Evidence of meeting #25 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was chair.
A video is available from Parliament.
President, Public Health Agency of Canada
This is mostly with NRC, so we will take it back to get that information.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
My final question is, if decriminalization of substance use, reducing stigma and treating addiction as a health issue is the proper public health policy—and you all seem to say it is—how can the government justify criminalizing possession and use of drugs in every province and territory in this country outside of British Columbia?
Deputy Minister, Department of Health
Mr. Chair, as I indicated, the government has a broad-based approach, focused on public education and awareness, harm reduction, treatment, research, and law enforcement to interdict illegal and toxic supply.
The section 56 exemption granted to enable decriminalization and simple possession in British Columbia, at the province's request, is part of a broader comprehensive policy, as we noted.
This is an exemption that is granted for three years. Following a pre-implementation period in British Columbia, it will take effect at the end of January 2023 and will be closely monitored and evaluated to inform future policy in consideration in other jurisdictions in the country, and at the national level.
It is a start, and a project that B.C. has proposed for three years, subject to a rigorous monitoring, evaluation and research component of work.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Davies and Dr. Lucas.
Next we have Mr. Lake, please, for five minutes.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
I'm going to follow up on my line of questioning from last time.
Just to understand the context for me, I get the complexity of the opioid crisis. As I mentioned before, my own father passed away from a lethal dose of OxyContin in 2003. I understand and I have sympathy for the concept of harm reduction. I think we have to have some important conversations around that.
Dr. Tam, I really think that we have to be able to have a very straightforward conversation around the complexity of these things. If someone at a house party with 10 18-year-olds was found to be carrying 1,000 lethal doses of fentanyl, as Canada's top public health official in the country, would your number one concern be stigmatization of the person carrying the thousand lethal doses of fentanyl?
Chief Public Health Officer, Public Health Agency of Canada
Indeed this decriminalization applies only to adults, but I think the key is—
Conservative
Chief Public Health Officer, Public Health Agency of Canada
Yes. The first thing is not to criminalize them, but to get help for them. I think they would be very unlikely to put themselves forward for further support or treatment if they knew they were going to be criminalized.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
We're talking about 1,000 lethal doses. We're talking about someone carrying enough fentanyl to kill 1,000 people. How do you even distinguish what's personal use and what's trafficking at that point in time?
Deputy Minister, Department of Health
That, Mr. Chair, is something that law enforcement does on a routine basis, and certainly this exemption does not apply to trafficking. That would be at the discretion of law enforcement: considering the circumstance and intent to traffic or for simple possession.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
Assuming the decision was made that 1,000 lethal doses were for personal use, what measures would even be available to deal with that situation for the person? What kind of treatment options would that person immediately go into? What would the Public Health Agency advise in that circumstance?
Chief Public Health Officer, Public Health Agency of Canada
A comprehensive approach, as Dr. Lucas has said, is very important. If there actually is an overdose, of course you need to treat with naloxone and then essentially meet the individuals where they are to get them into the help they need when they're ready.
As I understand it, the simple possession amount is a cumulative amount. Now, that may not answer your question straight away. I believe, in fact, that the communities impacted by the substance use crisis are the ones providing input into the amounts as well, and that many people have developed a tolerance to the fentanyl drugs and that's why there were so many different aspects taken into account as British Columbia applied for this particular policy—
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
How much would a person have to weigh to have a tolerance for 2.5 grams of fentanyl in their system?
Chief Public Health Officer, Public Health Agency of Canada
I cannot answer that question. I think people do develop a tolerance. It may be different for different individuals.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
I really don't know the answer to this: Is it possible that someone could have a tolerance for 2.5 grams of fentanyl?
It is possible? One of the doctors here is saying, “Yes.”
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
Yes, that's at 2.5 grams of fentanyl.
Okay. Now the doctor who said “yes” is saying “no”.
Seriously, is there a person on the planet who has a tolerance for 2.5 grams of fentanyl?
Deputy Minister, Department of Health
We would be pleased to provide some research to the committee in terms of consideration on this issue.
The Province of British Columbia has provided and will provide information with regard to the threshold, which, as Dr. Tam indicates, was based on extensive consultation with a broad range of public health experts, clinicians, people with lived experience, law enforcement, community groups, indigenous groups and others.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
On a point of order on that point, Mr. Chair, I would like, please, to be tabled with this committee, the science behind the 2.5 grams and how that 2.5 grams can possibly apply exactly the same for each of the categories on the list.
Thank you.
Liberal
The Chair Liberal Sean Casey
We're going to allow Dr. Powlowski one final question, and then I'm going to ask for a motion for adjournment.
Dr. Powlowski, you get the last question.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Okay, and I'm going to ask a really long question too.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
I'm going to help the Conservatives out with this, because they want our secret formula.
For those who don't have kids and don't know about SpongeBob, SpongeBob works at the Krabby Patty...or the Krusty Krab, which is famous for its krabby patties. As anyone who watches the show knows, Plankton is always trying to discover the formula behind the krabby patties. I think the Conservatives are convinced that we have a secret formula as to when we're going to end the mandate.
For example, it's when the COVID viral count in waste water falls below, say, 10 viruses per mL—I'm just making these numbers up—the immunization rate with the third dose is above 70%, when prevalence in the population is below some other level and where hospitalization is less than some specific number....
Now let me ask Dr. Tam. I think you've already given the answer to this, and the answer is, no, there's no magic formula, but also, isn't it important in terms of not only the absolute numbers, but how they're trending in terms of if the rate of the use of masks is decreasing, if social distancing is decreasing, if vaccination is plateauing and if the availability of treatments is increasing? Is it not an interplay of all of these things that makes giving specific numbers impossible?
Chief Public Health Officer, Public Health Agency of Canada
Yes, that would be correct. Also, one has to look a little further ahead in terms of projections as well. While disease activity may be low at one point in time, we know how this virus is mutating, so we also need to plan ahead. I think the government and the ministers are thinking through that as well because, the moment you drop the mask mandate, if then the next week something increases, it's very difficult to reinstate policies quickly. From an implementation perspective, for the protection of the travelling public and from a workforce perspective, constant shifts in policy are very difficult to manage.
Liberal
The Chair Liberal Sean Casey
Thank you very much, Dr. Tam.
We've reached our two-hour mark, and then some. To all of the witnesses, thank you for being here. Thank you for staying late. Thank you for your service to Canadians, and thank you for the remarkable patience and restraint that you showed throughout the two hours in your responses. It is greatly appreciated.
With that, colleagues, is it the will of the committee to adjourn?