Health Committee on April 16th, 2026

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you for that. I hope to come to my own conclusion when I go through your data.

I'm an ICU physician, and I've been very frustrated with some research. My practice is very downstream, and there are some preventative medicine and family medicine specialists here who are more concerned about upstream things.

It seems to me that in a lot of the talk when we talk about how, as a society, we're going to deal with addictions, we talk about the crisis, deaths and consumption. Ought we not to be more obsessed with upstream interventions, such as how we prevent kids from getting on this in the first place?

I haven't heard anything about that so far today.

[Dr. Alexander Caudarella]

Actually, we not only created the first prevention standards for communities, school-based and family, but we also have a whole sector of our organization dedicated to that. When we look at the next contribution agreement, not only are we focusing a lot on prevention, but we're also focusing specifically on youth.

Your question is a good one. When we're talking about working with cities, and when talking about this upstream work, there is a tremendous amount. When we're talking about “Canada’s Guidance on Alcohol and Health”, we're trying to make it a more upstream conversation.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

This is related, although it sounds very different: Do you think that drinking and driving should be stigmatized in our society?

[Dr. Alexander Caudarella]

You're asking a good question about whether there is such a thing as good stigma or bad stigma. I brought up smoking, for example; there was probably a good stigma that pushed people off it. Did it go too far, and now people are afraid to even identify and seek treatment? Perhaps it did.

Honestly, we need to look at balance. We need a balance in society in which people feel that other people shouldn't be punished because they use drugs, as those people need help.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you so much for saying this, because we've had department officials come and say that the Department of Health is here to fight stigma around substance use disorder. The Conservative position is that when we do these harm reduction sorts of things, are we...? I'm a clinician; I'm focused on my patients, but is there potentially a greater societal cultural cost when we drop a consumption site next to a high school. Would you agree that there's a potential for social harm with respect to upstream interventions and preventing people from getting on the stuff in the first place?

[The Chair, Liberal, Hedy Fry]

Thank you, we've gone over time. Maybe you can address this in another question, Dr. Caudarella.

I'll go to Ms. Chi for five minutes.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you, Chair, and thank you to all our witnesses for coming today.

I read through some of the bios of the witnesses, and their backgrounds are very impressive.

My first couple of questions are going to be for Dr. Francescutti.

You are an emergency department doctor...?

[Dr. Louis Hugo Francescutti]

That's correct.

[Maggie Chi, Liberal, Don Valley North, ON]

From your perspective, what are the substance use-related pressures you have been seeing very often on the front line?

[Dr. Louis Hugo Francescutti]

As you know, they're great. We have a variety of patients who present in our emergency department. Some of them have substance use issues. A lot of them have mental health issues. A lot of them have chronic issues.

Some of your committee members were asking for solutions upstream. We've found a solution. We've created a program called bridge healing. It immediately takes someone who's homeless and who's willing to go to a purpose-built building—three storeys, in a community, run by an NGO—and it provides them with the opportunity to get their life back on track. It's free of charge. They can stay as long as they need to. We have three buildings that are harm reduction and one building that's sober living so that we meet the needs of our clients.

We're able to take them from chaos, which is being homeless in an emergency department, and put them into their own room. They tell us that probably the most therapeutic thing we give them is a lock on their door. They sleep for a day or two; they wake up and then we help them. We get them ID. We open a bank account. We find out if they have legal issues. Then we find out what they want to do with their life. We help them with social workers, with pharmacists and with addiction counsellors. We start the journey of recovery. For those who go through the program, there's about an 80% reduction in return visits to the emergency room.

We're scaling up right now in Edmonton. The municipal government is giving us free land. Our Royal Alexandra Hospital Foundation gave us a $10-million donation to get started. Then, working with the feds and the province, providing the operating dollars, we're helping these people, who have very complex lives.

My only advice to this committee is that this is not a simple issue you're dealing with. You know that. It's very complex. We still don't know how complex it is. That's why it is crucial for CCSA to bring evidence that can allow policy-makers to make really good decisions.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you for that. The bridge healing program sounds really interesting in terms of addressing some of what I see are probably gaps in the current system.

You said you're scaling up and are now doing it in Edmonton. What are some of your future plans, perhaps, on scaling it in other provinces and hopefully a connected network across the country?

[Dr. Louis Hugo Francescutti]

We're working out the model so that others can come and ask us how we did it. In Edmonton right now, we want to create a healing house in every distinct neighbourhood. There are over 300. If we were to do this successfully—and we will—it would mean that we would eliminate homelessness in Edmonton within four or five years. This would free up capacity so that we can make absolutely sure we stay ahead of the game.

As others have said, we try to prevent people from ending up in this situation. I've yet to meet an addict who wants to be an addict. I've yet to meet someone who's homeless who wants to be homeless. These men and women are reaching out to us. They're asking for our help. I can't tell you enough about the moral distress it causes us as health care providers to “treat 'em and street 'em”. There should be a law in Canada that says if someone shows up at a health care facility who's homeless, they should not be discharged into homelessness. This would be a bold vision for creating a stronger Canada.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you so much for all the work you do.

My next question is for you, Mr. Elliott. In your opening remarks, you mentioned innovative solutions that you've seen in your work and the potential for scale. Can you share a couple of examples and some of the challenges you've been seeing in terms of scaling? What are some things that either community or government can do to support that?

[Scott Elliott]

I'll give a brief example of the Dr. Peter Centre and how we function. It's a holistic care model. Normally, people who access our facility would probably come because we serve great food. They would come for breakfast or lunch. In there, they get put into a path of care. We have nurses and nurse practitioners on board who are able to look at them and work with them immediately. Over time, we'll get the people into such therapeutic sessions as art therapy, music therapy and counselling.

Then, as I mentioned, we also have housing programs and subacute nursing care. The population—

[The Chair, Liberal, Hedy Fry]

Thank you very much. The time is up, Scott. You can follow up on that in another round.

Thanks very much, Ms. Chi.

I'll now go to the third round.

I'm going to Mr. Baber for five minutes.

[Roman Baber, Conservative, York Centre, ON]

Thank you very much, Chair.

Thank you very much, Dr. Caudarella, and welcome.

I understand that you're a strong proponent of safe supply.

[Dr. Alexander Caudarella]

I'm not sure where you would have obtained that information.

[Roman Baber, Conservative, York Centre, ON]

Obviously, you're an advocate for safe injection sites.

[Dr. Alexander Caudarella]

One of the unfortunate things is that.... Harm reduction has been around for 30 years. We need to be very careful not to look at the different pieces in different ways. When we talk about supervised consumption sites, when we talk about injectable opioid agonist treatment, when we talk about safe supply—even “safe supply” means very different things in different contexts—and when we talk about drug checking or different elements, it's very important to be very specific and to look at what we can do in different ways.

[Roman Baber, Conservative, York Centre, ON]

Fine.

Would you agree with me that safe injection clinics tend to increase criminality in local neighbourhoods, rather than decrease it?

[Dr. Alexander Caudarella]

On our website, you can find an evidence brief we did last year on supervised consumption sites. The evidence thus far from across the country is that supervised consumption sites do not increase the crime in the neighbourhoods around them, and they don't increase violent crime either.

That being said, as I was saying to your colleague, we have to meet communities where they are. If communities don't feel safe, it doesn't mean that we need to be dismissive of that. We need to have conversations about how we help people feel safe.

[Roman Baber, Conservative, York Centre, ON]

Are you familiar with Chief Truong of the London Police Service?

[Dr. Alexander Caudarella]

Not personally, no.

[Roman Baber, Conservative, York Centre, ON]

You've probably heard that he garnered quite a few significant headlines last year when he testified that a considerable amount of safe supply opioids in London are diverted for criminal purposes. Are you familiar with that testimony or that practice?

[Dr. Alexander Caudarella]

Yes, I am familiar with the testimony.