Health Committee on Dec. 4th, 2023

[Jennifer Saxe]

That's an excellent question. It's exactly why CIHI—working with the health transfers, which are going to be $200 billion, including $25 billion in new investments for mental health and substance use services—is working closely with provinces, territories and data partners to refine indicators and better collect consistent data.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Are you familiar with the letter from 17 leading addictions doctors or physicians? Have you met with that group?

[Jennifer Saxe]

I am aware, but I have not met with that group.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Are you familiar with the letter, from November 6, from 42 leading clinicians in addictions medicine? Have you met with that group?

[Jennifer Saxe]

We have met with a range of experts, and we continue to meet with a range of experts. We are continuing to collect data and evidence to better understand the concerns and make sure that our actions are grounded in evidence. This is what we've been saying.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I get that, Ms. Saxe. I'm specifically asking about the authors of these two letters. Have you met with either of these groups?

[Jennifer Saxe]

We have not met with them as a group.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Both of these groups say that safe supply is a nice marketing slogan, but it's not working. It's creating a whole new group that is addicted to opioids.

Would you agree with that? From what we know, safe supply is creating a whole new group addicted to opioids.

[Jennifer Saxe]

Prescribed pharmaceutical alternatives are—

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

All I'm asking is, would you agree with that statement?

[The Chair, Liberal, Sean Casey]

Ms. Saxe, there will be no more questions. Take the time you need to answer the question.

[Jennifer Saxe]

Prescribed pharmaceutical alternatives are one among many actions. We've been clear that we need a range of actions. No single action can be taken to resolve the overdose crisis in and of itself.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

You didn't answer my question.

[Jennifer Saxe]

It's important to have a suite.

I will note that prescribed pharmaceutical alternatives build on the evidence. It's strong, peer-reviewed evidence of medication-assisted treatment that is used internationally in multiple countries.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

She can't answer the question.

[Jennifer Saxe]

I think it's important to understand that there's medication-assisted treatment—

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I do understand that.

[The Chair, Liberal, Sean Casey]

Your time is up.

If you could finish your answer, Ms. Saxe, without interruption, we can move to the next questioner.

[Jennifer Saxe]

Prescribed pharmaceutical alternatives build on a strong evidence base of medication-assisted treatment. There is a strong evidence base.

This is a new and emerging action that's being taken as part of a suite of actions. It needs to be closely monitored, so that we can learn from it and adjust as we need with the evidence and research we are looking at.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Saxe.

Next, we have Dr. Powlowski, who's online, for five minutes, please.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I want to preface my remarks, as several other people have done. Let's hope we can make this a non-partisan approach and try to find commonalities, instead of fighting with each other.

I did want to talk about toxic and safe supply. I'm not sure if I have the numbers right, but someone said there were 1,900 overdose deaths in 2023 so far. What percentage of those are narcotics? Can anybody say?

[Jennifer Saxe]

That's the number of apparent opioid toxicity deaths. I can state that 48% of accidental opioid toxicity deaths also involved a stimulant, and 79% of accidental stimulant toxicity deaths also involved an opioid. We are clearly looking at polysubstance—multiple substances—and increasing toxicity.

If we look at the drug toxicity and the level of fentanyl and contaminants like benzodiazepines and others in our supply since 2016, you will see a significant increase. There has been a significant change in our drug supply since 2016 that we are adjusting to or responding to.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Now, I know that when somebody has overdosed on multiple drugs they're often synergistic, but what is determined to be the cause of death primarily? Is the overwhelming cause of these deaths from fentanyl? How much is mixed so they can't really determine the cause of death?

[Jennifer Saxe]

Overwhelmingly, fentanyl is found. There's a combination of drugs that can be found, but if you look at provincial or national statistics, fentanyl is involved in more than 80% of these opioid toxicity deaths.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

It would seem to me that one of the issues with safe supply is that safe supply.... If you're giving people narcotics, it's because they want narcotics or are addicted to narcotics. You're saying that a fair number of overdoses are by people who aren't specifically getting narcotics. They're doing crack or cocaine that turns out to be laced with fentanyl. The safe supply evidently wouldn't address that problem.