Evidence of meeting #18 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was police.
A recording is available from Parliament.
Liberal
The Chair Liberal Bill Casey
If you would amend your motion to that effect, we'll have a vote on it.
Research can help, because a lot of us don't know much about this subject. We need some time to brush up and learn about it.
If you can do that, we'll have a vote on it and move forward. Is that okay?
Conservative
Rachael Thomas Conservative Lethbridge, AB
If I could amend it then, rather than “undertake a study this fall”, it would say “initiate a study this fall”.
Conservative
Rachael Thomas Conservative Lethbridge, AB
Right now it reads, “Pursuant to Standing Order 108(2), the committee undertake a study this fall...”. Instead of “undertake”, I would be exchanging that word for “initiate.”
Liberal
The Chair Liberal Bill Casey
Perfect. “Initiate”; that works for me, but I'm just....
We have a motion on the floor.
Dr. Eyolfson.
Liberal
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm fine with the motion, but it's on the understanding that the motion won't say this. We understand we'll have one meeting to hear evidence and then carry on at some point in the future.
Liberal
The Chair Liberal Bill Casey
In the event we run out of things to talk about, it may be more than one but the motion says that we'll initiate the study.
Don Davies NDP Vancouver Kingsway, BC
No, Mr. Webber said that the suggestion from Mr. Oliver was that we start by having one meeting in the fall. I want to know clearly what I'm voting on, because the amendment from Ms. Harder doesn't clarify that, it just says “will initiate”. I'm happy to support the motion if it says that we initiate the need to study this by conducting one meeting to hear evidence this fall and then carry on as the committee meets as it desires or not.
NDP
Don Davies NDP Vancouver Kingsway, BC
We do have this pharmacare study with other motions that this committee has already passed. I had a motion on aboriginal health that was passed by this committee 10 months ago.
Liberal
Liberal
Darshan Singh Kang Liberal Calgary Skyview, AB
So when we do the study we are leaving it open-ended.
Liberal
The Chair Liberal Bill Casey
Unless we started and finished it in one meeting. That's possible, but it doesn't sound as if it will be.
Dr. Eyolfson.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
I would second it if it said “one meeting”.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
As in the definition of “initiating” being one meeting, yes. If that's what would be acceptable, if that's what the group wants, I would still second that.
Liberal
The Chair Liberal Bill Casey
We don't have to change the wording; the committee understands that it would be one meeting. Okay.
Conservative
Len Webber Conservative Calgary Confederation, AB
One meeting to initiate the study. It could require more than one meeting but we're going to initiate with the one to start with in the fall. Okay, got it.
Liberal
The Chair Liberal Bill Casey
We're all singing from the same song sheet.
Okay, we have a motion on the floor.
(Motion agreed to)
Liberal
The Chair Liberal Bill Casey
Now I welcome our guests. I'm sorry for the little delay, but this was unfinished business carried over from our last meeting. We did want to finish it, and I think we're ready to move forward.
I believe that we asked you to have a 10-minute presentation. We're going to ask you to wind it down to five minutes so we'll have lots of time for questions. It will help us get through everybody and give everybody a chance to hear what they need to hear. I don't want to miss anything, but you'll find our committee asks questions and they know where they want to go.
We have the Street Health Centre, Kingston Community Health Centres; Centretown Community Health Care; Jane Buxton, professor, University of British Columbia; and the Paramedic Association of Canada.
We'll start with the Street Health Centre, Meredith MacKenzie, physician. Please begin your presentation.
Dr. Meredith MacKenzie Physician, Street Health Centre, Kingston Community Health Centres
Good morning. Thank you for asking me to come to speak to this bill.
More than two years ago, this committee issued its report “Government's Role in Addressing Prescription Drug Abuse”, which recommended that the government consider overdose immunity law that would exempt individuals seeking help for themselves or others during overdose situations from criminal prosecution. Since this committee's recommendations more than two years ago, the situation in Canada has profoundly worsened. We're now the number one consumer of prescription opioids in the world. Non-medical use of prescription drugs is a public health crisis and there's an opioid overdose epidemic occurring across our nation.
In April 2016, British Columbia's provincial health officer declared a public emergency as more than 200 people had overdosed in the first three months of this year. In June the Coroners Service of B.C. reported that overdose deaths increased by 75% in 2016.
The situation here in Ontario is also grim, with opioid-related mortality increasing 463% between the years 2000 and 2013. This represents one death every 14 hours. Preliminary figures from Ontario's Office of the Chief Coroner show that fentanyl overdose accounted for one in every four opioid fatalities in 2014. So we see we've had 13 years of increasing and record-setting overdoses, more than double the number of drivers killed in motor vehicle collisions.
This government has acted to make naloxone available by amending the prescription drug list. Take-home naloxone programs have been available in most provinces for a few years. As you know, naloxone is a medication that is first aid for opioid overdose and can reverse fatal respiratory depression. Communities that do provide take-home naloxone and overdose prevention training have lower opioid-related overdose fatalities.
We know that 85% of overdoses occur in the presence of another person. Naloxone injections for opioid overdoses are most often given by bystanders, just like epinephrine pens are used for life-threatening allergies.
A critical step to surviving an opioid overdose is seeking medical attention. We know that more than 90% of people who have a heart attack will call 911 for help, but an Ontario study showed that only 46% of people will call 911 in an overdose situation. The primary barrier cited is fear of police involvement.
Opioid overdose is a medical emergency. Once naloxone is given to a person it lasts between 20 to 90 minutes. That means once naloxone wears off the overdose can recur. Calling 911 is a crucial step to survival and a cornerstone of opioid overdose treatment.
With the arrival of more potent opioids like powdered fentanyl and other fentanyl analogues across all communities in Canada, activating 911 is of particular importance. A shipment of one kilogram of carfentanil, an elephant tranquillizer, was seized in Vancouver by the Canada Border Services Agency in June of this year. This drug is 100 times more potent than fentanyl. Put another way, that's 10,000 times more potent than morphine, and this shipment contained enough drug to kill 50 million people. If people do not call 911, the risk of death is increased substantially.
We are also increasingly seeing drug contaminations in our communities. People who report non-opioid drug use are overdosing and dying because the drug they used unknowingly contained fentanyl. In Vancouver earlier this month there were nine overdoses in 20 minutes, in people who were using cocaine that was contaminated with fentanyl.
The best way to encourage people who have overdosed or witnessed an overdose to seek help from 911 is to provide protection from charges of possession. Early evidence in the U.S.A. indicates that 88% of people who overdose on opioids are more likely to call 911 after establishment of good Samaritan law and being made aware of its existence.
Many organizations have supported the adoption of Bill C-224. Some of these include the Canadian Medical Association, the Ontario Medical Association, the Municipal Drug Strategy Co-ordinator's Network of Ontario, the Canadian Drug Policy Coalition, and many boards of health and police agencies across Canada. A parliamentary petition garnered more than 700 signatures from coast to coast to coast.
This time of year many of our children head off to post-secondary schools. This is a time in life when they may make some dangerous or questionable decisions as their frontal lobes mature. They may be at a party and someone offers them a pill or something else to take. This pill doesn't look too dangerous. It looks like medication. We have seen fentanyl and other drugs being pressed into pills that look like prescription medication. The potential contamination of all drugs with highly potent opioids that are readily available in all of our communities makes overdose in this setting a very real possibility. Will their friends call 911 or will they be too afraid to call?
Constable Brian Montague, the media relations officer for the Vancouver Police Department issued a statement in June of this year confirming their position that they will not send a police officer to an overdose unless one is requested. He went on to describe that calls to 911 are not just coming from what he termed, “hard-core drug users”. He stated, “We're getting calls from 16-year-olds and 17-year-olds who are experimenting with drugs.”
The Vancouver police hope that this new strategy will mean that people who use drugs won't ever be too afraid of getting into trouble when they call 911. This government has already shown its commitment to bring forward a balanced approach to drug policy. Health Canada has supported access to supervised consumption sites like Insite in Vancouver. They have also revised the federal prescription drug list for naloxone. These are just some of the actions the government has taken to reverse the tidal waves of death across Canada.
The disaster of opioid overdose deaths across the nation requires every tool we can muster. Bill C-224 is not all that is needed to address this public health emergency, but it is a critical step forward. We need to protect the most vulnerable in our society. We must ensure that people feel safe to call 911. We must help Canadians in all of our communities to do the life-saving thing and to call for help immediately, without fear that their futures will be ruined by criminal charges. Canadians need this law passed now.
I thank the committee for your work on this legislation.