Evidence of meeting #133 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was treatment.
A recording is available from Parliament.
NDP
Gord Johns NDP Courtenay—Alberni, BC
Do you feel that the provincial government in Ontario is doing enough to support people who are struggling—the Conservative government there—in this toxic drug crisis we're facing right now?
As an Individual
I don't know very much about what's going on in Ontario—I've been more focused on Ottawa—but from what I've learned today from Dr. de Villa, I would have to say regarding the clinics she's talking about, I would look at bringing my son there because it's witnessed dosage. Maybe that will help. I want to get him away from where he can sell. The only other option I have is to call the police and put him in jail, and that's not an option. I want to get him away from a situation where he is diverting his safe supply—plus all the other patients I see. These people are homeless and marginalized, but they deserve treatment, not selling their stuff, walking around in a daze and collapsing on the sidewalk 12 blocks from here. Any of you members could go down there, walk and see what I see every Friday.
Something has to be done, and I'm not sure which.... I don't want to politicize it, either, but what I'm hearing today from Dr. de Villa gives me a bit of hope for some change. Something has to be done. You're just producing more addicts. You're introducing hydromorphone into the high schools—that's a fact—and if everybody's okay with that, then let's not politicize it: Let's just pretend everything's A-okay.
NDP
Gord Johns NDP Courtenay—Alberni, BC
Thank you again for your courage in fighting for your son.
Dr. de Villa, earlier this year the federal government rejected Toronto's application to decriminalize drug possession for personal use within the city's borders. Both the federal government and the provincial government in Ontario say that this is a health issue, not a criminal issue. The Minister of Mental Health and Addictions said in a statement that the city's request didn't adequately protect public health and public safety. We know this is a debate in British Columbia, where law enforcement say they need more tools, but law enforcement, the chief coroner of British Columbia and the chief medical health officer still support decriminalization. Do you believe that decriminalization is an important tool in the response to the toxic drug crisis? Do you think the request could have been modified to address concerns about public safety, like was done in British Columbia, and if so, how?
Medical Officer of Health, City of Toronto
I do, as does Professor Fallu, believe that the answer, the solution for us lies in a broad range of interventions. I think we need everything: more prevention, harm reduction and treatment and, yes, better drug policy. The evidence actually shows that this makes a difference, and that criminalizing people for drug use is actually not successful. It wasn't successful for alcohol; it will not be successful for other drugs. I think that's the short version of the story.
I regret that our application was not seen as supportive enough of—and you use the words—“community and public safety”. I assure you that, of course, while our application was made while keeping in mind people who use drugs and protecting their health as much as possible, it's also about the rest of the community, right? I'm a public health physician. My job is actually about the population's health, and that includes everybody. That application was developed with a broad range of stakeholders, with public consultation and, yes, with the involvement of law enforcement—although we recognized and we still argue, as does the evidence, that, at the end of the day, when we're talking about substance use, it should be appropriately treated as a health issue. However, policy certainly makes a difference, the environment within which we're operating makes a difference and, as Professor Fallu said on a number of occasions in front of this committee today, we absolutely need to think about the broader social determinants of health. Substance use and substance use challenges do not occur in a vacuum.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Johns.
Next we have Mr. Doherty, please, for five minutes.
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
To our witnesses, thank you for being here today.
To Mrs. Krupp, our family does have lived experience. My brother lives on the street, and has been on the street for years, struggling with his addiction. I lost my brother-in-law to an overdose, also an uncle, so I really, truly, appreciate your testimony today.
Dr. de Villa, is your position today the same as in 2018, when your office released a report in which you recommended the legalization of highly addictive and deadly drugs such as heroin, meth, cocaine and fentanyl? Is that still your position today?
Medical Officer of Health, City of Toronto
Thank you, Mr. Chair.
My position is that we need to take an evidence-informed approach to substance use—
Medical Officer of Health, City of Toronto
—and that the current criminalization of those who use drugs is actually not serving our shared objective of—
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
So, you agree that we should be legalizing heroin, meth, cocaine and fentanyl.
Medical Officer of Health, City of Toronto
I think we should be treating substance use as a health issue, and we need to modernize our existing policy approach to substance use.
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
You're a public health physician. Is that correct? You're not actively involved in these centres; you're a public health physician who drafts policy. Is that correct?
Medical Officer of Health, City of Toronto
I do not provide direct clinical treatment.
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
Okay. Thank you.
Dr. Fallu, I appreciate your testimony today.
You called decriminalization in B.C. a success. Are you aware that the leading cause of death for children aged 10 to 18 is overdose?
Associate Professor, Université de Montréal, As an Individual
Yes, I am, but—
Associate Professor, Université de Montréal, As an Individual
Do you want me to answer?
Associate Professor, Université de Montréal, As an Individual
Okay. You know, I'm a scientist, and I know that causal attribution is really complex. You cannot, because something is higher than before decriminalization, attribute this to decriminalization. There have been other factors at play—
Associate Professor, Université de Montréal, As an Individual
—such as inflation and housing problems.