Thank you, and thanks for having me today. I really appreciate the opportunity to come before the committee today, and I want to thank everyone here for all the time and attention being spent on such a critical issue.
I'm speaking to you today from Vancouver, where I live and work. I work full time in the field of substance use and addiction. I work in a number of different capacities. I'm a physician. I'm an educator with our fellowship program. I'm a researcher. I hold some leadership positions. I'm more than happy to answer questions about any of these areas today for the committee. I can speak about our current activities here in treatment, harm reduction, research, education, etc.
However, what I'd like to lead with and speak about as a clinician working on the front lines of the crisis is the complexity and how the overdose crisis must be conceptualized as a wicked problem. That is, it is a problem composed of innumerable complex and evolving issues. It needs to be approached as such.
I work at St. Paul's Hospital, which is, unfortunately, one of the epicentres of the overdose crisis in North America. My colleagues and I are witness to the scale, complexity and ruthlessness of this problem and how it has evolved over the past number of years. We see people from all corners of the problem, all walks of life and all sectors of society, and we bear witness to the terrible damage being wrought by the current toxic drug supply. We see the uncertainty that touches everyone. We know how quickly it's evolving and how limited we are, and we adapt to this.
In practice, that means I watch harm reduction interventions save lives in real time. I also see people failing to access that and suffering the consequences, or I see them being asked to solve problems they cannot solve. I see our treatment system and help people navigate that treatment system. I see successful outcomes, and I see those who have been unsuccessful in accessing or navigating our treatment programs—who have not found what it is they're seeking from our current treatment systems. Probably most importantly, my colleagues and I are faced all too directly, on a daily basis, with the realities of inequity and how significantly our system as a whole is failing to address many of the root causes of substance use and some of the ultimate drivers of the current crisis.
I'm all too aware that all the prescription pads and treatment programs in the world are not a replacement for things like primary care, appropriate prevention, appropriate care for physical and mental pain, and fundamental needs such as shelter and community.
From those experiences and that reality, it's all too apparent to me and my colleagues—and I think anyone working on the front lines in this sphere—that there is no one approach and no one solution that will address all the highly specific, rapidly evolving needs of every one of these individuals and communities in context. It is not possible to frame our approach in such a simplistic way.
I'm sure I am not describing anything to this committee today that they haven't heard already or were not aware of. Really, the need to conceptualize our response to the overdose crisis as a continuum of resources and approaches that speaks to all of these needs concurrently and is adapted to the many different contexts and variations we're finding across such a geographically and culturally diverse country is inarguable and, I don't think, controversial.
In summary, for the committee—as I said, I'm more than happy to talk about any of our activities or research at length today—my testimony for you, and my plea on behalf of the 20 Canadians who will lose their lives to overdoses today in our country, is that we collectively acknowledge this crisis as a wicked problem, with the complexity and sophistication it deserves. It is a problem that is non-partisan and that touches us all.
It is an emergency and one of the defining problems of our time, but it is solvable. We have evidence-based solutions and expert opinions for each of these individual contributors, which we can be talking about and implementing if we all get on the same page about so many of these challenging issues. In order to do that, we really must envision our response as an ambitious, emergent, broad and comprehensive one, and recognize that it needs to be adapted and tailored to so many different settings, to so many different communities and to so many different populations.
In the absence of recognizing this complexity and talking about it with that level of sophistication, we're going to continue to spin our wheels. I'm worried the progress that is attainable will not be there.