Evidence of meeting #17 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was overdose.
A recording is available from Parliament.
NDP
Don Davies NDP Vancouver Kingsway, BC
May I ask you, sir, is there a difference in this bill in terms of the quantity? I mean, if you're giving immunity for possession, is it simple possession? Does it matter if you've got a dime bag or if you have six ounces of heroin? Is there a distinction there?
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
No, but it also doesn't stop their boxcar full of heroin from being seized either, as it should be.
NDP
Liberal
Ramez Ayoub Liberal Thérèse-De Blainville, QC
Thank you, Mr. Chair.
I'm very proud of the bill, Ron, and I'm very proud that you're in front of us. I'll be asking my question in French.
As you have already answered many questions, I will try to focus on aspects we have not yet explored.
When someone makes a call from a location, it is presumed that they will remain on the scene. That's when they could be arrested if this new bill is not passed. Will it be necessary to amend provincial legislation or other statutes in Canada? Have you looked into these issues?
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
For this simple exemption for possession, for the people on the scene, for the person who makes the call for the victim, I don't think any other legislation is required. I don't think it impinges on provincial legislation in any way.
Liberal
Ramez Ayoub Liberal Thérèse-De Blainville, QC
I'm asking the question because the Quebec Civil Code contains a provision that strongly encourages citizens to help people in difficulty. Of course, they should not endanger their own lives to do so.
So there is something of a contradiction between requiring citizens to get involved and using that to arrest them. Obviously, there is a dilemma if that individual has illegal drugs on them. That is what the bill is trying to resolve. When it comes to that aspect, I think we need to look a bit further into legal issues. I am not a lawyer, but I'm under the impression that we need to look into the legal side. If I understand correctly, you have not considered that aspect.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
Not specifically; however, without this law in place, they still have that good Samaritan obligation to make the call, except at that point, they run a higher risk of being charged criminally, for possession and so forth. This removes that particular consequence from those people who feel compelled to make that call.
Liberal
Ramez Ayoub Liberal Thérèse-De Blainville, QC
We just talked about a situation where someone has to remain on the scene and not a situation where someone could call anonymously, leave the scene and make sure that help comes. That person would no longer be on the scene when help arrives. This is more about a situation where someone would help an individual while waiting for professional help to arrive. Currently, someone can call and leave the scene, with help arriving after they're gone.
I see that there is an issue with that in Vancouver, especially when it comes to police involvement. I was not aware of this, but I just heard about it. I don't know if the situation is the same across Canada.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
I think different jurisdictions have different police policies in that regard. One thing in particular that we want to avoid is people making the call and running away. We want them to stay on the scene so that they can help the person who's undergoing the difficulties, direct first responders to where the victim is, and proactively inform first responders of what might be the substance involved.
This is an encouragement to remain on the scene. It's not a compulsion. However, if they do leave, they don't meet the criteria. If they leave, they don't have an immunity. If they remain, they get the immunity.
Liberal
Liberal
Ramez Ayoub Liberal Thérèse-De Blainville, QC
Okay.
I have one last question about consultations and discussions.
A number of organizations were involved. Do you have a list of them? Do you have a report on the consultations and the support from various stakeholders, be it the police, the medical sector or government authorities?
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
Yes. All that information is available on my website. We can make that available to the committee. It's actually my parliamentary website, so it's available on the parliamentary site, I believe. We can also print off that list and submit it to the committee later.
Liberal
Liberal
The Chair Liberal Bill Casey
That completes our first round.
I have a question. What motivated you to bring this bill forth? Was it a personal experience? What was the catalyst that brought this bill forth?
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
I drew number eight in the order of precedence for private members' bills. We were in a frenzy because of the short time to do something, and we were looking for something that made sense and was worthwhile. It had to be short, and it had to be simple, but it had to be worthwhile. I felt there was no point in wasting the opportunity to put together a bill.
We went through a number of possible scenarios, and this leaped out as obviously the best thing to come forth. On its face, it's easy to do. It's easy to understand. It's easy to see how it will save lives. It's easy to see that we can achieve it in a reasonable time frame. Let's make the one shot I get at a private member's bill worthwhile: that's what drove it.
Liberal
The Chair Liberal Bill Casey
We're going to take a quick suspension to change panels.
We have four groups on the next panel, three here and one on video.
Liberal
The Chair Liberal Bill Casey
We're back in session.
We have three groups at the table and one by video conference.
We have at the table the Department of Justice, the Waterloo Region Crime Prevention Council, the Pivot Legal Society, and on video we have Christine Padaric.
Each group will have five minutes for an opening statement. Then we'll have questions around the table after that.
We're going to start with the Department of Justice, for five minutes.
Norma Won Legal Counsel, Legal Services of Health Canada, Department of Justice
We haven't prepared any opening remarks. We're here at the request of the committee to answer any questions you may have.
Liberal
The Chair Liberal Bill Casey
Are there no opening remarks? That's super. That was the best opening remark we've heard yet.
The Waterloo Region Crime Prevention Council, for five minutes. Do you have opening remarks?
Michael Parkinson Community Engagement Coordinator, Waterloo Region Crime Prevention Council
I'm going to talk fairly quickly.
My name is Michael Parkinson, and I am with the Waterloo Region Crime Prevention Council. It's my pleasure to provide evidence discerned from our research investigating the barriers to calling 911 during an overdose emergency.
The Crime Prevention Council mandate is to address the root causes of crime, fear of crime, and victimization. We work collaboratively with partners in a variety of fields, including social services, justice, health, enforcement, and so on. We've done that since 1995. We're the Canadian model for crime prevention through social development within Canada and beyond.
We began working on drug-related issues in 2006, knowing there's a relationship between problematic substance use, crime, and victimization. While likely most people will never engage in criminal behaviour because they're using substances, prescription medications, alcohol, or illicit drugs, we know that Canadian prisons are filled with people who have a connection to substance use. Correctional facilities, as you know, are an expensive intervention. They consume half the cost of the Canadian criminal justice system, and they have questionable outcomes for individuals, communities, and taxpayers upon release.
When health and social service systems fail to treat the root causes, the justice system is left to punish the symptoms, and drug-related issues provide a poignant example. We can do better, and indeed we must.
Canada is experiencing the worst drug safety crisis in our nation's history. It's not often reported in the media, but I assure you that is absolutely the case and not just recently either. In the U.S., the Centers for Disease Control and Prevention say that Americans are in the middle of the worst drug epidemic in U.S. history.
For both countries, the substances driving those overdose fatalities to record-setting levels are a class of pain medications called opioids, which are essentially pharmaceutical-grade heroin, and substances of known dependency for more than a century. There's a relationship between opioid sales, overdose deaths, and addiction. Canada holds the dubious distinction of being a global leader in prescription opioid consumption. The U.S. comes in for the silver medal.
In my province of Ontario, a person dies every 14 hours of an opioid-related death. That's a rise of more than 500% since the year 2000. That's more than 6,000 dead Ontarians. Deaths from acute drug toxicity surpassed fatalities on Ontario's roadways five years ago. Now we have what I would call the bootleg opioids, which is a class of high-potency opioids the Waterloo Region Crime Prevention Council first advised about in 2013. They're produced exclusively and distributed exclusively on the black market. They're being detected in substances in a variety of formulations across Canada and the U.S., and they are now responsible for driving overdose fatalities up, even as prescription opioid fatalities plateau.
In Alberta, from 2011 to 2015, the rise in overdose deaths was 4,500%. That's not a typo; it's 4,500%. In British Columbia, overdose deaths in the first five months of this year have risen 75% compared to the same period last year. You've heard they've declared a public health state of emergency for overdoses, but most provinces have no monitoring, and there are no emergency preparedness plans, much less interventions, in place.
Some of the fentanyls, and these are the bootleg fentanyls, are essentially weapons-grade substances. A kilogram of powdered fentanyl...there was a kilogram of powder seized in Quebec City a couple of months ago that contained enough lethal doses to kill every resident in Quebec City, or about half a million lethal doses. Multi-kilogram seizures are no longer unusual in Canada. The profit margins for the black market are absolutely extraordinary.
From research in B.C. we know that most people who tested positive for fentanyl are completely unaware of ingesting it. People who used substances occasionally and daily are at a significantly elevated risk of death. Canada's overdose crisis seems certain to get worse before it gets better. Bill C-224 is a key life-saving tool in our nation's first aid kit.
It is always worth remembering that an opioid overdose is a medical emergency, whether the victim was using it as prescribed or not. Opioid overdose victims cannot save themselves. They depend on a witness or a good Samaritan. Seconds do matter. It's the difference between life and death, or between a lifetime of brain injury or not. The best medical advice from the colleges across Canada always includes calling 911 and providing resuscitation to the victim.
In 2008 we provided a first glimpse into the extent and typology of overdoses in the Waterloo region. We combed through hospital data. We combed through coroner's data. One of the significant findings was that more people showed up at hospitals for an overdose than were brought in through 911. That's what we call the “dump and run” strategy. You want to do the right thing, but you're not going to call 911 because of fear of entanglement with the criminal justice system. You do the next best thing you can think of in the moment. You drive to the hospital, dump the victim off, and you split right away.
In 2012 we sought to determine the barriers to calling 911 during an illicit overdose emergency by conducting primary research in an area of southern Ontario that we thought might be representative of Canada in the main. We surveyed 450 people who were using substances or were on a path toward recovery from addiction. Almost 60% had witnessed an opioid overdose emergency. We found that despite the best of intentions, witnesses to an illicit overdose—and most often there's at least one witness—will call 911 and wait with the victim just 46% of the time. In contrast, 911 call rates for cardiac arrest are above 90%. We found that the primary reason for not calling 911 was fear of the police presence. We found that 83% of those surveyed thought they might face criminal charges if 911 was called. We could find no literature suggesting that one could educate people into calling 911.
These findings that 46% of witnesses would call 911 and that fear of the Canadian criminal justice system is the major barrier are consistent with some newer, albeit limited, data from across Canada. They are consistent with findings from across the U.S. and are the primary reason that most states in the U.S. have a good Samaritan law.
Liberal
The Chair Liberal Bill Casey
I have to cut off your incredible testimony.
We'll go to the Pivot Legal Society.