Mr. Chair, vice-chairs and committee members, thank you for inviting me and the Canadian Centre on Substance Use and Addiction.
It was the late Brian Mulroney who created CCSA through an act of Parliament 35 years ago as a neutral, arm's length agency to provide leadership on substance use health and to advance evidence-based solutions.
As CCSA's newest CEO, I've spent my first year listening to diverse voices on how we need to act to achieve the most impact. As well, I'm a family doctor who's worked across three provinces and a territory.
My patients have told me that, when someone with an opioid issue goes to an emergency department anywhere in Canada, rarely do they get support. In fact, less than one per cent of people surveyed in a recent study co-led by the Canadian Centre on Substance Use and Addiction, or CCSA, said they would go to their family physician for help with an opioid use issue.
With Ontario youths, the rate of use of opioid agonist therapy has declined over the past 10 years. We need wide access to treatment, but people are facing closed doors across Canada. We have a responsibility to open doors to treatment and make the access way as wide as possible.
No Canadian jurisdiction has resolved these challenges. They are challenges rooted in pain and tragedy, coupled with a deep sense of urgency, that have sent people and organizations off in all directions.
Countries that have successfully tackled past drug crises have done so not within silos, but with humility and collective whole-of-health, whole-of-government and whole-of-community approaches.
A spectrum of care that includes treatment, recovery and harm reduction, but that arcs towards improved health is required. To reduce risk, this spectrum must also include prevention.
In 2011, CCSA published the world's first evidence-based prevention standards. With the emergency declaration first happening eight years ago, we must think of the lives we could have saved if we had invested. It is why CCSA is committed to building community prevention coalitions.
Every community deserves to feel safe and every person deserves access to the care they need, when and where they need it. People want to help each other and we need to create opportunities for them to do so. CCSA has been working with people with lived experience, families, physicians, police and communities to move this forward. The real solutions will come from them and CCSA is committed to using its resources and data to support their collaborations.
We're hosting a series of community-level summits on the ground where the issues are felt on strategies to end substance use crises. One immediate outcome has been the establishment of competencies for prescribers of all levels.
Our failure to collaborate more effectively amongst sectors strains the broader health care system. Harms from substance use cost the country $49 billion or about $1,300 per Canadian.
I'll never forget, when I was working in the ER, watching a man lay in pain waiting for four days with a broken hip. His granddaughter never left his side. He didn't get a hospital bed because we had three people in our ICU with overdoses that they should never have had and two people waiting for heart surgery for drug-related infections that we waited to treat.
There is no turning back. We now live in an era of powerful synthetic drugs that are too cheap to make and too easy to buy, and where data and clinical practice are evolving rapidly.
In 2005, CCSA redirected resources in partnership with the provinces, municipalities, first nations, Métis and Inuit providers, enforcement agencies and key federal departments to drive everything we did towards supporting what our communities needed most. The resulting national framework for action to reduce the harms associated with alcohol and drugs was relevant, real and impactful.
We collaborated across divides then. Now, it is the time for the leaders of our field, myself included, to set the table and work together. The solutions are in the communities and we need to provide the data, the science and the resources to activate them.
Thank you for your time and for your study of these important issues.