Health Committee on Nov. 29th, 2018

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

Thank you very much, Mr. Chair.

Just so Mr. Ouellette knows—and I'm sure he does know—in southwestern Ontario, where Ms. Mathyssen and I are from, we are unfortunately very familiar with the meth issue in our communities.

If I were a homeless person in Winnipeg today and addicted to crystal meth, and I said that I'm ready for treatment, what would happen to me? Do I go right into a facility? What happens?

[Dr. Ginette Poulin]

It could be variable. If you were presenting with either psychosis or some kind of emergency, you might present into the emergency department.

Typically what's happening is that people are presenting to our non-medical detox, which is the Main Street Project. It has about 20 beds for females and about 30 for males. From there, you could be transferred into our Addictions Foundation Manitoba treatment programs, which reside within Winnipeg. We have a male and female 28-day program.

We also have—

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

Just so we know, with the 28-day program, how many beds are available for that?

[Dr. Ginette Poulin]

In female, we have just about 30, and the male, I think there are 36 or 40. That's specifically in Winnipeg.

Then, we have—

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

To Mr. Ouellette's point, there are 1,500 homeless in Winnipeg. I'm not saying that all 1,500 are on crystal meth, but there are probably a few who have tried it.

[Dr. Ginette Poulin]

Yes, many of them.

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

I'm not criticizing. I'm just saying that 36 is probably 500 too few.

[Dr. Ginette Poulin]

Yes, and that's why we're saying that globally we need more service.

Now, those are just within Winnipeg. We also have many who will go to residential treatment programs in either Thompson, Brandon, or Ste Rose.

That increases some capacity, but we are grossly unmatched when it comes to—

[The Chair, Liberal, Bill Casey]

Mr. Lobb, Dr. Fandrey wants to make a contribution here.

[Dr. Sheri Fandrey]

As well as treatment beds, I think we have to recognize that not everyone can or will access treatment when they are using methamphetamine. The overlap between serious trauma and methamphetamine use is striking. For that we need responses other than detox and treatment beds, which are critically important, obviously, but we need some sort of response for people who are not able to stop using for reasons of trauma.

Further to that, if the expectation is for people to become abstinent to go into treatment, we need much better supports for trauma. We haven't really been addressing the trauma issue around crystal methamphetamine. As people access services—which would be great—we need to respond to the emergent need for trauma services. Honestly, the wait times for trauma services are longer than for addiction services and they are less plentiful.

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

When you speak of trauma services, are you talking about counsellors and therapies and that type of thing?

[Dr. Sheri Fandrey]

Yes.

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

The $130-million emergency fund is a first step, I'm sure, but again, to be realistic, $130 million is not going to fix the problem. You had mentioned the lottery and gaming corporation has to provide services for people with gambling addictions. It's the same thing in Ontario. Am I wrong to say that the pharmaceutical companies, pharmacies and the like that are associated with this epidemic should have to chip into that fund and perhaps make it $800 million?

[Dr. Ginette Poulin]

I would love to see that. One of the challenges, when it comes to addictions, is that it is so multifactorial and layered that we all need to be part of that solution. If we could engage other parties, such as pharmacotherapists, absolutely, I think there would be benefit to that.

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

Is there any other country—I know it's not in every country but I think it's in quite a few—that is doing well at this prevention, or any...?

[Dr. Ginette Poulin]

Sheri may want to follow up on that.

Certainly in Manitoba we've been looking to some of the protocols and those are.... Earlier someone mentioned the olanzapine within the emergency medical services, but there can even be safety protocols for providing the environment within health care delivery, such as not having anything dangerous around and not using things that will escalate. We've been looking to New Zealand and Australia and certainly the U.K. for these kinds of protocols.

Sheri, do you have anything from the research aspect that you perhaps want to elaborate on?

[Dr. Sheri Fandrey]

I think Australia has been a leader, certainly in the English-speaking world, in terms of how to approach methamphetamine issues. They have been dealing with issues equal to, and possibly greater than, what we're experiencing for at least 20 years. They have put a lot of time, energy and resources into addressing all of the different facets. They have an approach that is much more focused on harm reduction, that is much more pragmatic and that meets people where they are rather than putting any kind of stipulations on them, such as, “You must follow this path or you must be abstinent.” They have had a great deal of success in minimizing the worst harms from methamphetamine use.

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

I am sorry but there is one last point I would like to make and I am running out of time. I have talked to many police officers about this issue and they say that, unlike anything else, crystal meth will steal your soul. It's not something that you can quit and then a year later be back doing your life. Is there anything out there for the one in a hundred who actually cure themselves of crystal meth but need support forever? What's out there now for that?

[Dr. Ginette Poulin]

I think what is really important is not only, like you were saying, the effects neurologically on the brain but to have ongoing supports for any other underlying mental health issue. We haven't really touched on that but most often residual depression and mood changes are experienced and need to be addressed along with that. I think that if we are omitting these things from the picture, if we're not addressing them, then we're missing the mark in conjunction with that power of the crystal meth, that high that it gives.

[The Chair, Liberal, Bill Casey]

Yes.

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

Is there any more time?

[Dr. Sheri Fandrey]

I think social supports are very important as well. They are possibly even more integral than what we've been talking about to this point. Helping people find other ways to cope, finding ways to increase their ability to react successfully in the world.... People do recover from meth and the rate of recovery would be more than one in 100. It's not easy and that's why supports of various kinds need to be in place. The opposite of addiction isn't abstinence. The opposite of addiction is connection.

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

In Winnipeg, then, or Manitoba in the broader sense, where is all this meth coming from? Is there 20% being made in Manitoba? Is it all coming across the border? Is it coming in through the airport? Where is this drug coming from?

[Dr. Sheri Fandrey]

A great deal of it is coming from outside of the borders. There has been little or no evidence of small-scale, clandestine labs in Manitoba in the last several years.

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

When it comes in, where is it coming in from?