Health Committee on April 16th, 2026

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

Do I have more time?

[The Chair, Liberal, Hedy Fry]

You have 42 seconds.

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

Are there any other international best practices that you could quickly illustrate for us?

[Dr. Alexander Caudarella]

We're doing a lot in the prevention space around that, to try to bring some of these things. A lot of the things that can be looked at are in reducing violence, how to deal with that, and how to reduce elements....

There was a previous question around stigma. How do you not become overly permissive with substance abuse? At the same time, you want to make sure that no individual who uses drugs experiences stigma. It's that the individuals aren't stigmatized, but at a population level, we're working to try to reduce the amount of problematic use.

This is something that other countries have wrestled with a lot. They have tried different approaches and different communication approaches. For example, we're working with some international organizations that want to speak to people in Canada who don't speak English as a first language, to support them in culturally relevant ways. I think you're going to see a lot of really interesting things coming from this.

[The Chair, Liberal, Hedy Fry]

Thank you, Mr. Caudarella.

Now I'll go to Monsieur Blanchette-Joncas for two and a half minutes, please.

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

Thank you, Madam Chair.

Dr. Caudarella, what concrete results can your organization point to in terms of actually reducing addiction?

[Dr. Alexander Caudarella]

There's a lot of talk about opioids, but when it comes to alcohol, we can't ignore the impact this research has had—and not just on people with an addiction. We're seeing numbers go down on that front, but we also know that most cancer cases affect people who are not addicted. That's why we want to see reductions across the entire population.

In addition, we recently conducted a study to determine which parts of the country have seen a reduction in the number of deaths linked to opioids and stimulants, and to explain the reasons for that.

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

I'm trying to understand how you measure the real impact of your actions on the ground. What are your performance indicators?

[Dr. Alexander Caudarella]

We have several. We have a system and a department at the centre that actually measure that.

We don't interact with clients directly, and that's why we want to find out whether people are using our work and whether patients' lives are improving. One unfortunate reality in this country—and the reason we're stepping up our efforts in relation to metrics-based care—is that, in most cases, we can't tell whether people are getting better or not. This is therefore a solution we currently have, not only to support health care systems, but also to help identify indicators that every province and territory can use to try to evaluate performance.

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

Based on what you just said, you don't know whether the situation is improving or getting worse for most people. That means you don't necessarily have enough reliable data to say that current policies are working.

[Dr. Alexander Caudarella]

One of the tools we have, for example, is the skills of those who work with us. We can demonstrate that the level of support provided by a site that has worked with us has improved.

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

Do you think the results adequately reflect the scope of the opioid crisis?

[Dr. Alexander Caudarella]

The opioid crisis is complex. That's why we also want to see a reduction in costs and economic impacts in the sectors where we work.

[The Chair, Liberal, Hedy Fry]

Thank you.

Ms. Konanz, you have five minutes, please.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

I have a question for Mr. Arao.

You told CBC News in 2016 that the number of overdoses you were seeing in Vancouver then was excessively high. The number of overdoses in Vancouver is even higher today, as you know, higher across the whole province, and the number of overdose deaths is significantly higher than in 2016. If overdoses were excessively high then, how would you describe them today?

[Neil Arao]

Thank you for your question.

In 2016, I was co-managing Insite, one of the first sanctioned supervised injection sites in North America. We started to see those numbers really become inflated.

Since then, as you mentioned, those numbers have grown consistently—almost exponentially. It's really unprecedented. I don't think I can even encapsulate it in a word that would capture how much it's grown.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

It's shocking.

Mr. Arao, the prevalence of drug consumption sites in B.C. has increased exponentially in the last decade, but so has the number of overdose deaths. Do you view any correlation between these two increases: more sites and more overdoses?

[Neil Arao]

As Dr. Caudarella was mentioning, the use of the supervised consumption sites is really one intervention in addressing some of those harms. When it's done in conjunction with the communities they serve, there's an identification with the health authorities and the communities of what would be the best approach to dealing with a lot of the overdoses.

Even with the supervised consumption sites, the main intention is to reduce the overall consequences of using solely or individually, and all the overdoses that are related to that—

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

It doesn't really seem to be working, wouldn't you say? The numbers don't work. We've talked a lot today about data. Your organization works with data. This is very obvious data. I would say that the two numbers are both rising: deaths and consumption sites. Do you think they are correlated?

[Neil Arao]

I don't, because from an evidence perspective, the supervised consumption sites are just one intervention designed to reduce those immediate harms and really connect people to care.

In this function, the number of overdoses that are reversed within those sites is consistently high. Can you imagine if those were absent? The number of deaths would be even higher.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

You imagine there would be even more.

There's been a lot of talk today about the continuum of care. It's been said that distributing drugs at consumption sites is part of a continuum of care.

I wonder if you could answer my question. I've heard a lot about a need for a continuum of care, for example, but in my community, there's no option for that continuum of care.

If someone's at a consumption site and decides, as you said, to quit drugs—“I'd like to quit drugs, and I want help; please help me”—there's nowhere for them to go. In fact, I was told by a resident involved in this system that in their community, it would be a two-year wait for treatment, and it wouldn't be anywhere in our communities, by the way. They would be sent somewhere else.

After two years...I'm sure you understand what that means. It could be death for somebody. What do you say about opening up these consumption sites yet not having a continuum of care in place, especially in rural communities?

[Neil Arao]

One of the examples I often refer to is Insite. A really novel thing about Insite was that it had a treatment recovery program right above it. There were two doorways, one to Insite and the other leading upstairs—

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

What do we do? Should we continue to build safe sites, or whatever they are called? Should we continue to build them if there's no treatment available for people to quit drugs, should they wish to do so?

[Neil Arao]

I agree with your sentiment that all of these different interventions have to be scaled accordingly. If there are harm reduction sites or supervised consumption sites, there also has to be accessibility to treatment. Having something operate in a vacuum or in isolation is not going to solve the problem.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Maybe we should hold off on more consumption sites until we build the system and build the continuum of care. Let's build the continuum of care before we build any more consumption sites. I think that's what you're saying.