely we should be trying to do everything we can to prevent marketing advertising reaching young people. We're still not doing it with alcohol, for example. Alcohol advertising is everywhere you look these days, and there's no way of shielding young people from that.

Adults will still be exposed to advertising, and we should be very careful not to underestimate the power of that industry to influence behaviour. Remember, this is the industry which back in the 1960s convinced everybody that smoking these dried leaves in paper would make you more successful socially, and romantically, and career-wise without doing any harm to your health. Half the adult population bought it. I think we're more sophisticated these days than we were back then, and that will help, but adults are still very susceptible to advertising. Advertising works.

Public health has been making this statement for a long time now, and we see it's beginning to have an impact. We see prominent health journalists, André Picard, for example, writing about the way alcohol is so aggressively promoted and advertised. Even within the advertising industry, Terry O'Reilly is an icon in the Canadian advertising industry, and he was recently making some comments in his programs about the way in which alcohol is very aggressively targeted toward women. CAMH data shows that alcohol use among women is increasing just as it is among men.

This is why I proposed that we really do everything we can to completely ban advertising of all kinds. Plain packaging is very important. I'm glad to see that being talked about. With regard to retail outlets, one of the things I would like to see is a plain packaging approach to retail outlets as well, because of the principle that a pack of cannabis or whatever, as with cigarettes, is an ad. Every time somebody pulls it out, it's an ad. Plain packaging minimizes that to a significant degree, and I would like to see that same thinking applied to retail outlets as well.

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. DeVillaer, Bill C-45 proposes very strict regulation of labelling, advertising, and marketing at the outset of legalization, whereas alcohol, pharmaceutical, and tobacco products all entered the legal market with much more relaxed regulation.

Do you think this will make a difference in our ability to protect public health?

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you for clarifying that.

I'll go back to Mr. Strang.

I think you mentioned that the public health goal underpinning Bill C-45 is the idea of taking products out of the illicit—I think you prefer the term “illegal”—market. Is that correct?

[Don Davies, NDP, Vancouver Kingsway, BC]

You're probably aware that Bill C-45 retains a criminalized approach.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Very good, thank you.

Picking up on one of your points, I would say that potency has been raised as a big concern. The cannabis of today is much more potent than previously. I think it was the nurses society that said it wanted to see really good control over the quality, the dose, and the potency that people are getting.

Another way of protecting the public from things that are not well controlled is to get rid of one of the suggestions that's in Bill C-45, which is to allow home growth. Home growth has absolutely no quality control on the product, on the potency, on any of these things, and also provides easier access for children.

I wonder if the Canadian Nurses Association would like to start, and then we'll let everyone comment on whether they think allowing home growth is a good idea.

[Dr. Robert Strang, Chief Medical Officer of Health, Nova Scotia Department of Health and Wellness]

Good morning to the committee, and thank you for the opportunity to speak to you today. I'm appearing on behalf of the chief medical officers of health for the 13 provinces and territories. I'm providing a collective public health perspective, not jurisdictional positions from any of the provinces and territories.

My remarks will be focused on this morning's topic of prevention, treatment, and low-risk use, but by necessity will touch base on other topics such as legal age, labelling, and packaging, which have been discussed in other sessions.

I have assumed that by prevention you mean the prevention of population and individual harm in relation to how cannabis is produced, distributed, retailed, and used, the prevention or at least the delaying of onset of use by those below the legal age, and the prevention of harm to populations that may be at increased risk.

Prevention is not just about providing information and education about risks and harms. Appropriate education and social marketing can be effective but only if they are part of a comprehensive strategy. Policy decisions related to how cannabis will be sold, how it will be priced, how it will be labelled and marketed, and the level of availability and accessibility are the most critical when it comes to preventing population harms, preventing harmful individual use, and minimizing underage use.

To be more specific, to have the strongest prevention approach, we make the following recommendations:

Cannabis should be distributed and sold through government monopolies where the primary objective is protecting public health and safety, and not revenue generation.

As recommended by the task force that advised the federal government, there should be no co-sale of cannabis with tobacco and alcohol products.

At the outset, price will need to be set to maximize purchase from the legal market, but over time, price needs to be used as a key tool in decreasing overall demand as well as encouraging consumption of lower-harm products, such as products with lower THC concentration and non-smokable forms.

Product promotion such as advertising, marketing, sponsorship, and product placement, including at the retail environment, needs to be prohibited at the federal level and complemented by similar provincial restrictions.

Product packages should be plain with clear and prominent warnings about risk.

At the retail level, prepackaged products such as cigarette-type joints should not be allowed as those can facilitate marketing, promotion, and glamorization of cannabis use.

The number, location, and density of retail locations, along with hours of operation, need to be carefully developed to balance access to legal products—and accounting for the current legislation's allowance of personal growing and online or mail order purchases—with prevention objectives.

Over the long term, a minimum age of 21 would be better than 18 or 19 at balancing between shifting young adults to legal supplies and decreasing use by those under age 18. I'm going to explain that recommendation a little more, because it is a key point that keeps coming up.

We know that one of the objectives is to move people from an illegal to a legal market. Certainly, setting age 19 or 18 will bring young adults into the legal market in the short term, but if one of our key objectives is to decrease use amongst youth who are under 18, and will always remain underage no matter if the age is 18, if they are using cannabis, they are going to have to access it from an illegal source. We know from clear evidence around tobacco and alcohol that setting an age of 21 versus 18 or 19 will, over time, have a greater impact on decreasing cannabis use rates and therefore keeping those individuals out of any market for cannabis for those under age 18. If one of our primary objectives is to have a set of circumstances that decreases use of cannabis by those who are underage, we are far better off with an age of 21 than of 19.

Moving along, public smoking and vaping of cannabis should, at a minimum, follow the current approach to public tobacco smoking and vaping, to prevent further normalization of cannabis smoking and re-normalization of smoking behaviours in general.

The approach to bringing edible and other concentrated and derivative products into the legal market needs to be done extremely carefully to minimize the normalization of cannabis consumption and protect children and youth. With respect to edible products, it must be made clear through legislative requirements that products that contain cannabis plant materials and extracts and active ingredients are not food products.

Since it is easier to loosen regulations than to tighten them, the initial regulatory approaches should err on the side of being more restrictive. Adjustments can be made as time progresses based on comprehensive monitoring and research. Such monitoring and research will need to be adequately resourced and established.

Programs that shape social and physical environments to support health and well-being in general, such as supporting healthy pregnancies, enhancing early childhood development, and ensuring adequate housing and income, are all important measures for primary prevention of problematic substance use in general and are and will be important in preventing problematic cannabis use.

Along with this submission, I'm pleased to attach a more detailed position paper from the provincial and territorial chief medical officers of health, as well as the Urban Public Health Network, who are the medical officers of health in urban centres. That more detailed report has been provided to the committee.

With respect to treatment, I do not have experience or expertise in the treatment of cannabis use disorders, but I would say that there are no treatment approaches or therapies that are specific to cannabis use disorder. There is a need for improving appropriate access to treatment of people with cannabis use disorder today as part of the need to improve treatment and access for people with a range of substance disorders. Whether the need for treatment will increase or decrease will really depend on decisions and the implementation of policies that I've discussed previously.

With respect to lower-risk use, an updated set of guidelines for lower-risk cannabis use, the development of which was led by Canadian experts, was publicly released in June of this year. Those guidelines have been endorsed in principle by the council of the chief medical officers of health. In summary, these guidelines recommend that the most effective way to decrease risk is to abstain; that the older one is when cannabis use is initiated the lower the risk of developing problematic use and adverse health effects over the lifetime. Higher THC concentration products have greater risks, so low THC concentrated products should be used. Synthetic cannabinoids, such as shatter, expose users to more acute and severe risk and should be avoided.

To protect lung health, routes of intake that involve smoking and combusted cannabis material should be avoided. Along with that, methods such as deep inhalation and breath holding that increase the psychoactive ingredient absorption also should be avoided. Frequent or intensive use has the highest risk of harm, so if people choose occasional use, one day a week or only on weekends is recommended. Avoiding driving while using alcohol and/or cannabis is extremely important.

Populations that are at higher risk from harm from cannabis and therefore should avoid use are pregnant women, people with a history or close family history of psychosis or substance use disorder. The combination of risk behaviours, such as early age of onset and frequent use, likely magnifies the risk. These low-risk cannabis use guidelines should form a key part of public awareness and educational initiatives related to cannabis legalization and should be incorporated in product labelling and should inform legalization policy decisions by all three levels of government.

With respect to Bill C-45, the provincial and territorial chief medical officers of health and Urban Public Health Network recommended in the paper I have provided that this initiative be guided by public health goals and objectives written into a statute. We were very pleased to see the public health orientation adopted by the federal government for this initiative and the explicit articulation of public health objectives as codified in the purpose section of the act, proposed section 7. We encourage provinces and territories to adopt similar public health orientation and include explicit articulation of similar objectives in their statutes.

Last, we suggest that the bill be amended to replace the word “illicit” with the word “illegal”. The term “illicit“ is stigmatizing in nature, and since stigma and discrimination reduction are important aspects of this initiative, we suggest avoiding using the term “illicit” whenever possible. We suggest using the term “illegal” instead, as it is a simple, clear, and unambiguous term that refers to the legal status of possession of the substance and it avoids the stigmatizing nature of the word “illicit”.

Thank you for your time and this opportunity. I look forward to our discussions.

[Dr. Serge Melanson, Doctor, New Brunswick Medical Society]

Thank you and good morning. My name is Dr. Serge Melanson. I am the chief of staff and an emergency room physician at Moncton Hospital here in New Brunswick. I'm speaking today on behalf of the New Brunswick Medical Society, a professional association representing more than 1,600 physicians in New Brunswick.

As a professional association, we believe that we have a key role to play in advocating for improvements to health care delivery in New Brunswick. We have led the way in various initiatives, such as the promotion of team-based health care delivery. We have also been successful in promoting healthy living initiatives and policy changes to protect youth from health hazards such as smoking and the use of tanning beds.

We recently launched a campaign to make New Brunswick one of the top three healthiest provinces in the next 10 years. We've also collaborated with schools to improve healthy food choices, and we have promoted the mandatory use of ski helmets to prevent head trauma.

I would like to thank the House of Commons Standing Committee on Health for inviting me to speak today to the concerns of the New Brunswick Medical Society about the legalization of marijuana for recreational use.

In June this year, our organization published a position paper on the recreational use of marijuana, which included recommendations to the Government of New Brunswick on an appropriate framework to limit the harmful effects of marijuana use on New Brunswickers.

We also want to inform the public about the health issues associated with cannabis use, and we recently launched an information campaign for the public on marijuana use.

Like tobacco and alcohol, cannabis use can lead to negative health impacts. While Canadians will have the choice to consume marijuana legally in little less than a year from now, it is essential that they understand the risks. Making cannabis legal does not make it safe. We understand that the goal of the federal government in legalizing and strictly regulating cannabis is to decriminalize use of the drug and reduce illicit sales of the substance, but we believe there are still substantial concerns to address when it comes to the particulars of legalization.

Our position on legalization is in line with that of the Canadian Medical Association and their recommendations built on Canada's experience regulating alcohol and tobacco. We also support the guidelines developed by the Centre for Addiction and Mental Health for low-risk use of cannabis. One issue of particular concern to us in this discussion, from a prevention and low-risk use perspective, is the proposed minimum age for the legal possession and purchase of recreational marijuana. We believe very strongly that the proposed age of 18 under Bill C-45 sends the wrong message to young Canadians—that it is safe for them to consume marijuana at that age. There is clear scientific evidence that the brain of a young adult is still developing up to the age of 25 and that marijuana consumption can have adverse effects on brain development. While we would ideally like to see the legal age for recreational marijuana set at 25 in Canada, we recognize that this is not likely feasible and that 21 may be a more realistic age for the prevention of illicit purchase by young adults.

Over the past 14 years of practising emergency medicine in Moncton, I've seen first-hand a significant increase in the amount of cannabis use and its negative health effects in patients presenting to the emergency department, whether it be as the primary cause of their medical problem, something that is worsening an existing chronic disease, or something that may be unrelated to why they're there. I deal with the effects of cannabis use in the ER in a number of situations. These can be patients experiencing unexpected effects due to cannabis being laced with dangerous chemical additives, patients experiencing a cannabis-triggered issue called cyclical vomiting syndrome, cannabis triggering serious mental illness, and patients experiencing such serious health issues as chronic lung disease as a direct result of cannabis use.

I see patients who have consumed cannabis, adolescents and young adults, for the most part, who then go on to develop their first episode of psychosis, schizophrenia, bipolar disorder, and other significant mental health issues. Teens or young adults consuming cannabis will have a higher likelihood of developing these mental health issues if they continue to consume cannabis. Some young people may also be under the impression that these medical issues are curable. The reality is that these are lifelong diseases. Young Canadians are taking a significant risk in consuming cannabis. We believe there is a clear association between cannabis use and the onset of psychotic disorders, because the brains of these young adults are still in development.

Since we know that the recreational use of marijuana will be legalized and that increased use is likely to have an impact on health care, it is important that the provinces and territories have adequate resources to deal with it.

If Parliament adopts Bill C-45, the Government of Canada will be responsible for ensuring that the provinces and territories are adequately equipped to react to increased pressure on the health care system.

In addition, the Canadian government must ensure that the provinces and territories have the resources to adequately measure the impact of legislation to better adapt their awareness and education efforts to the situation, as well as their intervention and treatment services over time. Research on public health will be needed to measure the harmful effects of increased cannabis use on our communities and our citizens.

It is also critical that governments at all levels invest the necessary resources to support a strong and ongoing education and awareness campaign. If Canadians are to be presented with the choice to consume legal cannabis, they must have easy and clear information on the risks associated with making that choice.

In closing, I would like to make it clear that a decision by the Government of Canada to legalize the use of cannabis must be advised by these precautionary principles. Government has a fundamental responsibility to protect its population. It is of particular importance, on the legalization of cannabis, for government to ensure that it is living up to its responsibilities to all Canadians.

Thank you.

[Karey Shuhendler, Policy Advisor, Policy, Advocacy and Strategy, Canadian Nurses Association]

Thank you, Mr. Chair.

Good morning, Mr. Chair, and members of the committee. My name is Karey Shuhendler. I'm a registered nurse and policy adviser for the Canadian Nurses Association, the national professional voice representing more than 139,000 registered nurses and nurse practitioners.

I'm pleased to be here today with Professor Lynda Balneaves, registered nurse and medical and non-medical cannabis researcher, who will be able to answer questions that are more technical in nature.

Professor Balneaves currently serves as an associate professor in the Rady faculty of health sciences college of nursing at the University of Manitoba, and is a nursing leader in the fields of shared treatment decision-making and complementary and integrative health care. She has published and presented on topics related to knowledge translation, integrative oncology, treatment decision-making, and medical and non-medical cannabis.

At the outset, I would like to thank the committee for studying this important issue and for inviting CNA to provide its recommendations. Legalization of non-medical cannabis will impact public health, and as such, requires a preventative approach to reduce the health risks and social harms associated with cannabis use. CNA welcomes the federal government's work to table Bill C-45, which would guide the legalization, regulation, and restriction of access for non-medical cannabis. CNA supports the passing of the bill and believes that legalization is an excellent option for addressing the harms of cannabis.

CNA recently conducted a national survey of nurses to assess the readiness for legalization, determine knowledge gaps and resources needed, and collect input on the sections of Bill C-45 that pertain to the scope of CNA's work.

While the two-month survey remains open until tomorrow, preliminary results indicate that a majority of nurse respondents favour the government's move toward legalization, and that the focus should be on preventing access and associated harms for young persons through a variety of mechanisms, including considerations around packaging, labelling, display, promotion, and sale of cannabis and cannabis accessories. Legalization can support the regulation of quality, dose, and potency, while minimizing social harms as well as the costs of prohibition. In addition, legalization can improve access to research potential harms or medical benefits.

In reviewing the bill, CNA was pleased with the moderate public health approach taken on the complex issue of cannabis legalization. In its current form, Bill C-45 promotes the removal of harms associated with the prohibition model, while recognizing the need to protect vulnerable populations, including youth. CNA has provided four recommendations for amending the proposed legislation, all of which are outlined in our brief. We encourage the committee to include all of CNA's recommendations in its final report, including those related to the sale and promotion of cannabis and cannabis accessories, and considerations around promotion and use related to alcohol.

Cannabis should not be treated in the same way as alcohol. The harms of alcohol use and current alcohol policy can be downplayed at times and should not necessarily serve as the model for cannabis policy simply because it is already established. Additionally, cannabis is different in that there are therapeutic indications and particular formulations for medical use. Thus, medical access should not be forgotten in the wake of legalization. While these other recommendations are not the focus of our presentation today, we would be pleased to answer any questions on the full range of recommendations put forth in our brief.

This morning we would like to focus on two of the four recommendations, namely, those related to youth criminal penalties and the inclusion of a comprehensive public health approach to the legalization of non-medical cannabis.

Our first recommendation, regarding youth criminal penalties, is specific to clause 8 and related subclauses. These state that a young person, aged 12 to 18, in possession of one or more classes of cannabis the total amount of which, as determined in accordance with schedule 3, is equivalent to more than five grams of dried cannabis, is guilty of an indictable offence, is liable and/or guilty of an offence punishable on summary conviction, and is liable to a youth sentence under the Youth Criminal Justice Act.

Not only can a criminal record limit an individual's ability to travel to certain countries, it can also lend itself to considerable social harms. For youth in particular, a criminal record can be a barrier to volunteer opportunities, which are often required by school curriculums, and can play a role in scholarship decisions. A criminal record can also reduce career opportunities and contribute to poverty and poor health outcomes. Legalizing cannabis while maintaining criminal penalties for youth can disproportionately disadvantage young people, particularly those from marginalized or racialized communities, potentially barring them from opportunities to equitably advance and contribute in our society.

Given the evidence that 21% of 15-year-olds to 19-year-olds in Canada have used cannabis in the past year, such legislation could potentially impact a large number of youths. Alternatives to a traditional punitive approach to addressing both minor crime as well as problematic substance use have demonstrated success. Examples such as drug courts, which use a restorative justice approach, offer an alternative to traditional justice processes. These models offer full engagement and accountability of the offender, and help to address the broader range of contributing issues such as poverty, health, or social justice issues that may have brought the person to commit the offence in the first place.

Consider a 15-year-old struggling with problematic cannabis use caught possessing more than five grams for personal use. He uses non-medical cannabis to self-medicate for undiagnosed anxiety and depression which is exacerbated by the stress associated with living in poverty. Would criminalizing possession or even imposing a significant fine help this teen, or would he be better served through a drug court system with a restorative approach, where the teen can be accountable in his own healing, provided with opportunities to link with health and social service organizations to address the root causes of poverty, and offered treatment services to address undiagnosed mental health and substance use issues?

With this in mind, CNA recommends that youth possession of cannabis not be subject to criminal penalties, that the government use a restorative justice approach as the guiding principle for addressing youth possession, and that such depenalization eliminate current or future repercussions for youth by removing the provision under clause 8 and related subclauses of the cannabis bill.

Our second recommendation is for the government's investment in a public health approach to cannabis, including a comprehensive public education program. CNA strongly supports the recommendations made to the federal task force on cannabis legalization and regulation to learn from other jurisdictions, such as Colorado and Washington, and to invest in comprehensive public health and education programs including those related to cannabis use while driving well in advance of legalization.

Canada spends more than one billion dollars annually to enforce cannabis possession laws, arresting about 60,000 Canadians for simple possession, and this accounts for about 3% of all arrests. Legalization should remove significant social harms as well as the financial costs associated with enforcement under the current model of prohibition.

With this in mind, CNA recommends that once legalization is in place, the government use a portion of the savings from enforcement and/or revenue from sales to invest in initiatives that contribute to positive health and social outcomes. Such investments should include tools, training, and guidelines to support public education programs for cannabis harm reduction strategies, programs for substance use prevention and treatment, and research to better understand the harms of non-medical use, as well as the potential benefits of medical use. Cost estimates for these measures can be derived from jurisdictions where cannabis has already been legalized, from public education campaigns that have been launched, and from current federal government investments in public education related to tobacco use.

Nurses are the largest group of health care providers in the country and are often a person's first point of contact with the health care system. As such, nurses are well positioned to contribute to the development and delivery of this kind of health education.

Results of a Nanos Research poll commissioned by CNA in August of this year, which will be tabled, note that more than nine out of 10 Canadians support or somewhat support nurses educating Canadians on the risks associated with non-medical cannabis use.

Preliminary results of CNA's national survey of nurses noted that 49% of respondents indicated that they felt comfortable initiating a conversation or responding to patient concerns about the risks associated with non-medical cannabis use. Based on these results, CNA is committed to providing additional educational resources on non-medical cannabis to support nurses caring for people across the continuum of care.

I would like to close by emphasizing that the legalization of cannabis is an excellent opportunity to reduce harms associated with non-medical cannabis use, but we must get this right. CNA encourages the committee to urge the federal government to incorporate all of the recommendations put forward by CNA.

Thank you.

[The Chair, Liberal, Bill Casey]

Seeing quorum, we will call our meeting to order. This is meeting number 67 of the Standing Committee on Health. We are doing our study on Bill C-45 on cannabis. Today our panel is focused on prevention, treatment, and low-risk use.

I welcome all of our guests who are here both by video conference and at the table.

As individuals, we have here today Michael DeVillaer, assistant professor and policy analyst at McMaster University, and by video conference, Mark Kleiman, professor of public policy at the Marron Institute of Urban Management at New York University.

Welcome.

From the Canadian Nurses Association, we have Dr. Lynda Balneaves, a registered nurse and medical and non-medical cannabis researcher, and Karey Shuhendler, policy adviser, policy advocacy and strategy. From the New Brunswick Medical Society, we have Dr. Serge Melanson, by video conference from Moncton. From the Nova Scotia Department of Health and Wellness, we have Dr. Robert Strang, chief medical officer of health, by video conference from Halifax.

Thanks very much. We'll start with 10-minute introductory remarks from each organization. Then we'll go to questions from the members.

We'll start with the Canadian Nurses Association, Dr. Balneaves.

[The Chair, Liberal, Bill Casey]

Okay, thanks very much.

That brings to a close our panel for today. Again, I want to thank all of our panellist, on behalf of the committee members, for sharing your information, your knowledge, and your experience with us.

I want to acknowledge our video conference participants, Dr. Le Foll and Dr. Levy. It's difficult to do what you've done today and we appreciate your patience with us and sharing your time with us.

Again, thanks to everybody. You've contributed a lot to our study. You've participated in Bill C-45, and we appreciate it very much.

With that, I'm going to end the meeting, but I just want to say that we're having a fifth panel tomorrow night at six o'clock, from six to eight. The last panel on Friday is moved to tomorrow night.

[Don Davies, NDP, Vancouver Kingsway, BC]

Let me move quickly to that other area in my limited time, because edibles and other concentrates are not covered by this legislation, and I believe you have recommended that those products be regulated. As pointed out by Ms. Hasheminejad, the lesson from Colorado is that people prefer to obtain their products from legal sources. If we keep edibles, concentrates, and other products in the black market, then this bill will not meet its full potential.

What is your position on whether Bill C-45 should include edibles and concentrates in the legalized regulated frame?

[Don Davies, NDP, Vancouver Kingsway, BC]

Now Bill C-45—I've used this term before—legalizes to some degree, but it's not full legalization; it'll be less illegal. There will still be criminal penalties for possession of over 30 grams, for growing over four plants, and for selling. If a 20-year-old sells to a 17-year-old, they're subject to criminal sanctions.

Would you agree with me that Bill C-45 continues to risk disproportionate harm to marginalized and racialized communities by continuing essentially a criminalized approach to some forms of cannabis?

[Elena Hasheminejad]

We would like to conclude by thanking you for the opportunity to convey the ideas and recommendations of our members. Further recommendations related to the legalization of the recreational use of cannabis can be found in our position paper, which we've left with you today, titled “The Public Health Implications of the Legalization of Recreational Cannabis”.

Our position paper expands on the recommendations that we've made today, along with other areas of focus such as taxation, age, sales, and access, and we would be happy to speak to these as well.

OPHA believes that Bill C-45 and the recent response from Ontario are steps in the right direction. We believe that, through effective public health-focused policy interventions, a comprehensive, collaborative, and compassionate approach to drug policy can be put in place that the government's commitment to legalize, regulate, and restrict access to cannabis.

We welcome the opportunity to collaborate with the federal government and others to achieve this shared goal and will continue to offer our local, provincial, and national networks our evidence-based information, knowledge, and expertise.

We thank you for your time and consideration today.