Health Committee on Oct. 8th, 2024

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

So, in your—

[The Chair, Liberal, Sean Casey]

Thank you, Mrs. Goodridge.

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

[Brendan Hanley, Liberal, Yukon, YT]

I wanted to echo my colleagues around the table in thanking you, Mr. Charles and Ms. MacDonald, for having the courage to share Brianna's story, particularly when the experience is still so raw and the grief so fresh.

One of the most compelling things you said in your very compelling testimony was that Brianna was using drugs to self-medicate. There, I think, lies one of the key links between mental illness and drug use.

Ms. MacDonald, you mentioned the breakup when she was ten and a half. If you look back on Brianna's short life, when was the first opportunity, do you think, for intervention? Was that intervention available and accessible?

[Sarah MacDonald]

The first intervention was probably when she was about 11 years old and I found her actively smoking weed. It was the first time I caught her. We tried to put her into a treatment centre then. She didn't feel that she needed to go, because she didn't feel it was a hard enough drug.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you for that.

Dr. Wieman, thank you for your testimony.

In Yukon, according to the chief coroner, in 2023, of the 20 deaths from toxic drug overdoses, 14 were first nations people. Again, that echoes the disproportionate impact on first nations communities. I wonder if you can describe some successes that could be emulated, particularly in the areas of prevention, land-based healing or aftercare, and that we could learn from based on what you've observed.

[Dr. Cornelia Wieman]

Around the province of British Columbia, as I mentioned, we're broken into five different regions, and our regional teams each probably have a community or a grouping of communities that has a success story to share. One of the things we hear the most as a model is that culture saves lives for first nations people, so we advocate very strongly for a model that respects both western medicine and what clinical medicine has to offer and what traditional healing, ceremony and being on the land have to offer. There are examples of that around the province.

Another example is Cheam First Nation in the Fraser Salish region, which was the first first nations community in British Columbia to have an overdose prevention site located on reserve. I think that took place after a lot of discussion within the community and a realization that because of the number of deaths, something had to be done.

One of our roles at FNHA is to also foster that cross-community communication. For example, the Tla'amin first nation on the Sunshine Coast has spoken publicly about their success in bringing the number of deaths due to toxic drugs down over the last several years, so we're looking for an opportunity where they can share their learnings with other communities, not just within the Vancouver coastal region but also with the other regions of British Columbia.

There are peer reduction programs, and we have different harm reduction grants. We gave out 108 harm reduction grants last year. We have an opportunity at different gatherings for those communities to share what they did with the money, for example, and how that improved the situation in their communities. We do track that and we share it in different fora.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you so much for that. Certainly, I'm sure the committee would be happy to receive any specific experiences from first nations in B.C. on some of these successes, so they can be emulated and shared.

Briefly, Dr. Larney, you talk about some overall trends in Quebec versus other provinces and what you see coming.

Quebec still has, I think, a remarkably low relative overdose fatality rate compared with peer provinces.

Are there protective factors at work in Quebec that are playing out differently than in other provinces?

[Dr. Sarah Larney]

Yes, certainly.

I first will just correct a point of fact: Decriminalization in British Columbia did not extend to people under the age of 18.

In Quebec, one thing that has differed in Quebec specifically compared with other provinces is that traditionally there has been a preference for stimulants—particularly a long-standing preference for cocaine—versus opioids in Quebec. That has, somewhat perversely perhaps, been protective against opioid overdose deaths.

However, the drug supply now is so contaminated and so unpredictable that this protection is no longer present. Basically all drugs now have a much higher risk of overdose because of contamination with fentanyl and other substances.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Larney.

I'm sorry to cut you off, but we're well past time.

Mr. Thériault, you have two and a half minutes, please.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, earlier we talked about young people's access to drugs. This morning, a very credible radio station in Montreal, 98.5 FM, revealed that Dr. Marie‑Ève Morin, who, as you will no doubt recall, has testified before our committee, noticed that Meta's platforms were authorizing ads for illegal drugs. She intervened and went to great lengths to contact people at Meta to get them to close these accounts, but she never succeeded. When she revealed this situation, Meta closed her account.

I'm going to go even further. I hope that all those who are concerned about young people's access to drugs will stop advertising on Meta's platforms. It's one thing to publish something, but it's another thing to advertise and promote.

I'm sharing this with you, and I'll come back to it. I thought it was important to talk about this today, because these platforms are very popular with young people. It is unacceptable that such an undertaking should be tolerated and encouraged.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Thériault.

Next we'll go to Mr. Johns, please, for two and a half minutes.

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

I'll start with Mr. Kulmala.

First, I want to commend you and your industry for your leadership in investing in prevention and education. We don't talk enough about prevention and education.

Can you speak about some of the success that you're finding through Tailgate Toolkit, which is very popular on Vancouver Island, where we both come from.

Also, can you maybe speak about loss of income as possibly being a barrier for those who want to seek treatment?

Do you believe there's an opportunity to provide income supports for those who want to seek treatment and need help?

[Rory Kulmala]

Thank you.

I think the success we see is really about the interest in our industry and turning to actively seeking out the Tailgate Toolkit. They want to see what they can do to support their workers. We do get people's first-hand expressions of how the program has helped them create awareness, or they say that they know somebody hey can use this with.

As far as income replacement is concerned, there are mechanisms for employed people through their health and benefits plan, so that if they have to take a leave of absence to have mental health or any kind of care, that supplements their income. There's short-term disability or long-term disability. That's why we advocate for employees to have—not necessarily a robust health care benefits plan, but a benefits plan.

When it comes to people who are outside of that, there is always opportunity. For people who are using and need to supplement—they have a mortgage or they have a family to take care of—that just feeds the mental stress if they can't do that.

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

How much time do I have left, Mr. Chair?

[The Chair, Liberal, Sean Casey]

You have just under a minute.

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

Okay.

I'll turn my time over to you, Dr. Wieman. Is there anything you'd maybe like to add to what you heard today, or is there any message you feel needs to be heard by the federal government to help tackle the toxic drug crisis?

[Dr. Cornelia Wieman]

Thank you for that. I'll be brief.

I think what I want to leave you with is the understanding, as I said earlier, that the toxic drug crisis of 2024 is not the toxic drug crisis of eight or nine years ago. The current unregulated supply of drugs is very dangerous and potentially lethal.

I also think that most people who are interested in saving lives are advocating for the whole range of services, all the way from prevention, education and awareness to harm reduction, detox, treatment and recovery, and aftercare. That's what we advocate for at First Nations Health Authority. As mentioned by Dr. Larney, this attempt to create a false dichotomy between either-or, that harm reduction and treatment are mutually exclusive, is false and harmful.

I think the other thing that needs to be understood is that there are nuances to this toxic drug crisis. People who use substances come from all walks of life. I'm really glad Mr. Kulmala was here today. There has to be an understanding of the shades of grey around the toxic drug crisis. There are many different stories. There are many different pathways to better health and wellness for people who use substances. We have to acknowledge that entire spectrum.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Wieman.

Dr. Ellis, you have five minutes, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Chair.

Mr. Charles and Ms. MacDonald, thank you for being here. I apologize for not being here earlier, but I have read your testimony. Thank you for that and telling Brianna's story to Canadians.

Now, I realize you're not experts in this, but you do have, obviously, significant lived experience. If you had to design a system talking about a couple of things, the prevention of drug use and then rehabilitation afterwards, what advice would you give to us and all Canadians?

[Lance Charles]

Time is the key, honestly. It's all based on how these children are. Every child is different. Every person is different. It shouldn't be time-specific. If it takes longer, they deserve longer. If treatment isn't working, there should be a broad spectrum of available research just to be able to develop treatments for other people. Some treatments work for some but not all. It can't just be a blanket. There needs to be research and there needs to be a lot of time put into deciding which path to move forward on.

I don't think there's one solid, good answer. I believe if time, structure, education and all of these things were followed, there would be a good program in place and this stuff wouldn't happen to our children and our people.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Mr. Charles.

When we're talking a bit about prevention, obviously this is the health committee, but that falls under education, perhaps. Do you believe there should be programs in schools to educate kids on the harms of drugs and that type of messaging out there, such as what drugs look like and what they can do to you? Do you have any thoughts on that at all?

[Sarah MacDonald]

I do think there should be some sort; there is for sex ed and stuff, so why isn't there for drug education?

[Lance Charles]

I'm with her on this one, but at the same time, you have to be sensitive. These are children's minds. They are undeveloped. They don't deserve to really know these things just yet; maybe in the teenage years, yes.

It's the same thing with the sex ed programs. They're teaching them younger and younger these days, allowing children to think, “Hey, look, I can think like an adult. I'm learning about stuff that adults know.” It's making them comfortable—too comfortable. I believe education should be there, but it should be very sensitive to what the child's mind is, because it is undeveloped.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much. That's an excellent point. We have to be cautious with the messages we're giving and at what ages. I think that's very well said.

Maybe we can turn our attention a bit to looking at the criminal element in this entire problem. Again, what advice would you give to the Canadian government to say, “Do you know what? Obviously, there's a criminal element here. People are selling drugs. People are making them illegally.”

Do you have any ideas, perhaps, around punishment and jail time, etc.? Are there efforts we're making on that front that should be different?

[Lance Charles]

I believe the criminal justice system should actually be a little bit more strict. It should really crack the whip down on these drug dealers and people who are selling drugs, especially to children. I believe the revolving door that's happening in this system is failing us. Criminals are getting locked up for a couple of months, tops, and then they're back out. They just keep doing it, back and forth, nonstop. They don't care: they're making money. It's all about money.

I believe stricter policies should shut this revolving door. If they are caught doing it more than once, there should be an indefinite suspension. They should be kept there, because these are the people who are killing our children. I feel that the policies in place right now need to be really updated a lot. I feel that the justice system needs to stand strong and stand by the people who matter, and that is the parents of these children who are dying.