Evidence of meeting #2 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was home.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Karin Phillips  Committee Researcher

4:30 p.m.

Liberal

The Chair Liberal Bill Casey

Do you mean the side effects of marijuana on young people, or the actual impact?

4:30 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

I think there's a wide range of things, but most importantly.... You may call them side effects; I call them complications. You can talk about both. I'm sure Dr. Eyolfson has the same viewpoint as I do, that we categorize those differently.

I think it's important that people go in with their eyes wide open on the impacts that marijuana can have on Canadian kids.

4:30 p.m.

Liberal

The Chair Liberal Bill Casey

Mr. Davies.

4:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thanks.

Here's what I would suggest, Kellie. I haven't read the report, but it appears that from May 2014 to October 2014 the committee did a study called “Marijuana's Health Risks and Harms”. I'm not familiar with that report, but I'm wondering if that would be a good place to start. We could just pull that report and see if it gets at the issues that you think ought to be got at, or if you think that's some—

4:35 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

I have read the report. I guess, in keeping with what you said in the comment before this one, that we should be forward-looking. I would encourage everyone here to read the report, absolutely. I think that would be of value.

4:35 p.m.

Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

Well, I think that when you say “forward-looking”, marijuana is marijuana, and that report would be as good as we would get, probably, unless there are new issues that have arisen out of marijuana, such as genetically modified marijuana and the effects of that or something. I think that marijuana is marijuana.

4:35 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

I would hesitate to say that. Similar to pharmaceuticals and other hard drugs that are currently illegal on the market, they are changing it on a daily basis. I can tell you that meeting a young person in 2010 who said they had been on marijuana is a quantifiably different experience from meeting a child who comes through the door and says they had marijuana last month.

Mark my words, in the same way that our colleagues are doing their best to update, modify, and make more effective cardiac drugs every day of the year, there are individuals out there making more potent marijuana, changing the consistency, and looking at the other places it can be placed. It's not just about smoking it, but whether they can make it an edible product or something else. I think these are important things to look at.

As I say, I still practise medicine. I'm still at CHEO here in Ottawa. I think it's important that everyone here have a complete understanding of the impacts of marijuana.

4:35 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you very much. That's really meaningful.

Mr. Ayoub.

4:35 p.m.

Liberal

Ramez Ayoub Liberal Thérèse-De Blainville, QC

Regarding marijuana, you are saying that there are different levels and that it changes with time, and I understand that well. How will we be able to decide what kind of marijuana we are talking about? Although that drug is currently illegal, we know the government wants to legalize it at some point, but for people of a certain age and not for youth, so as to make the use safe.

How will we be able to find out what that drug's effects are on young people, what its potency is, where it grows, and so on?

4:35 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

I understand your concern, but that's like saying that we shouldn't study the drug formulary at this table, as was recommended before, because drugs are changing every day. I think we have a responsibility here to take a look at these issues in totality, whether that be a drug formula, as others of your colleagues have suggested, or whether that be looking at diabetes, which again is an evolving disease entity that we have different treatments for. I think this should be treated in the same manner.

4:35 p.m.

Liberal

Ramez Ayoub Liberal Thérèse-De Blainville, QC

I'm not saying not to study it—

4:35 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

No, no, but recognize, I think, that all of these things will change, potentially even in the course of when we're studying them. That's not a reason to not look at something.

4:35 p.m.

Liberal

Ramez Ayoub Liberal Thérèse-De Blainville, QC

Absolutely. I agree.

4:35 p.m.

Liberal

John Oliver Liberal Oakville, ON

It's still up for debate, but if we were to look at this, I think it would also be important to look at what regulation does to improve things and to reduce the risk to children. Regulation allows licensed manufacturing. It allows potency to be identified on labels, much like production of alcohol, so that you understand what you are absorbing. It's released through controlled environments, rather than the black market and the uncertainty of that. I think the regulation aspects of how it's prepared, licensed, and regulated may mitigate the risks of children being exposed to it.

I think we could probably all quickly agree that children using marijuana is completely unacceptable and that there are health risks. There are a lot of studies that show the long-term consequences of underage young Canadians using marijuana, so how do you better restrict access? I don't remember the exact numbers, but I think the WHO study—the World Health Organization—said that right now Canadian teens are the highest or second-highest users of marijuana globally. How do we reduce access, or limit access, or have zero access to marijuana, while at the same time regulating the production of it and licensing its release?

4:40 p.m.

Liberal

The Chair Liberal Bill Casey

I'm not sure, but we may end up with this subject anyway, as the legislation comes forward. In the meantime, it's a valid issue to talk about and it would be good to find out what the government's plan is to regulate the quality or the aspects of the product.

Mr. Davies.

4:40 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Chairman, you read my mind.

This issue is going to come before this committee sometime in the next four years. All indications are that the government is going to proceed with some sort of legalization framework for marijuana. If and when that happens, that legislation will come before this committee, or if it doesn't come before this committee and it goes to justice, perhaps there will be a joint justice-health committee, or maybe this committee will look at the health impacts.

Yes, it could be a...joint committee.

4:40 p.m.

Some hon. members

Oh, oh!

4:40 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

I was just waiting for that one. I could see you chomping at the bit on that one.

4:40 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

At that time it will be appropriate for this committee to have a comprehensive and thorough look, as Kellie suggests, at the full health impacts and ramifications of marijuana. I have no doubt that this will be coming at some point. Of course, if after two years there isn't anything from the government, then maybe we can revisit the issue at that time.

4:40 p.m.

Liberal

The Chair Liberal Bill Casey

We'll have it on the list for the steering committee to look at and see what the steering committee decides.

I don't know whether we're going to get marijuana and physician-assisted dying. I don't know whether or not that will end up at this committee. It may, or maybe some aspect of it will come to us. Again, it might be a joint committee, as you were saying, of justice and health.

Are there any other questions on the subject?

Mr. Eyolfson.

4:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

I forget which minister I talked to, but Kellie brought up this question at the last meeting, and it didn't look as though this committee would be dealing with physician-assisted dying. It would be justice and the special committee, so we likely wouldn't be dealing with it. That's just as a point of information.

4:40 p.m.

Liberal

The Chair Liberal Bill Casey

When I was getting my hair cut yesterday, one of the members of the committee was there, and he said that he thought we would get it, so I don't know.

4:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

I may have been misinformed.

4:40 p.m.

Liberal

The Chair Liberal Bill Casey

I don't know. This is barbershop talk, so I'm not sure.

Anyway, you have the floor, Mr. Eyolfson.

4:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

Thank you for putting me in this part of the order, because you're making my job far easier. Many of the things that were on my list have been discussed, so I can just go through some of them to reiterate my feelings on them.

We talked about universal pharmacare. I agree. I spent 20 years of my career as an emergency physician, and I saw people come in sick because they couldn't afford their medication. It's a regular occurrence. If you consider a plan that will make sure that everyone can get their medication, people might say that it's awfully expensive, but it's much more expensive not to. If you look at the cost of one patient who has to come to the emergency department for diabetic ketoacidosis and who ends up in the intensive care unit, you could have probably paid for a lifetime of that patient's insulin for the cost of that one visit.

That's just one example, but I think it's a very, very important example. We might be able to show that there's a net financial benefit in the long run in addition to it being the right thing to do.

Also, with regard to the interplay of seniors care, home care, and homelessness, I agree. It was said by a couple of people that hospitals are often bed-blocked by seniors who don't have any acute medical problem but who cannot go home. They have mobility issues, they become demented, and they don't need to be in a hospital, but there aren't proper home care supports or personal care home beds for them.

It's become so critical that sometimes people like this are brought into the emergency department by concerned family members, and internal medicine departments won't admit them because there's nothing medically wrong with them. In some appalling situations, we've seen patients stuck in our emergency department for in excess of a month. Again, you'll save substantial amounts of money by making sure that seniors have adequate housing and adequate home care.

This plays into homelessness as well. There are people who are homeless who are not seniors, and they are very expensive to the health care system. Given the large numbers, hospital admissions for frostbite and hypothermia in Winnipeg among the homeless, as you can imagine, are very, very costly. Again, dealing with homelessness would take a big burden off the health care system and probably ultimately save money.

As for other issues, I agree on the organ donation strategy.

Antimicrobial resistance is something for which I think there might be a bit of interplay between departments. I know we have a very long list, but something that has come to my attention, which might be worth looking into if we have the time, is re-emerging antibiotic resistance. We're dealing with this in the medical community and we're trying to educate health care providers on their prescribing practices.

Another significant source of antibiotic resistance is the agricultural community, which uses antibiotics in animal feed. For people who aren't familiar with this practice, when you feed antibiotics to healthy animals, they tend to grow faster, so basically you get a more profitable cattle operation. Somehow, and I don't quite know the mechanism, members of the ranching community are able to obtain antibiotics without a prescription from a veterinarian in response to an illness, and they are able to routinely feed them to their cattle. That practice looks as though it may be a significant source of antibiotic resistance, and it's a practice that I would certainly like to see banned. It's banned in many countries in the world, and I think banning it would help to ameliorate an evolving public health crisis.

There are other things on this list that I wanted to speak to. I agree that we need to take a closer look at supervised injection sites and at harm reduction in general. There is some science supporting it, but I think we need to look at all aspects of it, including the science behind it, the social issues behind it, and the justice issues behind it. I think it's a very important thing. There's tremendous potential to improve health outcomes by properly looking at this issue.

That's all I have so far.