Evidence of meeting #67 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was legal.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Lynda Balneaves  Registered Nurse and Medical and Non-Medical Cannabis Researcher, Canadian Nurses Association
Karey Shuhendler  Policy Advisor, Policy, Advocacy and Strategy, Canadian Nurses Association
Serge Melanson  Doctor, New Brunswick Medical Society
Robert Strang  Chief Medical Officer of Health, Nova Scotia Department of Health and Wellness
Michael DeVillaer  Assistant Professor, Policy Analyst, McMaster University, As an Individual
Mark Kleiman  Professor of Public Policy, Marron Institute of Urban Management, New York University, As an Individual
Trina Fraser  Partner, Brazeau Seller LLP
Brenda Baxter  Director General, Workplace Directorate, Labour Program, Department of Employment and Social Development
Norm Keith  Partner, Fasken Martineau DuMoulin LLP
Clara Morin Dal Col  Minister of Health, Métis National Council
Isadore Day  Ontario Regional Chief, Chiefs of Ontario
Wenda Watteyne  Senior Policy Advisor, Métis National Council
David Hammond  Professor, University of Waterloo, School of Public Health and Health Systems, As an Individual
Mike Hammoud  President, Atlantic Convenience Stores Association
Melodie Tilson  Director of Policy, Non-Smokers' Rights Association
Pippa Beck  Senior Policy Analyst, Non-Smokers' Rights Association
Steven Hoffman  Professor, Faculty of Health, Osgoode Hall Law School, York University, As an Individual
Beau Kilmer  Co-Director, RAND Drug Policy Research Center
Kirk Tousaw  Lawyer, Tousaw Law Corporation
Stephen Rolles  Senior Policy Analyst, Transform Drug Policy Foundation

9:45 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you.

9:45 a.m.

Professor of Public Policy, Marron Institute of Urban Management, New York University, As an Individual

Mark Kleiman

The goal ought to be to not have the price decrease.

9:45 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you for clarifying that.

I'll go back to Mr. Strang.

I think you mentioned that the public health goal underpinning Bill C-45 is the idea of taking products out of the illicit—I think you prefer the term “illegal”—market. Is that correct?

9:45 a.m.

Chief Medical Officer of Health, Nova Scotia Department of Health and Wellness

Dr. Robert Strang

Yes, the goal is to bring people into a legal market, but a legal market that is driven by the objectives of public health and public safety, not for profit.

9:45 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

This legislation would not do that for edibles and concentrates and other products. In other words, on July 1, 2018, those products will still be in the illegal market without any regulation whatsoever on quality, packaging, on anything.

We've heard evidence that somewhere between 30% and 60% of the products being consumed by people in North America are some form of creams or nasal sprays or tinctures, or edibles of some type.

Would you agree that we should be moving expeditiously to bringing those products into the regulated market exactly for the public health and safety concerns that you mentioned, or should we leave it to the illegal market?

9:45 a.m.

Chief Medical Officer of Health, Nova Scotia Department of Health and Wellness

Dr. Robert Strang

I don't disagree that we need to bring in edibles as part of this, but the world of edibles becomes very complex, and I think it's appropriate that we do this in a staged approach.

There are enough complexities right now, as I'm sure you're well aware of from your hearings this week. We need to get through some of the other pieces and then grapple with the very complex area of edibles. Control of consumption, who uses them, workplaces, schools, etc., becomes very difficult, and that requires considerably more thought and policy conversation.

9:45 a.m.

Liberal

The Chair Liberal Bill Casey

Thanks very much, Mr. Davies.

Now we move to Ms. Sidhu.

9:50 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you all for being here and sharing your valuable information.

My question is for Dr. Melanson.

We all know that in 2015 the highest use of cannabis in Canada was among youth, at 21%. Professor Kleiman said there's a huge amount used, no matter whether it's legal or illegal. My colleague did a town hall yesterday and shared the fact that 45% of youth are using now. I did a round table in my riding, and the number who are using has doubled.

Dr. Melanson, you said in your statement that you saw a patient in the ER where cannabis was laced with another drug that was more dangerous. It's life threatening for all of our youth.

That is why our government, after extensive consultation with law enforcement, has introduced legislation to legalize, strictly regulate, and restrict access to cannabis. Don't you think this approach is better than when youths are taking laced cannabis? What is your thought about that?

9:50 a.m.

Doctor, New Brunswick Medical Society

Dr. Serge Melanson

Ms. Sidhu, thank you for that important question.

My reference to the lacing of cannabis was based on my historical experience with the fact that there is currently, as you know, no legalized market for cannabis. I would presume there would be some benefit in having this substance controlled from a safety standpoint, in terms of what additives or not are incorporated into it. I suppose that's also under the assumption that once this substance is legalized the illicit market will entirely evaporate, which I think may not be the case.

I'd also like to point out that there are other significant health risks to youth and young in particular. As you likely already know, the leading cause of death among young people and youth is trauma. We recognize that trauma, whether it be from a motor vehicle accident or high-risk behaviour, is often associated with either alcohol or an illicit drug, including marijuana use. This is also something I've seen substantially, despite seeing all the public awareness in 2017 around the use of alcohol and illicit drugs and high-risk behaviour.

To answer your question, I think there is the potential to see improvements in regard to the mixing of more potent toxic agents in cannabinoids as we see them today. Unfortunately, I don't think that will remove the risks to youth and young people in regard to what kinds of trouble they can get into.

9:50 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

My next question is for CNA.

Our government made a historic investment of $5 billion throughout 2017 that can ensure mental health support for 500,000 Canadian youth. Mental health resources and research will benefit all Canadians. How will this specific area of funding and research support the government's goal to protect the health of Canadians and minimize the harms of illicit cannabis?

9:50 a.m.

Policy Advisor, Policy, Advocacy and Strategy, Canadian Nurses Association

Karey Shuhendler

Thank you for the question.

Legalizing will remove a lot of the harms of illicit cannabis. On your question about the funding for mental health, that is an excellent investment. We applaud the government's investment in mental health services because they are necessary. There's always room for improvement as well, and as we said in our testimony and our brief, additional investment through either revenue from sales or enforcement savings should go into mental health programs and substance use prevention and treatment programs. I think that while the $5 billion is a great investment and indicates that there is a need for additional mental health services in Canada, there should be additional money taken from the legalization of cannabis to invest in mental health.

9:50 a.m.

Registered Nurse and Medical and Non-Medical Cannabis Researcher, Canadian Nurses Association

Lynda Balneaves

Just to add something for information's sake, I'll be meeting with the Canadian Institutes of Health Research on Monday in Montreal. There will be researchers from across the country who will be discussing the CIHR priorities in cannabis research and the use of non-medical cannabis in Canada, and so there will probably be additional funding specific to research that will look at the social as well as the health effects of non-medical cannabis use following legalization.

9:55 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

My next question is for Dr. Melanson again.

How do you see the role of health care practitioners, non-profit educators, community organizations, and other non-governmental organizations providing public education for youth on cannabis? I also applaud the work you are doing for public education, especially on healthy eating for kids. What do you think about public education for youth on cannabis?

9:55 a.m.

Doctor, New Brunswick Medical Society

Dr. Serge Melanson

Again, it's about utilizing tools that youth and young people access. Here in New Brunswick—we're the New Brunswick Medical Society—we use electronic formats and also traditional means of getting the message to them that despite the legalization of cannabis there is still some degree of risk in using it. As the other panel members have mentioned a number of times, an informed decision, understanding all risks, is what is key when using legalized marijuana. That is the staple of the message we have provided to the citizenry in New Brunswick thus far.

I would also point out essentially that the educational campaign would need to be sustained, and not simply reflective of what is going on currently, and that a comprehensive strategy between provinces and across the country likely needs to be adopted, to make sure that the message that our young people in particular are receiving is consistent. We don't want to be sending mixed messages.

9:55 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

My next question is for Dr. DeVillaer.

9:55 a.m.

Assistant Professor, Policy Analyst, McMaster University, As an Individual

Michael DeVillaer

Mr. DeVillaer, please. Thank you.

9:55 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Mr. DeVillaer, Bill C-45 proposes very strict regulation of labelling, advertising, and marketing at the outset of legalization, whereas alcohol, pharmaceutical, and tobacco products all entered the legal market with much more relaxed regulation.

Do you think this will make a difference in our ability to protect public health?

9:55 a.m.

Assistant Professor, Policy Analyst, McMaster University, As an Individual

Michael DeVillaer

I think there are some positive aspects of Bill C-45 arising from the task force report. For example, it looks as if the direction we're going in is that advertising for cannabis products will only be allowed in places frequented by adults. That would include cannabis retail outlets, perhaps alcohol retail outlets, gambling casinos, maybe in promotions before adult-rated films. There are a number of possibilities there.

I think that presumes that only young people are affected by advertising and marketing, and yes, absolutely we should be trying to do everything we can to prevent marketing advertising reaching young people. We're still not doing it with alcohol, for example. Alcohol advertising is everywhere you look these days, and there's no way of shielding young people from that.

Adults will still be exposed to advertising, and we should be very careful not to underestimate the power of that industry to influence behaviour. Remember, this is the industry which back in the 1960s convinced everybody that smoking these dried leaves in paper would make you more successful socially, and romantically, and career-wise without doing any harm to your health. Half the adult population bought it. I think we're more sophisticated these days than we were back then, and that will help, but adults are still very susceptible to advertising. Advertising works.

Public health has been making this statement for a long time now, and we see it's beginning to have an impact. We see prominent health journalists, André Picard, for example, writing about the way alcohol is so aggressively promoted and advertised. Even within the advertising industry, Terry O'Reilly is an icon in the Canadian advertising industry, and he was recently making some comments in his programs about the way in which alcohol is very aggressively targeted toward women. CAMH data shows that alcohol use among women is increasing just as it is among men.

This is why I proposed that we really do everything we can to completely ban advertising of all kinds. Plain packaging is very important. I'm glad to see that being talked about. With regard to retail outlets, one of the things I would like to see is a plain packaging approach to retail outlets as well, because of the principle that a pack of cannabis or whatever, as with cigarettes, is an ad. Every time somebody pulls it out, it's an ad. Plain packaging minimizes that to a significant degree, and I would like to see that same thinking applied to retail outlets as well.

10 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

10 a.m.

Liberal

The Chair Liberal Bill Casey

That completes our seven-minute round.

We'll go to a five-minute round starting with Mr. Webber.

September 14th, 2017 / 10 a.m.

Conservative

Len Webber Conservative Calgary Confederation, AB

Thank you, panellists.

Dr. Melanson, I find it interesting your talking about cyclical vomiting syndrome and how you attribute that to marijuana use, yet people going through chemotherapy and having nausea issues tend to go to marijuana to eliminate the nausea. I find it interesting that it affects some people one way and some people the other way. Do you have any comment on that at all?

10 a.m.

Doctor, New Brunswick Medical Society

Dr. Serge Melanson

It's a very excellent question, Mr. Webber. I think that really underlines our lack of understanding of what the scientific value of cannabis truly is and its perhaps beneficial or harmful effects. You quite accurately pointed that out. Also, as a practising physician, I myself will often encounter patients who will give testimonials to the effectiveness of cannabis with reducing nauseousness; yet during the same work shift, I will perhaps encounter a young person who is in the midst of a cyclical vomiting syndrome.

To be quite honest, the medical literature is not clear on what the physiological reasons for that are, which I think should give us great pause in regard to whether we are going to expect the increased usage of this substance in our communities and not fully understand its medical implications or health implications. I think it really underscores the importance that research will play going forward in regard to studying the effects not only from a population-based standpoint but also from a medical physiological standpoint. We need to make sure that is heavily promoted. Otherwise we will continue to operate in the dark, as it were, regarding the true effects of this substance on one's health.

10 a.m.

Conservative

Len Webber Conservative Calgary Confederation, AB

Thank you for that. I agree.

Mr. Kleiman, I have a question for you. You mentioned that you were quite involved with Washington state and their legalization process. Is it Washington state that did not allow home cultivation? Is that true?

10 a.m.

Professor of Public Policy, Marron Institute of Urban Management, New York University, As an Individual

Mark Kleiman

That is correct. Washington allows home cultivation for people with medical recommendations, but not for people who merely want to use it for non-medical purposes. That contrasts with Colorado, which does allow homegrown.

10 a.m.

Conservative

Len Webber Conservative Calgary Confederation, AB

It's Colorado that allows homegrown for recreational use. Is that—