Evidence of meeting #23 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was fentanyl.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Lisa Lapointe  Chief Coroner, British Columbia Coroners Service
Bonnie Henry  Deputy Provincial Health Officer, British Columbia, Office of the Provincial Health Officer, British Columbia
David Juurlink  Head, Division of Clinical Pharmacology and Toxicology, Sunnybrook Health Sciences Centre
Sean LeBlanc  Founder and Chairperson, Drug Users Advocacy League

9:55 a.m.

Chief Coroner, British Columbia Coroners Service

Lisa Lapointe

Absolutely.

I heard our Minister of Public Safety say recently that we cannot arrest ourselves out of this situation. We know that approach—the shaming, blaming, and arresting of people—has not worked. It significantly has not worked. In fact, the deaths and rates of overdose have only increased. Treating this as a health problem, such that if somebody becomes ill from a drug they call an ambulance and are treated at a hospital, is the only way we are going to save lives.

In keeping with the treatment aspect as well, if you develop a terminal illness, or an illness that is potentially terminal, a cancer, for example, you expect that you will be treated and that treatment will be available. If you become addicted to drugs, treatment should be available.

9:55 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Let me pick up on that, both Ms. Henry and Ms. Lapointe.

I'm going to speak bluntly here. There seems to be a division in this room and with this government on Bill C-2. The government seems to stubbornly refuse to acknowledge that it needs to make any changes to Bill C-2 .

Ms. Henry, the words you used were that Bill C-2 contains extreme barriers. Hon. Hedy Fry, when she was the Liberal Health critic, said that Bill C-2 was designed to avoid the opening of safe consumption sites. I think Dr. Perry Kendall has said that too.

I'm going to ask you directly. The Liberal government seems to suggest that the problem isn't with Bill C-2. It's just explaining the requirements to groups, and if we can facilitate that, we can get more safe injection sites.

The facts are that we have two injection sites in the country, InSite and the Dr. Peter Centre. There is not a single site that has opened in this country in the last year and a half. We have one application currently, and that's from the City of Montreal. With the Toronto Board of Health, everybody is telling me that with the barriers, it takes months and hundreds of hours to get an application in.

My question is, what are the barriers in Bill C-2 that you think are unnecessary?

9:55 a.m.

Deputy Provincial Health Officer, British Columbia, Office of the Provincial Health Officer, British Columbia

Dr. Bonnie Henry

I could talk for a long time on that. Some of them are outlined in the written report that we sent in.

There are about 25 different pieces of Bill C-2 that I find are barriers. One of the key ones is requirement for opinions from neighbourhoods that are not necessarily based on fact, and the types of opinions that need to come in. It's a challenge to get those, because it reopens questioning around supervised consumption services and their worth. It's a challenging part.

The other part that is just ridiculous is that you have to name every single person who will work in the facility, and none of them can have a criminal record. People like Sean would be excluded from working in a site, which we think is ridiculous, because peer support is really important and it helps.

There are a whole variety of them that I can certainly list for you.

10 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thanks. Maybe you could send those to the committee, all the barriers that you see—

10 a.m.

Deputy Provincial Health Officer, British Columbia, Office of the Provincial Health Officer, British Columbia

Dr. Bonnie Henry

We can do that.

10 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

—because what jogged me was this connection of it being a health issue, not a policing issue. You have to get the approval of the local chief of police. What other medical or health service do we have in this country that you have to get the chief of police to sign? Shouldn't that be a medical decision, not a criminal decision?

10 a.m.

Deputy Provincial Health Officer, British Columbia, Office of the Provincial Health Officer, British Columbia

Dr. Bonnie Henry

I believe so, and it's the opinion of the chief of police. I will say that we have had a lot of positive response from the policing services in B.C., including the RCMP E Division.

Through the minister, Health Canada has expressed interest in working with us on trying to overcome some of these barriers, but we do still feel that repeal or an extensive revision of Bill C-2 would be most appropriate.

10 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Dr. Juurlink, I want to give you a chance. You've talked about there being no national system of surveillance in Canada. Even the number of Canadians who die annually from opioids is unknown. You've talked about the CCSA. You've called that an inadequately resourced non-governmental organization. They've made 58 recommendations that you say have not been prioritized or implemented. What can you tell us about those recommendations? Have they been implemented? Which ones do you think ought to be implemented?

10 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you, Doctor.

10 a.m.

Conservative

The Vice-Chair Conservative Len Webber

Next is MP Sonia Sidhu.

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you to all the presenters.

Dr. Juurlink, you mentioned opiate prescription by physicians. What kind of restrictions need to be placed on the doctors who are prescribing opioids?

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

What kind of restrictions need to be—

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Yes, on the physicians when they prescribe—

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

No, can you talk about any preventative measures? You said that one in eight deaths of those aged 25 to 34 in Ontario are due to opioid overdoses, so what kinds of preventative measures are you thinking of, such as physicians not being allowed to prescribe higher opioid doses?

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

What kind of education do you think needs to be utilized.

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Mr. LeBlanc, you said that we need to educate our kids about harm reduction. At what age does this need to be taught? Is it in elementary school or middle school?

10 a.m.

Founder and Chairperson, Drug Users Advocacy League

Sean LeBlanc

I see, at least in Ottawa, children as young as 13 even getting into fentanyl. There seems to be no progression. When I was young, people would start with marijuana, then alcohol, and kind of progress their way up. They're starting at fentanyl and these hard-core opiates at a really young age, so yes, I would say that education about it should start in junior high school, at grade 7 and 8.

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

Ms. Lapointe, you referred to language. Is there any strong language with respect to heroin that would have an impact on the crisis? Is there a great impact with the language? Can you outline any other example of how language and definition have impacted the crisis in B.C.?

10:05 a.m.

Chief Coroner, British Columbia Coroners Service

Lisa Lapointe

Before I answer that, I'd like to emphasize that we have a dearth of research in this area. We do not have evidence across the country as to exactly who's dying, when they're dying, and why they're dying. We don't know, for example, how many people who are currently dying were prescribed opiates. If you're going to implement evidence-based solutions, you need evidence, and we do not have that. I would certainly call on this committee to seek some investment in the research.

To answer your questions, one of the things we hear anecdotally from the people are working with illicit drug users is that the language around stronger drugs, more powerful drugs, will cause a certain segment of the drug-using population to seek out those drugs. We're talking about people who are now actively seeking fentanyl because it's a better high, because it's stronger than the heroin they've been using, for example.

I also want to be clear that the drug deaths that we're seeing in B.C. are not just from opiates. Cocaine is also often involved. Alcohol is often involved. We are starting to do the research to pull out the different substances, but without knowing exactly what substances are killing people and how they started to use those substances, I would argue that we really can't implement any meaningful solutions.