Thank you, Mr. Chair.
I'm Dr. Jeff Blackmer, the vice-president of medical professionalism for the Canadian Medical Association. On behalf of the CMA, I would first like to commend the committee for initiating this emergency study of the public health crisis in Canada. As the national organization representing over 83,000 Canadian doctors, the CMA has an instrumental role in collaborating with other health care stakeholders, governments, and patient organizations in addressing the opioid crisis in our country.
On behalf of Canada's doctors, the CMA is deeply concerned with the escalating public health crisis related to problematic opioid and fentanyl use. Physicians are on the front lines of this epidemic in many respects. We are responsible for supporting patients with the management of acute and chronic pain. Policy-makers must also recognize that prescription opioids are an essential tool in the alleviation of this pain and suffering, especially in palliative and cancer care.
The CMA has, for a long time, been concerned with the harms associated with opioid use. We appeared before this committee as part of its 2013 study on the government's role in addressing prescription drug abuse. At the time, we made a number of recommendations on the potential role of government, some of which I will reiterate for the committee today.
Since then, the CMA has also taken a number of actions to contribute to Canada's response to the opioid crisis. These actions have included advancing the physician perspective in all active government consultations.
In addition to the 2013 study by the health committee, we have also participated in the 2014 ministerial round table and recent regulatory consultations led by Health Canada. Specifically, we have contributed input on tamper-resistant technology for drugs and the delisting of naloxone for the prevention of overdose deaths in the community.
Other actions that we've undertaken have included undertaking physician polling to better understand their experiences with prescribing opioids, developing and disseminating a new policy on addressing the harms associated with opioids and other prescription medications, supporting the development of continuing medical education resources and tools for physicians, supporting the national prescription drug drop-off days, and hosting a physician education session as part of our annual meeting in 2015.
I'm also pleased to report that the CMA has recently joined the executive council of the First Do No Harm strategy, which, as you know, is coordinated by the Canadian Centre on Substance Abuse. In addition, we have joined seven leading stakeholders as part of a consortium formed this year to collaborate on addressing the issue from a medical and clinical standpoint.
It's important for the committee to recognize that inappropriate prescribing of opioids is not the sole contributing factor to our current crisis and that targeting this issue alone will not lead to a resolution of the problem. However, physicians must accept our share of the responsibility, and we are prepared to play our part in doing what is necessary to move forward in addressing this very complex and multi-faceted problem.
I'll now turn briefly to the CMA's recommendations for the committee's consideration. These are grouped into four major theme areas, the first of which is harm reduction.
Addiction needs to be recognized and treated as a serious, chronic, and relapsing medical condition for which there are effective current treatments. Despite the fact that there is broad recognition that we are in a public health crisis, the focus of the federal national anti-drug strategy is still heavily skewed towards a criminal justice approach rather than a public health approach. In its current form, the strategy does not adequately address the determinants of drug use, treat addictions, or reduce the harms associated with drug use. The CMA strongly recommends that the federal government review the national anti-drug strategy and reinstate harm reduction as a core pillar of the strategy.
Supervised consumption sites are an important part of a harm reduction program that must be considered as part of an overall strategy to address the harms associated with opioid use. The availability of supervised consumption sites, as you know, is still highly limited in Canada. The CMA maintains its concerns that the new criteria established by the Respect for Communities Act are overly burdensome and deter the establishment of new sites. We continue to recommend that the act be repealed or, at the least, significantly amended to address this issue.
The second theme I will raise is the need to expand treatment options and services. Treatment options and services for both addiction as well as pain management are very under-resourced in Canada.
This includes substitution treatments such as suboxone and methadone, as well as services that help patients taper off opioids or counsel them with intervention such as cognitive behavioural therapy. Availability and access of these resources vary significantly by jurisdiction and region. The federal government has a role to play in prioritizing the expansion of these services across the country. The CMA recommends that the federal government deliver additional funding on an emergency basis to significantly expand the availability and access to addiction treatment as well as pain management programs.
The third theme I will raise for the committee's consideration is the need for greater investment in both prescriber as well as patient education resources. For prescribers, this includes continuing education modules as well as training curricula at all levels of the medical continuum. We need to ensure the availability of unbiased and evidence-based educational programs in opioid-prescribing, pain management, and the management of addictions. Furthermore, support for the development of educational tools and resources, based on the new clinical guidelines that will be released early next year, will play a very important role in the overall approach.
Patient and public education on the harms associated with opioid usage is critical. As such, the CMA recommends that the federal government deliver new funding to support the availability and provision of education and training resources, not just for prescribers but for patients and the public as well.
Finally, to support optimal prescribing, it's critical that prescribers be provided with access to a real-time prescription-monitoring program. Such a program would allow physicians to review a patient's prescription history for multiple health services at the point of care, prior to prescribing medications. Real-time prescription-monitoring is currently only available in two jurisdictions in Canada.
Before closing, I should emphasize that the negative impacts associated with prescription opioids represent a complex issue that will require a multi-faceted, multi-stakeholder response. A key challenge for public policy-makers and prescribers is to mitigate the harms associated with prescription opioid use without negatively affecting patient access to the appropriate treatment for their clinical conditions. As one CMA past president said, the unfortunate reality is that there is no silver bullet solution, and no one group or government can address this issue alone.
The physicians of Canada are committed to being part of the solution.
Thank you very much.