Health Committee on April 16th, 2026

[Dr. Alexander Caudarella]

Thank you. That's an excellent question.

We undertake a number of different things.

First, as I mentioned before, we have a Canadian substance use costs and harms study. Part of that is looking at over 20 different administrative databases, all the surveys done and all the vital statistics. With that, we produce what we feel are the country's best prevalence estimates. It's where we see that alcohol use has gone down and cannabis use is increasing. We want to use it, increasingly, to help communities plan more for the future.

In addition, we recognize that data is complicated. This is where our network comes in. We take all the data from drug seizures and surveys and match it to everything from what cops on the street are feeling and seeing to what doctors in emergency rooms are feeling and seeing—and how that connects. It's why we've been able to produce recent reports on new additives and drugs, or on why deaths seem to be decreasing.

Further, we're working closely with provinces and territories on some very specific data points. Right now, we're engaged in understanding the number of treatment beds available in this country, the needs in each jurisdiction and whether we're meeting them appropriately.

We don't want to create data that's just on a shelf. We want to create data that people are actioned to use and that we're told people actually need. We're very proud of the data work we do, and we're really looking forward to doing more and more in collaboration with the hundreds of organizations in this country that we're very thankful to work with.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

In other words, many of these organizations use your data and adapt what they are doing, presumably, based on what the data tells them.

[Dr. Alexander Caudarella]

Yes. In addition to the data being very frequently referenced in provincial legislatures and federal pieces, we're hearing more and more that, at the local level, people are using it to make decisions.

This is why, for example, in our most recent project—which is happening here in Ottawa—we're trying to take some of those costs and harms as data points and then apply them at the local level. Ideally, as we do more and more, we should be seeing fewer criminal justice costs and more appropriate housing—the different pieces around this. We see a lot of use of this, but we're pushing ourselves. This has been a big goal of mine over the past three years that I've been here.

You're a physician. You admitted that you hadn't heard too much about us. We are really working to change that. This is part of why we're present at every big conference happening. We now have relationships and partnerships with most of the major organizations. We're working with cardiologists. We recently published how they can do more to help patients who use drugs. We're trying to reach people where they are. We're working with primary care providers regarding alcohol and helping them understand how they can do more to help people with respect to cannabis. Physicians, right now, don't know what to say when people come through the door and ask, “Should I smoke pot or not?”

You're right, and we're actively working to have a bigger and bigger presence. We have more partners every day. It makes me very proud that we're working more with people.

[The Chair, Liberal, Hedy Fry]

You have one minute and 10 seconds.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

The act references programs of excellence. Can you point to a specific initiative that seems to be resulting in a positive effect?

[Dr. Alexander Caudarella]

I'll talk about our small cities initiative.

We want things to land in people's backyards better. It's not just about whether it works in the evidence and is implementable.

Of the two projects that came up and that we were able to feature, one was in Lethbridge. If, one day, you decide you don't want to use drugs and want help, you could find a low-barrier job—

[The Chair, Liberal, Hedy Fry]

You have 30 seconds.

[Dr. Alexander Caudarella]

—that day to help clean the streets or help build. You'd be paid for that.

Similarly, in our small cities initiative, we worked with Timmins, Ontario. Suboxone, or opioid agonist treatment, is still hard to come by. We don't have high enough treatment rates across the country. They got their paramedics to dispense on site so that somebody wouldn't need to see a doctor. They could start feeling well that very minute, right away.

I don't want to look away from some of the best innovations happening in some of the smallest places in this country. One of the biggest lessons we've learned is that we don't need to look just at Toronto, Vancouver and Montreal to see what's happening. There are some best practices coming out across the country. Our job is to make sure those are interconnected.

[The Chair, Liberal, Hedy Fry]

Thank you, Dr. Caudarella.

We'll now go to Monsieur Blanchette-Joncas for six minutes, please.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you very much, Madam Chair.

I would like to welcome the witnesses joining us today.

My first question is for you, Dr. Caudarella, and it's a simple one. Have you seen any indication that the fight against the opioid crisis has been a priority for the federal government over the past 15 years?

[Dr. Alexander Caudarella]

I would say it has been a priority, but in different ways for different governments. The reality is that there has been so much suffering that there's often a desire to be the hero and take credit. However, it's becoming clear that no single government or minister will emerge as the hero; it will take millions of individual actions.

This Liberal government has done a lot, but we need to see more and more co-operation between different departments and between different levels of government. We want the federal government to work with the provinces and territories, as well as with municipalities.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Since we're talking about levels of government working together, I'll give you some concrete examples.

Since 2011, so for more than 15 years, Quebec has increasingly recognized the expertise of pharmacists in addressing safety issues in the context of the opioid crisis. They have the necessary expertise, they are available to people in the regions, as well as in urban centres, and they have hands-on experience. However, the federal government is preventing Quebec from acting in accordance with regulations that would allow them to go further. We're in the middle of an opioid crisis, but pharmacists have not been granted practitioner status to intervene and combat the crisis.

I'd like you to tell me more about this. How is it that in 15 years, no one in the government has acknowledged that this could be a solution? Quebec has been asking for this for 15 years, and no one is budging, so I have questions. Are these people just not getting it? Do they lack the necessary expertise? Or are there people within the government itself who are under the influence of opioids and therefore unable to act?

[Dr. Alexander Caudarella]

I don't work for Health Canada. I don't work for the government. However, I can tell you that we spent an entire day in Montreal just a few weeks ago. One of the things we discussed was why the results observed in Quebec were more similar to what we were seeing in France than to what we were seeing in other parts of eastern Canada.

I give presentations. You know, many people in this country didn't know that for many years, death rates in Quebec were 20% of Ontario's. That was a far cry from what we were seeing in Timmins, for example. Our goal now is to more or less figure out how the rest of the country can learn from what Quebec is doing, and vice versa. We're working on that, and we're having a lot of success.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Once again, Dr. Caudarella, I don't think we're accomplishing miracles. That said, what I don't understand is why we're still hindering the process to enable clinical interventions that are useful and could reduce risks for patients, including opioid-related risks. It's been 15 years. I'll refer to my example again, but in my view, it's crazy and unbelievable that a government would make a request to another level of government that ultimately fails to act. I'm using Quebec as an example, but other provinces have also called for this regulatory recognition of the status of pharmacists as health care practitioners.

Just think this: A pharmacist cannot intervene quickly to reduce the risks associated with the use of a substance. In your opinion, doesn't this jeopardize the safety of patients?

[Dr. Alexander Caudarella]

That's an excellent question.

This is where the Canadian Centre on Substance Use and Addiction really wants to hear from the provinces as well. If an issue like that arises, the centre could produce a report on the scientific evidence and make recommendations.

Again, I can't tell you why the government is doing one thing or another, but we can help you find answers to these questions and develop effective approaches in Quebec and across the country.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

I understand.

Personally, I associate delays with risks, especially when there is a delay before professionals can intervene to assist people who use opioids. Research shows that, in some cases, administrative delays in modifying or discontinuing a prescription increase risks for patients.

What is your opinion on this?

[Dr. Alexander Caudarella]

There were many innovations and changes during the pandemic, for example, in the way methadone was distributed and how eligibility was determined.

There is something very interesting about that.

One thing we've learned more than anything is that we sometimes focus a lot on what we're doing, but we don't focus on how we're doing it and if we're doing enough of it. We're always looking for the perfect solution. There's a mix of doing some things too fast and not looking at them closely and, for other things, waiting and not doing....

This isn't just with the federal government.

The same applies to provincial and territorial governments. There are various steps that can be taken. I believe there could be a lot more action and evaluation.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

I completely agree with you. In fact, you've pointed out a serious problem that, sadly, affects our health care system: We operate reactively rather than preventively. However, science shows us that by focusing on prevention, we reduce costs and move away from risks.

Is our health care system making full use of pharmacists to prevent addiction, or are we still depriving ourselves of a useful solution, which I spoke to earlier?

[Dr. Alexander Caudarella]

I'm no expert on the subject, but in my opinion, all members of the health care system are probably underutilized. As a doctor, I can tell you that when one of my patients starts feeling unwell, it's almost always the pharmacist who calls me, rather than the patient coming to see me first.

Does that mean every private chain can start increasing the number of prescriptions? No. We saw problems when there were too many prescriptions. Problems should be properly resolved through monitoring and evaluation. We must be creative. There's no doubt about that.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I now go to the second round. The second round is a five-minute round, with the exception of Mr. Blanchette-Joncas, who gets six minutes because he's a very special person.

[Voices]

Oh, oh!

[The Chair, Liberal, Hedy Fry]

We begin the five-minute round with Mr. Mazier from the Conservatives.

[Dan Mazier, Conservative, Riding Mountain, MB]

Thank you, Chair.

Dr. Caudarella, who provides the main source of funding to the Canadian Centre on Substance Use and Addiction?

[Dr. Alexander Caudarella]

The majority of our funding—all of this is publicly available on our website—comes from a contribution agreement with Health Canada and the Government of Canada. We also receive funding—

[Dan Mazier, Conservative, Riding Mountain, MB]

That answered the question. Thank you.

According to the most recent annual report, the centre received more than $11.5 million from Health Canada last year. Is that correct?