Evidence of meeting #127 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was use.
A recording is available from Parliament.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
I know I just arrived, and I apologize. Was he on a five-minute round? How could he still have time left? I thought our convention at this committee was that any time you used to bring forward a motion was actually lost time.
Liberal
The Chair Liberal Sean Casey
No. The clock stops. I'm sure Ms. Goodridge would be able to confirm that.
Conservative
NDP
Gord Johns NDP Courtenay—Alberni, BC
Thank you.
Ms. Eaton, you talked earlier about the fact that there's no plan. It's something that we've also been calling for. The government has had a high-level meeting around auto theft, and I'm not saying that's not an important issue, but they still have not had a summit on the toxic drug crisis. They have put forward a plan, but there's no timeline and there are no resources attached to that timeline.
Can you talk to and speak a bit about how critical it is that the government put forward a plan with resources and a timeline to implement that to respond to the toxic drug crisis and the mental health crisis happening in Canada?
National Chief Executive Officer, Canadian Mental Health Association - National
Thank you so much, Mr. Johns.
Absolutely: We would thoroughly support a summit to address this crisis.
The death toll is great across the country, and we can't sit idly by. We will soon be releasing some really interesting information about the fact that provinces have actually reduced the amount of money they are spending on mental health and substance use care. It is lower than the percentage that they were spending even 10 or 15 years ago.
We are really interested in the government looking closely at this issue and at what legislative means they can use to actually change this situation to save lives. We would absolutely encourage a plan and a summit.
NDP
Gord Johns NDP Courtenay—Alberni, BC
Do you think that expanding coverage under the Canada Health Act is the best path forward to the challenges we're facing with mental health and substance use care? What would that solve?
National Chief Executive Officer, Canadian Mental Health Association - National
We absolutely believe that a change to the Canada Health Act is necessary. We see provinces not being held accountable for actually investing in mental health and substance use care. We don't have national standards. We don't have the ability for someone to use their provincial health card to get the essential services we need.
Also, we see this patchwork quilt of funding across the country, which means that rural regions are remarkably unserved, even by the existing services of the Canada Health Act—like doctors and psychiatrists—let alone mental health and substance use health services.
We absolutely see the Canada Health Act as a remedy.
Liberal
Conservative
Warren Steinley Conservative Regina—Lewvan, SK
Thank you very much.
This is for Dr. Conrod.
We have done the so-called safe supply experiment for about nine years now, and I was wondering about the before and after. Do you have the numbers of overall deaths before safe supply started, for approximately those 10 years, and for the nine years after safe supply had been introduced into the Canadian public by this NDP-Liberal government? Have there been numbers?
Could you say and extrapolate some information between how many more overdoses we have had in our country before and after this what they call “safe supply”—which I don't agree with—experiment?
Clinical Psychologist and Professor of Psychiatry and Addiction, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, As an Individual
I'm afraid I can't directly answer your question. I don't know if the data that exists right now could even answer that question. There are a number of different factors that have changed over the past decade and two decades that have contributed to where we are at right now.
I do want to just clarify one thing. This notion of safe supply is kind of a mixed bag of treatment services and possibilities. I know that there are some researchers from the CRISM network who intend on producing some material that might be helpful to the Canadian government and communities across the country, to better just unpack what is meant by safe supply, what practices are safe and what might actually have unintended consequences for the broader population.
We need a lot more work and clarity around some of these practices.
September 24th, 2024 / 12:20 p.m.
Conservative
Warren Steinley Conservative Regina—Lewvan, SK
I appreciate that very much.
Mr. Sword, thank you for being here.
I had a conversation with a constituent who came to my office. His son had overdosed as well. His conversation was very similar. The ease with which his son.... He overdosed, and this gentleman's grandson was sitting there when his father overdosed. He was sitting in front of the TV when his grandfather came and found his son dead. He said that the biggest thing that he could not do was to stop the ease with which his son was getting drugs. He was getting them online and delivered right to his door. It was very similar to Snapchat. He was accessing the drugs online.
I think Dr. Conrod has done some research on the ease with which people can get drugs online now. It's something that—for me as a father—terrifies me. I have three kids. They are 7, 9 and 11, and it terrifies me that with a click of a button, a 12-year-old could get drugs to their doorstep.
Do you have some data that says what we could do as legislators to help with that and to try to curb the ease of these kids and adults getting drugs online?
Clinical Psychologist and Professor of Psychiatry and Addiction, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, As an Individual
Is that question directed to me?
Clinical Psychologist and Professor of Psychiatry and Addiction, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, As an Individual
There's a lot to say here, but it's important that we recognize that young people are using digital media and, therefore, digital media must be designed for young people's use, and it's not right now. There are all kinds of privacy features, for example, and defaults that assume that the user is an adult, when we know that a very large portion of the users of social media and other digital platforms are not. They're minors. We can force industry to change some of their default features so that, for example, young people are less likely to be solicited by a stranger online. That could go a long way to protecting young people. We could also monitor environments in which young people meet online.
Conservative
Warren Steinley Conservative Regina—Lewvan, SK
Thank you very much.
Actually, Mr. Sword, I'd like to leave you with the last word. If there's one thing you could ask us as legislators to do, how do you think we could help to make sure that what happened to your beautiful daughter doesn't happen to anyone else? What is the best advice we could have from you, sir?
As an Individual
It pretty much comes down to funding. Invest in the mental health of our children. It's our future that we are throwing away. Most kids now are looking at a grim future with the prices and the way the economy is going. They're not dumb anymore and they're looking for escapism. Some kids are turning to drugs to forget about the problems, while others are turning to video games. Neither one is mentally healthy for them.
We need to actually invest in our future and get the funding they need so they can get the help they need before they become true addicts.
As an Individual
Yes. They need a light at the end of the tunnel. All they see is darkness.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Sword and Mr. Steinley.
Next, Ms. Kayabaga, go ahead for five minutes, please.
Liberal
Arielle Kayabaga Liberal London West, ON
Thank you, Chair.
I would also like to thank our witnesses for being here today, especially you, Mr. Sword, for sharing your heart-wrenching testimony. My thoughts are with you and your family as you continue to navigate this.
Perhaps I would like to start with Dr. Judson.
Dr. Judson, I'm sure a lot of things have changed since you started practising. I'm curious to know if methadone or Suboxone can be diverted. Besides maybe an injectable formulation, do you think there's a medication that can be diverted? Do you agree that zero diversion is almost impossible when we're talking about prescribed drugs or even some non-prescribed ones?
As an Individual
There is no such thing as zero diversion. When methadone programs first started in the early nineties, protocols were set in place to minimize that diversion, which required patients who were just recently initiated on methadone to attend the pharmacy every day and consume a witnessed dose of methadone. They weren't able to take any doses of their methadone home until they had achieved evidence of significant stability. That usually required a period of over three months.
After three months of a patient's denying use of substances, substantiated by witnessed negative drug screens, in which the patient had to produce a urine sample under witness conditions, if those twice-weekly urine samples remained negative over a period of three months, then a patient would be able to take one dose of methadone home a week, and after a month that increased to two. It would take six months—nine months really—to get all of their take-home doses, otherwise known as “carries”. Even that didn't prevent diversion, but it certainly reduced it.
Compare that with what is happening in safe supply clinics, particularly in London. You could go to a clinic in London and say that you had a problem with opioids. Chances are significant that you would walk out of that doctor's office with a prescription for Dilaudid—enough to last a whole week. You might have to have one witnessed dose in front of the pharmacist, and you would get the rest of your doses to take home. If it didn't happen immediately, it would happen certainly after about two or three weeks that you would be getting maybe 50 or 60 tablets to take home. That's far more than a patient who has just had abdominal surgery would require for the management of their pain. That is just tantamount to negligence. It's just incomprehensible. It's unconscionable that someone who is active in their disease of addiction would be trusted to take that amount of an opioid home.
Liberal
Arielle Kayabaga Liberal London West, ON
Thank you.
There haven't been a lot of conversations around the socio-economic impact on people who become patients with drug-use disorders.
I'm curious to know, Ms. Kennell, what perhaps your thoughts are on some of the comments that the Conservatives have been really pushing on making treatment forced. I'll give just a small example. Some communities have lower income. The median income is much lower than perhaps in some of our colleagues' ridings. What are your thoughts on the socio-economic impacts and these forced treatments? Obviously, we've seen some research that this hasn't worked.
What would happen to people who would be forced into treatments, treatments sort of offered as jails? What are your thoughts on this?
National Director, Public Policy, Canadian Mental Health Association - National
Thank you very much, Ms. Kayabaga.
Your question, I would say, has two parts. The first is the socio-economic context that people struggling with substance use disorders and mental illness face. We know, for example, that 25% to 50% of people who are homeless or facing housing insecurity have a mental health or a substance use health concern.
The correlation there is unignorable; therefore, it requires us to be thinking cross-jurisdictionally and cross-sectorally to come up with solutions that truly address the crises and the intersectional nature of the crises that we're facing. The creation of the Canada disability benefit that came online this summer is an example of the type of federal intervention that can reduce the strain that poverty has on people dealing with mental health crises and substance use disorders.
In regard to the issue of involuntary treatment, I would encourage the committee to focus on interventions that are squarely within the federal jurisdictional purview. We know that every province and territory in Canada has a mental health act. We know that apprehensions under those acts are rising in the face of threat to public safety and threat to harms at the individual level; therefore, we know that there are legislative options that are being utilized provincially and territorially.
They are not perfect, and we need to acknowledge the incredible amounts of trauma and harm caused when we involuntarily detain individuals, which can be long-lasting, while also prioritizing the voices of people with lived and living experience who interact with the system every single day. We must ensure that we are responding to their needs and their experiences with the system when developing legislative amendments to those acts or considering new legislative options.
