Health Committee on Oct. 1st, 2024

[Dr. Sumantra Monty Ghosh]

This is something that I struggle with because in terms of the for-profit substance-use care, provided that it's evidence-based and evidence-focused, it does provide an easy route for individuals to access it, provided they have the means to access those services. I don't necessarily think it's a bad thing, but from an equity perspective it does not provide equity to the greater population.

One thing that Alberta has done, if I may, is that it has increased capacity for treatment supports. They're moving towards standardizing it. I haven't seen that yet, but many of them do provide medication-assisted treatments.

Last, but not least, it is providing a bit more rigour around the programming. That is something it is doing, but it's not necessarily ubiquitous. It needs to be better mandated and better standardized, in my opinion.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ghosh.

We'll go to Mr. Doherty, please, for five minutes.

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

Dr. Patel, do you have evidence that safe supply isn't being trafficked or diverted to schoolyards?

[Dr. Rakesh Patel]

I don't know how you would actually do that study because safe supply drugs are not tagged. There's no way for anybody to know that a dilly bought by a school kid would come from—

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

Would you support traceability measures on so-called safe supply?

[Dr. Rakesh Patel]

No.

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

Why is that?

[Dr. Rakesh Patel]

It's because it's a sinister entity. You're basically trying to govern somebody's autonomy. We don't do that for anything else, so why would we do it here?

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

Dr. Patel, has your program received federal funding through SUAP annually?

[Dr. Rakesh Patel]

I think it's a three-year program right now. It's renewed on a three-year basis.

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

I take offence to Mr. Johns' comment to you regarding the politicization of safe supply and the opioid crisis.

I do agree with you that we are seeing more of it. It is more evident. It is out in the open. Our communities look like war zones. I thank you for telling this committee what the high is like for those who are addicted to these drugs, and that they're chasing it all the time—continually chasing that high. It's why first responders say that if they attend somebody who has overdosed and they administer naloxone or what have you, the person who comes out of that or is rescued is very angry. Oftentimes they come up swinging.

I would offer to you this: Why politicians...and why it's become such a hot-button topic is that, since 2016, over 47,000 Canadians have lost their lives to overdoses. We continue to spend a lot of money on programs, but we're failing Canadians. That is why it is a hot-button topic.

We don't disagree with you in that more services should be there. At least on this side, we're saying we should do everything in our power to get people the help they need. I think that is part of the testimony that you provided earlier on.

Dr. Patel, what does primum non nocere mean in the Hippocratic oath?

[Dr. Rakesh Patel]

First, do no harm.

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

First, do no harm—is that correct?

[Dr. Rakesh Patel]

That is correct.

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

How do you square that, as a physician, providing safe supply to those who are addicted to drugs rather than trying to get them help?

[Dr. Rakesh Patel]

If I don't give them safe supply, they're going to die and it's game over.

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

Have you ever asked somebody on the street how they feel about living on the street? You said earlier on that you haven't asked that.

[Dr. Rakesh Patel]

I have asked. Nobody actually aspires to live on the street. Nobody actually aspires to use drugs. It's a coping strategy.

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

It's a coping strategy for what?

[Dr. Rakesh Patel]

All of the trauma they've gone through in their lives.

For some people, they've lost their homes because of interest rates and inflation. Other people have lost jobs. They end up on the street, because there's no other place to go.

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

They may be struggling with PTSD or a moral injury. Dr. Monty mentioned brain injuries as well. We see many people who are struggling with traumatic brain injuries who end up on the street, or what have you.

In my province, overdose is the leading cause of death for children aged 10 to 18. Were you aware of that?

[Dr. Rakesh Patel]

I'm sure the statistics are correct, but no, I'm not.

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

One of the families had a daughter who recently lost her life. The daughter was 13 years old. She just turned 13, living in a homeless encampment. You mentioned patient autonomy. This family tried, repeatedly, to get their daughter, who was struggling with addiction, who was suicidal, into treatment. The family was told by the health authority, and those who were there, that if she wanted to kill herself, that was her choice. She just turned 13.

How do you feel about that?

[Dr. Rakesh Patel]

I think the experience that she and her family went through was absolutely horrible and unbecoming of a health care system.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Patel, and thank you, Mr. Doherty.

Next, is Dr. Hanley, please, for five minutes.