Health Committee on Dec. 4th, 2018

[Sarah Blyth]

In my opinion, the more people we get safe access to drugs, the more we're taking people like him out of the picture completely. We need people to get safe access to dosed drugs and to be seen and cared for by medical professionals. I think that's really the biggest solution in terms of government. It's something that the government—

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

When you say “dosed drug”, do you mean a dose of crystal meth?

[Sarah Blyth]

Yes, or a stimulant replacement.

People need to get care. Some choose to use drugs, but a lot of folks are using drugs because they're self-medicating for a variety of reasons and they need medical care. A lot of these people are the most vulnerable in society. We need to work on doing something that we haven't done before.

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

Okay.

Mr. Dowie, I'm from Ontario and not too far from Shelburne. With regard to the 28 or 29 beds you have at your facility that OHIP or the local health network pays for, can someone come into your facility to an OHIP bed if they're on methadone?

[Vaughan Dowie]

It's no to methadone but yes to Suboxone, and the reason is relatively easy. As I said, we start people off in the wilderness program. In Ontario, to be able to administer methadone, you have to be a member of a health college, whether that be as a physician, a nurse, a pharmacist or whatever. Our staff in the woods, because they're in the woods, aren't able to do that. They're not members of the college so they're not able to safely administer methadone. They can't go to the local pharmacy, because—

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

Suboxone is similar—I'm not a pharmacist—but not exactly the same. Is that right?

[Vaughan Dowie]

You could administer it. It's a pill, basically, to be administered. You don't need to be a member of a health profession to do so.

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

Then why don't the doctors prescribe Suboxone instead of methadone to people?

[Vaughan Dowie]

I can't answer that. I think there's a shift going on now. There's a little less methadone being prescribed and a little more Suboxone being prescribed.

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

It's seems a little unethical. We've had a number of people come through our office and they have no money. Their parents have spent their retirement trying to help these people out, and they can't get access.

I'm not being critical of you. I'm kind of being critical of the government or the doctors who shouldn't be prescribing this. They should be helping their patients so that they can get an OHIP bed—if they can actually get an OHIP bed.

[Vaughan Dowie]

In a lot of metropolitan areas, going to a methadone clinic or whatever is no more of a hardship than anything else. You can go to the pharmacist and get your methadone there. We're an outlier in that we're in the woods, so we're not able to safely administer it.

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

What about the cost of a bed? I read an article in regard to London and Windsor in Ontario that said that 20 beds could cost $5 million to $15 million. Now, how could there be such a range for that? Amongst the industry, what is the cost of a bed?

[Vaughan Dowie]

Like a lot of things in life, it depends. For us the cost of a hospital bed is about $460 a day. What we get from the government is really about $412. That gives us about $4.3 million for the 29 beds. It depends on your staffing model and how it is done. For instance, we are more clinically intense than other programs in that we have more therapists involved, so it's a little more expensive.

As for what goes into the hospital bed, those are your labour costs, your facility costs, your food costs and all the other things that go into it. Your staffing model is an important element in that. I would say that the cost of a youth bed in Ontario, which is all I can talk about with any certainty, is probably somewhere between $300 and $450 a day.

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

Mr. Falcon Ouellette and I used to have an apartment in the same complex downtown. In the downtown here—I'm sure Mr. Falcon Ouellette has seen the same thing—there are three shelters, and I'm not being critical of the shelters when I say that they are the epicentres of social issues. Just in my time down there, I've seen people shooting up on the staircase of my condo where you enter. I've seen people pass out and crack their forehead wide open. I've seen a multitude of things, as many probably have in their own communities.

What I can't understand is that there is a non-stop flow of the fire department, the ambulance, EMS vehicles and police officers. It is just a continuous circle. I think to myself, if your cost is approximately $4 million a year, why would the provincial or federal government not partner with the city and put 200 beds in? The cost of the policing and the EMS has to be 10 times, even 100 times that.

Where is the disconnect here between governments and people who actually know what they're doing?

[Vaughan Dowie]

I will answer really quickly.

As I said, we have a social return on investment study. We're able to show that for every dollar the government invests in our program or in youth treatment generally, they are going to get a ten-time return.

Why is it that people don't do that math? I would say it's probably because government thinks really short term, one mandate at a time, and these are multi-mandate payoffs. I think that's part of what goes into the equation.

[The Vice-Chair, Conservative, Marilyn Gladu]

That's your time.

Now we will go to Mr. Davies, for seven minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Madam Chair.

Thank you all for being here. I can tell that your front-line experience dealing with the full gamut of substance use and addiction is powerful and something that this committee really needs.

I'm going to do something a little bit different.

You have all answered all the questions I had by describing very accurately what the roots of the problems are, so I'm going to pick up on something that was said. I think Ms. Blyth said the words “doing something we haven't done”, and someone else mentioned that we need a fundamental policy shift.

Here are the answers I heard you give that I was going to ask, but it's redundant now.

I heard that there is widespread contamination of drug supply across this country. I have numbers and figures. It was 39% of the drugs tested recently in British Columbia that were not at all what the person purchasing the drugs thought they were. I heard Ms. Jackson say that cocaine is actually meth, so we know there's widespread contamination.

We know that there is—let's just call it what it is—grossly inadequate access to timely treatment in this country across the board, every modality, every population, from indigenous people to women to young people. Whether you're dealing with alcohol all the way to heroin, people can't get access when they need it. If there's one thing we know about addiction, it's that when a person is ready to seek treatment—if they are ever ready to seek treatment—you have to get them in now or it's a death sentence.

I think, Mr. Favel, you described this endless cycle, this 19th-century approach to drug use and addiction, treating it as a criminal issue as opposed to a health issue.

I'm going to get right to what I think are some of the foundational solutions and get your opinion on this.

To each one of you, isn't it time that we stop treating drug use and addiction as a criminal issue and start dealing with it as a health issue?

[James Favel]

It's what I've been saying for years already.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Ms. Jackson.

[Darlene Jackson]

Although the Manitoba Nurses Union does not have a position on decriminalization, our nurses believe that we need to treat. We need to be there to provide treatment and get patients healthy. Putting them in jail doesn't solve that issue.

[Don Davies, NDP, Vancouver Kingsway, BC]

Ms. Blyth.

[Sarah Blyth]

I see people in and out of jail all the time. Even the police I speak to, the ambulance people, the firefighters, all know that we need to get folks safe access to something that's not going to kill them. That's the first line of front-line treatment, especially with people who have been addicted for many, many years. They need someone to come to. Organizations like our overdose prevention site is the first line of recovery. They need people to help them.

I guess that's all I have to say about that.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Dowie or Ms. Creighton.

[Dr. Victoria Creighton, Clinical Director, Pine River Institute]

I would just say that treatment does work. It works when you work with the family, you work within the community and you focus beyond the symptom, when you really look at the underlying yearnings that a child has. It does bring about change. They will have a life worth living.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Dowie or Ms. Creighton, what is the current wait-list?

I think you had the number of people. What's the current wait-list for government-subsidized beds at Pine River Institute for young people?