How much time is left?
Evidence of meeting #136 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was opioids.
A recording is available from Parliament.
Evidence of meeting #136 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was opioids.
A recording is available from Parliament.
4:45 p.m.
Conservative
4:45 p.m.
Conservative
Tom Lukiwski Conservative Moose Jaw—Lake Centre—Lanigan, SK
I'll cede the rest of my 30 seconds to the next intervenor.
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Liberal
The Acting Chair Liberal Doug Eyolfson
Thank you very much.
We're now going to go to Mr. Baylis, for five minutes.
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Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
Thank you for being here, everybody. I would like to understand the differences in the gateway to opioid use between Canada and the United States. Ms. Hedberg, you said that a lot of people are on prescription drugs, and that leads them into a list of drugs. Do you know the numbers, or the percentages?
4:45 p.m.
State Health Officer, Oregon Health Authority
I don't know the exact numbers or percentages. What we do know in the United States.... There was an article by a couple of economists from Princeton, who were looking at the causes of death and saw that it was particularly white middle-aged men in America who had an increase in opioid overdose deaths. As we were hearing from the previous speakers, it is much higher in rural parts of the United States than it is in urban parts, believe it or not.
Again, I think local data are really important. With white middle-aged Americans, they were talking about the epidemic of despair. It isn't just physical pain. For people who have had jobs in the construction business, forestry, agriculture or whatever, when those jobs move away or people lose them, they're left with economic despair, as well as physical pain.
4:45 p.m.
Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
If I understand, the prescription rate of narcotics is much higher in the United States than it is in the rest of the world. Is that correct?
4:45 p.m.
State Health Officer, Oregon Health Authority
Yes, that's my understanding, and when people are faced with that physical pain and start thinking about—
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Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
I understand that. Thank you.
Ms. Burgess, in Canada, our doctors are monitored much more for their prescription of opioids, to the point where they're not even going to prescribe them when they should be prescribing them, because they're afraid of being labelled as a prescriber of these drugs. What I'm trying to understand is whether the type of patients seen in the United States, as Ms. Hedberg mentioned, is the same as the type of patients we see in Canada. Do we still have this type of, as she mentioned, white, middle-class people who are sliding into drug use illicitly, or are they homeless people? Does that cadre of people exist in Canada as well?
4:45 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
It does. As in the United States, a number of years ago there was a huge push, usually, as we know now, from pharmaceutical companies promoting the treatment of pain by physicians as the next vital sign, and particularly OxyContin or oxycodone—which is a very nasty drug, because if you take one, very often you'll just say it feels great.
4:45 p.m.
Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
In that sense, though, if you have 100 patients, how many are going to meet the same criteria Ms. Hedberg mentioned?
4:45 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
Within the community practice I am in, very few will; it's not prescription driven. However, certainly as a prescriber, all of us have college-mandated limits currently. I do palliative care, so I deal with a lot of opioids appropriately, I think. There is this situation now where we do need to find more appropriate and effective ways to deal with chronic pain.
4:50 p.m.
Liberal
4:50 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
Particularly chronic pain.
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Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
Pain that lasts more than six months, chronic pain, is what I'm driving at here, because in the United States they've had great success—and correct me, here Ms. Hedberg, if I'm wrong—by moving towards these alternative pain management devices or products, and in Canada we're very far behind on them.
We're not going to solve this for everybody everywhere, but I'd like to know your thoughts. If one of the actions the federal government could take along with the provincial governments is a strong investment in alternative pain management technologies or methodologies and... I understand it won't address all of them, but it's something that's been very successful in the United States. Would this be something you'd encourage the government to look at?
4:50 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
Absolutely. We've actually set up that program for our inner city patients now, because access to alternative supports for chronic pain in our country requires us to pay. Not every province provides that free.
4:50 p.m.
Liberal
4:50 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
Exactly, and even if you're poor, you still have to pay $10 or whatever, and that could be a discouraging process.
4:50 p.m.
Liberal
Frank Baylis Liberal Pierrefonds—Dollard, QC
Because it's not covered; it's a private pay.... If governments were to take on that, at least they'd start to carve off and could see the same successes that we saw in the United States, if the governments were to say they'd cover the cost of alternative pain management treatments.
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Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
If we're saying that's what we should be offering, then we should be paying for it.
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Liberal
4:50 p.m.
Clinical Associate Professor, University of British Columbia, Vancouver Coastal Health
Yes, it is. That's what we're doing. We've got a little program going that's free to our patients right now with physio, OT, counselling etc., but that's just a small pause. That should be available to all of us.
4:50 p.m.
Liberal
The Acting Chair Liberal Doug Eyolfson
I'm sorry but your time is up.
We're going to go on to our last member for questions.
Mr. Rankin, you have three minutes.
4:50 p.m.
NDP
Murray Rankin NDP Victoria, BC
This first question is for Ms. Lapointe. According to a recent article in the The Georgia Straight, the overdose prevention society site on East Hastings Street is apparently the only location in British Columbia, and only one of two in all of North America, the other being in Lethbridge, Alberta, that permits clients to smoke drugs in supervised settings. That's because all of those supervised injection facilities like InSite can get around Canada's Controlled Drugs and Substances Act with a federal exemption from the law. They can't avoid a provincial law that forbids smoking inside a workplace. In your view, should access to supervised inhalation services be expanded across Canada?