Health Committee on April 16th, 2026

[Dan Mazier, Conservative, Riding Mountain, MB]

Yes or no?

I'm tight on time.

[Dr. Alexander Caudarella]

The regulation of drugs is a very complicated issue, and there's a lot to be said about public safety preventions.

[Dan Mazier, Conservative, Riding Mountain, MB]

I have one last question.

Are you aware that day cares have been forced to shut down after supervised consumption sites opened near them, yes or no?

[Dr. Alexander Caudarella]

Yes.

[The Chair, Liberal, Hedy Fry]

Thank you.

[Dan Mazier, Conservative, Riding Mountain, MB]

Do you believe—

[The Chair, Liberal, Hedy Fry]

Your time is up, Mr. Mazier.

I'll go to Ms. Sidhu for the Liberals for five minutes, please.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Madam Chair.

Thank you to all the witnesses for being here with us.

My question is for Dr. Caudarella.

Dr. Caudarella, how has federal investment in substance use programs improved coordination and outcomes across Canada?

You were talking about wraparound services. In your remarks, you were talking about cardiology and when people are going to a cardiologist or for primary health care. Can you talk about that?

[Dr. Alexander Caudarella]

Absolutely.

One thing we sometimes talk about is how we tackled smoking. We made it a whole-of-health issue. It didn't matter where you went. Every door was a place to be supported, treated and helped.

Obviously, this is very different in this context, but I believe very strongly in the power of primary care to deliver many of the services, including opioid agonist treatment and most of the things that are most needed.

People need support. They need coaching and help. They need to be able to individualize the solutions to their local realities. It's why, for example, we're involved in national leading efforts to do work around measurement-based care. How do you measure and make sure people are improving? How do you provide for concurrent disorders?

What we are also seeing increasingly—which is really nice, and maybe this is a reality of a bit more fiscal austerity—is organizations wanting to work together. We're seeing governments wanting to work together. We're seeing people wanting to find the solutions. Being right but having, as Mr. Mazier was saying, day cares closing and people who are upset and frustrated isn't a solution. How do we all work together?

I'm finding that, when I go out and I tell people that they can have a role, that they can do something about this and that primary care physicians can help them, I'm met with tons of enthusiasm. One of my colleagues who's here, for example, went and met all the newcomer clinics and centres. They're very keen to find ways to support their communities. Our job is to reach more people in a more timely way.

[Sonia Sidhu, Liberal, Brampton South, ON]

Early intervention is important. How important is prevention?

This government is taking a balanced approach that includes prevention, treatment and recovery. Why is it critical that Canada stay grounded in evidence, and how can your organization support this?

[Dr. Alexander Caudarella]

There's the piece about evidence, and then there's how people see themselves in that evidence and how that evidence is provided to them in a useful way.

Again, I don't think people are done with data. People want data, but they want data that resonates with them and is useful. I think that's how we move things forward in an evidence-based way. If people see themselves as part of these processes and solutions, things get better. When it comes to the need for evidence, we also....

It has been 10 years of these issues. At first, people very appropriately responded with the here and the now. If you're 18, 19 or 20, and you're dying of an overdose now, you were eight at the beginning of this crisis.

We need to look across this prevention-recovery spectrum. It is absolutely very important. We need to recognize that every single person who goes through treatment will go back into a community that needs to support them. This is part of the nuance around questions we were being asked around regulated drugs or different pieces because, ultimately, community needs to provide an environment that supports the healthiest well-being possible.

[Sonia Sidhu, Liberal, Brampton South, ON]

What opportunities do you see to further strengthen collaboration with the federal government to make more progress?

[Dr. Alexander Caudarella]

There are a few big elements. One is that there isn't a prevention workforce in this country yet. There are probably lots of roles that different things can do.

The second part is that I think most people in this country, unfortunately, aren't even able to access the care that is available to them. When we look at how things like federal government roles can support making sure that all the provincially available services are within grasp and in hand, this can be really important.

The last thing I'll say is that the federal government can have a really important role in which its levers are there, but it also has a role as a partner to the provinces and territories and other levels of government. I think we're seeing an emergence of the ability for these different levels of government to work together. In the past, CCSA has—

[The Chair, Liberal, Hedy Fry]

Please wrap up.

[Dr. Alexander Caudarella]

—been a big support in terms of creating that.

[The Chair, Liberal, Hedy Fry]

Thank you.

Mr. Blanchette-Joncas, go ahead for six minutes, please.

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

Thank you, Madam Chair.

Dr. Caudarella, you mentioned the authority to prescribe medication earlier, but I'd also like to draw your attention to deprescribing. That's what I was talking about in relation to pharmacists. They currently lack the authority to deprescribe opioids to patients who no longer need them.

In your opinion, doesn't this have an impact on addiction and the associated risks?

[Dr. Alexander Caudarella]

The issue of deprescribing is an excellent question.

I believe that one of the things we did about 10 years ago was to move too quickly to deprescribe medication for many people without steering them in another direction, to help them seek treatment or obtain appropriate medication. That's what I would say. We haven't really conducted studies in this area, but that's my opinion.

As for the transition, as has been said, pharmacists are the ones who realize that there is a problem. I would like them to have the ability to refer people directly for other treatment or to other doctors if, for example, they are concerned that the person who has been prescribing the medication is not prescribing the right medication.

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

Okay.

I'm referring to your organization's data, which state that inadequate understanding of the risk of addiction posed by prescription opioids, as well as frequent prescriptions or high-dose prescriptions for pain relief, are the two main factors that have contributed to the opioid crisis in Canada.

Pharmacists are the first line of defence in this crisis. However, their hands are tied because they don't have health care practitioner status, even though this is an essential component in effectively combatting the opioid crisis in Canada. The Quebec government has been asking for this for 15 years. Nothing is happening.

What's going on?

[Dr. Alexander Caudarella]

I'd be happy to check with my organization to see if I can find more information for you on this topic. I don't think we are making full use of all the resources available in the health care system; there's no doubt in my mind about that. However, I'm not sure about the situation on this specific area.

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

We'd appreciate it if you could provide the committee with a detailed response in writing.

[Dr. Alexander Caudarella]

Absolutely.

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

I think it's an indispensable solution, but nothing has been done about it for 15 years.

[Dr. Alexander Caudarella]

We can look into that, absolutely.

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

Let's revisit a topic you're surely familiar with.

Your main funding agreement with Health Canada expired on March 31, 2026. That wasn't long ago. Can you assure us today that your operations will continue uninterrupted—yes or no?