Government Operations Committee on May 1st, 2024

[Jenica Atwin, Liberal, Fredericton, NB]

Yes. I have a separate issue.

[The Chair, Conservative, Kelly McCauley]

We're onto the next issue. I've recognized Mr. Genuis first, and then it will be you. You'll be up after Mr. Genuis.

Mr. Genuis, I apologize. Go ahead, sir—from the top.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

No problem.

I have a separate issue that I want to raise. It's a motion that I have put on notice. I'll read it, and then I'll explain it:

That the committee, in relation to the opioid epidemic and toxic drug crisis in Canada,

(a) order the production of all contracts, agreements or memoranda of understanding to which the Government of Canada is a party, signed since January 1, 2016, concerning the purchase, acquisition or transfer of Dilaudid or any generic form of hydromorphone for use in any safe supply program, together with any related documents concerning the amounts, dosage and frequency of delivery of the hydromorphone to be used, provided that these documents shall be deposited with the clerk of the committee, in an unredacted form and in both official languages, within three weeks of the adoption of this order; and

(b) order the governments of the provinces and territories to provide, to the clerk of the committee, documents consistent with those described in paragraph (a), where that government is a party, within three weeks of the adoption of this motion.

Colleagues, I do want to say up front that I will spend a few minutes explaining the rationale for this motion. It's an issue that this committee, in the period that I've been on it, has not looked at in detail, but importantly, it is related to the mandate of the committee, the operations of government. It's a contract request, which is in keeping with some of the work we've done in the past. It does pertain to a policy area that is newer to us, so I want to lay out the rationale in terms of the context and why this particular request for documents is a high priority for me.

We have been discussing in various fora—of course, most notably in the House—the impacts of the opioid crisis and the impacts of the policy currently being advanced and pursued by, I think it's fair to say, the NDP-Liberal government working in B.C. especially, and considering exceptions to the Criminal Code in other areas. The policy that they like to call “safe supply” is substantively really something else. It's about giving taxpayer-funded dangerous hard drugs, which people are then permitted to use along with other dangerous street drugs, in public places—in hospitals, on buses, in public parks and in places where families, seniors, children and other vulnerable people are present.

This is the policy of the current government. They have allowed an exception to the Criminal Code in B.C. They're considering exceptions in other parts of the country that would allow public drug use of dangerous hard drugs. This is something that even the B.C. NDP has now called for substantial changes to.

There are a few different parts to their policy, but one part of this is the idea that for all Canadian taxpayers, the money they work hard to earn and are forced to pay to the government would be used to purchase dangerous hard drugs, which are then provided to people who are struggling with addiction. We don't support this policy. We think that for those who are suffering with addiction, a better policy emphasizes support for treatment and recovery.

That emphasis on treatment and recovery reflects a fundamental optimism about the potential of the human person. All people, regardless of the challenging circumstances they face, have the potential to pursue and benefit from recovery programs. The policy of giving taxpayer-funded dangerous hard drugs to people in this situation reflects a deep pessimism about people in that situation. It reflects, sadly, a belief in some quarters of this country that continuing to take dangerous hard drugs is just the best that can be hoped for in these circumstances.

I reject that pessimism. I believe we can and should work to bring our loved ones home drug-free.

I embrace that optimistic account of human potential, and that's why I believe in a treatment and recovery model. Sadly, for too long in this country, people who want treatment and recovery, and maybe those who kind of struggle back and forth with deciding on that path but make a choice to pursue that path of treatment and recovery, often find that such support is not available to them, so they're not able to pursue that path.

Wouldn't it be better if, instead of spending taxpayer dollars on giving dangerous hard drugs to people struggling with addiction, we invested those resources into treatment and recovery programs? There's the impact on the individual who is struggling with addiction, but then there's also the wider impact on the community associated with safe supply programs. It's important to say that this impact is not limited to the places or even the provinces in which safe supply programs, so-called, operate, and it is not limited to places where these exceptions to the Criminal Code apply.

I can say that we see in my province and in other parts of the country the impact of what's happening in British Columbia. Let me explain that a little bit.

In British Columbia, especially, the government is pursuing this policy of giving dangerous hard drugs to those struggling with addiction, and very often it's something called Dilaudid, which is a patented version of hydromorphone. I'll talk a bit more about Dilaudid in a minute.

We see a lot of evidence of what is called diversion. We know that, quite obviously, if somebody has a severe addiction to, say, fentanyl, chances are that if they're receiving free Dilaudid, or another form of hydromorphone, it does not satisfy the intensity that they're used to with the product that they have used in the past. What often happens—and I think there's considerable evidence to show this—is that individuals are able to receive those free, taxpayer-funded hydromorphone pills, which they sell to others. Then, they use that money to buy street drugs, fentanyl etc.

The effect then is that you have this expansion of supply, a proliferation of available Dilaudid pills that are then causing new addictions. They're more accessible. They're easier for people who are trying drugs for the first time to get access to. I think there's good evidence as well that they get taken to other parts of the country and that there is organized crime involvement in this, where there is a Dilaudid prescription.

Somebody receives the Dilaudid. They sell it. They buy their drug of choice, and then organized crime delivers that Dilaudid product to somebody somewhere else in the country. Organized crime is making money off that, and they're benefiting from the taxpayer subsidy that's going into that original drug.

The effects of this are very significant in the Lower Mainland, but the effects are not limited to the Lower Mainland. These policies of taxpayer-funded dangerous, free drugs lead to a significant increase in supply in general. We're flooding the market with very dangerous drugs, and it makes those drugs cheaper and easier to access for people who haven't used drugs before. This is a very dangerous effect of the policy being pursued by the NDP-Liberal government.

We have public drug use. We have diversion. We have increasing harms, increasing addictions and increasing overdoses. The social effects of this policy are significant. I've talked about the impact on the individuals who are struggling with addiction. We've talked about the wider impacts on the community and the impacts on vulnerable young people who are maybe receiving these diverted Dilaudid pills. We see in general how there's been a backlash against these policies because many people are hurt by them.

Let's also acknowledge a reality on the other side of it: that while there are many people who are hurt by these NDP-Liberal drug policies, there are a few people who benefit from those drug policies, and that is, in particular, those companies that are involved in producing the drugs, which are then purchased with taxpayers' dollars and made available. That is, I think, fairly obvious. If you're in the business of manufacturing and selling opioids, then the greater use of your product, especially with the taxpayer being willing to...well, it's not the taxpayer being willing to, Chair, but the person responsible for dispensing taxpayer money being willing to purchase large quantities of those drugs and give them away for free.

While that might be bad news for communities and for individuals affected, on the other end of this it's good news for the bottom line of the companies. They potentially have an interest, then, in perpetuating policies that allow them to continue to sell more of their product and to sell more of their product specifically to the government. The sad reality is that a person struggling with addiction is a repeat and captive customer if you're in the business of producing and selling these dangerous drugs. We should be aware of the agenda of the pharmaceutical companies that are benefiting from these policies. It might be true in theory that a pharmaceutical company could put aside their self-interest and support treatment and recovery, but that would require a complete and rare suspension of any self-interest calculation.

The other thing when we look at the interests of the companies that are involved in producing and selling these products is that I think we should reflect on the history of how these companies have operated in the past. This really goes back to the first wave of a kind of opioid legitimization. If you look historically at the opioid crisis, I think we can say that there have been two periods of corporate-driven opioid legitimization, with a kind of interregnum in between.

In the 1990s, we had the first wave of corporate-driven drug acceptance. At the heart of that was Purdue Pharma. Purdue Pharma produced a new product, which they aggressively marketed. They minimized the risks, and they did so for their own bottom line.

The history of this is that opium is the original opioid. There was a long-standing reluctance in the medical community to prescribe opium except in the most extreme circumstances. Purdue Pharma came along with their new product, OxyContin, a patented semi-synthetic opioid. They sought to create the impression that it was less dangerous than what was already on the market, but in many cases it was actually much more dangerous.

OxyContin incorporated a kind of controlled release technology. It was designed to facilitate a controlled release of opioid-related pain relief over a period of time, and that was supposed to create the illusion of less risk. This was manipulatively marketed, because OxyContin's controlled release mechanism was not tamper resistant: It could be modified easily to release all of its hit at once. It carried all the same risks.

In that context as well, Purdue Pharma made all kinds of clearly unfounded claims, minimizing the addiction risk. They made claims that were absolutely not supportable by the science, which they nonetheless promoted. They aggressively marketed OxyContin as the solution to not just acute pain, but also ongoing chronic pain. They called it the drug to stay with.

It was very successfully marketed and they made a ton of money in the process. I think it's worth remembering as well that this was intentionally marketed through the lens of minimizing stigma. They said okay, there's a stigma around opioids; we want to minimize the stigma around this new product so that people will buy more of it.

The result of this was that, at the very beginning it was a new product and there wasn't much stigma. People with different levels of short- and long-term pain were prescribed OxyContin. Then, because it was much more addictive than people had been led to believe, and because of the well known tolerance-inducing effect associated with opioids, people could just not get the same impact, the same level of pain relief, with the same doses.

The familiar story you'll hear from people with lived experience is often this. There was an initial event causing pain. Maybe it was a car accident, maybe it was long-running, unexplained chronic pain, and then opioids were prescribed in response. What followed was opioid addiction, as the individual went through a spiral of needing higher and higher doses in order to achieve the same effect. Then potentially, eventually, not able to get what they're perceived they needed in the context of pharmaceutical opioids, they went to street drugs.

This was the history of OxyContin and it's part of the wider history of Purdue Pharma and the Sackler family who owned Purdue Pharma. That family had a history of running various businesses that went back further than OxyContin, which involved simultaneous and conflicting interests in different pieces of the medical world. Members of the Sackler family ran Purdue Pharma, but they also were involved in a highly successful pharmaceutical advertising business involved in the publication of medical journals, medical education and in fact sponsoring a whole movement of greater so-called “awareness” of the epidemic of untreated pain, the idea of pain being a fifth vital sign.

All of this was marketed with the goal of being able to sell opioids.

There are various other examples of this. The Sacklers played a major role in the marketing, for instance, of Valium in the 1970s, the first wave of the overpromotion of benzodiazepines. I think we're seeing, sadly, another wave of the overuse of benzos today.

In any event, the Sacklers made this argument through Purdue Pharma about pain and stigma. All of that argument pointed to, “You've got to just buy more of our product. That product conveniently is problem-free and here we are selling this great product that's going to make us a lot of money and we're off to the races.”

We know the effects of that, though. We know that increasing the supply of opioids and removing the stigma around those substances was not the solution; it was actually the cause of a massive new problem. We have an opioid crisis today primarily because of the overpromotion and the lies that were told around OxyContin and that were subsequently maintained and promoted by Purdue and, I should say, frankly with the support of McKinsey, for as long as the charade could possibly be continued.

Let's fast-forward to today. One of the things we need to note about many of the current conversations and debates around the NDP-Liberal policy is the way that some of the arguments being made by people who support the expansion of the supply of dangerous drugs—funded by the taxpayer—actually mirror the original arguments made by the Sacklers through Purdue. Back in the 1990s and early 2000s, people said that if we took away the stigma around these substances and made them more widely available so that people could get them in response to their perceived need, we would solve the problem. The result was just a massive increase in supply and more people accessing these drugs, setting them up on a ladder to pursue more and more dangerous substances.

Today, we have people making similar arguments. They're saying we have this problem of addiction, and the solution is to reduce the stigma around substances and dramatically increase the available supply. In fairness, the intent is that they only be supplied to those with existing addiction challenges, but that's not the effect of the policy.

You can kind of see how the original failure is, nonetheless, being repeated, with the new program that is being pursued by the government today.

It's troubling for me that Dilaudid, the go-to, so-called safe supply product, is also a Purdue product. Not only are we seeing a repeat of the same kind of history and very similar arguments being made to justify overpromoting drugs and making them more available, but we're seeing the same company at the centre of it. We're seeing how Purdue Pharma is again making Dilaudid. This provides a significant benefit to their bottom line.

After all that happened with Purdue and OxyContin, the lies that were told and the disregard that was shown for human lives, why are decision-makers going back to the same people who substantially caused the opioid crisis in the first place, saying, “Now you can make this new product, which we're going to buy from you,” and thinking that's the solution?

The same justifications are being used. If we increase the supply of the drug, we're going to solve the problem, apparently. The same arguments are being used. The same company is being brought in to supply the products.

Are we really supposed to believe that this big pharma company, Purdue, after being compelled to pay billions of dollars in settlements in the United States...? We're behind on that in Canada, by the way. We Conservatives have been pushing that those responsible for the opioid crisis be required to pay the full compensation, and that all of that money be used to support treatment and recovery. We've been pushing for accountability for these companies in Canada.

However, in the midst of all that has happened, all that we know and all that has been spent, now this government is going back to Purdue to purchase Dilaudid. That should be troubling. It's troubling for me, and I think it's troubling for many Canadians as well, who are wondering about these purchases, potential conflicts of interest, what's happened in terms of lobbying and what kinds of astroturf organizations have been set up to advance the interests of these companies.

That brings us to the motion today and recognizing that the company that caused the opioid crisis, Purdue, is now producing Dilaudid, which is being purchased through government programs and provided to people. Supposedly, Purdue is the solution to the problem Purdue caused. We need, at a minimum, to see what is in these contracts to understand what was committed to, what was agreed to.

One of my biggest concerns in the context of these contracts is understanding what, if any, indemnification structures exist within them. We know that the last time Purdue was responsible for supplying dangerous drugs en masse to the public, they were significantly sued, and they had to pay billions and billions of dollars to compensate the victims. It may well be that efforts have been made to prevent that from happening in the future through some kind of indemnification structure. If these contracts include indemnification agreements that protect the companies that are producing these dangerous drugs from being accountable for their effects, I think the public would probably want to know that.

Mr. Chair, I'll just wrap up here in a moment, but I'll make a few summative comments. We all know and hear from, in many cases, our constituencies but also, in many cases, our own families about the devastation associated with the opioid crisis. This opioid crisis started because Purdue Pharma told lies, manipulated information and aggressively marketed a new semi-synthetic opioid product, minimizing its risks. A lot of people took it. A lot of people developed substance-use disorders as a result of that dangerous misinformation.

Then there was a period of increasing awareness around the problems of this, but now we've gone back into this period where some leaders—especially the policy leaders of this NDP-Liberal government—are pushing the idea that increasing the supply of dangerous drugs is the solution. Once again, they're claiming that more supply, that a more widely available supply of drugs, is fine and is the solution instead of the continuation of the problem. Also, the company that caused the opioid crisis in the first place is at the centre of supplying the supposed solution in Dilaudid. Once again, you have, in this new wave of corporate-driven drug overpromotion, the same company, Purdue Pharma, with a new, differently branded opioid product. This government is falling for it all over again.

I should say as well, Mr. Chair, that the motion does not specifically reference Purdue. It references Dilaudid, obviously, which is a Purdue product, but the motion also says “or any generic form of hydromorphone for use in any safe supply program, together with any [relevant] documents”.

I'll add briefly that I think we need to look, as well, at other cases, at other companies that are trying to get into this. I want to share one example of this. Some of you may have heard of a company called Fair Price Pharma. Fair Price Pharma is, I understand, run as part of a partnership involving Dr. Perry Kendall, a former B.C. public health officer. Dr. Kendall is involved in this company that is seeking to sell injectable heroin. He has been quoted as saying that heroin should be more available. For instance, he said in one interview:

I think it is inexcusable that it is not more widely offered in Canada. I can think of no other evidence-based, effective treatment for a life-threatening condition that is withheld from individuals who could benefit from it.

It is inexcusable and unethical.

He is saying that not making heroin more available is “inexcusable and unethical”.

Fair Price Pharma is led by someone who has been very involved in the public conversation around so-called safe supply programs. He continues to be very involved in public conversations around these so-called safe supply programs, but he is also leading a company that is trying to sell a product that is a very dangerous drug, which is ostensibly being marketed as, “Let's give away more dangerous drugs as a supposed solution to the problem.”

I was able to find—in public disclosures, by the way—that there have been extensive meetings between Fair Price Pharma and the federal government. These included two separate meetings with the former minister of mental health and addictions, Carolyn Bennett, and these meetings were to discuss regulatory pathways regarding diacetylmorphine, which is heroin.

Beyond the history of Purdue Pharma and the relationships, we know about the history of that company in promoting dangerous opioids. We can see as well this very Canadian example of a former public health officer who had a particular perspective and approach that he advocated when it came to drug policy. Now that he's out of that role, he is co-leading a company that is selling dangerous drugs and he clearly has regular access to the government as part of that effort.

We shouldn't pretend that in spite of all the harm that's being done by these dangerous NDP-Liberal drug policies there aren't some people who benefit. Those are the people who are making and selling these products. They're their shareholders. They're the high-priced lobbyists for these companies, who meet with government ministers. I would like this committee and parliamentary committees in general to do more work to try to uncover some of the relationships that have existed between these bad, dangerous, harmful policies and some of the corporate actors who have benefited from them.

There have been various people in the media who have done great work digging into this and finding out various parts of it, but it's work that is, obviously, constrained by public disclosures. If some of these corporate actors were creating and funding astroturfing organizations that pushed a message that served their corporate interests, of course, there would be almost no way of tracking that, short of making document production requests.

This committee has unique powers to do that, and these motions are important for getting to the bottom of how these dangerous, harmful policies that serve narrow corporate interests but hurt communities are actually being formulated and coming about.

I hope we will be able to order the production of these contracts. I did warn you in advance that I would have a few things to say on this subject, but I will wrap up my comments there.

[The Chair, Conservative, Kelly McCauley]

I'm going to interrupt you there, Mr. Genuis, because we're out of resources.

Before we adjourn, I will just say that at the next meeting you will have the opportunity to resume this so we will continue this motion and you will have the floor.

We are adjourned.