Good afternoon. Thank you again for the invitation to present to you today.
While the overall prevalence of methamphetamine use is low, at approximately 0.2% of the Canadian population, the impact of its use on individuals, families, friends and communities is extremely high. As Donald just mentioned, the reasons a person might use methamphetamines vary as widely as the individuals themselves. Inevitably, the outcomes are common: illness, psychosis, injury, disease and often death. In the testimony of previous witnesses today and on previous days during this study, you've heard about the need for improved harm reduction and more treatment facilities and enforcement to address this problem. These are all important steps to mitigate the current situation.
From a public health perspective, however, there is a paramount requirement to look at why people use psychoactive substances, such as methamphetamines, and to identify upstream approaches to reducing this consumption. Psychoactive substances can be used as a coping mechanism by those who have experienced trauma, violence, social marginalization or the loss of cultural identity. We also know that the social determinants of health often underlie problematic substance use. Homelessness, poverty, social isolation, racism and stigma can all be precursors of problematic substance use.
It is known that those at the lower end of the social gradient have poorer health outcomes. They tend to have higher rates of consumption of intoxicating substances, are more likely to be incarcerated and are disproportionately composed of people of colour and indigenous people. Steps must be taken to address these issues, by addressing the social determinants of health, and the harms we have caused to the indigenous peoples of Canada. I encourage this committee to make recommendations for bold action.
For example, the Government of Canada should develop an action plan to fulfill all the calls to action from the Truth and Reconciliation Commission in the next four years; increase investments in social housing, using a housing first model; fully explore the potential of a basic guaranteed income; support families in raising their children by adequately funding early childhood education and care in every jurisdiction of our country; and, as recommended by the Canadian Association of Social Workers, promulgate an act of Parliament that includes principles similar to those found in the Canada Health Act, to help guide Canada's social transfer and other social investments, and make possible shared performance indicators across our country.
These are just five upstream recommendations that will help slow the number of daughters and sons whose lives are torn apart by methamphetamine use.
It is also important to recognize that problematic substance use is a health condition that can be managed and successfully treated for those who are ready. Unfortunately, methamphetamine use, as has been mentioned, is a very difficult condition to treat. Psychosocial counselling and behavioural-management approaches can be effective, but there are simply not enough drug treatment services in Canada to meet the demand. Further exacerbating the situation is the lack of national standards for private drug-treatment services, leaving patients and their families vulnerable to questionable treatment regimens that cost thousands of dollars.
Unlike opioid-use disorder, where medication-assisted treatment is available, there are currently no accepted drug-based therapies to treat problematic methamphetamine use. Given the millions of dollars spent in the United States on this type of research, I find it unlikely that such a silver bullet will be discovered.
Despite these confounding circumstances, there are actions the Government of Canada can take to relieve some of the suffering associated with methamphetamine use, in the short term. These recommendations are from the Canadian Public Health Association's 2017 position statement on the decriminalization of personal use of psychoactive substances, which I believe was circulated in your background packages.
When CPHA speaks of decriminalization, we are speaking of the simple possession and use of drugs. I'm not talking about the property crime or physical violence that often accompanies drug use. I'm not talking about the large-scale trafficking and manufacture of drugs. Problematic drug use is a health issue that has, for the past 40 years, been recast as a public safety issue. There absolutely are public safety components to this, but for the individual, it is a health issue. If you want to make the necessary changes to reduce the impact of illegal drug use in this country, then you need to treat it as a health issue and act accordingly.
One step in accepting methamphetamine use as a health issue is to decriminalize possession for personal use and to provide the necessary health promotion, harm reduction and treatment services necessary to address the needs of substance users.
To that end, the Canadian Public Health Association calls on the federal government to work with the provinces, territories, municipalities, and indigenous governments to decriminalize the possession of small quantities of currently illegal psychoactive substances for personal use and provide summary conviction sentencing alternatives, including the use of absolute and conditional discharges.
Decriminalize the sale and trafficking of small quantities of illegal psychoactive substances by young offenders using legal provisions similar to those mentioned earlier.
Develop probationary procedures and provide a range of enforcement alternatives, including a broader range of treatment options, for those in contravention of the revised drug law.
Develop and improve access to harm reduction and health promotion infrastructure, so that all those who wish to seek these services can have ready access, and increase the availability of high-quality treatment services to meet the demand.
Finally, provide amnesty for those previously convicted of possession of small quantities of illegal psychoactive substances.
Thank you.