Veterans Affairs Committee on March 8th, 2017

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Okay. Thanks.

[The Chair, Liberal, Neil Ellis]

You have one minute and 20 seconds.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

All right.

Very briefly, you heard my question in the House today in regard to mefloquine.

[Kent Hehr, Liberal, Calgary Centre, AB]

You're asking it to the right person.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Good. I'm glad to hear that.

Australia just released information on what they are doing for all their soldiers, the impacts on them and what the effects are. Attempted and committed suicide are possible outcomes. They are providing treatment and care specifically for individuals identified as having taken mefloquine and needing this care.

How do we get this on the radar here so that these individuals have the care they need? They're not being treated for mefloquine toxicity, and it's not being recognized.

[Kent Hehr, Liberal, Calgary Centre, AB]

First off, I'm very proud of the 4,000 people we have working from coast to coast to coast on mental health issues—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

This isn't mental health. This is a brain stem injury. It's physical. It requires different treatment than PTSD requires. That's what's come through very clearly in the studies in Germany, Australia, the U.S., and Britain.

[Kent Hehr, Liberal, Calgary Centre, AB]

Any veteran who comes forward who has an illness or injury tied to military service will be served by our department with the best available technology and expertise that this country can provide.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you.

[The Chair, Liberal, Neil Ellis]

Go ahead, Ms. Lockhart.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you, Mr. Chair.

Thank you, Minister and General, for being with us today. As you know, we've been working on a mental health study and have concluded our service delivery study. A lot of the testimony you've given today has given us some answers to some of the things we've been hearing through that testimony, so I thank you.

One thing we've heard from veterans is that their access to cannabis for medical purposes has really made a positive change in their lives. Some of them feel that the changes VAC has made are really taking away their medication. In regard to your department's decision to reassess the acceptable amounts of marijuana for medical purposes, what evidence led you to make that decision?

[Kent Hehr, Liberal, Calgary Centre, AB]

I think we have to start with this at a higher level. When I came into the department, there was no policy rationale for the provision of 10 grams a day of cannabis for a veteran for their medicinal purposes, whether for mental health, physical ailments, or whatever. We searched and we searched, and lo and behold, none was found.

Because cannabis is not a drug that is regulated by Health Canada—there are no provisions on that there or otherwise—I said we needed to get together with the medical community, veterans, stakeholders, and licensed producers to try to get a policy framework. It's not a drug regulated by Health Canada. We felt we were in a policy void, in a vacuum.

Through those meetings, our searching, our consultations with the medical community and otherwise, and other expertise—people are looking at this emerging field—we came across much information. The studies go both ways. In fact, there are some medical practitioners who believe it's harmful. Some say there's a benefit. Our government is trying to do things based on evidence and science and good policy.

We even came across information from the Royal College of Physicians and Surgeons stating that the vast majority of people should not be taking more than three grams a day. They look at that as an upper limit for people to safely use when dealing with any medical condition. It's evidence like this that we are coming across from talking with many doctors, with veterans.

We understood that many of them were, in their situation, finding their lives improved. We get that. This was no easy decision that we made, but we felt we had to do it.

We feel we have allowed for some flexibility. Of course, we will reimburse. Remember that Veterans Affairs Canada is a reimburser of marijuana. People can get medicinal marijuana, should they choose, from various licensed producers across this country. Right now we will only pay for three grams, and only when you go to your physician.

We've understood that treating everyone the same is not always going to be effective, so we've allowed some flexibility in the program. If you go to a specialist and they affirm your diagnosis and affirm that cannabis is a valid treatment for it, and they've looked at your medical file and agree with your physician that this is where you should go, then there is that ability for us to reimburse for more.

We felt that this was necessary. You have to remember that the health and wellness of veterans and their families is at the core of what we do, and our policy decisions are driven toward that end. In our view, this policy fits with that mandate, full stop.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you, Minister.

When we've been studying mental health, one of the things we've been talking about that ties into this as well is research on marijuana use when it comes to mental health treatment and PTSD. Is that an area that you anticipate...? Is there some way that VAC can contribute to research in the future for all of these items?

[Kent Hehr, Liberal, Calgary Centre, AB]

I think that's an excellent question.

One thing we're going to be moving ahead on is having a centre of excellence for mental health and PTSD. We envision a large component of that being dedicated for research to understand the best practices out there and allow us to get people help in regard to mental health. There is no doubt that is a growing issue for us at Veterans Affairs Canada.

I'm also very proud of an organization called CIMVHR. I forgot the acronym. Can you help with that?

[Gen Walter Natynczyk]

The Canadian Institute for Military and Veteran Health Research.

[Kent Hehr, Liberal, Calgary Centre, AB]

Very good, General.

It's where our university systems have tied into researching this area. There's a long history of funnelling in information and of getting people moving the needle forward on veterans' issues. We have a strong partnership with them. In fact, before I make some stuff up and get myself in trouble, General, would you fill in the details here?

[The Chair, Liberal, Neil Ellis]

Sorry, Minister. Thank you. I have to move on to the next round.

[Kent Hehr, Liberal, Calgary Centre, AB]

Okay, good, but it's a very good program.

[The Chair, Liberal, Neil Ellis]

Mr. Kitchen, you have five minutes.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Minister and General, thank you both for being back with us here today.

I'd like to go back to medical marijuana. How much are you anticipating saving with the changes that you've made?

[Kent Hehr, Liberal, Calgary Centre, AB]

I'm frankly not sure. I didn't factor any of that into my calculations. You'd have to look at.... I don't even know if we have any calculations on that.

[Gen Walter Natynczyk]

Sir, if I may, from our perspective this is an issue, as the Minister said, about wellness, about well-being, about the medical professionals' advice that anything north of three grams may not be in the best interests of the veteran, so this was not costed in terms of what we foresaw with regard to cost savings because this is not about the money. This is about wellness.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

That's what we've heard from a lot of our witnesses in our studies. A lot of the witnesses have said to us something along the lines of it being in the best interests of their families and of the veterans, and we found that a lot of these witnesses have told us that the use of marijuana has actually given them back some functionality in their lives, has reduced their heavy opioid use over the years and minimized the number of medications that they have to take. Would you not agree, then, that we should be doing a study on medical marijuana?

[Kent Hehr, Liberal, Calgary Centre, AB]

Well, I'll talk about the policy as we implement it.

Because of the information we had from meeting with the medical experts and the veterans, we believe that we've come up with a flexible policy that allows us to keep people safe as well as allowing for flexibility if they want to go to a specialist or want to get what they believe is in their best interest.

In terms of research, I believe it's something we are looking into. It's something that people at CIMVHR and other organizations out there are doing, and I believe we have an obligation as a department to keep track of this emerging research to see where it goes.

Do you have anything to add?

[Gen Walter Natynczyk]

I'd just like to add that when the minister spoke at the CIMVHR conference in Vancouver in November, he tasked the department, in partnership with the Canadian Armed Forces, to conduct the research to again look at best practices with regard to the merits and the details of using marijuana for medical purposes.