Health Committee on Oct. 18th, 2016

[Réjean Leclerc]

For this drug, the training takes about four hours.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

I'm sorry for interrupting you, but I only have a little bit of time here.

I want to talk to Mr. Bursey. You mentioned a couple of times about the drugs coming from outside Canada. We've had other presenters here as well who have indicated they're coming mainly from China, which is the number one source of illicit drugs in this country. Mr. Chair, I know that we talked about my motion and bringing that to the table, and I will respectfully do that after our presenters are finished with this session here, but I would like to put forward that motion at that time regarding bringing the Chinese ambassador here as a witness, to appear before us to provide evidence as to the measures being taken by the Chinese government to address the manufacture, distribution, and sale of illicit opioids that are coming here to Canada. I will wait until after this session here.

I do appreciate all of you and your comments here today. They've been very insightful, thank you. I assume my time is up.

[The Chair, Liberal, Bill Casey]

Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, Mr. Chair.

First of all, I would like to thank the stakeholders for their presentations here and for bringing us up to speed on this crisis we are facing.

Dr. Blackmer, how many safe injection sites do you think we would need to contain this epidemic, and would they be helpful in future crises too?

[Dr. Jeff Blackmer]

I don't think we have information on the exact number that's needed. I know that different municipalities have looked at their own individual needs. Certainly here in Ottawa we've had a number of conversations that perhaps more than one would be appropriate for our population. They've done some analyses in cities like Toronto and Montreal, and in other urban locations as well.

I think the point to understand with this is that the harm reduction piece, which would include supervised injection sites, is one part of an overall strategy to combat opioid addiction. It's not a panacea for this entire issue, as we've heard before, but it's one aspect that deserves some further attention and I think support as well.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

What other avenues could we explore, in your opinion, to alleviate this crisis?

[Dr. Jeff Blackmer]

Other than harm reduction?

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Yes.

[Dr. Jeff Blackmer]

There are a number of pillars. There's the prevention piece, which we've heard about, and education for physicians and other care providers in looking at alternatives, with different types of pain management initiatives and interventions. There's the treatment for patients who are addicted, whether that's detox, which does not work very well for narcotic and opioid addictions, or whether that's substitution therapy with things like suboxone. Then there are the prescription monitoring programs, which are a very important aspect of this.

Again, addressing any one of these issues will lead to unintended consequences, as we've already heard. We need a national strategy—we've heard a little bit about what that could look like—that will address all of these types of issues. Whether it's the availability of naloxone at the front line, better education of care providers, or harm reduction strategies, it needs to be multi-faceted.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Okay.

There was a pilot project carried out at a supervised site in Vancouver that provided drug users with the option of testing their drugs for fentanyl. They found that 86% of the drugs tested contained fentanyl. When Dr. Bonnie Henry, the deputy provincial health officer of British Columbia, appeared before this committee on October 6, she noted that legislative barriers prevent individuals from checking their drugs for fentanyl, and that exemptions would need to be made under the Controlled Drugs and Substances Act to allow this practice.

In your opinion, should legislative barriers be addressed to facilitate individuals to test their own drugs for fentanyl or possibly other substances? If yes, how should the drug test kits be made available to people who use drugs? Do you think this will help alleviate the overdose problem?

[Dr. Jeff Blackmer]

I think that would be one part of an overall strategy, to be able to identify those substances and act accordingly. I think many Canadians have been quite shocked to hear some of those statistics that fentanyl is making its way into other substances through this means. We've heard about importation from foreign countries. I think testing these substances makes a lot of sense, but as one part of an overall strategy.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, sir.

Mr. Bursey, what role can pharmacists play in identifying and treating individuals with substance use disorders?

[Alistair Bursey]

Pharmacists often are the eyes and ears of physicians on the front lines. We see patients, especially addiction patients or patients who are receiving pain medications, many times throughout the year. In New Brunswick, the average number of visits by a New Brunswicker to a pharmacist is 16 times a year. It's a great opportunity for identifying and for collaborating with our physicians on our addiction programs to find solutions and make sure that these patients who are in the throes of addiction can get treatment. I think pharmacists play a key role in collaborating with other health professionals.

[The Chair, Liberal, Bill Casey]

Your time is up.

Ms. Malcolmson, thank you for coming.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Thank you, Chair.

I'm Sheila Malcolmson, member of Parliament for Nanaimo—Ladysmith. We have the sad honour of having had more deaths per capita to drug overdose than anywhere else in British Columbia has, since 2008, so this has been happening for some time.

The B.C. coroner, just last month, said that Vancouver Island Health Authority—just think of this beautiful island paradise, this rural area—has had the largest increase in opioid deaths, a 135% increase from last year, and we have the highest rate of overdose deaths in British Columbia. So I appreciate the work that all of you men and women are doing on the front line and all of the advocacy that you're doing through all of your organizations.

Mr. Emberley, you were quoted last year as saying that this is really a disaster that's happening all across Canada. We're hearing that again and again here. In your view, is the opioid overdose crisis a national emergency?

[Dr. Philip Emberley]

I believe it is. At first we were hearing of it in pockets. We were hearing that it was a problem in Vancouver, and maybe in the Prairies as well, but every community has been affected by this. Working in a pharmacy, we see it.

I see in the west end of Ottawa, where I work, that there's a certain population that has been profoundly affected by this. We see people getting into trouble with medication. We see people coming in early for their opioid prescriptions, and there's a sense that they're getting out of control with their own personal use of these medications. It is definitely a national problem; no community is unaffected. For that reason, I believe we have to treat it as a national crisis.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Thank you.

Mr. Blackmer, we really appreciate the advocacy that your group is doing. I note that the Government of Ontario recently appointed an overdose coordinator. This is the first province that has taken that position, to put someone in the role of developing surveillance and reporting systems, to gather data on overdose deaths and to make informed decisions about patient care.

Do you believe that the federal government should follow suit by tasking our chief public health officer with coordinating a national response to the opioid overdose crisis?

[Dr. Jeff Blackmer]

I do absolutely, and I think there's a lot that the federal government can learn from what's being done at the provincial level. You alluded to whether or not this is a national emergency. British Columbia has declared a provincial state of emergency, which it has done primarily to have access to some data that it would not otherwise have, not just on deaths by overdose, but on the actual number of overdoses. I think there's a lot the federal government can learn by looking at what some of the individual provinces have done and instituted, and then trying to roll that out at the national level.

[The Chair, Liberal, Bill Casey]

Time is up. I'm sorry.

That concludes our testimony today. I really want to thank the presenters for their contributions here. You've all been closely involved with this issue and you've helped us a lot. Your testimony will be reflected in our report. Thank you very much for coming

To the committee, we have some committee business to do, so we're going to take just a two-minute break and then we'll reconvene to deal with some motions.

[The Chair, Liberal, Bill Casey]

We will reconvene now.

We have some motions to deal with. When we started this study, we agreed that it would be public and broadcast, but this is committee business and we need to have the agreement of committee as to whether it's going to continue to be public and broadcast, or held in camera because it's committee business. I know that Mr. Webber, who is the mover, prefers that it be in public. This discussion is just on whether we're going to go in camera.

Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Yes, but I would like it to be known publicly that I would like to put this motion on the table.

The fact is that we've had numerous presenters here indicating to us that these illicit drugs are a problem and mainly are coming from China. We've had the Canada Border Services here. We've had the RCMP here. They've all indicated that the problem is China and the illicit drugs coming from there. We're talking about the “super drugs” like super fentanyl and carfentanil. These are drugs that could wipe out the population of Canada with some of the shipments that are coming here.

I do want to put the motion on the table right now, Mr. Chair:

That, pursuant to Standing Order 108(2), the Committee call upon His Excellency Mr. Zhaohui LUO, Ambassador for the People's Republic of China to appear before this Committee to provide evidence as to the measures being taken by his Government to address the manufacture, distribution and sale of illicit opioids into Canada.

[The Chair, Liberal, Bill Casey]

Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

Thank you, Mr. Chair.

Without discussing the merits of the motion, in fact, I think we should have stayed on the topic that you asked us to stay on: are we going in camera or not? Regardless of the merits of the motion, I believe it is the committee's practice that we discuss witnesses to our committee in camera, and I would request that we move in camera immediately.

[The Chair, Liberal, Bill Casey]

Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

I echo Mr. Oliver's words.