Health Committee on June 3rd, 2024

[Dr. Bohdan Nosyk]

I think those things contribute to the problem. We have had a lot of experience with opioid agonist treatment over a very long time. It has been accepted that this is a chronic recurrent disease and that people typically go through stages of remission and relapse. That process has continued, but as people relapse they're now being faced with a far more toxic illicit drug supply. It's far more dangerous to relapse off opioid agonist treatment nowadays, and so we need more options to keep people safe.

Treatment is one part of a continuum of services that we need. I think we need to adjust our expectations and adjust our knowledge, based on the introduction of new contaminants into the drug supply, which is still happening. The ground is still shifting beneath our feet here. We're trying hard to keep up. It's painful to watch our outcomes continue to deteriorate and it's painful to hear from physicians who are trying their best to keep their patients alive. It's difficult.

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Thank you.

We have just returned from visiting various Canadian cities. We met with front line organizations, such as the one represented here today by Ms. Jutras. We found that people are suffering, and people are looking for solutions, both for the people who help drug users and save lives, and for drug users.

You talked about finding options. We are gathered around this table and we have to find a solution to overcome this crisis. What can you recommend to us?

The question is for you, Dr. Nosyk.

[Dr. Bohdan Nosyk]

I'm sorry.

We need to recognize that there is a place for recovery, a place for outpatient treatment and definitely a place for harm reduction. All of these need to work together. Again, it's painful to see continuing deteriorated outcomes. It's also frustrating to see that, more and more, this has become a public discussion about finding culprits and throwing stones, rather than finding solutions. I came here to provide the expertise and evidence I have generated or come across. I hope I'm coming across as a constructive member of this panel and giving you evidence to build on.

We need more information. That was the bottom-line statement in my introductory speech. We don't know very much of anything about recovery-oriented models of care. We don't know very much of anything about the outcomes of short-term detoxification. That's the sort of thing that needs to be reported systematically across the country.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Nosyk.

Next, we have Mrs. Goodridge for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you.

Mr. Somers, you started out your opening statement by referring to the fact that you're in recovery. I was wondering if you could share a little of that with us, because I think it probably shapes how you approach your work here.

[Dr. Julian M. Somers]

Honestly, I'm not sure, but you can decide.

I was adopted. I grew up with and was exposed to traumatic experiences at an early age and developed mental illness symptoms and addiction symptoms. Those persisted for a number of years, starting around age nine. I left school and was out on my own as an early teen. I was relocated to another family, where I found the beginnings of some stability.

When we look at how people identify recovery, it includes several components: connection, hope, an improved sense of identity, motivation for the future and a feeling of empowerment—recognizing that one of the core features of addiction is the experience of loss of control over one's behaviour while one is aware of the harms that are resulting. Those components spell the acronym CHIME. CHIME was produced through meta-analyses and systematic reviews. It's been replicated. This is how people describe their experience of recovery.

That was certainly true for me. I was fortunate to find it through study, mountaineering and pouring my energies into those types of activities. I never went to 12-step meetings, but I know many people, of course, who benefit from other methods of transcending their loss of control and finding those qualities summarized in the CHIME acronym.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you for sharing that. I think it's important for people to understand what exactly recovery is and how it can look and play out in different spaces and aspects.

When it comes to Fair Price Pharma and their heroin.... Do you believe there should be a move towards a retail heroin business in Canada, as is being purported by Fair Price Pharma?

[Dr. Julian M. Somers]

No. I think that would be a very ill-advised step.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Regarding the vending machines for so-called safe supply that Dr. Mark Tyndall has put forward, do you think that is a responsible use of taxpayer dollars?

[Dr. Julian M. Somers]

Not at all.

The familiar refrain, which has some truth to it, is that addictions are problems of loss of connection. Therefore it is bewildering to put a vending machine between the government and a person who is suffering, rather than an opportunity to interact with a human who can accompany them on some constructive steps along the healing path.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

I heard you a while back at a conference in Calgary talking about the housing market. One of the studies you did was on who were most successful post-recovery in housing, and housing models.

I wonder if you could expand on that a little.

[Dr. Julian M. Somers]

Canada has a major tradition of following deinstitutionalization, along with many other places. It's a tradition predicated on closing large institutions on a commitment to institute community-based, recovery-oriented services. This is a decades-old refrain we were reminded of when Senator Kirby crossed the country and summarized his findings in “Out of the Shadows at Last”. Once again, we were told we have not closed that gap.

Canadians funded the world's largest randomized control trials to evaluate recovery-oriented housing in comparison with usual care. The results were dramatic. I led the trials in Vancouver, where our focus was on addiction. We found dramatic reductions in crime and medical emergencies, and improvements in health—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Are there any documents on that?

[Dr. Julian M. Somers]

There is a large number of peer-reviewed publications.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

If you could table those with the committee, that would be spectacular.

[Dr. Julian M. Somers]

I will.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

To follow up on some of these points, I wonder if we could get agreement around the room to have documents produced, specifically financial documents, donor information and contracts with the government for Fair Price Pharma and MySafe, and add them to our committee.

I'm wondering, Chair, if we could have—

[The Chair, Liberal, Sean Casey]

You're out of time, Mrs. Goodridge.

That's a request for unanimous consent for the production of some documents.

Is everyone clear on what's being asked for?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Yes.

[The Chair, Liberal, Sean Casey]

Okay.

Do we have unanimous consent to request those documents?

[Brendan Hanley, Liberal, Yukon, YT]

No, not right now.

[The Chair, Liberal, Sean Casey]

Okay. There is no unanimous consent.

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

Mr. Chair....

[The Chair, Liberal, Sean Casey]

Do you have a point of order, Mr. Johns?

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

Yes.

I'm happy if my colleague wants to bring this back at another time so we can revisit it.