Thank you.
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.
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.
October 22nd, 2024 / 12:10 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. de VIlla.
Mr. Thériault, you have the floor for two and a half minutes.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Mr. Chair.
Mr. Fallu, as I understand it, you're not the only one arguing that prohibition and criminalization lead to stigmatization. This situation is an obstacle to improving the lives of people with addictions, and even to treatment. Diversion helps to counter some of the stigma. If someone loses their job because of their criminal record, that doesn't get them closer to treatment.
Isn't diversion decriminalization to a lesser degree?
Since we're talking about police forces, they seem to be stakeholders in this approach, particularly in Quebec and Montreal.
Is that the case?
Associate Professor, Université de Montréal, As an Individual
Diversion is the approach Quebec has taken recently, as has Portugal, where I am at the moment. This approach was adopted in 2000, and it was implemented in 2001. It's been 25 years.
It's definitely a step in the right direction. Decriminalization doesn't prevent the police from intervening. Again, we need to have an informed debate about this. The police do respond here in Portugal. They police cannabis across Canada. There are rules. However, decriminalization creates a grey area that allows the stigma to continue. It's certainly a first step, but it doesn't solve everything. We need to stop condemning decriminalization for things it can't fix.
Since Mr. Doherty put words in my mouth, I'm going to set the record straight. I never said that decriminalization in British Columbia was a success. It's probably better than prohibition, but it's a half measure. It's not enough. It doesn't solve all the problems, but at least it solves some of them.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Fallu.
Mr. Gord Johns, please go ahead for two and a half minutes.
NDP
Gord Johns NDP Courtenay—Alberni, BC
Thank you, Mr. Chair.
I'll follow up on that. We know that Alaska saw a 45% increase in toxic drug deaths last year alone, and its death rate is now higher than British Columbia's. In fact, Lethbridge is triple that of British Columbia where they closed safe consumption sites. In Regina, where they don't have a safe consumption site, it is 50% higher—actually more than that— than British Columbia for their death rate. Baltimore is 400% more than British Columbia. Tennessee and West Virginia are both higher. They don't have safe supply. They don't have decriminalization.
Professor Fallu, you hear politicians blaming safe supply flooding our streets or decriminalization as the drivers of the death rate. Maybe you can comment on that. I will say that in British Columbia, the death rate went from 7.9 per 100,000 to 30.3 under the Christy Clark and John Rustad government in the three years prior to the NDP government, and that actually went from 30.3 to 46 under the B.C. NDP, but then it came back down to 41 since decriminalization.
Maybe you can speak about that because that provincial government didn't have safe supply, and it didn't have decriminalization.
Associate Professor, Université de Montréal, As an Individual
I don't say "safe supply". It's quite unfair to talk, and continue to talk about, safe supply. I hear more Conservatives, if I may politicize this a little, talk about anti-harm reduction, and safer supply advocates use the word “safe supply”. We use the term "safer", because it's safer than unregulated and uncontrolled substances that are on the market. That's prohibition. Prohibition is refraining from have some rules and quality controls. It stigmatizes people.
Safer supply is an attempt to do something, because this problem is basically at its very core a problem of deaths. If people die from overdosing, it's because they don't know what they're taking. I took fentanyl in a hospital setting. I knew what it was. It was under medical supervision. Fentanyl is not a dangerous drug. The danger is not knowing what you're taking. Let's say if you go to a liquor store and buy alcohol, you need to know what's in it. Either it's 5% alcohol or 95%. How can you have responsible use? It's impossible.
Safer supply is a way to have a plaster, a band-aid solution, on something that's very much more profound. It's the absence of control in a context where people use and will continue to use, so we have to find nuanced solutions, as my colleague Dr. de Villa said.
Safer supply is maybe new. We need to continue evaluations, but what we know up until now, the balance is on the side of positive effects.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Fallu.
Next, we have Mr. Moore, please, for five minutes.
Conservative
Rob Moore Conservative Fundy Royal, NB
Thank you, Mr. Chair.
Ms. Krupp, regarding the term “safe supply”, or “safer supply” as the previous speaker said, Conservatives didn't invent that term. It is through listening to those with lived experience like yourself that we're seeing the evidence of this approach being anything but safe.
When I hear your description of your son's experience and your experience, nothing about it sounds safe. Nothing about it sounds safer. You referred to his so-called safe supply as a currency, and the now its prevalence in high school, its diversion, and the lack of traceability of this so-called safe or safer supply.
Can you comment a bit on that? In your opening remarks, you mentioned that your son is still using crack cocaine and fentanyl. Is he still using these hard drugs while diverting his safer supply?
What about this, in your opinion, is safe?
As an Individual
Again, I'm just going to point to my lived experience with my son. I don't see anything safe about it. How could it be called safe supply, when three-plus plus years later, he's still going to the clinic. He's still seeing the same doctor. All that he's dropped is his methadone, and he's done that himself. I think his methadone should never have been dropped, because the methadone has to be...According to what I've read, you can't drop the methadone if you're still into fentanyl.
All of that is to say that three-plus years later, he's getting his methadone. He's getting his Dilaudid. The Dilaudid is a means or currency for him to continue using crack cocaine, so it's not safe, because he's still using unsafe street drugs. The whole purpose of the safer supply program was to divert addicts from using harmful street drugs.
That's not happening, in my experience. Not only is he continuing to use harmful street drugs, but the safe supply that he's being administered every day by a doctor is making its way where it should not be, which is in the skateparks—my son was a skateboarder. Adolescents have money to buy these pure hydromorphones. I cannot call this safe. Otherwise, my son's results would be different. We're not talking about a month or 30 days; we're talking about three and a half years. There's your experiment of our lived experience of safer supply. Take it from me, it's certainly evidence-based and fact-based.
Conservative
Rob Moore Conservative Fundy Royal, NB
Thank you.
Professor Fallu remarked that nothing has changed in the last decade. In fact, there have been tremendous changes in law. I'm thinking specifically of the current Liberal government's Bill C-5 that now allows those that are importing, exporting and producing—such as in a meth lab—schedule 1, the most serious drugs, to not serve any time in prison but to have house arrest, which puts them back into the community.
Concerning our evidence about your son being able to obtain these drugs, what message do you think it sends to young people if there's no consequence for someone who's running a meth lab or importing cocaine into our country and, all the while, as you described it, the federal government is handing out this so-called safe supply?
As an Individual
I wasn't aware of the finer points of Bill C-5, so thank you for that. I'm going to educate myself on that.
There have been changes. In fact, methadone was.... I want to bring that because I know the doctor said that methadone was highly regulated by Health Canada up until, I think, 2015 or 2016.
Why all of a sudden can everybody dispense methadone at any clinic? A doctor who wasn't trained to dispense methadone killed my daughter. That's a fact.
In terms of house arrest, that's the most ridiculous thing I have ever heard. In other words, you can come and produce crack and whatever, you can be a liberal in a progressive country, but you cannot.... Hard drug use is not normal. It shouldn't be encouraged to be normal. It should be treated, and it should be pointed to recovery. My son doesn't want to be a drug addict. He doesn't want to use methadone, crack or fentanyl. He wants to be normal, but he's an addict, and we have tried to get him help.
Yes, it is very nuanced, as the doctor has said. First of all, if you're producing drugs and selling them on the street, you go to jail. That sends a message. Perhaps people have to start a vigilante thing, and we'll take care of the drug dealers as parents.
Liberal
The Chair Liberal Sean Casey
Yes, you're out of time.
Next we'll have Ms. Kayabaga, please, for five minutes.
Liberal
Arielle Kayabaga Liberal London West, ON
Thank you, Chair.
I also would like to extend my condolences to Masha.
Thank you so much to all of you for being here.
My questions are going to be for Mr. Fallu.
Good afternoon, Mr. Fallu.
Earlier someone mentioned something about the Alberta model. I looked it up because I've heard about it, but I thought, “Let me dig in a little bit,” when you mentioned it.
The Premier of Alberta said that the Alberta model is working, yet we're seeing that the opioid crisis has contributed to nearly 90% of the deaths in Alberta.
What are your comments about the Alberta model, and what can we learn from the facts?
Associate Professor, Université de Montréal, As an Individual
Thanks.
First of all, once again, I want to say that we have to have a fact-based debate. I never said, as MP Moore said, that nothing has changed. I said that there were tiny, small changes. Please, let's talk about reality here.
By the way, I said I'm a person with lived experience of drug use, and I'm a normal person. I'm not addicted. I've been using since I was 15 years old. I have to rectify that. Everybody here probably uses alcohol in our normal lives, too. Alcohol is a hard drug.
As for the recovery model, recovery is very important, but addiction or a substance use disease is one of the most difficult human behaviours to change. We used to call that a chronic health disease. Even after three years, the success of recovery is really tiny.
We have to put the burden on the evidence of recovery, too. It's very difficult to help people to stop using. Helping people to live better lives reduces use, but people have relapse episodes, and they go back. Sometimes it's a long life to get better. Sometimes it's easier or faster, but overall, recovery is really important. We need all the tools. It may be effective in some cases, especially when people are ready and have other factors helping that, but having only recovery as a strategy will kill people.
Liberal
Arielle Kayabaga Liberal London West, ON
Thank you.
I do want to put on the record that not everybody uses. It's very important to note that because it would be misleading to say that everybody in this room or around our country uses. That's not true.
I have a question about the fact that you're very open about your journey of drug use, and you're a professor. Obviously, there are a lot of young people who listen to you talk about prevention. At the same time, you have been very open about your journey of drug use.
How do you manage to be relevant on drug prevention and be so open without glorifying it? This is something that has plagued many communities and affected many families.
Associate Professor, Université de Montréal, As an Individual
That's a very good question.
First of all, you're right; it's not everybody. It's almost everybody when we include medications over a lifetime. It's really rare that somebody uses neither alcohol, coffee, tobacco nor medications, but it's not everyone who uses.
Yes, I've reflected on that. I don't have all of the time I need here to explain my journey, but it's certainly not to glorify drugs. It's really to destigmatize and change the representations. I say this because all of what we see is completely distorted from reality, because there are a lot of people using. Even healthy, active people in our society, contributing taxpayers, judges, police officers, lawyers, journalists and politicians use drugs. Until we just speak the truth, we will be very bad at doing what we need to do in addressing this complex reality.
As Dr. de Villa said, it's a complex thing. We need complex solutions and a nuanced discussion. I don't want to say, neither.... And maybe that is the problem around these debates. We're not nuanced; it's either good or bad. We need to be nuanced. It's not to glorify drug use.
Conservative
