Health Committee on Feb. 1st, 2024

[Eric Costen]

I couldn't give you a date.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

You'll forgive me for being a bit shocked by that. It's a pretty significant thing.

Being briefed at large is one thing. I'm not putting you on the spot, but you'd think that the minister would be asking a lot of questions of her officials. Did she ask any questions of her officials? Did her office reach out to you to get a sense as to what this was all about?

[Eric Costen]

Yes. I can say with complete confidence that the minister is very, very engaged on the crisis and the situation in British Columbia and, frankly, throughout communities across the country.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Let me ask you this: Should drug users be able to use drugs in playgrounds? What's your actual view?

[Eric Costen]

Well, as a public servant, I don't know that my own personal view features too prominently in this, but—

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

What is your professional view?

[Eric Costen]

My professional view would be to add to the minister's response. In response to the B.C. request last summer to amend the exemption to exclude playgrounds and other places, the minister signed off on that exemption. We provided an amended exemption that excluded playgrounds and other public places.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

That means the view that officials presented to the minister is that drug users should not be able to use drugs on playgrounds.

[Eric Costen]

We supported the minister; we had no cause to brief other than in support of B.C.'s request to make that amendment to exclude playgrounds and other public places.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Have there been any consultations by you or your colleagues on legalizing drugs like heroin, cocaine and meth?

[Eric Costen]

No.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Definitively, there have been absolutely no conversations on legalizing any of these hard drugs.

[Eric Costen]

My job, and our job as public servants, is to execute the policy of the government. The policy, as I understand it, is not to pursue legalization or decriminalization of other substances beyond what is currently in place.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Thank you. I appreciate that view a great deal.

You know, it is clear that fentanyl being prescribed to kids leads to addiction, leads to death and drives down the price of illegal drugs on the black market up to 90%. At what point will the evidence that's been assessed lead officials to recommend to the minister to end the so-called safe supply of drugs that are killing Canadians, killing kids?

[Eric Costen]

Thank you for that question.

My response to that, just through observing the conversation that has happened so far this morning, is this: I can say unequivocally that the department, right now, is taking into full account all the evidence that's being brought to bear, whether it's published evidence—some of which has been referred to—or data that we're collecting from our own sites, in order to ensure we have a full, clear-eyed and systematic view of the situation. Decisions will then follow.

As the minister said earlier pertaining to federally funded projects, where we see continued adherence to strict protocols to mitigate risks of diversion, the anticipation is that they will continue. However, I think the minister is also on record as saying that in the absence of these, we're also prepared to take action.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Costen.

Next we're going to Mr. Jowhari for five minutes.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

I'd like to get some feedback from you, Mr. Costen.

I'll start by highlighting the fact that our colleagues—specifically the Conservatives—have been trying to portray, over the last 50 minutes, an image of a government that is decriminalizing drugs and making them available on the streets, and that our claim of harm reduction is only designed to divert these so-called legal drugs into the street and then to children on the playground, where they get sold to them. That's it. That's the scope of the work we're trying to do as it relates to opioids.

There's no mention of the work we are doing on prevention or treatment. Really, they're changing the channel on the work and activities we are doing under harm reduction and the scope of the conversation we are having on drugs. They are pointing toward a study that is being done, an experimental pilot or whatever it is they want to call it, saying that therefore Canada is in crisis. I agree. As it relates to that, we are in crisis, but simplifying our approach to dealing with this crisis down to basically saying we are decriminalizing drugs and putting drugs out on the street through diversion is not fair.

I'd like to give you the rest of the three minutes that I have to break it down for Canadians out there. There are four pillars, and each pillar is designed to serve a very clear purpose. They work hand in hand, and we are at the earliest stages of collecting data. Hopefully, this data will guide us, rather than five-minute clips going on social media for “likes”.

I'll stop and let you speak, Mr. Costen.

[Eric Costen]

Thank you very much for the question, Mr. Chair. I'll do my best in this brief moment to explain the full strategy in concrete terms.

As the minister said in her remarks, the focus of the government's response to the crisis over several years now has been to try to be as comprehensive as possible. That means moving forward a series of measures and initiatives to prevent drug use from occurring in the first place. Dr. Weiss referred to some of those initiatives. There are many others focused on the so-called upstream end of the spectrum, where we're looking to delay or prevent initiation from occurring in the first place.

There are also a number of initiatives targeted at reducing stigma. Some of the members of this committee have made reference to stigma and just how much of a barrier the stigmatizing nature of having a drug problem is with respect to integrating into all aspects of our society, including being able to access care. There are a number of initiatives focused on reducing stigma. The exemption provided to B.C. is one example of that, but there are others.

There's a lot of conversation around harm reduction. The conversation around prescribed alternatives is clearly one that is top of mind for this committee and many Canadians. That intervention and other harm reduction interventions are in place as life-saving, acute interventions in response to the problem we're seeing play out in Canadian communities right now, which is that the drug supply in Canada is 80% fentanyl and is increasingly adulterated by other substances, which makes the risk of using drugs extraordinarily high. That's why people are dying.

Then beyond that, we have treatment interventions and enforcement.

Thank you.

[Majid Jowhari, Liberal, Richmond Hill, ON]

I have another 30 seconds.

Can you quickly tell us about the scope of the drug decriminalization in our government agenda?

[Eric Costen]

It is the exemption under the Controlled Drugs and Substances Act that would allow for the possession of small amounts of drugs in British Columbia.

[The Chair, Liberal, Sean Casey]

Thank you.

Thank you, Mr. Costen.

Ms. Larouche, you have the floor for two and a half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Mr. Chair.

Thank you to the representatives of the Canadian Institutes of Health Research, the Department of Health and the Public Health Agency of Canada.

I'd like to come back to my previous question on the import of illegal drugs. In a Health Canada document, you say you want to control drugs by working with private sector partners to reduce the money laundering that supports fentanyl trafficking. There is a great deal of emphasis on safe supply, but we get the impression nothing's happening when it comes to reducing the size of the illegal market.

Can you tell us if you're making significant progress on this file and talk about your fight to reduce the size of this illegal market?

[Eric Costen]

Thank you for the question. If I may, I will answer in English; it's easier for me.

Strictly speaking, I'll be able to give you a brief answer on the extent to which law enforcement agencies throughout the Canadian government are looking to reduce the size of the illegal drug market. As an employee at Health Canada, my ability to speak to that is somewhat limited. The public safety ministry would be the primary responsibility, but I can say there are a number of activities under way domestically within Canada targeted at serious criminal activity in the production and trafficking of illegal drugs.

Importantly, the crisis that your committee is studying is in fact a continental crisis. The experience we're seeing in Canada is very much shared in the U.S. The enforcement activities that Canada does to try to disrupt major transnational criminal organizations is actually done in very close partnership with the United States. Those are border controls to stop precursors and fully formed drugs from coming into the market. It's working with the U.S. Postal Service and the Canadian postal service to ensure that there are mechanisms in the mail system, because we know that drugs, because they're so potent, are often transmitted through the mail. There is actually a White House/prime ministerial action plan on the opioid crisis, which is largely directed at enforcement activities. There is a trilateral fentanyl working group, which brings together law enforcement agencies from Mexico, the United States and Canada to look specifically at the question of fentanyl trafficking.

There is quite a bit happening here. That's just a snapshot.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Costen.

Next we're going to Mr. Johns for two and a half minutes.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Thank you.

We're hearing about diversion and concerns around that. I can tell you right now that you can go and buy toxic drugs in any community across this country and die. This is happening right now in our communities.

What evidence do you have that diversion is causing harm, as you're hearing from the Conservatives? There is very strong evidence that people receiving a safer supply have reduced overdose and all-cause mortality and reduced emergency department use and hospitalization, but there is no evidence of harm from the diversion of safer supply medications. This is according to the coroners in both British Columbia and Ontario. There are no increases in youth seeking treatment in British Columbia.

If diversion is a barrier to funding, what published scientific evidence are you, or the people who are spreading this information, relying on to make these claims?