Health Committee on Nov. 29th, 2018

[Suzy McDonald]

Essentially, the idea of the model is that you provide outlets for youth so that they're able to be involved in sports or other extracurricular activities early on. This diverts them from any possibility or any desire to move into illegal substances because they're very active and involved in their communities.

[The Chair, Liberal, Bill Casey]

Thank you very much. We're done there.

That completes our seven-minute round.

I want to ask one question. You said there are 220,000 people awaiting treatment. How many are in treatment?

[Suzy McDonald]

That number varies widely. The statistics I was giving were from quite a number of years ago.

We are doing some baseline surveys right now to figure out how many people are still waiting for treatment. The number of people in treatment varies considerably. It's increasing because of the recent funding provided. I don't have a figure for you for that today. Ask me that again in six months and I'll be able to provide an accurate answer.

[The Chair, Liberal, Bill Casey]

What's your best guess?

[Suzy McDonald]

I really can't guess.

[The Chair, Liberal, Bill Casey]

Now we move along to our five-minute round. We're going to start with Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair.

I would like to thank my colleagues who have asked questions so far. You asked half of my questions, so I'm a little bit irritated by that. The next time I'm going to ask to be first, Mr. Chair.

I'll start with the public education that is being provided out there. Ms. McDonald, you indicated that it's not working. Is it because there's a lack of it? Is it just not resonating, or is it not adequate? Maybe talk a little about that, if you don't mind.

[Suzy McDonald]

I'm not sure I said that it wasn't working, but I do think that there's more that can be done in the area of prevention and public education. I think there are two components to that. One key component is about prevention, writ large, and the role that we and the provinces and territories have in schools and in helping children to understand what drug use means and what drugs look like. A fair amount of work has been happening there, both at the federal level and at the provincial and territorial level.

I think there has been a change in messaging and in tone in how people are doing that across the country, from this mantra of “don't do drugs” to instead providing evidence-based information to children in the context of peer education and teacher education. That helps to move that forward.

The second piece I was talking about was this issue of stigma and the idea that many people see drug use as a moral failing. There is the lack of understanding around the fact that it is in fact a health issue—there is a serious health component to it—and that it can happen to anyone in any walk of life across this country.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

I have a question for Chief Superintendent Paul.

Ben Lobb mentioned that a lot of the ingredients are coming from other countries. I don't know if you can answer this or not, but what are Canadian border services doing? How do they check for the drug when it does cross the border? Can it be detected by dogs? How are they finding the stuff? Obviously they're not, because the product is getting into the country. Can we do a better job at the border to prevent it from coming in?

[Trevor Bhupsingh]

I'm not going to speak for the Canada Border Services Agency. What I'll say is that they're using a mix of tools, including all sorts of intelligence and working with other sorts of law enforcement in different countries. In terms of detection methods, you will find a lot of these drugs, including methamphetamines, being distributed through mail systems, so they would use things like X-rays and detector dogs, etc.

There are a number of different tools that border services officers use in trying to identify illicit shipments of drugs.

[Len Webber, Conservative, Calgary Confederation, AB]

I see.

When you do enter a meth lab, you indicated that in some cases you see the actual packaging of over-the-counter drugs—cold medication or whatever. Are the pharmacies throughout the country aware? I'm sure they are, but are they tracking the sale of their products, and if there are individuals coming in who are purchasing large amounts of this medication, are they tracking or monitoring or maybe just watching?

[C/Supt Paul Beauchesne]

Thank you very much for the question.

That's exactly what the national chemical precursor diversion program.... There is an acronym for it. We usually just use the acronym. I don't have to spell it out.

For me, it's outreach. It's outreach to those companies, as far as even Canadian Tire and Home Depot, to be able to make them aware. That is the part of the program I think is the most important. It is that information that we glean from our municipal departments, from our provincial departments, with the federal government, and then all together we try to attack the phenomenon or the trend in different ways.

[Len Webber, Conservative, Calgary Confederation, AB]

I see. Okay.

[Michelle Boudreau]

Perhaps I could add a little bit. I know you're on time, so I'll try to be very fast.

Certainly pharmacies are aware, and colleges of pharmacy as well. For example, in Alberta and B.C., the college of pharmacy recommends that these products are kept behind the counter so that you have to ask. In some places they'll even take your ID, etc., and really try to control the amount to each person as well.

Mr. Chair, I wonder if you could permit me just one minute. I would just like to reply to the question we were asked about the time of the high. I know you're meeting later with the CCSA. From their report, you are quite right: It does depend on the route of administration and it can be as long as 12 hours. What is interesting here is the amount of time it takes to leave the body, compared to cocaine. With cocaine you can have 50% of it gone within an hour, whereas it takes 12 hours for 50% of the methamphetamine to leave the body. I just wanted to add that because you seemed quite interested.

[Len Webber, Conservative, Calgary Confederation, AB]

On the treatment for someone who has overdosed from meth, there isn't anything, right? There is nothing like naloxone for fentanyl.

How do they treat people when they do come in?

[Suzy McDonald]

Essentially they treat the symptoms that might be exhibited. If it looks as if someone is suffering from psychosis, they might be able to administer a medication specific to psychosis. But with treatment, as I said, there is no immediate ability to reverse an overdose from methamphetamine.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

[The Chair, Liberal, Bill Casey]

Dr. Eyolfson, you have five minutes.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

I would like to thank Ms. Sidhu for giving me her time to continue to ask some questions.

I want to pick up on a thread we were on when my time ran out. We went, again, into harm reduction. I should qualify this. I don't think it's the panacea for all the problems, but it's an important pillar.

There is a lot of public misperception and, quite frankly, a lot of political push-back, depending on the province. The Government of Manitoba is showing absolutely no interest in pursuing supervised consumption sites. The Government of Ontario is starting to push back and is saying it wants to either close them down or at least restrict how many open.

Would you recommend that the provinces start embracing this as one of their pillars of treatment for this problem?

[Suzy McDonald]

I think that, when you look at the issue of substance use, you really need to have elements of all four of the pillars that we have set out at the federal level, which are prevention, treatment, harm reduction, and enforcement, all supported by evidence.

Harm reduction is an important pillar to any approach to substance use in Canada, and there are different ways you can implement harm reduction across the country.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Absolutely.

Another thing we talked about with harm reduction—and there seems to be, again, some push-back from those who don't understand—is needle exchange programs. Certainly on the needle exchange programs in prisons, there has been push-back from certain players there.

Just so we get this out there, because people don't understand, you don't have more needles out there in the system when there is a needle exchange. People are bringing back their dirty needles in exchange for clean needles. Is that correct?

[Suzy McDonald]

Generally what we would find is that, where needle exchanges are available, there are in fact fewer needles scattered about those sites. In fact, those are being returned and exchanged, so there is less needle debris associated with those sites—needle exchanges, supervised consumption sites or others.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

You also said, and I just want to reiterate this, that needle exchange programs do, in fact, decrease the transmission of blood-borne diseases like hep C and HIV.

[Suzy McDonald]

The evidence is very clear that there is a decrease in blood-borne infections when needle exchange programs are present.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

I just wanted to clarify something, as well. You talked about the symptomatic treatment, and this is something I understood from drugs like this. I've looked after a few cocaine overdoses in my time, and meth is rather different, in that it's more resistant to some of the sedatives you'd have to use. Sedatives like benzodiazepines, midazolam or Ativan were a big part of it, and this is rather resistant.

There's been some interest in the anti-psychotic drug olanzapine. It's come to our attention in the press that our first responders, our paramedics in Manitoba, are now able to use olanzapine for people in the field, in meth-induced psychosis. Should we be improving the awareness of this and encouraging more services to do this?