Evidence of meeting #5 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was strategy.
A recording is available from Parliament.
Conservative
Laurie Hawn Conservative Edmonton Centre, AB
Sticking with the international theme for a second, all countries, not just first nations, are facing the same kind of health-care challenges writ large that we are. Are we doing any research with other countries to learn from them?
Knowledge Broker, Canadian Centre on Substance Abuse
CCSA is involved in a number of collaborations and research initiatives. One example has to do with new psychoactive substances—how to monitor them and share information across jurisdictions, domestically and internationally. We drew on some international data from Australia, the U.S., and other countries to support the work of this strategy.
Chief Executive Officer, Canadian Centre on Substance Abuse
The U.S. is number one in per capita use, and there is Europe and Australia. But in a lot of these countries the problem is not manifesting itself as we have seen here, because the supply availability is very different, or at least it hasn't reached our level yet. This is an opportunity for Canada to lead by saying, “If you're going down the road of expanding accessibility to certain drugs, be mindful of these practices”. I think that's an opportunity for Canada.
Conservative
Laurie Hawn Conservative Edmonton Centre, AB
Are we doing that at all? Is Health Canada doing that with their international partners?
Chief Executive Officer, Canadian Centre on Substance Abuse
Last year, at the Commission on Narcotic Drugs, Health Canada tabled a resolution on a take-back initiative, encouraging individuals to take the drugs out of their cabinet and bring them back to pharmacies. That resolution was adopted by the Commission on Narcotic Drugs. It provided a toehold, if I can say it that way, for the international community to consider in determining where prescription drugs fit in the realm of abuse.
I think there's ample room, as this strategy and other efforts go forward, for Canada to demonstrate how to deal with the problem. We can offer examples of identification, commitment, investment, follow-through, and best practices.
Conservative
The Chair Conservative Ben Lobb
Great. Thank you very much.
That concludes the first round of questioning.
For the benefit of the committee, the clerk reminds me that a couple of weeks ago he sent around the study that Ms. Fry asked about. We all get a lot of e-mails in a day. If anybody would like the clerk to resend it, please contact me or him, and he'll be glad to send it so you can review it.
Okay? Great. I just wanted to get that out there.
Next up we have—this our next round—Ms. Morin.
Go ahead, please.
NDP
Isabelle Morin NDP Notre-Dame-de-Grâce—Lachine, QC
Thank you very much, Mr. Chair.
I want to thank the witnesses for joining us today.
Mr. Perron, at the end of your presentation, you put forward three recommendations, the last of which had to do with the commitment of the resources you need.
Could you elaborate on those resources? Are you talking about human or financial resources? For the committee's benefit, I would like to understand what your needs in this area are.
Chief Executive Officer, Canadian Centre on Substance Abuse
Thank you for the question.
NDP
Isabelle Morin NDP Notre-Dame-de-Grâce—Lachine, QC
Can you please keep your answer brief, as I have other questions for you?
Chief Executive Officer, Canadian Centre on Substance Abuse
Okay.
The CCSA needs resources to support the implementation of the strategy and, more specifically, to coordinate the working groups we listed earlier—the five working groups and the action teams. We have requested financial support from Health Canada to be able to take on that role....
Chief Executive Officer, Canadian Centre on Substance Abuse
We have requested $1 million a year for the implementation and coordination of the strategy. With that money, we will be able to encourage not only the participation, but also the investment from other levels of government, other professional organizations and the non-profit sector. That would provide significant benefits, as we have seen in our other strategies.
NDP
Isabelle Morin NDP Notre-Dame-de-Grâce—Lachine, QC
Okay. Thank you very much.
During your presentation, you told us about three kinds of medications that require attention—opioids, stimulants and sedatives. I thought that was very interesting because you are the first person to tell us that there are three types of medications. Today, I am most interested in stimulants. I want my colleagues to know that, since I am a bit younger, I was exposed to those drugs at university.
I studied education at the Université de Sherbrooke. So we are talking about a world of educated people. Despite that, one of the problems at the end of semesters was that students would look for Ritalin. This is nothing new. Four years ago, I remember that people were seeking Ritalin because it's a stimulant that helps improve their concentration during exams. That was a very sought-after drug, and I was worried because I knew people who used it without a prescription.
I don't see anything in your recommendations aimed specifically at the university world. Much is said about young people. Individuals who appeared before us at other meetings told us about young people at elementary and high school levels, and about prevention. This issue is a source of concern for me, and the RCMP representatives we heard from last week said that the biggest problem was not in what we knew, but in what we did not know.
So I'm wondering whether you have anything to say about that. What solutions do you have in mind, and what can be done to remedy these kinds of issues? No one has talked about this so far, and I would very much like to know what your solutions are.
Chief Executive Officer, Canadian Centre on Substance Abuse
Thank you.
I would have asked you to talk about the problem because that's exactly what is happening with stimulants. Across the country, we are seeing that the availability and accessibility of those drugs—Ritalin, Adderall and that whole range of drugs prescribed for attention deficit issues—is very high. The consumption of those drugs is abusive, especially among university students during exams for improved concentration. If I may say so, that's an alternative to Red Bull.
Chief Executive Officer, Canadian Centre on Substance Abuse
Unfortunately, that still has harmful effects and could be dangerous if consumed. The abusive use of stimulants would be part of that strategy of prevention, more specifically when it comes to the recommendation on awareness raising. Ms. Robeson should correct me if I'm wrong, but I believe that we have no specific recommendations for the university demographic in terms of those drugs.
To open another door, I just want to mention that the Canadian Centre on Substance Abuse is co-chairing the National Alcohol Strategy. We held a meeting last week, and representatives from the Acadia University were part of our group. We discussed the prevention messages we would like to communicate to that segment of the population when it comes to not only stimulants, but also alcohol. I would perhaps also like to create links with that strategy.
NDP
Isabelle Morin NDP Notre-Dame-de-Grâce—Lachine, QC
I have one last question on stimulants. It concerns the same group of individuals.
So few people have access to a family physician that many of them go to an emergency clinic to obtain a prescription. It's actually very easy to obtain a Ritalin prescription at an emergency clinic. Do you have any suggestions regarding access to family physicians in terms of resolving the prescription problems? People can obtain a prescription for a medication they do not need because they don't have a family physician. Do you have an opinion on the topic or any relevant studies to share?
Chief Executive Officer, Canadian Centre on Substance Abuse
We have mostly been focusing on ways to better educate physicians who are working in emergency clinics. For instance, we talk about what tools those physicians need to have and what questions they should ask those who come to see them. We emphasize the importance of identifying those individuals who could try to commit fraud and those who are there to try to find a physician.
Of course, access to a family doctor is a much broader issue that involves considerations that go beyond this strategy. It would be desirable for everyone to have access to a family physician, but, for the time being, the focus is mostly on better awareness raising among the available physicians.
Conservative
The Chair Conservative Ben Lobb
Thank you, Ms. Morin.
Next is Mr. Wilks. You have five minutes, sir.
Conservative
David Wilks Conservative Kootenay—Columbia, BC
Thank you, Mr. Chair.
Thanks to the witnesses for being here today. Mr. Perron, it appears that several recommendations in the First Do No Harm strategy have both CCSA and Health Canada listed. Would you explain further how CCSA's mandate differs from that of Health Canada's? Since we are looking at identifying the federal role, we want to make sure that there is no duplication of effort. Would you talk about that for a while? Then I have one more question after that.
Chief Executive Officer, Canadian Centre on Substance Abuse
Thank you, sir.
Actually, that's a very good question because people often ask about the difference between the two. If we go back to the CCSA Act, which was circulated, our role is really about bringing together all levels of government, and the not-for-profit and private sectors. Our job is ensuring that the efforts and investment that Health Canada wishes to place on the table vis-à-vis on issue can best be leveraged with other levels of government—but also with those other components.
CCSA's role is really about bringing together that national band of organizations and advance it beyond that of one particular department or level of government. It has worked well in other areas and has allowed the federal government and other levels of government to more precisely undertake what they see as their specific role, as opposed to having to take on all aspects of it.
Did you want to comment further on that, Paula?
Conservative
David Wilks Conservative Kootenay—Columbia, BC
I'm curious about this. So CCSA is funded to take on these responsibilities called for in the First Do No Harm strategy. What happens if you don't continue the coordinating efforts you've spoken about?
Chief Executive Officer, Canadian Centre on Substance Abuse
There's always a danger in bringing a lot of people to the table and creating an expectation of collaboration on a go-forward basis. That said, I'm very keen.... Let me put it this way. The fact that everybody has been to the table and remains at the table and is prepared to invest their own resources, time and moneys toward commonly understood and advocated-for recommendations is a very significant addition, value-added, to whether a federal investment would be provided to this equation.
Essentially, federal dollars going to CCSA—because that's largely how we're funded—provide for a maximal national return. In fact, we can demonstrate that in other areas of the strategy. To not fund CCSA at this point in terms of a very specific—and Madam from the NDP asked earlier about what we required—would do two things. One, it would certainly lose the momentum of the partners who are prepared to move this thing forward. Second, it would risk a tremendous amount of duplication, lost connectivity, and the ability to leverage funds that are currently in the system now.
Ultimately, it has taken us a long time to get here and to have the clarity of where to go. It wasn't because there wasn't anything happening; there was a lot happening, but it wasn't connected. Being able to connect it now into a comprehensible whole that everybody can have a reasonable portion of is the role that Parliament created for us to play.
The funds that we would require to move that forward is what our partners have said they want from us. I think if we don't do it, there's a great risk that we'll be coming back to this committee in three or four years and having the same discussions all over again.