In fairness to our guests....
Evidence of meeting #84 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A video is available from Parliament.
Evidence of meeting #84 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A video is available from Parliament.
8:15 p.m.
Conservative
8:15 p.m.
Conservative
8:15 p.m.
Liberal
The Chair Liberal Sean Casey
To our guests from the Public Health Agency of Canada, you are welcome to stay but you are free to go.
Thank you, and thank you so much for your patience.
8:15 p.m.
Conservative
8:15 p.m.
Some hon. members
Oh, oh!
8:15 p.m.
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
Mr. Chair, the article reads:
What are Canadian government bodies doing about diversion? As it turns out, very little.
I emailed a list of diversion-related questions to Health Canada, B.C.'s Ministry of Mental Health and Addictions and Ontario's Ministry of Health....
...both the B.C. government and Health Canada replied. Neither answered my two simple yes-or-no questions, either ignoring or deflecting them.
It continues:
Health Canada didn't mention any additional anti-diversion measures in its email, but said that it will “monitor and assess available information” and “take appropriate action where necessary.”
I emailed Health Canada's response to over 10 addiction physicians. Those who replied were uniformly critical of the agency's recommendations, which they called “inadequate” and “puzzling.” According to Dr. Lam, Health Canada seemed to be “significantly out of touch with the realities of opioid use disorder and the market for illicit substances, which is concerning.”
It's concerning, indeed, Mr. Chair. Clearly if Health Canada can't even articulate a strategy to mitigate safer supply diversion, their government overlords have no inkling of how to address this crisis either.
The article continues:
To Health Canada's credit, at least it drafted a personalized response. When B.C.'s Ministry of Mental Health and Addictions replied, it simply referred me to two documents produced by the [British Columbia Centre on Substance Use]....
Several addiction physicians I spoke with said that both they and their colleagues who work on the front lines generally believe that the BCCSU's guidelines, which are tremendously influential in Canadian addiction policymaking, fail to address the potential risks or harms of safer supply.
Echoing his colleagues, Dr. Kahan said that, “Health Canada and B.C. government, researchers, public health officials and harm-reduction advocates have ignored these concerns and given funding and uncritical support for safer supply.”
Then it says:
The addiction physicians I have spoken with have consistently claimed that the BCCSU uses inadequate research to support safer supply. This includes three former BCCSU staff members who spoke on a condition of anonymity, for fear of career repercussions.
Mr. Chair, enough is enough: enough stonewalling, enough sidestepping, enough adjourning debate. The opioid epidemic is not an issue we can run from. There are lives at stake. Addressing this crisis is infinitely more important than partisanship.
This Liberal-NDP government must end its funding and support for these so-called safe supply programs now or else pay them the attention they deserve and fix them. Clearly the current system is broken. For the sake of our kids, our communities and our country, this committee needs to give the opioid crisis the care and attention that it deserves immediately.
Mr. Chair, I talked at length regarding these challenges and these reports that we're seeing and hearing. It seems as though every day, honestly, you cannot turn on the news or look at social media.... Well, maybe not social media anymore because you can't get news on there.
I don't know about my colleagues, but whether it's in my social media inbox, in comments on posts, in my email or in phone calls over at my office, we have so many stories of yet another death related to opioids or fentanyl.
At one point, Mr. Chair, I spoke of this young player who I coached. His name was Chad Staley.
Hopefully that wasn't a heavy sigh from across the way about hearing yet another story from me.
Chad was an outstanding—outstanding—hockey player, community member and teammate. He was a young boy from Kennewick, Washington, I believe. When he came to our team to play as a junior for our team, he was just wide-eyed and bushy-tailed and a true leader on and off the ice. That translated into success both on and off the ice. He had an NCAA scholarship.
I believe it was in the second year of his scholarship that he was playing in a hockey game and injured himself. On the bus ride back to his campus, I believe it was, he was in so much pain that one of his teammates gave him a pill, what they thought was like a T3, Tylenol with codeine. Chad put it in his pocket and went back to his home. At one point, the pain was so much that he took the pill. That pill was laced with fentanyl. You can imagine the shock and the horror of his parents who found their child—not a drug addict, not a drug user—passed away.
That story is replayed over and over again. Maybe it's not a hockey player. Maybe it's not somebody with a scholarship but a blue-collar worker, or a president or a vice-president of a university in our province, or two professionals on the island, a husband and wife, taking recreational drugs, who died of an overdose from fentanyl. With my motion I've been talking about the increasing rate of deaths attributed to overdose in our homeless population.
Last week, I talked about that. If you don't believe me, we at least should believe the 17 leading experts in addiction medicine: Dr. Mel Kahan, medical director for META:PHI and co-chair of the methadone treatment and services advisory committee; Dr. Robert Cooper, who served on the board of the Canadian Society of Addiction Medicine and was chair of the OMA section on addiction medicine; Dr. Paul Farnan, in the field of occupational medicine and addiction medicine for over 25 years and clinical associate professor in the department of family practice, University of British Columbia; Dr. Michael Lester, physician assessor for the College of Physicians and Surgeons of Ontario and secretary for the OMA section on addiction medicine for 13 years; Jennifer Melamed, who served on the board of the Canadian Society of Addiction Medicine; Launette Rieb, clinical associate professor, University of British Columbia, and a physician certified in addiction medicine; Maire Durnin-Goodman, who has extensive experience in managing addiction disorders; Dr. Ray Baker, clinical professor at UBC who served on the board of the American Society of Addiction Medicine; Dr. Harry Vedelago, chief of the addiction medicine service, Homewood Health Centre; Dr. Alan Brookstone, addiction medicine and family physician with over 30 years of clinical experience; Dr. Clement Sun, founder of ACT Addiction Clinics; Dr. Oded Samuel, with over 25 years' experience in the field of addiction medicine; and Dr. Annabel Mead, medical director at B.C. Women's Hospital and Correctional Health Services, with 20 years' experience in concurrent disorders, pain, women's health and youth addictions.
A lot of people said a lot of things, both good and bad, regarding my intervention last week. As I said before, if you don't believe me, believe the people who are the experts. All I'm saying is that we have to be better, as I've said from the very first day I came to this committee or any other committee. Those who have been here as long as I've been elected know that I always challenge us to be better when it comes to these issues and that I truly believe we can leave a legacy of action, not inaction. That's where I come from on this. I shared my personal story not to gain sympathy or get likes on Instagram, Twitter, Facebook and other social media. It's just to say that I don't have the answers. I know we can be better.
Our family lives it each and every day. I appreciate all those who have come to me and shared their personal stories regarding loved ones and their own family challenges with addictions and mental health. It truly is one of the toughest things to do, especially given this role we're in: being raw and vulnerable and sharing that. I did not expect to be that emotional last week when I shared that story. It's something we live with each and every day. I expected it to be...but the reality is that I get frustrated. I get angry when we're sitting with these families—not just mine—that are crying and asking us to do something, and we're powerless. We're powerless to stop this drug from coming onto our streets, communities and country. For eight years, I've listened to a government say we need to do better and be better, yet here we are still struggling with this. The issue is not going away. It's not getting better. It's getting worse.
It's amplified by programs such as safe supply. I will be the first to agree that there are many tools in the tool box. It's not one-size-fits-all. However, this is not working. It's causing more problems—a whole new wave of opioid addictions among our youth and young adults. It's plaguing our streets and nothing is being done. We just go merrily on our way.
I honestly wish we could have a conversation around the table with the cameras on. We have expertise on all sides, and I know they've experienced this in their professional lives. However, I know what will happen. Somebody from the other side will move to adjourn the debate, rather than have an actual debate. I bet there's something going on right now. Somebody is saying, “The Conservatives are filibustering again and not letting our colleague's private member's bill go through. The Conservatives are up to no good once again.”
The chair is nodding his head. After all I've said, I get that reaction. It's disappointing, Mr. Chair. I know you to be a good person, but it is disappointing. Shake your head again all you want. It's disappointing. It truly is.
Why can't we have a conversation about this? Why can't we do something about this?
I believe there are good people on all sides of the House. I know it to be true because we have sidebar conversations with people from all parties who say they feel exactly the same, yet when we come through those doors or we go into the House, common sense goes out the door.
I'm eight years into this job. I haven't been here long enough to be jaded, although it may sound like it. I truly believe there are good people on all sides, but if you aren't willing to fight for our most vulnerable, what are you willing to fight for? Why are you here? Truly. Why are you here?
We're sent here with a mandate to listen to Canadians, to fight for Canadians and to make lives better for Canadians. I guarantee that each and every one of our colleagues was asked, when they were running for nomination and they were asking people to vote for them for their nomination, “Are you going to toe the party line? If this issue is really important to me and your constituents, how are you going to vote?” You can hear the echo of the whip crack.
Aren't committees supposed to be the masters of their own destiny? That's what I hear from the Liberals all the time: “I had nothing to do with it. Committees are free to do whatever they want.” If we're free to do whatever we want, let's do the study.
Their heads are down. They're checking their emails, texting, shaking their heads and laughing.
Committees—
8:35 p.m.
Liberal
8:35 p.m.
Conservative
8:35 p.m.
Liberal
8:35 p.m.
Liberal
Darren Fisher Liberal Dartmouth—Cole Harbour, NS
Respectfully, nobody is laughing. Nobody is smiling. Everyone has been listening intently all night long.
Thank you.
8:35 p.m.
Liberal
8:35 p.m.
Conservative
Todd Doherty Conservative Cariboo—Prince George, BC
Mr. Chair, I'm close to wrapping up, so people can breathe a sigh of relief for now, but I will tell you this: I will continue to push and fight for those who are our most vulnerable, whether they are homeless on the streets, whether they are our youth becoming addicted to opioids or whether they are the families who have been left behind to pick up the pieces.
If you're listening to this, I commit to you that I'll continue to fight for you, and I'll continue to fight until our colleagues in the Liberal-NDP coalition stand up and agree to doing this study and truly finding out how we can make things better for those who are struggling with addictions.
Thanks.
8:35 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you.
Next up is Dr. Ellis.
Just so people know, there are four people on the speakers list. We have Dr. Ellis and then Dr. Hanley, Mr. Davies and Mr. Thériault.
Dr. Ellis, you have the floor.
8:35 p.m.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you very much, Chair.
I want to thank my colleague for his hard work on this topic. I think everyone around this table would realize clearly that this is a topic that is incredibly emotional for my colleague, both because he has a heart as big—as my grandmother might say—as all outdoors, but also because it's very personal to him. I want to thank him not only for sharing his passion and his personal story, but for his advocacy for those who, sadly, don't have a voice here themselves. I would echo his comments that, realistically, they are who we're all here for.
It's interesting, colleagues, that oftentimes people wonder why this is important to us, why we are fighting about it, whether there is a plan to deal with it elsewhere in the calendar and those kinds of things. You look back to the study—I know our colleague from the NDP was here and Ms. Sidhu was also here—in 2016, when this issue came before the health committee. Looking at the statistics at that point in time, it was astonishing to the committee that there was a death every three days due to an opioid overdose. That was 2016.
Here we are, after eight years, and we know clearly now that there are more than 20 deaths a day. We've gone from a death every three days to more than 20 deaths a day. Should that seize this committee...? Back then, a death every three days was an opioid crisis. Now, we have 20 deaths a day. I wish I were a wordsmith and could tell you the superlative of an opioid crisis, but I don't know that there is a word that could even describe what we now exist with, which is 20-plus deaths a day.
Why is it also important? People will say that we're politicizing this. It's partly a political issue, I'm sad to say, because of this issue of safer or safe, or whatever you want to call it.... Let's just call it what it is: It's a government-funded supply.
My colleague raised a good point about homelessness and addiction and services that are or are not available. You often wonder which came first, the addiction or the homelessness, the homelessness or the addiction. We could argue that for days here.
The one thing, though, that we, as Conservatives, wish to bring forward, of course—which is intimately and integrally related—is the issue of the government supply of hydromorphone on the streets. We know very clearly, as my colleague mentioned, that many addiction medicine experts out there are absolutely and totally against this concept. What I'd like to outline this evening for everyone, and for the millions of people out there who have joined us, are the words that should bookend the story that I'll tell in the middle. They're the words of addiction medicine specialists who talk about safer supply.
I want to read this letter from a physician referenced by my colleague. His name is Robert Cooper. I asked him for permission to use this.
This is an email to the Minister of Mental Health and Addictions. It says that, on a daily basis, they are seeing opioid-dependent patients relapsing on inexpensive and widely available diverted hydromorphone from safe supply programs, and his colleague presented some pictures of pill bottles from safer supply programs. He says that they are seeing this lead back to fentanyl use and then to overdose deaths. They are seeing many people with no history of opioid dependency starting new addictions with diverted hydromorphone.”
Here with are with this lame idea—I'll come to why I called it a lame idea—that giving people free drugs will suddenly help them not be addicted. It's not just free drugs; it's also free drugs in a unsupervised manner. We certainly know from significant clinical use of opioid agonist therapy, which is the supervised reduction by a health care professional in the amount of opioid that an individual is using, can be beneficial in the treatment of opioid use disorder. I think everyone would agree that makes sense, but to give people an opioid....
Do you know what? I've probably said this at this committee before. I know I've said it in the House of Commons. People will often look at a pill, such as an eight-milligram pill of hydromorphone, and say, “It's just a pill. It's the size of an Advil or a Tylenol. How bad could it possibly be for people?” We know that it is incredibly potent. I'll come back to its potency when we continue on with this sad tale.
The letter from Dr. Cooper goes on to say—and this is bolded, colleagues—that this is not harm reduction; it is harm, and this is not safe supply; it is reckless supply. This is a reckless way to go about trying to.... I don't know what the original intent was. I hope the original intent was to try to help folks with opioid use disorder, but when you have experts in the field out there ringing the alarm bells loudly and repeatedly, then I would suggest that this government, which appears to be hell-bent for leather on continuing safe supply for unknown reasons....
Why do we say that? We had the former minister of mental health and addictions here. I can remember very clearly talking about dosages of fentanyl. When we talked about dosages of fentanyl, we talked about how, in this decriminalization experiment, for personal use you could have 2.5 grams of fentanyl. We know very clearly that if we were to work in an emergency room, perhaps to do a reduction of a dislocated shoulder, you might get 100 micrograms of fentanyl. We're talking here about 2.5 grams of fentanyl. I said that was enough to treat 25,000 people, and the retort from the minister at that time was related to saying that it was always cut with something.
Do you know what? I looked at what the Government of Canada website has to say about fentanyl. It's quite fascinating. This is what the Government of Canada website says about fentanyl: “Fentanyl is a very potent opioid pain reliever. A few grains can be enough to kill you.” That's a few grains, and we have the Minister of Mental Health and Addictions suggesting that 2.5 grams is an okay amount to have for personal use.
The website continues, “Fentanyl is usually used in a hospital setting. A doctor can also prescribe it to help control severe pain.” Yada yada yada—here we are, continuing this fight. People ask why we're now interrupting a study on pandemic prevention and preparedness. First of all, it's mainly because this topic is killing Canadians. If we as a health committee are not seized with that, and we as the opposition are not seized with calling out a government that is clearly doing the wrong thing and allowing the death of its own citizens, such that there is now a framework for people with addictions to be able to kill themselves by medical assistance in dying....
Not only is this Liberal government wanting to kill Canadians who have depression. They now want to kill Canadians who have addictions. Is that simply because it's easier? Is that easier than treating them? They're trying to kill them now by giving them an amount of opioids for free in a “safer supply” program. Now we are going to have a society based on a framework endorsed by this government—
8:45 p.m.
Conservative
8:45 p.m.
Liberal
8:45 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
This will give Mr. Ellis a chance to catch his breath.
Mr. Chair, it is now 8:50 p.m., and you mentioned that some speakers wanted to speak, which may have been the case at the start. However, when we have a list of speakers, we all agree in a friendly way on speaking time for each person. That's how the committee normally operates.
I want to accept the invitation of Mr. Doherty, who would like to speak with the other members of the committee, but we've been monopolizing speaking time for nearly two hours.
Wouldn't it be a good idea, Mr. Chair, for you to suggest to the members that we continue until 9:30 p.m. so that at least the people who have raised their hands to speak may do so?
Since there are no more witnesses and our schedule has been completely upended, it seems to me that the people who want to speak should be able to do so. Couldn't you move that?
I can move it, if you wish. It seems to me there are three or four potential speakers.
How many are on the list, Mr. Chair? I understood that there were four. Do they have 10 or 15 minutes of speaking time each?
8:50 p.m.
Liberal
The Chair Liberal Sean Casey
There are four.
Yes, Mr. Thériault, I can move it, but Mr. Ellis has the floor and he's entitled—