Evidence of meeting #4 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was enforcement.
A recording is available from Parliament.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Are these people sort of a high recidivism rate among substance abusers in prison? Aren't they the same people going out and coming back in later on?
Commissioner, Correctional Service of Canada
No. In any given year, about 75% of the offenders coming into the system are first-time admissions to the federal system.
Commissioner, Correctional Service of Canada
If we're looking at two years beyond warrant expiry, approximately 10% of them come back. After five years, it's about 20%.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
You work with a community, you say. Looking at your statistical data, what is the community showing with regard to those who go out and never come back?
Commissioner, Correctional Service of Canada
We find that the individuals who take the substance abuse programs that we're offering, both the institutional ones and the community maintenance programs...we see those individuals up to—just that program alone—up to 63% of them do not commit a new offence or a violent offence.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
You say there's a maintenance program. Does that mean things like substitution programs in the community using methadone and things like that?
Commissioner, Correctional Service of Canada
We use an opioid substitution therapy in the institution and if somebody has started it there, we'll look to link them up in the community as well. We find that individuals who go through the methadone program, who have been addicted to heroin, have a better chance of success than if they do not go through that program.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I agree with you on that, but there is now a very large body of work telling us that there is a small percentage of high-risk individuals who do not respond to any of the current substitution programs such as methadone or suboxone. The question, then, is what about a program that works for them? If you believe, and you said earlier that you agree with evidence-based results.... If the evidence shows that some of this very tiny group of people needs to take the pharmaceutical drug diacetylmorphine, would you not consider that to be a substitution treatment for that tiny group of people?
Commissioner, Correctional Service of Canada
That would be something that we would look at. We would go through the normal processes for any substitution drug to be added to the formulary. We would look at the issues of efficacy and effectiveness as well as cost, but we'd also look at that. One of the overlay issues is the potential impact of that kind of drug being in an institutional setting. It's one of the factors we have to always weigh.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Yes, I think that's important because now there's a huge set of studies that are showing that in fact for that tiny group, if they don't get diacetylmorphine or hydromorphone, which is Dilaudid, they will go onto street drugs again. So that's one way of stopping them getting back into that street drug system. I'm glad you think that evidence should work in some of these things.
I wanted to talk about the idea—and I don't know who should answer. Mr. Chair, you might want to direct that to whoever should answer it—you talked about the First Do No Harm program. Does that mean that you think that harm reduction is an important piece, if First Do No Harm is the obvious medical ethic? Who wants to answer that?
I noticed that no one had harm reduction as part of their comprehensive package of looking at substance abuse and at looking at decreasing the amount. Who wants to...?
Mr. Chair, who wants to take the First Do No Harm and tell me why there is no harm reduction in your programs?
Conservative
The Chair Conservative Ben Lobb
Who would like to take that question on? Public Safety? RCMP? Would anybody like to tackle that question?
Acting Head, National Anti-Drug Strategy, Department of Justice
I can answer part of it and my colleagues can chip in.
There were representatives from the federal government involved in this report called First Do No Harm that was led by the Canadian Centre on Substance Abuse. I think you'll be hearing from Michel Perron later this week, and Public Safety led the enforcement action plan. Lots of good ideas and lots of good recommendations came out of this report including one which was to expand the policy authority of the National Anti-Drug Strategy to include prescription drug abuse. But it has not been related to discussions about harm reduction.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I know the Canadian Centre on Substance Abuse has harm reduction as one of their pillars. So I just wondered why are we cherry picking some things and not others, especially when internationally it has been shown that harm reduction is of use. In Australia, in Europe, it is now completed accepted as a piece of that, because when you reduce harm and the person knows they're not going to die, their tendency to want to be treated becomes greater.
How much time do I have, Mr. Chair? A quick minute.
Ms. Davies talked about coordinating. I remember, in 2002, the report from the committee on this issue suggested that everyone integrate the work they do. Integrating the work that you do means working with the provinces, etc.
I know that in British Columbia there's a triplicate program for opiates. It means that when the doctor writes a prescription, there are three pieces to it. The doctor keeps one, the pharmacist gets one, and the colleges get one which they share with the police, and therefore you stop. It's been very effective in stopping double-doctoring.
Why wouldn't you, working with the provinces, think this is a good idea to promote as a national strategy? It's not just provinces. You're working with them. You all said that—that this integrated approach is working. So why wouldn't that happen, especially with people the federal government is responsible for, like Inuit, first nations, and the armed forces?
Director General, Law Enforcement and Border Strategies Directorate, Department of Public Safety and Emergency Preparedness
Those are all good ideas. I don't think anybody on this panel can really speak to them with any authority, though.
Again, Mr. Chair, I think this is largely in the neighbourhood of Health Canada,
Liberal
Hedy Fry Liberal Vancouver Centre, BC
No, because this works for the police in the provinces that I talked about. They're part of that program.
The question is, why can't we do that nationally, given that you are working with provinces? Everybody is working together without any gaps in the system. That's all I wanted to ask. Do you not see the benefit of doing that kind of thing and getting results?
Conservative
Conservative
The Chair Conservative Ben Lobb
If any of our guests have a take-away thought and would like to get back to the clerk of the committee at a later time, you're quite welcome to do so.
Thank you.
Next up, for a round of seven minutes, we have Mr. Wilks.
Go ahead, sir.
November 18th, 2013 / 4:15 p.m.
Conservative
David Wilks Conservative Kootenay—Columbia, BC
Thank you, Mr. Chair.
I thank the witnesses for being here today. Most of you are from the enforcement side, so it becomes somewhat tricky, shall we say, from time to time, when you're talking about treatment and prevention. Most of the dialogue that you people are dealing with is on the enforcement side.
Mr. Cormier, sir, I'll lean my first question to the RCMP. I'm a retired member, so I'll respect the rank. Back in 2009—I don't know if the RCMP stopped collecting—they used to publish an annual drug situation report.
Could you tell me if that still goes on? If it does, where can it be found, or is it internal?
Insp Jean Cormier
My expert here advises me that it's no longer being published. Those types of reports, as you acknowledged, were being published in 2009. Things have changed since then.
Conservative
David Wilks Conservative Kootenay—Columbia, BC
Okay.
Is there an anticipation...? It seems to me that it would be a valued report for all people concerned to know the drug statistics from the RCMP across Canada.
Insp Jean Cormier
Right.
The statistics in relation to prescription drugs, I believe, would be maintained by Health Canada. We do have statistics on seizures certainly. We would have access to that already.
Conservative
David Wilks Conservative Kootenay—Columbia, BC
Okay.
Certainly, from my perspective anyway, there will always be a portion of society who is not concerned about treatment and prevention. Their job is to actually lure people into the problem.
This may be directed to the Department of Justice, but is there anything under the CDSA or FDA, or the Criminal Code, for that matter, that may relate to the context of prescription drug misuse or abuse? There's not a lot in there right now, aside from double-doctoring.
Senior Counsel, Criminal Law Policy Section, Department of Justice
I'm not sure exactly what you're trying to look for. There is the offence of double-doctoring in the CDSA. The Criminal Code doesn't really have anything that's relevant to this area. If you're talking about contextual type offences or things of that nature—