Health Committee on April 15th, 2024

[Dr. Nathaniel Day]

I think that Alberta does not feel particularly well supported in its policies around the response to the drug crisis. I think we would appreciate seeing certain things happening.

For example, one of the greatest predictors of a person's staying in recovery—if they've gone through treatment and are on evidence-based treatment medications—is employment. Are there opportunities for the federal government to support employers to take on people in early, sustained recovery? Are there opportunities for the unemployment insurance system, for example, to support persons in active addiction who have lost their jobs to receive supplemental funds so that they can successfully attend treatment, recover their lives and go back to work?

There are a lot of things that we could be talking about that I don't think are controversial, that I think could have broad support in the public to support recovery for our population.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Day and Dr. Ellis.

Next is Dr. Powlowski, please, for two minutes.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I previously brought up the fact that I think public consumption is detrimental to society in many ways. As a committee, if we're going to make recommendations, what do we do about it? If we allow and decriminalize possession, where are people supposed to use their drugs? When people are homeless and are users, are they supposed to go into their tents and quietly die there so that we can't see them? What is your solution?

I really mean this. If you don't have a solution now, think about it. Do we put the safe injection sites out of the public domain? Do we patrol around there? How do we do it so that we let people who are addicts use drugs, but not in public, because of the detrimental effects?

That's for anyone who wants to answer.

[Fiona Wilson]

Sure. I can jump in.

I think you really speak to the importance of having services like overdose prevention sites readily available to people in the community. We have 12 of them here in Vancouver, but now we recognize that 60% of the people who are dying are dying through inhalation, not injection.

It's a question of pivoting and being able to accommodate those individuals so that they are able to use safely if that's what they choose to do. That's why services like safe consumption sites are so incredibly important.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

If anyone else wants to add their two cents' worth there, go ahead.

[D/Comm Dwayne McDonald]

Perhaps I could add to Deputy Chief Wilson's comments.

People like choice. They like to have options when it comes to anything in life. When it comes to the consumption of drugs, if there's only one option and it doesn't suit them, then they're going to go where it suits them, and that may be public consumption.

As noted, in some of our supervised consumption sites or overdose prevention sites, there are no inhalation rooms or there is no ability to inhale. We find that most of our overdose deaths are related to fentanyl and to inhalation, so we need to provide spaces, I think, that would allow for that, but it can't be a space where someone has to take a bus for four kilometres and go across the city to find that space. Those spaces need to be readily available.

However, there also need to be multiple options in terms of treatment, counselling and safer places. I think it deserves a conversation so that we don't force people into one pathway that may not work for them.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Powlowski and Mr. McDonald.

Mr. Thériault, you have the floor for two minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

My question is for Deputy Commissioner McDonald or Assistant Commissioner Ng.

During the drug seizures in Prince George and Campbell River, the Minister of Public Safety and Solicitor General for British Columbia stated that there was no evidence of widespread diversion of safer-supply drugs in British Columbia, which was supported by RCMP Assistant Commissioner John Brewer.

A month later, do you agree with what he said? Why? What should be done to avoid such diversions? What are your solutions?

[D/Comm Dwayne McDonald]

I'm not aware of the Attorney General's comment. I do know that the Province of British Columbia acknowledges that there is diversion of safer supply drugs, just as there is with other prescribed drugs. In the case of Prince George, we have direct evidence, which has led to criminal charges, identifying safer supply drugs that have been diverted and were seized in conjunction with a multitude of other illicit substances.

I think that to move forward in dealing with the diversion of drugs, whether they be safer supply or prescribed drugs, we first have to be well educated to be able to identify them properly. Once we determine that they may be diverted safer supply drugs, we need to know where they have been diverted from, if that wasn't made evident in the investigation. If they are coming from a particular outlet, we need to work with our health authorities to find out where the cracks are and how those drugs are being diverted.

If they are being transported by a criminal network from elsewhere in the province, we need to know where they originated, and then we can work with the health authorities to identify problematic users who may be diverting their safer supply and trading in the illicit drug market.

[Luc Thériault, Bloc, Montcalm, QC]

However, if I understand correctly, you have had no answers to your questions and you don't know where these diverted safer-supply drugs are coming from at this time.

[D/Comm Dwayne McDonald]

To clarify, in some contexts we know exactly where it's coming from, because the investigation has borne that out through direct observations. In many cases, some of the drugs are being seized in their original packaging. Often, however, the identifying information, such as the original customer's name or location, has been scratched off of those bottles, and there's no tracing element that is put into safer-supply drugs. If those drugs are located outside a package or have been repackaged in a plastic bag, for example, we will not be able to determine their initial origin was.

[The Chair, Liberal, Sean Casey]

Thank you.

The final questions will come from Mr. Johns. You have two minutes.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Deputy Commissioner McDonald, when you were asked earlier about the prices of hydromorphone, you said that they've dropped significantly.

Can you talk about the prices of toxic and deadly concentrated fentanyl, benzos and tranquilizers? Have the prices of those on the street also dropped significantly, or even plummeted?

[D/Comm Dwayne McDonald]

Since we saw the initial influx of fentanyl into the market here in British Columbia some years ago, it has become cheaper. It is the drug of choice. Unfortunately, it is easily accessible. That is why, in my opinion, it is such a killer: You have a cheap drug that is readily available, and in small amounts it can result in death.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Toxic fentanyl is driving down the price of all drugs. Would you say that?

[D/Comm Dwayne McDonald]

I don't know if I could say that it's driving down the price of all drugs; it's just that fentanyl is so prevalent in the market that it's becoming cheaper and cheaper. It is by far the drug of choice among users who are attracted to opioids.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Deputy Chief Wilson, you heard from Deputy Commissioner McDonald about the need for safe consumption sites to allow inhalation and to be closer to people.

Can you talk about how increased homelessness in major cities is contributing to public drug consumption? Would you say that adding more safe consumption sites and allowing inhalation would help counter some of the concerns around the decriminalization policy in British Columbia?

[Fiona Wilson]

Absolutely. It's a great example of the need to have a multi-faceted approach to this problem.

It's not just about decriminalization and it's not just about safe supply and it's not just about education, treatment and prevention. It's about everything together. I think increasing the number of safe injection sites and safe consumption sites where people can inhale, as opposed to just injecting, is a very important piece of that approach. When you overlay our increases in homelessness, I think it's really important to provide individuals with safe places where they can use drugs. We know that's what many people are choosing to do in any event.

I heard recently from a person who was actually in the Downtown Eastside for 20 years, and he has now been clean for 11 years. It took him literally dozens of times in treatment, and he's only alive today because of the intervention of harm reduction and safe supply services.

I think this is a very complex issue. It's really important that we take this approach that covers all different sets of circumstances. Ideally, we provide prevention and education so that people don't start using in the first place, but we also have to address the fact that there are some folks who are entrenched and who are using, and we want to try to keep them alive. Then there is everyone in between.

That's probably my main comment today: We really do need a multi-faceted approach, and no one approach is better or worse than the other. They're all really necessary.

[The Chair, Liberal, Sean Casey]

I want to thank all of our witnesses for being with us today. The level of professionalism and the conciseness of your answers are really appreciated. We appreciate what you all do to keep us safe every day. Thanks for being with us.

Is it the will of the committee to adjourn the meeting?

[Some hon. members]

Agreed.

[The Chair, Liberal, Sean Casey]

We're adjourned.