Evidence of meeting #120 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was perrin.
A recording is available from Parliament.
Gord Johns NDP Courtenay—Alberni, BC
Dr. Somers, addiction is obviously a chronic relapsing condition, and it takes years for people to recover. Why would you be against safer supply to replace the unregulated, toxic and poisonous straight drug supply for people who relapse?
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
It's imbalanced. The broad programs internationally that have shown the greatest success in dramatically reducing high-risk addiction have put the goal before themselves of ensuring social reintegration. That theme was also once active in North America.
In fact, that is the format in which methadone was introduced as a practice. It was not a stand-alone drug administration program but an inducement into a much more comprehensive process that ensured social reintegration.
By adding drugs and not paying attention to the necessity of supporting robust social reintegration, we are essentially, in many cases, providing into a system of poverty a fungible asset.
NDP
Gord Johns NDP Courtenay—Alberni, BC
That's not the question. I think we all understand that this is a complex issue. It requires a comprehensive, full slate of responses. I'm trying to get an answer on that.
You talked about—
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
The answer is that it will make things worse.
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
It's the evidence.
NDP
Gord Johns NDP Courtenay—Alberni, BC
The First Nations Health Authority, the BC First Nations Justice Council, the Canadian Association of Chiefs of Police, Dr. Henry, who you seem to not support—
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
The Canadian Association of Chiefs of Police—
NDP
Gord Johns NDP Courtenay—Alberni, BC
Hold on, I'm not done yet.
All four chief medical health officers on Vancouver Island, where I live, the chief coroner of B.C. and the expert task force on substance use have all called for and supported a safer supply of substances. I guess what I'm hearing from you is you seem to know better than them.
You've talked about—
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
Were any of them trained in addiction?
NDP
Gord Johns NDP Courtenay—Alberni, BC
There are many who were on the expert task force on substance use. Absolutely. We're talking about those who are trained in addictions.
As well, you've cited conflict of interest. You went after Dr. Perry Kendall, who established a non-profit called Fair Price Pharma, and also Dr. Tyndall, who created MySafe, which is a non-profit.
Can you explain? These are non-profit pharmaceutical operators trying to create a safer supply of substances, but you've talked about them being for profit.
Also, we heard about 50 esteemed experts who wrote a letter that disagreed with your paper on housing.
What do you say to those experts who wrote the letter, including Dr. Nosyk, who's on this panel right now?
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
There are a number of allegations in your preamble. I'll focus on the question you concluded with.
We wrote a review. It did not, as Bohdan suggests, veer away from discussing the facts of what we found. Other reviewers at the same time had reached the same conclusion, which was that there is no evidence to support the safety or effectiveness of these practices.
In fact, if you search the BCCSU's website and the materials they're providing, you will see that exact disclaimer today. There is no evidence to support the safety or effectiveness of—and there are a variety of practices; fill in the blank—in order to reduce risks associated with fentanyl and other street drugs
That was the main conclusion. How did they assess it? They used the AMSTAR rating system. Bear with me. AMSTAR is a rating system for—
NDP
Gord Johns NDP Courtenay—Alberni, BC
You have to be very quick because I have other people I want to ask questions of.
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
Well, you asked. I'm answering.
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
They used the AMSTAR rating system, which is a rating system for systematic reviews. I've published systematic reviews on substance use and mental illness over the years. It's important they be standardized. Rapid reviews are not systematic reviews.
What you're pointing out is that 50 people signed on, in an emotional reaction, to a critique of a rapid review using an entirely inappropriate tool, which is basically—
NDP
Gord Johns NDP Courtenay—Alberni, BC
Thank you. I have a minute left.
Dr. Nosyk, would you like to give some comments on what you just heard?
Professor and St. Paul's Hospital CANFAR Chair in HIV/AIDS Research, Faculty of Health Sciences, Simon Fraser University, As an Individual
Again, this was a review that was done very early in the stages of implementation. I would just urge the panellists to read the review, read the critique and come to your own conclusions. I'll leave it at that.
NDP
Gord Johns NDP Courtenay—Alberni, BC
I'll go back to you, Dr. Nosyk.
You've heard me talk about all of the different organizations. Now their credibility is being undermined by saying they're not experts in substance use.
What are your thoughts on that when you hear about the long list of different qualified experts that I just talked about and the organizations they represent?
Professor and St. Paul's Hospital CANFAR Chair in HIV/AIDS Research, Faculty of Health Sciences, Simon Fraser University, As an Individual
I would argue that their credibility is very much intact.
NDP
Gord Johns NDP Courtenay—Alberni, BC
When you hear their credibility being attacked and you produce peer-reviewed research.... Your peer-reviewed research is being undermined when you hear comments that counter what Dr. Somers said.
Professor and St. Paul's Hospital CANFAR Chair in HIV/AIDS Research, Faculty of Health Sciences, Simon Fraser University, As an Individual
I don't take it personally. I think it's good to have dialogue. I think it's good to have alternative positions on matters. We need to discuss. This isn't a simple issue.
We had plenty of critiques on our work when it came out and we responded thoroughly as best we could through public presentations. We tried to deal with it as scientifically as we could. I'm all for debate.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Nosyk.
Thank you, Mr. Johns.
Next is Mr. Genuis for five minutes, please.
Conservative
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Thank you, Chair.
My questions will be for Dr. Somers, but I do have a quick comment for Professor Perrin.
I want to say, sir, that I respect your sincerity and your conviction. I've read your book. I do think your comments demonstrate the risk of combining good theology with bad science. I agree with you that love and compassion should define the character of our approach, including love expressed through effective dissuasion from danger and support for recovery but, as Dr. Somers has demonstrated, the NDP-Liberal approach to drug policy is wreaking havoc in our communities. It's causing diversion, and it's supported without credible evidence and pushed to the extreme by self-interested industry groups.
My first question is for Dr. Somers.
Many people are hurting as a result of the ongoing and escalating drug crisis, but there are some who benefit from it. Those who produce and sell the products driving this opioid crisis are making money off the suffering of others. Whether they wear hoodies in dark alleys or suits and ties in the halls of power, these drug dealers are benefiting from the pain of the most vulnerable.
You've talked about public health officials like Dr. Perry Kendall, who have gone from health policy roles where they advocate for decriminalization and so-called safe supply directly into business selling pharmaceutical-grade hard drugs.
Do you think that there should be rules in place to prevent former public health officials from going on to financially benefit from their previous positions?
Clinical Psychologist and Distinguished Professor, Faculty of Health Sciences, Simon Fraser University, As an Individual
Yes, there absolutely should be rules. These types of relationships should be transparent. The Stanford-Lancet Commission urged the same thing.
In fact, when they assessed the roots of the North American opioid crisis in Canada and the U.S., the first area they highlighted was conflicts of interest and the movement—and Dr. Kendall, unfortunately, illustrates this—of people from roles in senior public health and governance roles into, in his case, the BCCSU, and then also into roles with other organizations like the BC Centre for Disease Control, which has been flagged as a source of funding for the very company that he and Dr. Schechter started.
It's one thing to consider whether the action of moving into pharmaceutical provision of drugs is a sensible thing. It's quite another to be advocating for that and setting oneself up to be the provider, so yes, there should be transparency.