Health Committee on Nov. 29th, 2018

[Michelle Boudreau]

If you'll permit me, since I understand you're at the beginning of your study, I'll just talk a little about the Controlled Drugs and Substances Act and the regulations and schedules, and how I think it aims to do exactly what it is you are suggesting.

The Controlled Drugs and Substances Act, or the CDSA, is our framework legislation, and then we have various schedules under that, as you may know. Methamphetamine is on schedule I.

We then have a schedule that relates to these precursors. As you were talking about the ingredients that you would need to create something like a methamphetamine, there are very strict regulations around the precursors. If I look, for example, at the class A precursors, those are the type that are essential to creating controlled substances. The pseudoephedrine that you mentioned, and P2P, which is another common ingredient—

[Ben Lobb, Conservative, Huron—Bruce, ON]

I'm sorry to interrupt. I hear what you're saying and I have some knowledge of that. I'm saying that we just heard from the chief superintendent that when they do seizures, these tablets are at the scene.

They're a controlled substance. Are these Canadian tablets, U.S., Mexican-made tablets? Where are these tablets coming from? What I've read is that Canada is pretty tight, the U.S. is pretty tight, and south of the U.S. could be a problem.

Is this right? Does Mexico do the same thing as us, or where's the gap here?

[C/Supt Paul Beauchesne]

Thank you for the question.

What I can say is that substances come legally into Canada, and then there are distributors within Canada who then ensure access for Canadians. As part of the national chemical precursor diversion program, we keep very close relations with those distribution companies, to be able to give us any kind of indication of something that's unordinary, not legit.

We work very closely. That information comes into our provincial, municipal and federal entities, and we follow up with those. That's part of the national chemical precursor diversion program.

[Ben Lobb, Conservative, Huron—Bruce, ON]

In your program, have you identified gaps then, bad actors or people or corporations or entities that are not doing their solemn duty?

[C/Supt Paul Beauchesne]

We do get information and follow up on it. Some of those investigations lead to accusations, and some do not.

[Ben Lobb, Conservative, Huron—Bruce, ON]

The other thing I want to talk about is on the treatment side. In Ontario, if you're addicted to heroin, etc., and you're on methadone, you do not qualify for an OHIP bed at a treatment facility. That is unfortunate, because usually if you're at that point, you don't have any money left.

Would somebody who is addicted to crystal meth qualify in any province to go to—I'll use the Ontario term—an OHIP bed that would be covered by the taxpayer?

[Suzy McDonald]

I'm not an expert in provincial requirements for various treatment beds.

The recent funding provided by Health Canada through the emergency treatment fund that's being negotiated with each of the provinces allows us to scale up all forms of treatment including treatment beds, where that's appropriate, and to make them available across the country. But provincial rules around how those are implemented vary among each province and territory in Canada.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Were they in negotiations with the provinces to say they need to make sure that people who have no money should qualify for those beds? Was that part of the discussion in those operating dollars in the emergency fund?

[Suzy McDonald]

It's a good question.

We set out the parameters that required how provinces would spend that money and what kinds of treatment forms would be allowable. We did not—

[Ben Lobb, Conservative, Huron—Bruce, ON]

One quick question....

[The Chair, Liberal, Bill Casey]

You're done. Sorry.

Welcome to the committee, Ms. Mathyssen. You're up for seven minutes.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you very much, Mr. Chair. I'm very glad to be here.

This obviously is a significant study as we grapple with the cost of health care and issues around addiction.

Madam McDonald, you talked about research and not knowing so many things. Are we investing enough in research? Not just in drug use, but I'm hearing across the board that medical research is not what it needs to be if we're going to grapple with various issues.

Do we need more investment?

[Suzy McDonald]

I think we have recently made significant investments in the area of research related to problematic substance use. Through the Canadian Institutes of Health Research we have funded what's essentially a network across Canada, like the Canadian research initiative in substance misuse, which has four nodes across the country and is doing significant research in the area of all forms of problematic substance use. I referred earlier to an innovative study around men who have sex with men related to methamphetamine use. That is being done through them.

The reality is a recent analysis was done of treatment options for methamphetamine, a 2018 review of the literature, that indicated we do not have good guidelines for how to treat methamphetamine use. This is an area where more research can and should be done, both in Canada and internationally.

We are working with international partners to see if we can scale up that research to better understand how we can provide better treatment for methamphetamine users.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you.

[Kimberly Lavoie, Director, Drug Policy, Department of Public Safety and Emergency Preparedness]

In addition to what my colleague from Health Canada said, we are also working with Statistics Canada to get a better grip on a complete profile of who the methamphetamine user is.

A study on opioids was recently done in Surrey, B.C., that took data from a number of different metrics to get a complete picture of who those people are. We're looking at using that methodology to do a similar study on methamphetamine use somewhere in western Canada. We're currently in negotiations with StatsCan on that.

Internationally we have a North American drug policy dialogue forum with both the U.S. and Mexico. Coming out of the most recent meeting on November 9 was a commitment to do a threat assessment on methamphetamine for North America.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you.

Madam Lavoie and Madam McDonald, you've both touched on my next question.

You talked about the social determinants that lead to drug abuse and the classics: homelessness, poverty, unemployment.... We know the cost of poverty in this country is catastrophic in the human and economic cost.

I'm wondering what specific social interventions would be most effective if we want to prevent this particular social isolation, this increase or catalyst of drug abuse.

[Suzy McDonald]

I think this is an area that we've been paying a tremendous amount of attention to, and we have partnered with departments across the federal government. Really I think the first piece is sharpening this evidence base, so it's addressing key information gaps around the socio-economic data. Kimberley spoke a bit about a very important survey that starts to talk to us about which are the most important social determinants of health when it comes to substance-related use.

We certainly also believe that reducing stigma—and that means really helping people to understand that drug use is a health issue—is a key piece of what we're doing. I think the other part of it really is working with ESDC and other departments. The new poverty reduction strategy, the new housing-first strategy and so on are all areas where we've been able to influence and talk about how we can start to do a better job in integrating the various social determinants across the work we do.

Our chief public health officer in Canada talks a lot about resiliency in youth and how we build resiliency in youth. That's an area of focus for us as well. If we're able to address resiliency and mental health issues in early childhood, then we will be much better off in the long term in Canada.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you.

We've heard for—and now I'm going to reveal how long I've been at this—30 years or more about the social determinants of health. We've heard from the Canadian Medical Association, the nurses, organizations in the field, and they keep coming back to housing, housing security. We don't have that in this country. In fact, it's been postponed.

Should we be looking at something concrete now instead of continually postponing it?

[Suzy McDonald]

I think the issue of housing security is one that's important for all Canadians. I know we are working hard to move that forward. I'm not an expert in that area but what I can say is that there are direct links between housing and problematic substance use in Canada. We were very pleased to be able to work with our colleagues to change some of their policies to ensure that someone is no longer required to be substance-free in order to access housing for some of their programs. We think that's a big step in the right direction.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Okay. I thank you for that.

I'd like to turn to Paul from the RCMP. You talked about the realities of money laundering and organized crime, and one of the things that occurred to me was the danger that a police officer faces in terms of intervening. In a community not far from me, there was an explosion. A meth lab exploded and it destroyed the house. It injured the family. Up until that moment, you'd wonder what was there.

What about the danger to police officers with regard to organized crime, these clandestine operations? Could you comment on that?

[C/Supt Paul Beauchesne]

These clandestine laboratories that are basically providing methamphetamines to the population are very dangerous explosives. I'm not an expert in the explosives category but there's also the matter of the effects on the person. When police are called to a situation in which someone may be on methamphetamines, obviously it's not a good situation.

We've all seen some of those interactions between police and people suffering from mental illness and whatnot. They are very front of mind for us. We're getting better at our training. We look at the four pillars of the strategy. Police officers over the years are getting much better. We have the tools to be able to intervene. We have the tools to be able to use the laws and to charge people, but I think we're really doing a better job in terms of the harm reduction and, when we get to those situations, we are more aware of being a gateway to services as an option instead of going through the courts and the justice system.

I think we've come a long way in doing that and the strategies. That's how we feed more into the global strategy.

[The Chair, Liberal, Bill Casey]

That's excellent. Time is up, sorry.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

But Mr. Chair, I was just getting started.

[The Chair, Liberal, Bill Casey]

I know, but actually it's over.

Now we go to Mr. Ouellette. Welcome to our committee. I know you've been involved with this issue, so I'm sure you'll have some interesting input.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Thank you very much, each and every one of you, for coming. I really greatly appreciate the opportunity to ask a few questions.

I have very short questions. One of them is about schedule I, schedule III and the precursors using the ingredients. Schedule I has mandatory minimums of one to two years depending on the production, but if you are unauthorized to use the ingredients, it's a maximum of 10 years.

From what I've understood, is that so people do more importation of the actual drug, because it's more of a deterrent to actually producing it here in Canada? I've heard from the Winnipeg police that most of the drugs actually come from Mexico right now, using ingredients coming from China and India. Is that true?