Health Committee on Nov. 18th, 2013

[Paul Saint-Denis]

I have a couple of observations, Mr. Chairman.

One is that, as I recall, the health representatives when they were here pointed out that Canada is the second-highest consuming nation of prescription drugs. That means that the number of drugs that are circulating is high indeed. And they're circulating through legitimate means; these are drugs that are being prescribed. So when we talk about a systemic problem, there may be an issue there with respect to the proper prescribing of drugs.

A lot of the drugs that are prescribed end up sometimes being stolen, sometimes being misused. There's theft of drugs from pharmacies. I don't think that a systemic regulatory approach would solve or correct or prevent thefts from pharmacies, thefts from homes, thefts from elderly residences where drugs are stolen.

[Libby Davies, NDP, Vancouver East, BC]

I don't disagree with that, but for sure if there were some kind of system in place that prevented people from shopping around and getting double or triple prescriptions, if there were a check system in place, surely that would be a vast improvement. Would you agree that needs to be done?

If it's done in one province or maybe a couple of provinces, great, but there are huge gaps across the country.

[The Chair, Conservative, Ben Lobb]

We're over time, so please give just a real quick response there, if you have one.

[Paul Saint-Denis]

In terms of a national approach—as you're aware, we do have the offence of what's essentially called “double-doctoring”; it is not that—the offence is seeking to obtain or seeking a narcotic. That applies nationally. As Ms. Davies has pointed out, there are certain provinces that have a systemic computerized mechanism for dealing with prescriptions and keeping track. Perhaps it's something that could be done across the country, but these are issues that are regulated by the provinces, so it really comes down to provincial intervention in that area.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Saint-Denis.

Next up for a seven-minute round is Mr. Hawn. Thank you, sir.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you very much, Mr. Chair.

And thank you to our witnesses for being here.

I have a number of questions, so I'd appreciate reasonably concise answers, if you could. I'd like to start with Public Safety.

There's some talk about grassroots, getting into community groups and so on to work with them. I think it would be fairly common sense to attack it at the lowest possible level—community groups and so on dealing with youth and keeping the youth off drugs.

Can you speak to the level of coordination with community groups? Do you have any examples of that? Does big pharma have a role to play in that on the education side?

[Trevor Bhupsingh]

One of the things we're looking at.... I agree, Mr. Chair, that there are probably a number of ways we can go at it with respect to, I would say, almost awareness, at a number of different levels.

The problem we're seeing on the law enforcement side is that this ranges from some nexus to organized crime in some ways, down to just individuals. In dealing with the individual aspects of it, I think you're right, there's probably an opportunity for us to start some awareness campaigns that are grassroots, in local communities. I think that on a go-forward basis that is something we'll look at.

With respect to pharma, there probably is a role. What could be done? Ultimately there are a number of things, in terms of discussion with them, control mechanisms, etc. Again, that's part of the solution.

But the focus for us is really about awareness, number one, that this is a growing issue, and then number two, attacking this probably at a number of different levels, including the grassroots and individuals and you guys.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

This is a subjective question that will probably generate a subjective answer, but where do we start with young people to talk about abuse of prescription drugs and abuse of illegal drugs or illegal substances such as marijuana? Do we start at grade 6, grade 5, grade 4? Where do we start?

[Taunya Goguen, Manager, Serious and Organized Crime, Department of Public Safety and Emergency Preparedness]

I don't have a great answer for you other than to say that this is within Health Canada's domain and it's really their area of expertise.

I know that the RCMP also has some programs targeting youth, so they may want to add a word.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Sure. Go ahead.

[Insp Jean Cormier]

I can add to that, for sure.

We have a number of different awareness programs. One of them is the aboriginal shield program, which targets in principle the aboriginal community and certainly the youth starting at school age.

We also have the drug abuse resistance program, which is well known as DARE. That also targets kids of school age, but more in grades 7 and 8, before they go to high school, where they are more likely to be exposed to, or get offered, different types of drugs. Again, it's about awareness and prevention.

We also have DEC, the drug endangered children program, an early intervention initiative that seeks to stop the cycle of child abuse caused by the exposure to drug activities. The program involves a resource guide, which has been translated into French, and training program service delivery personnel have access to that.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you.

Through you, Mr. Chair, to Commissioner Head, you talked in your remarks about CSC being an international leader with respect to substance abuse programming and treatment.

Can you expand on that a little bit, the programming and more specifically the treatment for drug abuse within the system?

[Don Head]

Most definitely. Over the last 20 years, we've developed a series of programs, based on research, that target various issues, substance abuse being one of the bigger issues that we deal with. Through that research and the work of our staff, we've developed various substance abuse programs that are delivered to offenders. These are moderate-intensity programs and high-intensity programs, even to the point where now the programs have also been tailored to address the specific needs of aboriginal offenders and also some of the unique needs of women.

Many countries around the world have adopted our programming framework and have put it in place in their jurisdictions.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Can you describe a high-intensity program?

[Don Head]

A high-intensity program would run anywhere from 12 to 18 weeks and require engagement four to five days a week, for three to four hours. Then there's ongoing follow-up with front-line staff, with the parole officers who look after the cases and any other individuals who would be interacting with the offender.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

I'm trying to drill down here a little bit. Can you be a little more specific on exactly what goes on? Is it abstinence from drugs? Is it supplying drugs and tapering off? Or how do you do that?

[Don Head]

It's based on a social-psychological model in terms of presenting situations to individuals and having them look at alternatives other than going to drugs. It's looking at how to make better choices, how to make smart choices that do not involve drugs, alcohol, or any other intoxicant.

A cognitive-behavioural model is the model that we've been using.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Does that involve supplying them drugs in the process?

[Don Head]

Our belief is that we need to have drug-free prisons, and we'll continue to operate in that manner. That's our enforcement piece. Our treatment piece is along the lines of the programs that I'm talking about.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Again, this may be a bit out of your lane, but if that works within the correctional system, where obviously you have, pardon the expression, a captive audience, would you see the same application for people outside of the prison system in terms of treating drug abuse?

[Don Head]

I think there is a good framework there to be followed. We have worked with some community-based organizations, because one thing we're really interested in is that any gains the offenders make while they're incarcerated will get carried over into the community. We will deliver a maintenance program for offenders under the supervision of the community, but we also will work with other agencies so that they can support those offenders beyond the warrant expiry date.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you.

That's it, Mr. Chair.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Hawn.

Next up we have Ms. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much.

Those were very interesting presentations by everyone.

I know that what you are specifically dealing with as part of the team is the supply side, but from my knowledge as a physician and my understanding of these issues over the years, you can't only deal with supply side at any one point in time. You have to look at why the demand; the demand side is something you have to look at.

I would like to reiterate Mr. Hawn's request for short, crisp answers. I'll try to ask short, crisp questions.

Mr. Head, you said that 80% of offenders who came in were addicted in some way, or were taking medication of some kind, either prescription or illicit. I also note you said that after 20 years of doing this, this statistic has remained constant. Do you look at evidence-based...? I mean, if some statistic remains constant over 20 years, is there an opportunity to look at whether or not this is the right procedure?

[Don Head]

Yes, we do use evidence. The 80% figure is not the same group of people who move through the system. As new admissions come into the federal system, 80% of them have had some kind of substance abuse problem in their life.