Health Committee on Feb. 1st, 2024

[The Chair, Liberal, Sean Casey]

I'm sorry, but that's your time, Ms. Goodridge.

Go ahead and finish your answer, Minister.

[Ya'ara Saks, Liberal, York Centre, ON]

You've referred to anecdotal evidence. We have taken rigorous mitigation measures with safer supply programs, but in addition—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

One is too many.

[Ya'ara Saks, Liberal, York Centre, ON]

Am I at time, Chair?

[The Chair, Liberal, Sean Casey]

Finish your thought, please.

[Ya'ara Saks, Liberal, York Centre, ON]

What I will say is that when the exemption was put into place at the request of the B.C. government, B.C. chiefs of police, at that time, said that they had every tool available to them, and resource, to ensure public safety in public spaces. It was at the request of the B.C. government in September that we signed off on additional amendments. Again, at their request, we continue to work collaboratively and comprehensively, and assess and monitor the exemption.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

The last round of questions for the minister will come from Ms. Sidhu, please, for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you, Minister, and to the officials joining us today.

In April 2019, this committee travelled across the country to witness first-hand the impacts of the rise of problematic methamphetamine use. It was an eye-opening study for all of us. Back then, we saw stigma associated with substance use and addiction. That was a significant issue we had to address.

Can you talk about that, Minister, and tell the committee about the work you and your department are doing to combat stigma?

[Ya'ara Saks, Liberal, York Centre, ON]

There's a full suite of tools that we need to address stigma, both in the prevention space and in the harm reduction space, and it starts by really creating spaces within communities to meet people where they're at. That is why programs like SUAP provide such comprehensive outreach programs. The workers there are incredible. The work that they do day in and day out is compassionate and caring. It's also anchored in the evidence of what works best to meet the needs of those who are most vulnerable, to get them to medical care and assistance. However, that is just one piece of the puzzle.

We're doing prevention work particularly when it comes to youth. Our integrated youth services support has been so significant in understanding how in communities our young people, who are at vulnerable stages of life, really also need interventions that are community-supported, so that they are protected and supported in a world where the toxic drug supply is so pervasive.

Dr. Weiss can speak to some of the early evidence of the integrated youth service on how it is working and how it's being implemented. However, we've also committed $20 million towards the Icelandic model that will be rolled out this year to meet youth and also reduce stigma.

[Dr. Samuel Weiss]

The integrated youth services model, which is now active in nine out of our 13 provinces and territories and in eight indigenous communities, seeks to provide a community-based program for individuals to receive mental health and substance use care, as well as all related services that can allow them to have the best chance for a healthy trajectory, including sexual reproductive services, housing services and the like. It operates under a model called measurement-based care, which means that every individual who is seen is on a walk-in basis, with no appointment and no referral required. They have their services and they participate directly in measuring the actual outcomes.

This is a transformational moment, because we hope to see this level of service available, including at a virtual level as well, for those in outlying regions at the most vulnerable period of time, when young people are at highest risk for developing substance use disorders as well as chronic mental illnesses.

What's remarkable is that it's working from the grassroots up. We have municipalities, communities, provinces and the federal government all working together. Community health is the future, and that's why we're very enthusiastic about it.

If you complement it with what is hopefully to be adopted, the Planet Youth model from Iceland, which seeks to have communities come together to ensure that young people are not diverted away from healthy activities to unhealthy activities, you start to focus on the upstream issues that really lead, ultimately, to addiction and chronic mental illnesses.

As part of our strategy, I think as a country we have to recognize that youth are the most vulnerable. If we're able to provide them with the resources needed where they're at, there's a greater likelihood we'll stem the tide of individuals susceptible to the increasing toxic illicit drug supply.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Minister, I came across an interesting study from the University of Alberta from last year that studied public opinion in Alberta and Saskatchewan on safer supply programs. The majority of respondents, almost 64% in Alberta and 56% in Saskatchewan, supported safer supply programs that replace illegal street drugs with pharmaceutical alternatives for those unable to stop using.

The study suggests there's no lack of public support for these measures. Can you share your thoughts with this committee about the diversity of opinion Canadians have towards this issue?

[The Chair, Liberal, Sean Casey]

Be as brief as you can, Minister, please.

[Ya'ara Saks, Liberal, York Centre, ON]

I would say this is why, in combatting stigma, if we go back to your previous question, we need a full suite of resources and supports that include prevention and harm reduction, including safer supply, because we understand that when you meet someone where they're at in their struggle, at their most vulnerable, and when you see them and you get them to safety, that is when we break down the walls of stigma and also bring people to a better place in their health.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

That concludes the first hour.

I want to thank you for accepting our invitation to be here with us and for the patient manner in which you took our questions. I know the format is difficult. It's not always easy to give a very short answer to a very short question, but you've handled it well. We certainly appreciate you being here and appreciate the work you do and the passion you bring to the work that you do.

We're going to suspend to allow the minister to take her leave, and then we're going to continue on with officials in about five minutes.

We're suspended.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

We now have with us officials who were introduced at the outset of the meeting, so I don't think we need to do that again.

I don't believe anyone has an opening statement. If I am correct in that, we can go right to questions, beginning with the Conservatives.

Mr. Majumdar, you have five minutes, please.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Thank you, Chair.

Recently, a new fentanyl prescription protocol was established in British Columbia. Under this protocol, physicians are allowed to prescribe fentanyl to children without parental consent or awareness.

Have you raised any concerns to the minister about the prescription of fentanyl, a drug so toxic that Health Canada's website states that even a few grains could kill you?

[Eric Costen, Associate Deputy Minister, Department of Health]

Thank you for the question, Chair.

We've spoken to the minister at length about the crisis writ large and about developments in British Columbia. With respect to the prescription guideline that you're describing, we've made the minister aware that based on our conversations with the B.C. government, the latest information we have is that while the guidance has been enacted, no prescriptions have in fact been provided to anyone under the age of 19.

That would be about the extent of the conversations we've had with her at this point on that particular guidance.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

If you don't mind, when were you first made aware of the protocol?

[Eric Costen]

I honestly couldn't say on the spot here.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Could they table it with the committee—

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Could you table it with the committee when you do discover at what point you found out?

[Eric Costen]

Sure. Absolutely.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Thank you.

Did you end up providing a briefing to the minister on the protocol change? If so, what did that briefing include?

[Eric Costen]

I don't recall that there was a specific briefing on that exact protocol. The conversations happened in the context of her mandate writ large with respect to the crisis and developments that are happening week over week throughout the country.

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

This protocol has a significant consequence for Canadian kids. Do you know when the minister became aware of the protocol change?