Public Safety Committee on Oct. 29th, 2014

[The Chair, Conservative, Daryl Kramp]

Colleagues, I call to order the Standing Committee on Public Safety and National Security. This will be meeting number 35.

We have witnesses today from 3:30 p.m. to 4:30 p.m., and other witnesses from 4:30 p.m. to 5:30 p.m. Of course, this is televised.

We apologize to our witnesses for any technical difficulties we've had here today. We regret that. However, as the story goes, it is what it is, but maybe you're blessed if you can't see us.

[Voices]

Oh, oh!

[The Chair, Conservative, Daryl Kramp]

I meant that simply from a visual...but I guess we could take that a number of different ways. Maybe the chair is opening his mouth to some criticism here.

At any rate, let's go ahead.

We have with us Matthew Skof, president of the Ottawa Police Association. Welcome, sir.

[Matthew Skof, President, Ottawa Police Association]

Thank you.

[The Chair, Conservative, Daryl Kramp]

By video conference, we have Michael McCormack, president of the Toronto Police Association. Welcome, sir.

From the Toronto Board of Health, we have Dr. David McKeown, Medical Officer of Health.

Thank you very much, gentlemen, for being here today.

We will start with opening statements. You have up to ten minutes, if you wish, then we will go to our round of questioning. We will start in the order that I have the names down here as witnesses. It will be Mr. Skof first, followed by Mr. McCormack, followed by Mr. McKeown.

Mr. Skof, do you have an opening statement?

[Matthew Skof]

I do. Thank you very much.

I would like to thank the Ministry of Public Safety for providing me with an opportunity to speak to you today. As introduced, my name is Matt Skof. I'm president of the Ottawa Police Association.

I've worked in policing for 18 years and have had a vast and challenging career. I've worked in all patrol areas in the city of Ottawa. This included the downtown community district office in the ByWard Market, and in Vanier. For those of you who may be unfamiliar with these areas, they present unique challenges for police. They are more heavily populated, they have higher levels of homelessness, poverty, higher crime in both major and minor classes, drugs, prostitution, and mental health issues.

When I became a sergeant, I remained in the district working closely with the residents and businesses in the ByWard Market. I represented the Ottawa Police Service on many community committees that covered addiction problems, homelessness, prostitution, and mental health issues.

For the past three years I have been serving the membership of the Ottawa Police Association as president, representing 1,400 sworn police officers and 600 civilians. As president, I have been called upon many times to comment on the issue of supervised injection sites. I believe it is more appropriate to characterize safe injection sites as supervised sites. From a policing perspective these facilities continue the use of highly addictive substances. While I appreciate the argument that they are alternatives to shooting up in back alleys, the supervised injection sites perpetuate and encourage heavy, damaging drug use.

We are here today to consider public policy issues in relation to injection sites. In my view, it is crucial that within this debate we hold all the evidence up to the light for its full and careful consideration.

Last year I participated in a press event held by ministers Leona Aglukkaq and Steven Blaney , where new guidelines were introduced. At that time, questions were raised about the principal argument made by advocates of supervised sites, most particularly the suggestion that supervised sites decrease HIV infection rates.

You can see in tab 2...and unfortunately, I didn't have it translated. I wasn't sure if a speech had to be translated, so I apologize for that. There are 20 copies that will be translated for you, apparently.

I have carefully examined the data, and it does cause me great concern. I want to share that concern with this committee today.

When we examine the data, it is noteworthy that in Ontario, Alberta, Quebec, and Atlantic Canada the frequency of new cases of HIV has decreased, just as it has in British Columbia. This fact appears to have been overlooked in the arguments raised by proponents of supervised sites. Arguments that urge you to expand injection sites must be complete. When considering HIV rates overall, Ontario, Alberta, Quebec, and the Atlantic provinces do not permit supervised sites, and yet have comparable improvements in HIV data. Suggesting there is a nexus between supervised sites and improved HIV outcomes is tenuous. The evidence makes it clear that making that claim is incomplete.

At the heart of this discussion, though, is the fundamental question “Where will supervised sites be located?” Based on my experience, this question is often reframed to be “Which neighbourhood will be sacrificed?” This is given the fact that several square blocks are allocated to the transporting of illegal narcotics that are consumed at the supervised injection sites.

With regard to InSite, at tab 3 of my material the committee will find photographs I took last year when I attended a conference in Vancouver. My purpose in including these photographs is to illustrate the challenges the business communities and local residents face on a day-to-day basis. Nearly all of the properties had to go to great lengths, and at times significant expense, to ensure the safety of their clients and the security of their property.

Police encounter a number of issues in the areas allocated to supervised sites. Most concerning is that there will be a boundary in which the possession of illegal drugs will be tolerated. This area will become known to drug users and traffickers within hours of its creation. In creating injection sites, we create concentrated trafficking zones. Traffickers will carry only enough drugs to make small but frequent transactions. If stopped by the police, these traffickers will claim immunity, relying on the presumption of innocent possession within a known boundary around the supervised injection site.

If you look at tab 4, in the first picture you can see two males, one with a red knapsack and one with a green one. I observed the two males working in tandem while the male with the red knapsack trafficked drugs. In the second photograph, I observed the male in the camouflage pants traffick drugs to the male walking away from him in the brown jacket.

Both of these photographs were taken in close proximity to InSite. Neither of the two persons who purchased drugs walked into InSite, but went in the opposite direction. I stayed in the area for several hours and observed many transactions of this nature.

We return to the fundamental question of “Do you still want to live in this neighbourhood, or near it?” Before answering, it is necessary to consider that these surrounding areas have increased levels of prostitution, homelessness, and antisocial crime—theft, burglary, and swarmings. Clients of supervised injection sites often fall into these behaviours for the purpose of supporting their habit.

In tab 5, the photo was taken in an alley two blocks from InSite. The male did not live in the area, but attended for the purpose of dumpster diving and to find and sell anything of value. My observations were confirmed when I spoke directly with this individual. He was very candid with me that he was trying to support his drug addiction.

I have no reservations in telling this committee, based on my policing experience, that locating a supervised injection site brings an increase in crime. These crimes extend well beyond consuming drugs in a supervised location. Individuals who purchase drugs in these areas often walk away from the supervised location to shoot up in alleyways, stairwells, and parking lots within the local community.

At tab 6, I provide you with a photo of a group of people in front of the Carnegie Community Centre in Vancouver, blocks away from InSite and smoking what seems to be crack cocaine. I have to tell the committee that this photograph causes me a lot of concern. In my capacity as a police officer, I've coordinated several street-level drug projects in the ByWard Market and the Vanier area. At no time did I ever observe drug use in which the consumer smoked crack cocaine sitting in front of a community centre, nor have I ever observed someone smoking crack with such disregard for public scrutiny.

Let me be clear: I accept that we do have a drug issue in our community. I observed it at the street level, and often on a daily basis. When we consider alternative approaches to treating these conditions, we must be honest with each other. In Ottawa the distribution of rubber tips to limit the spread of disease from sharing crack pipes failed, because the users claimed they changed the taste of the drugs being inhaled. The needle exchange program required volunteer needle hunters to recover used equipment. Ottawa has many social programs trying to address these growing social problems. Supervised injection sites might have the best intentions, but they fail, increasing the attendant issues of trafficking, prostitution, theft, homelessness...and the list can go on.

Ottawa invests many resources into the ByWard Market, to name just one busy area, but adding a supervised injection site will only necessitate a significant increase in public funds. Based on my experience as a police officer, I would say that a preferred investment for a government would be one in rehabilitation facilities. Sadly, in Ottawa today there are significant wait times for persons who want to turn their lives around. This wait time leaves a vulnerable person at the mercy of their addiction on the street. We all know that getting a person to a place where they know they need help is half the battle, but we don't provide sufficient beds for them.

In closing, I would ask the committee to consider the following. As a sergeant working on the Ottawa streets, I would never be able to approach this committee and speak candidly. My message would have gone through any number of official police filters. I can speak to you today, however, because I am a representative of a police association in Canada.

As president of an association of professional police, I speak on behalf of my 2,000 members. My message to you today is as candid as I can be. My message to you is not censored by budget constraints, or through the lens of political interests. My message today is grounded in many years of working on the streets in Ottawa, with dedicated and concerned police officers and civilian members.

This concludes my remarks for the committee. As always, I'm available for your questions.

[The Chair, Conservative, Daryl Kramp]

Thank you very much, Mr. Skof.

Now we will go to the opening statement from Mr. McCormack.

Go ahead, please, sir.

[Michael McCormack, President, Toronto Police Association]

Thank you.

Good afternoon. My name is Michael McCormack. I'm the president of the Toronto Police Association. Here in Toronto I represent one of the most diverse communities in all of Canada. I also represent over 8,000 members.

First of all, I want to thank the standing committee for giving me this opportunity to speak to some of our association's concerns regarding amendments to Bill C-2.

I'd like to start off by stating that our association does not support the current configuration of supervised safe injection sites. I'm not here to argue the medical evidence, whether or not they reduce the number of deaths from overdoses or prevent the spread of infectious disease. I'm here to speak about our public safety concerns from a policing perspective.

The goal in policing is to improve the quality of life in the community by reducing crime and disorder and the fear of crime and disorder, and enhancing public safety, which is something that we do in the policing community. We believe supervised injection sites contribute to social and economic deterioration and further victimization where they are located. They do little to achieve our goal in policing, which is public safety.

I've worked—again, this is from a policing perspective—in 51 Division in downtown Toronto, which is a unique division. It has the second-highest density of government housing in North America; almost 90% of all the halfway houses and stationary homes in Toronto are located within the boundaries of 51 Division. I've worked there for almost 15 years, in major crime, street crime, dealing with all types and different levels of crime. What we found was that in a division like this, 90% of the crimes we dealt with were either drug or alcohol related. This is a big concern to us in the policing community.

When we talked about where we go, when we looked at all the anecdotal and other evidence around safe injection sites, and when we reviewed the evaluations of these sites, we were very critical of their methodology and the findings. We found that the public safety issues have been downplayed or not considered, or even poorly measured in a lot of this research.

For example, one study used only three crime types for benchmarks: drug trafficking, assault, and robbery and vehicle theft. Notably absent were the other crimes that from practical experience we found were missing in the indicators linked to drug use, such as break and enter, shoplifting, theft from auto, fraud, prostitution, panhandling, selling of stolen property—not to mention the countless provincial offences.

What we find too is that it's really hard to measure these offences, because given the way.... We just looked at the report on unreported crime that the federal government puts out every year. We find that people who are using drugs—we consider them victims of drug abuse or addiction—are very reluctant to come forward and report when they are, in fact, the victims of crime, whether of theft, sexual assaults, or involvement in prostitution. That's something that really concerns us.

But overall, when I look at policing somewhere in Toronto, with such diverse and widespread communities in different pockets throughout this city, when we're dealing with people who are looking to use intravenous drugs—it's not only heroin, it's also MDMA and other types of chemicals that they inject—they call it jonesing, or needing a fix, for a reason. We have all these communities throughout Toronto, as I described, and we have different pockets where you have a concentration of drug users. It's not one area where all your intravenous drug users will be congregating or hanging out. We found in working in the projects that the drug users will go get their fix, and we will find needles and syringes in schoolyards, elevators, corridors, and stairwells. The drug addicts get their drugs, they need their fix, and they go to the nearest location where they can have a little bit of privacy. They'll inject and then move on from there.

The whole premise of having a centralized injection site really baffles us in the policing community, because you're taking a heck of a leap of faith to think that a person who's addicted to drugs is going to, for instance, go to wherever the drug dealer is, buy their drugs, get their syringes, jump on the subway or take a taxicab or ride their bike to go to a safe injection site, and then inject—and go through that process four or five times a day, which is what we find with intravenous drug users. It's not a once-a-day event and then they move on and their day is normal. They inject up to four to six times a day.

So the logistics escape us. There needs to be some dialogue around how this would actually work. How do people see that as being effective? We're very puzzled about how that would be applied to somewhere like the city of Toronto.

As I said earlier, most of the drug addicts that I've ever dealt with as a practical matter were forced into criminality to support their habit. Where are they going to get $100 to $200 a day, which is what it requires to support this addiction? They do it by supporting their habit with theft from autos, break and enters, and other types of crimes. With that addiction they're victims, but they're victimizing the community as well.

Again, when we're talking about safe injection sites or supervised injection services, you go where the market is. Drug dealers are, for lack of a better word, business people, and they're going to go where the market is. So if you have a safe injection site—this is some of the experience we've found from the Vancouver experience as well—drug dealers will go where the market is. They'll go where people are going to use.

If they're going to traffick, they'll congregate in the areas where they can sell to the users. When we have a safe injection site, we have people who are going to be using. The drug dealers are going to go there, which is further going to facilitate and increase the amount of crime and that type of activity in those neighbourhoods. So we're very concerned about the drug dealers going there and about further victimization of the addicts.

When I worked in 51 Division, I could look out the back gate of 51 Division and see a methadone clinic. That's quite a different premise: people are getting treatment, the product is on site, and it's managed. This is a very different concept. So we're very concerned about the practical basis for this and how this would work.

The other concern we have from a policing perspective is that we are the ones expected to police those areas and increase enforcement and our presence. When we looked at it, we found in Vancouver that there was a dip in crime around the supervised injection site, but there were, I think, an additional 83 police officers who were put into that area to police. We found in Toronto that whenever we increase policing into a community, there is a significant dip. Police presence does have an impact on crime. For us, the police, we're going to be left mopping it up and it's going to be a demand on police resources. Police need to be consulted and have more dialogue and evidence on how this is going to impact our already taxed police resources.

We have some real concerns about the practical basis of this. Again, I'm not talking from the health perspective. That's not what I'm here to do. I'm talking from a public safety basis. From the Vancouver experience, when the 81 police officers were surveyed, in I think 2008, the individual officers who worked in that area said that their perception and feeling was that there was no actual decrease in the indicators of that type of illegal activity, whether it was public injection of drugs—they were still cleaning up syringes and needles from all over that community—or the congregation of people in that area, including prostitution, and street-level crimes. We're obviously very concerned about that, and that's something the policing community is going to be left to deal with. So we need to have more dialogue and see more evidence-based discussions, as Matt referred to, around what the outcome is going to be and how this is going to work with these communities.

I'll conclude my remarks by saying that we feel there needs to be more independent research to provide a more balanced and inclusive review of the impacts of these injection services on public safety. We need to improve the body of research in this area with objective studies, evaluations, and measurables that all stakeholders can agree on. We feel that the measurables would include crime rates, disorder indicators, property values, other economic indicators, social indicators, and data gathered through the community, law enforcement, and multi-sector consultation.

We also need to explore other strategies, including education and prevention strategies, and judicial enforcement strategies—

[The Chair, Conservative, Daryl Kramp]

Could you very shortly wind up, please, Mr. McCormack?

[Michael McCormack]

—yes—such as investing in drug treatment courts with alternatives to incarceration and treatment centres. We feel that we need to focus more on treatment and that this is a band-aid solution to a bigger problem.

Thank you.

[The Chair, Conservative, Daryl Kramp]

Thank you very much, sir.

Now we will go to Dr. McKeown, please.

You're on, sir.

[Dr. David McKeown, Medical Officer of Health, Toronto Board of Health]

Thank you very much.

I'd like to thank the chair and the members of the committee for the opportunity to speak with you today.

My name is Dr. David McKeown. I'm the Medical Officer of Health for the City of Toronto and the executive officer of the Toronto Board of Health. My remarks today are presented on behalf of the board of health.

You should a have a copy of our full written submission.

My perspective is somewhat different from that of my law enforcement colleagues, because I come at it from a public health point of view. Toronto is one of several cities in Canada looking to implement supervised injection services as part of an evidenced-based, comprehensive approach to health services for people who inject drugs. As you know, potential operators of these services require an exemption under the Controlled Drugs and Substances Act in order to legally operate, and Bill C-2 sets out the proposed requirements for this exemption process.

The Toronto board of health considers the requirements in the act to be excessive and quite disproportionate when compared with processes for making decisions about other kinds of health services, and we urge the development of a more appropriate exemption application process.

The board also feels that the proposed bill is not consistent with the decision of the Supreme Court of Canada ruling on supervised injection. If Bill C-2 is passed as written, we believe it will be a significant barrier for any community or any health system in any province that has come to the decision that these services would serve both the public health and public safety interests of local residents.

Injection drug use, as we know, is associated with significant public health risks, including the transmission of blood-borne diseases such as HIV and hepatitis and, of course, overdose. The risk of overdose, in fact, is twice as high for injecting illicit drugs as for other forms of consumption. This risk increases when people inject alone, as no one is available to intervene or seek medical assistance in an emergency. Without a safe place to inject, some people turn to public spaces such as washrooms, alleyways, or the street.

Public injecting is not only an issue for people who are homeless. People living in shared accommodation, in shelters and temporary housing, or rooming houses may fear losing their housing if they're found to be injecting, and so will turn to public spaces.

Based on these and other risk factors, the Toronto and Ottawa supervised consumption assessment study, a research study, concluded that Toronto, with its pattern of drug use, would benefit from multiple small supervised injection services integrated into existing health services, which are already serving people who inject illicit drugs. This is a different model from the Vancouver InSite service. The Toronto board of health supports this model and this approach to expand a continuum of health services for the needs of this particularly at-risk population in our city.

As you know, in 2011 the Supreme Court ruled that the Minister of Health's decision not to extend the section 56 exemption for Vancouver's InSite service was not in accordance with the principles of fundamental justice, and violated section 7 of the Canadian Charter of Rights and Freedoms.

The Supreme Court also ruled that for future exemption applications, the minister must exercise discretion within the constraints imposed by the charter and aim to strike an appropriate balance between achieving public health and public safety goals, and both are important in this issue.

Furthermore, the Supreme Court said that the minister should generally grant an exemption where the evidence indicates that a supervised injection service will decrease the risk of death and disease—that's the health interest—and where there is little or no evidence of a negative impact on public safety.

The requirements set out in Bill C-2, we feel, rather than striking this appropriate balance are focused much more on public safety concerns without recognizing significant public health benefits. If we are truly to have respect for communities, we must recognize that harm reduction services such as supervised injection not only provide better health outcomes for people who use drugs but they may also help to improve public safety in local communities. For example, as we read the research, it is shown that supervised injection services can help reduce public drug use and the discarding of needles, and certainly do not increase crime.

People who inject drugs are, from a public health practitioner's point of view, among the most vulnerable members of our community, and they often struggle with complex health and mental health issues. They are much more likely to be victims than perpetrators of crime, and the profound stigma and discrimination they experience create barriers to their accessing mainstream health and social services that the rest of the community would use.

Broadly, harm reduction services tend to be effective because they're designed to be welcoming and non-judgmental, and they focus very specifically on the health needs of people who use drugs.

The board of health has a number of specific concerns about the requirements set out in Bill C-2, and I'm going to mention each of these briefly.

Demonstrating local need for a health service is a very reasonable requirement for an organization seeking to implement supervised injection services, whether making that case to the provincial government or for an exemption. However, producing scientific evidence on the medical benefits of these services should not be necessary at this point.

The evidence has been reviewed over and over again. The Supreme Court and many other health organizations have already recognized that these services are an evidence-based health intervention based on a wealth of peer-reviewed national and international research.

The exemption application process laid out in Bill C-2 requires letters from a broad range of officials outlining their opinions about the proposed service and identifying any related concerns, along with details of how the applicant will address those concerns. There really is no other health service that is required to obtain a consensus of opinion from a wide range of sector leaders in order to operate.

Bill C-2 also requires consultation with professional medical associations and a broad range of community groups. This breadth of consultation is likely to be beyond the capacity of most health service organizations or health systems seeking to implement these services. Furthermore, there's already widespread agreement among health professional organizations—the CMA, the CNA, and so forth—that supervised injection services should be available as a part of a comprehensive range of interventions in health facilities that serve people who use drugs.

The proposed bill also does not specify what would constitute an acceptable community consultation process, including the range and type of community groups to be consulted. Some community engagement is prudent, and in fact good practice, in order to inform local residents and businesses about the service, how it will operate, and to establish mechanisms for addressing any issues that might arise.

I think this process is part of being a good neighbour for any health service, and it benefits everybody involved. However, it is not reasonable to expect organizations to consult with individuals and groups in the community who are not expected to be affected in any way by the service.

Bill C-2 also requires police checks for all staff who will work in the program for the previous 10-year period, including noting any drug offence convictions. Further, police check documentation is required from people whose country of origin is not Canada, if the staff member resided outside the country during the previous 10 years.

On a practical note, applicants can't really conduct police checks in advance of submitting an exemption, because they're not likely to be recruiting or retaining or hiring staff until they've secured the exemption and are ready to open. Furthermore, the need for police reports from countries outside Canada clearly discriminates against anyone who has emigrated from an area of the world that is war-torn or has an oppressive regime where the information is not likely to be available.

It also discriminates against workers who have past drug offence convictions but are now law-abiding and suitable for employment. Workers with that kind of first-hand knowledge of the issues facing drug users play a critical role in the delivery of harm reduction services, as they're often able to connect better with at-risk individuals because of their shared experience. Given that a key goal of these programs is to engage with at-risk individuals, to link them with health services, including treatment services, strategies such as employing peer workers who have past experience with drugs should not be impeded by the legislation.

Bill C-2 also allows the Minister of Health to request any other information deemed relevant. This is a very open-ended provision in the legislation, and depending on the inclination of the minister and the nature of the request there could be significant further barriers.

The bill allows the minister to give public notice of an exemption application, and the general public would have 90 days to comment, regardless of whether they have any relationship to the application or the proposed service at all. Both of these requirements could lead to cumbersome delays or impediments to implementing supervised injection services.

Legislation generally should provide clarity and certainty in public policy on whatever issue it concerns. An overarching concern with Bill C-2 is that there's really no indication as to whose opinions of support or opposition or what level and what type of information submitted would result in an application being accepted or denied. It has been the experience of other cities that once a supervised injection service is up and running, community concerns tend to either be addressed or not materialize at the level in which they might have been predicted.

This certainly has been the case in Vancouver, where both InSite and, perhaps more significantly because it's relevant to the model that looks more appropriate for Toronto, the Dr. Peter Centre have secured broad community support. The emphasis in Bill C-2 in demonstrating widespread support from many different stakeholders does not recognize the challenge of the poor level of understanding of the nature and benefits of supervised injection services in the general community.

Bill C-2 imposes an onerous and complex process on the approval of supervised injection services, which is unlike that for any other health service. There's no indication that provincial governments, which have constitutional responsibility for health services, were consulted in developing the legislation, nor is there any indication that health professionals or other organizations with expertise in supervised injection were involved.

Given this lack of process and the onerous requirements laid out in the legislation, we encourage the federal government to take the time to go back and develop a more appropriate, practical, and well-informed process for CDSA exemption; and further, that the application process be developed in consultation with the appropriate provincial public health, public safety, and community stakeholders.

Thank you very much, Mr. Chairman.

[The Chair, Conservative, Daryl Kramp]

Thank you very much, Dr. McKeown.

We will now go to our round of questioning, and we will start with Mr. Norlock, please, for seven minutes.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you very much, Mr. Chair.

Thank you to the witnesses for attending today.

Mr. Skof, you related to us some of your observations when you were in Vancouver—taking pictures, doing other observations. When you go to court as a police officer and present those to the court, would I be correct in calling that evidence?

[Matthew Skof]

If I had actually proceeded with criminal charges, then sure, absolutely.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

That would be evidence.

[Matthew Skof]

Yes.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

So when somebody says there's an evidence base, if you were putting together a case, that could be considered to be evidence toward an evidence-based case.

[Matthew Skof]

Absolutely.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Okay.

It was also mentioned by some people....

By the way, in your comments, when you related to your political “neutrality”, shall we say, some people here disagreed, because I thought I heard a scoff somewhere.

[Matthew Skof]

No pun intended.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

At any rate, getting back to the questions at hand, one thing that was mentioned by one of the witnesses was that some people who are being consulted may not be as qualified as others. As I remember the evidence of the minister, part of the people in the neighbourhood who should be consulted are parents and parental groups.

Do you believe that parents and business owners in neighbourhoods are qualified to judge whether or not they would like a supervised injection site in their neighbourhood?

[Matthew Skof]

I would say it's actually critical to have their opinion.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Would you say the police officers and people whose job it is to make sure that the public is kept safe are proper people to comment on a supervised injection site?

[Matthew Skof]

Absolutely, sir.