Health Committee on June 6th, 2024

[Dr. João Goulão]

Okay.

Well, we have a complementarity between the responses that are insured by the state and supported by the state, and the private responses that are also supported financially by the state. For instance, we have an out-patient clinic in each district capital. We have 18 districts. Each has at least one centre, which has the responsibility to ensure prevention, treatment, harm reduction and reintegration in its territory. If they do not have the capacity to offer the responses needed in this territory, they may establish a contract with NGOs acting locally.

We built quite rapidly a network of responses. I must say that in therapeutic communities, for instance, they are mostly private, NGO-run. The state has only three therapeutic communities, but we have 68 run by NGOs with different models. The state responsibility is to certificate and to support the development of those communities, and then we pay for the services they supply to our patients.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Dr. Hanley.

We now go to the final two rounds of questions.

It's now over to Mr. Thériault for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Shouldn't I have five minutes, Mr. Chair?

[The Vice-Chair, Conservative, Stephen Ellis]

You have two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Very well.

Mr. Felicella, you've been through a lot. As Mrs. Goodridge said, you're proof that recovery is possible.

No matter whether they agree or disagree on certain points, everyone who has appeared before the committee agrees on this: Relapse is part of the recovery process. Stigma looms when someone relapses. Every relapse is self-stigmatizing. Can you talk about that and the importance of harm reduction in that regard?

[Guy Felicella]

Yes, sir. Thank you.

Stigma in our society is just as deadly as the drugs themselves. It's the main reason why people use alone and don't reach out for help and support. It's the main reason why people are dying as well. It's not just the drugs, but on top of that, the shame and just how you feel like such a failure. You try to go into a program and you try your best. I don't think people in our society celebrate that there are people trying, but often they're just not getting the results that they need.

The reality is that the toxic drug supply doesn't change when you're in treatment. It gets worse and worse and worse. Then when you do relapse, it's there to ambush you and kill you. We're just not going to think we're going to have this revolving door of sending people into treatment and then back and not have a harm reduction safety net underneath that. People will die. People won't get better.

As I said, although campaign slogans like “bring your loved ones home drug-free” sound appealing, the reality is that it's not the truth. That's why we have to have all systems of care that meet and support people's needs. If we do that and really do it in a way so that we do both harm reduction and recovery equally, I promise you we will reduce the number of deaths in this country.

[Luc Thériault, Bloc, Montcalm, QC]

There's a lot of focus on prevention, but don't you think we need to do a lot more work on relapse prevention? Shouldn't we talk more about that?

[Guy Felicella]

One hundred per cent. I think you have to look at our society too as to why people are using drugs. Go way up river before people fall in, and really give them the tools that are in place. Canada has been in a health crisis for many decades, where not as much has been put into it. We're seeing the catastrophic results because the drug supply changed so dramatically.

I think you're right. We have to do more prevention. We have to do more of everything. That is the key to all of this. We really have to inform everybody in Canada. Like we've all said on this panel, I haven't been into a community where, sadly, I haven't seen toxic drugs impact somebody's life.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you, Mr. Thériault.

Mr. Johns, you have the floor for two and half minutes.

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

First, Mr. Chair and committee, I want to thank you for giving us this extra round.

Dr. Goulão, is the treatment program your country runs for-profit or not-for-profit?

[Dr. João Goulão]

Most of the treatment is not-for-profit. It's free of charge in the official responses in the units run by the state. It is almost free of charge in private responses, such as therapeutic communities. The state supports 80% of the costs and the patient or his family must support 20% of it. If that is not possible, if the patient has no financial capacity, social security can support the remaining 20%. Nobody stays out of care because of a lack of financial resources.

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

Mr. Felicella, we have about a minute and a half left.

Is there anything you heard today that you want to comment on or anything you feel left unsaid? I'm sure you have lots to say.

[Guy Felicella]

Yes, most definitely.

I just think people look at British Columbia and they think it's a harm reduction province. That's incorrect. It's an everything province. We have scaled up treatment here. We have over 3,600 treatment beds right now that people can access. We also have harm reduction services. I think the province has scaled up, since 2017, 607 beds with more to come. We also have the recovery community centres, which are places where people who have the desire to change their lives get group therapy. We also have the road to recovery program out of St. Paul's.

It was unfortunate that some members of this health committee didn't show up for that tour, because it really shows the importance of recovery being met at a hospital where people can go in and get access to detox and treatment through those recovery services. We have contract beds through health care services.

British Columbia is really fascinated with doing all aspects and understands that this approach needs a full continuum of care. That's what we'll continue to work on here. That's what I'll continue to fight for. That's what I'll continue to advocate for not just in British Columbia but across the world, because it's so important. I don't want to see anybody die anymore. This is just too tragic.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Mr. Johns.

Thank you to the witnesses.

Albeit unusual, I do wish to set the record straight in the sense that members from the Conservative Party were unable to attend because of wildfires. Let's be clear.

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

There was also a death in the family.

[The Vice-Chair, Conservative, Stephen Ellis]

Yes, there was also a death in the family.

That being said, colleagues, we are at the end of our round of questioning. I want to thank the witnesses for taking the time to appear and share such valuable information today.

Colleagues, we'll suspend for five to seven minutes and resume in camera for drafting instructions. Those of you online, please use the in camera link to rejoin the meeting. The meeting is suspended.

[Proceedings continue in camera]