Mr. Speaker, it is indeed a pleasure to rise in House and debate my private member's bill, Bill C-307. Let me say to all members of Parliament that many times they can go many years, even a decade, before they have a private member's bill drawn, so obviously when they do have an ability to debate their own private member's bill, it is a real honour in this place.

This is an act to amend the Controlled Drugs and Substance Act (tamper resistance and abuse deterrence).

The issue of prescription drugs and illicit drug use has touched every riding in this country. It is an issue that, as hon. members know, we face in the communities we represent, an issue that has ravaged some communities, destroyed families, and has taken far too many lives.

Most tragically, it has taken a disproportionate number of young people, including young indigenous Canadians, from us. Every day we open the paper we see another death, or, this past week in Winnipeg, three or four deaths.

The intent of Bill C-307 is to enable the federal Minister of Health to require prescription medicine, specifically opioids, as defined under the Controlled Drugs and Substances Act, or the CDSA, to have abuse deterrent formulations and/or tamper-proof, tamper-resistant properties. By doing so it would make these drugs more difficult to crush, snort or inject, and reduce their potential for misuse, abuse, and diversion to our streets by criminals.

The bill will make it possible for Canada's Minister of Health to take immediate action whenever Canadians are being hurt or killed by a specific prescription drug.

We have all heard about the crisis of illicit fentanyl wreaking havoc in our communities. The Minister of Health, the Minister of Public Safety and Emergency Preparedness, and our law enforcement agencies across Canada are addressing part of the problem. However, before some people, especially our youth, abuse these dangerous, illegal drugs, they are often exposed to these chemicals that can give them a powerful and addictive high by their tampering with legitimate fentanyl or legitimate opioids, but especially legitimate fentanyl patches, or a host of other prescriptions: codeine, morphine, OxyContin and others.

Some people who abuse opioid pain relievers, for example, do so by tampering with prescription opioid products by crushing the pills and snorting, liquefying, injecting, or ingesting these crushed and altered substances. Instead of the pill being digested or dissolved and releasing its payload of pain relief into the body as intended, as most pill forms of medicine, from digestive drugs to heart medicines, are designed to safely work, the abuser gets, with an eight to 12 hour dose of pain relief, a significant euphoria or a high in as little as eight to 10 minutes or less.

Abuse-deterrent or tamper-resistant technologies are evolving fast, and these advancements in medical science are absolutely exciting. Aside from making pills harder to crush, to snort, or to inject, companies are also making pills with antagonist formulations. I am not a scientist, but these pills may contain an active ingredient like Oxycontin or hydromorphone, but also naloxone. If someone can break the protective casing, manipulating the active ingredient or the opioid within the pill, for example, it will not cause a high because the naloxone would mitigate the effect.

It is amazing some of the science that is now being used in tamper-resistant or abuse-deterrent formulations. New drugs coming to the market are also in what are called pro-drug formulations, so the only way the opioid can be released is by digestion. If the pill is manipulated beforehand, its active ingredients are encased in a way that it makes them almost impossible to extract from the formulation or from the pill.

Moreover, some companies are investing in technology to stop patients from pill-popping these medications. Basically, once a pill is being broken down in someone's stomach, any others with active ingredients would be rendered inert; they would not work.

Still other technologies are being developed that introduce aversive agents in the same pill as an opioid. For example, naltrexone can be combined with an active opioid so any tampering or manipulation will precipitate symptoms of withdrawal, not the intended high that the abuser would seek.

The science changes things very quickly. In the crisis we are in, we need a government that can adapt as well. I can appreciate that my colleagues may be skeptical of some of the science or see this as some type of science fiction out there. Before I really started looking at this and studying it, I had no idea. I thought that tamper resistant meant it came in a package, but it is so beyond that. It is amazing what technology, innovation, and science have done to the point where now today we should be taking advantage of it.

In fact, just south of us, the Americans are taking advantage of it. The United States FDA has now approved seven of these products, which are having a dramatic impact in reducing levels of prescription opioid abuse. As well, the FDA and other bodies have conducted independent studies to attest to this fact. Even more promising is the fact that the FDA reports that over 30 such new ADF medicines are in development by both brand and generic manufacturers.

Because the molecules for all opioids, including oxycodone, codeine, fentanyl, hydrocodone, hydromorphone, and others are off patent, the competition in this area is fierce, which depresses any premiums manufacturers may want to charge. Cost is not an issue for these medications since the pan-Canadian Pharmaceutical Alliance, involving all FPT governments, can aggressively bulk buy and bulk reimburse them at a cost amenable to taxpayers.

If Bill C-307 were available to be used by Canada's Minister of Health, then whenever we found that a specific drug in the opioid class and beyond was being abused through physical manipulation, the minister could ensure that this particular drug only be dispensed in an abuse-deterrent or tamper-resistant form when it is available. These technologies should be the exception and not the rule in powerful pharmaceutical products.

Passing Bill C-307 would complement the work already undertaken by the previous government, and commendably accelerated by our current government in providing guidance to manufacturers this past March on how to bring these drugs to Canada to make abuse-deterrent label claims in Canada.

While it may surprise my colleagues in the House to compliment the government of the day, this issue is about public health. It is about saving lives. It is about doing the right thing. It is too big and too important for partisanship. It is too important to be critical of the science. We should all be encouraging the government to move on this.

As I mentioned earlier, all members of Parliament know about the waves of drug abuse that are impacting Canada and many other nations. Canadians are calling on government and health authorities to take action. Bill C-307 is one answer to that call. It is an answer that would be an effective, upstream harm reduction intervention to prevent abuse in the pharmaceuticals before it can occur. It is a ready complement to other downstream measures being taken by public health authorities, first responders, addiction workers, and law enforcement. I am hopeful my colleagues will agree that Bill C-307 would provide a non-partisan and practical measure for Canadians.

All members of the House were pleased when the Minister of Health took action this past summer to further control six ingredients known to be used in the illicit drug trade. I thank her for that action. I was working on this private member's bill and I heard that she was taking action on fentanyl. Although it did not cover it to the extent that I would have liked, I commended the government for doing that.

Bill C-307, though, is a very small part of legislation that was tabled in the House by the previous government in the final days of the 41st Parliament.

In November 2013, the Senate committee on social affairs, science and technology issued a unanimous all-party report and recommended that Health Canada pursue abuse-deterrent formulation technologies and regulatory change.

In April 2014, the House of Commons health committee issued a unanimous report on the federal government's role in prescription drug abuse. Three of the recommendations supported tamper-resistant and abuse-deterrent formulations. In fact, the opposition Liberal Party at the time said that we did not go far enough as a government on the issue of tamper resistance and abuse deterrence. I encourage all members to read those reports.

This is an expeditious regulatory change that can save lives.

I am aware that the current government continues to work towards a new drug strategy. We are on the eve of a national opioid summit this weekend, with many experts drawn from across Canada. I am a member that will be attending that. I commend the government again for having this summit. Yet I also believe that Bill C-307 would allow all members of Parliament to take some action together and immediately.

Bill C-307 is an opportunity for us to get behind a measure right now. We look forward to what the health minister will propose, but we do not have to wait. We can do some things right now.

I want to thank the employees of the House of Commons who help members of Parliament with private members' bills. I have had a great deal of help drawing up Bill C-307, and I am following much of their advice. The final two sections of Bill C-307 would allow the minister an appropriate amount of time to prepare the necessary regulations. I have accepted their legal advice that I have received to establish the timeframe. Apparently, it is a reasonable time period and there are precedents, but I am not a lawyer.

Outside the House, there is considerable support for abuse deterrence and tamper resistance to be applied to prescription opioids. Many companies, brand, generic, and start-up, with both the United States and Canadian roots, are in various stages of research and development on their own products.

Fifteen industry members of the Abuse Deterrent Coalition wrote to Canada's Minister of Health in support of abuse-deterrent and tamper-resistance formulations so they would be able to apply them across the entire class of opioid medications. Also, 37 of Canada's leading pain and addiction specialists have written Canada's health minister in support of abuse-deterrent formulations.

Many Canadian organizations have commented on the value of abuse-deterrent and tamper-resistant formulations. Some of them support these formulations as part of a comprehensive approach to addressing the issue of prescription drug abuse, misuse, and diversion.

I am not opposed to a comprehensive approach, but every weekend when we pick up the paper and see more and more deaths, we ask ourselves what we can do right now. This bill is one of those things.

Some of those associations and groups that support this type of technology, tamper-proof and abuse-deterrent formulations are: the Canadian Medical Association, Canadian Pharmacists Association, Canadian Association of Chief of Police, Canadian Public Health Association, Paramedic Association of Canada, Canadian Centre on Substance Abuse, Centre of Addiction and Mental Health, Canadian Society of Palliative Care Physicians, Centres for Pain Management, and I could go on with the list.

The abilities of the government to regulate tamper resistance exists, to some extent, right now through a general power. However, Bill C-307 would provide a more specific power for our Minister of Health.

We are in the midst of a public health crisis when it comes to prescription and illicit drug misuse, abuse, and diversion. My time in this place, 16 years, has taught me that in the life of each Parliament, there are rare occasions when we come together to support a worthy private member's initiative. I have been encouraged in this term, as I have seen many of those happen.

I believe Bill C-307 affords us this opportunity to confront, combat, and curtail prescription opioid abuse in a meaningful way, while not impacting patients who benefit from these medicines.

Let us do the right thing, the right thing together and the right thing for our country, by supporting and passing Bill C-307.

Controlled Drugs and Substances ActPrivate Members' Business

6:50 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, all parliamentarians take this issue very seriously.

I am the representative of Winnipeg North. Just the other night three people died from a drug overdose in the beautiful community of Meadows West. This type of thing is happening all over country. We recognize that there are 12 or more individuals being treated in hospital every day, that is one of the numbers I have heard.

The Minister of Health has acknowledged this as have other ministries. The government is aggressively pursuing what we need to do as a national government, meeting with the different provinces. In fact, I believe the minister of health for Manitoba is going to be in Ottawa tomorrow to talk about this very important issue.

It really important for all us to appreciate the fact that we all recognize this is a crisis situation. Our hearts go out to those victims and their families that have endured so much as a result of overdose.

Would the member agree that it is absolutely critical we incorporate all the stakeholders to ensure we come up with a plan to address this critical issue?

Controlled Drugs and Substances ActPrivate Members' Business

6:50 p.m.

Conservative

Kevin Sorenson Conservative Battle River—Crowfoot, AB

Mr. Speaker, just as an aside, I saw this on my wife's Facebook account. A young girl who lives in our community put a picture on Facebook of the home where those in the member's riding where killed. She said that this was the home in which she was raised in Winnipeg.

Again, here is a beautiful young girl, almost like a second daughter to us, who is mourning these people she did not know, but that was the area, the community, and the home where she was raised.

I go back to the member's question, which is correct. On issues like this, we must work in a non-partisan way. I am pleased that the Senate committee issued a unanimous report saying that we should move towards this. I am encouraged that the House committee in the former Parliament said that we should move toward this. Even the Liberal Party said at the time that we did not go far enough and we needed to do this type of measure.

This is one small tool in the tool box. It is not going to solve the problem, and I recognize that. However, for those prescriptions, where there is abuse and misuse, let us use those tools and save the lives of young Canadians.

Controlled Drugs and Substances ActPrivate Members' Business

6:55 p.m.

NDP

Christine Moore NDP Abitibi—Témiscamingue, QC

Mr. Speaker, there are molecules in the extended opioid family that we have known about for a fairly long time. They are available in generic form and are therefore relatively inexpensive. They are often used to treat cancer patients.

If the measure proposed by the bill is implemented and we require these medications to be available only in a tamper-resistant form, there could be consequences. For example, the fact that drug companies can obtain new patents for drugs that are modified to make them tamper resistant may drive up the cost of the new form of the drug.

Does my colleague have any suggestions to prevent a situation where the same basic molecule becomes much more expensive because a drug company got a new patent for a product that has been around for decades?

Controlled Drugs and Substances ActPrivate Members' Business

6:55 p.m.

Conservative

Kevin Sorenson Conservative Battle River—Crowfoot, AB

Mr. Speaker, that is a very good question. When we start making these changes, is it going to drive the price way up? Are there only a few companies that have this technology? Those are all good questions.

The United States has adopted this in great measure. It is like anything else, it will initially drive up the cost between 8% and 12%. Most said that it was closer to 9.5%.

However, once the pharmaceutical companies see that there is a will of Parliament to move in this direction, many pharmaceutical companies can move on this very quickly. Like anything else, as more and more come on board, as we have heard, and I have talked to many of them, the price of this will again go down.

The member's other question was whether it would change the formulation of the drug. If the pill is changed so it cannot be crushed, will it still solve the pain people experience? The pharmaceutical companies assure us that pain relief and the active ingredient in the prescribed drug would remain constant and strong, but it could not be abused to degree it is now.

Controlled Drugs and Substances ActPrivate Members' Business

6:55 p.m.

Brampton West Ontario

Liberal

Kamal Khera LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, before I begin my remarks on this piece of legislation, I would first like to take a moment to discuss the current crisis that is facing our nation.

Across this country we are facing a national emergency that has cost lives. This tragedy is something that I think all members agree is completely unacceptable and one that we need resources and initiatives to address.

Earlier today the Minister of Health, along with the Minister of Public Safety and the Parliamentary Secretary to the Minister of Justice , met with the premier of British Columbia and her cabinet colleagues to discuss the crisis in British Columbia. The province's delegation provided parliamentarians and Canadians with a glimpse of the real human impact of this crisis. This meeting built on a trip that the Minister of Health made to Vancouver last week where she met with local first responders, the mayor, provincial ministers, and the provincial task force addressing the crisis.

How we go about addressing this crisis is incredibly important. We do not want to create potential harm or unintended effects with well-intentioned ideas. This is why any action that the federal government takes must be based on sound evidence. With this thought in mind, I would like to speak to Bill C-307, an act to amend the Controlled Drugs and Substances Act, tamper resistance and abuse deterrence.

Insofar as the intention behind the bill is to address the opioid crisis, I share the member's concerns. The minister, I, and our government commend the member for wanting to work to address this crisis; however, while I appreciate my hon. colleague speaking about this, unfortunately our government cannot support Bill C-307.

As a brief reminder to members, in the case of pills intended to be swallowed, tamper-resistant properties could, for example, make them more difficult to be crushed or dissolved. If tamper-resistant regulations were put in place, it would mean that only tamper-resistant versions of certain drugs or classes of drugs could be sold in Canada.

I would like to make the point that we strongly support tamper-resistant products and continue to encourage pharmaceutical companies to continue to make progress and invest in this technology. We also know that any strategy to address opioids needs to be comprehensive and that there is no silver bullet to address this issue.

Our government acknowledges that making tamper-resistant products mandatory has an intuitive appeal. However, Health Canada's review of the evidence concluded that the introduction of tamper-resistant versions of one drug does not reduce the overall harm of opioid misuse. This is a concern that was also echoed by many witnesses studying the opioid crisis who appeared before the Standing Committee on Health.

These conclusions came about due to a number of factors, and the minister's decision not to move forward with these regulations at this time was not taken lightly.

I should make the point here that the minister already has the ability to do what this legislation intends, under regulation, and at this time the risks outweighs the benefits. Regardless of this legislation, if evidence changes, the Minister of Health will already have the ability to take regulatory action.

However, the evidence today points to several things that do not make it possible to support the bill. First, tamper-resistance has not been shown to prevent the most common form of misuse, which is swallowing intact tablets. Second, the small number of individuals who choose to crush or dissolve a drug are more likely to switch to non-tamper-resistant drugs, including illicit drugs, than to stop misusing drugs altogether. This is also known as the balloon effect. These people may even be at increased risk of harm or death if they switch to using street drugs such as heroin or illegal fentanyl.

Beyond the minimal impact that requiring tamper-resistance would have on opioid misuse, such regulations could also negatively impact patients who legitimately need access to these drugs. I would also stress that mandatory tamper-resistant formulations primarily benefit the patent-holder. New tamper-resistant formulations can be patented and sold at substantially higher costs than their generic equivalents. Passing regulations requiring pharmaceutical companies to only produce tamper-resistant forms of their products would increase the cost to patients and provincial governments, which in many cases pay for their prescription drugs.

These extra costs are estimated to run into millions of dollars if only one drug, OxyContin, is legally required to be tamper resistant. Therefore, the minimal potential benefits simply do not outweigh the risks and the costs.

I would also like to note that tamper-resistance technology is not sufficiently developed to cover the entire class of opioids, some of which come in the forms of patches, sprays, or injectable liquids.

As members can see, it simply is not in the public interest to move forward with regulations requiring drugs to have tamper-resistant properties.

This is not to say that Health Canada is not supportive of drug companies voluntarily including tamper-resistant features in their products. That is why Health Canada released a guidance document for all opioid manufacturers that will help guide them in making their products tamper resistant, should they desire to do so.

As I said earlier, over the next two days, the Minister of Health will be hosting a summit on opioids to bring together experts, patient groups, governments, and regulators to discuss the current crisis and identify actions for moving forward, building on our five-point plan announced earlier this year.

Other actions to save lives have also been taken. We are switching the status of naloxone and improving a user-friendly nasal spray version of naloxone following an expedited review. We will also be proposing a variety of regulatory changes, including requiring both a prescription for low-dose codeine products and new warning stickers to be placed on dispensed opioids. We will be approving properly established, managed, and community-led supervised consumption sites. We will be proposing regulations to control the precursors of fentanyl. We will be allowing physicians of certain patients to apply for special access to heroin-assisted treatment under the special access program. Also we will be supporting the private member's bill, Bill C-224, the good Samaritan drug overdose act, proposed by the member for Coquitlam—Port Coquitlam, a bill that would save lives, as Bill C-224 would encourage people witnessing an overdose to call 911 by providing immunity from minor drug possession charges.

In conclusion, I would like to once again reiterate our government's support of any measures grounded in sound evidence that would help address this troubling public health crisis, and once again, I want to thank the hon. colleague for raising this issue.

As previously stated, if forthcoming evidence demonstrates that there would be a positive net benefit impact from requiring drugs to be tamper resistant, there are already existing authorities within the Controlled Drugs and Substances Act to move forward with regulations.

Controlled Drugs and Substances ActPrivate Members' Business

7:05 p.m.

NDP

Christine Moore NDP Abitibi—Témiscamingue, QC

I am pleased to rise, Mr. Speaker, especially after the two hon. members who spoke before me.

In my question to the Conservative member who is the sponsor of the bill, I raised some of the concerns I have with this bill. However, I will support it since the change to the regulations allows Health Canada to require drugs to be resistant to tampering and abuse. This is not mandatory, but Health Canada can opt for this requirement. It is not mandatory if the effectiveness of the drug is not proven or if there is a concern that it will drive up the cost too much. However, this bill gives Health Canada the option and that is why I will support it.

The bill introduced by my colleague seeks to respond to the problem of substance abuse, mainly fentanyl, a very powerful substance compared to other drugs in the same family. Other opioid analgesics have been on the market for a long time and are generally used more than fentanyl.

As many of my colleagues know, I was a nurse. In the vast majority of cases, when doctors prescribe drugs to people at home, they prescribe Dilaudid, which is hydromorphone, or morphine, which has been in use for a long time. Fentanyl is rarely prescribed to people living at home. It is mainly used right in the hospital and is rarely prescribed elsewhere. It is typically administered by injection in a hospital setting or by skin patch for patients with cancer or terminal illness.

Other opioids are used too. One of these is Demerol, or meperidine, which has been around for a long time, but is not used much because of its serious side effects. Another is oxycodone, which has also been associated with overdose and addiction, and codeine, a medium-strength opioid typically used to treat more moderate pain that is not severe enough for morphine.

Most of the people who are prescribed a drug go home with hydromorphone or morphine, generic versions of which are available for the reasonable price of about 40¢ to 50¢ per pill.

Long-acting tablets, on the other hand, can be much more expensive. For instance, tamper-resistant medication can easily cost between $10 and $20 per tablet. Forcing people to use these products could have a serious impact, given that they are much more costly. In addition, these products are often under patent protection, because the fact is, pharmaceutical companies work very hard to develop these drugs.

The most common form of tampering is crushing the drug in order to snort it or inject it. In most cases, patients with a legal prescription are not the ones doing these things, but rather people who steal the drug from patients they know. For instance, some people might raid their grandmother's medicine cabinet to see what they can get. Sadly, these people will steal from their friends and family.

Some measures could be introduced in terms of prescription practices, for instance, and the services offered by pharmacists. It could be a question of giving patients smaller amounts of medication. Perhaps they could be given a week's worth at a time, rather than a month. We need to find ways to ensure that smaller quantities of drugs are found in peoples' homes. This would also mean that patients would be less likely to be robbed.

We also need to educate patients about this phenomenon. They could be told not to keep their medication in plain view, for example, on the kitchen table where everyone can see it. We could try these kinds of measures.

As for skin patches, I have heard stories of people using syringes to pull out the liquid from inside fentanyl patches. It is extremely dangerous. With these kinds of practices, an overdose is almost guaranteed. That is another serious danger.

It is entirely appropriate to want drugs with tamper-resistant properties. My only fear is the higher cost for patients, especially when we are talking about terminally ill cancer patients. They should not find themselves in situations where they can no longer pay for their medications.

We could also work on doctors' prescribing habits. People could be prescribed drugs that are less likely to be stolen. For example, I believe that oxycodone should be used as a last resort when prescribing opioids. The use of this drug should be limited.

Clearly, there needs to be some soul searching if injectable drugs are being used at home, unless they are required for home palliative care, which usually does not last very long. We should perhaps limit as much as possible the use of pills at home. We could ensure that pharmacies only dispense small quantities to avoid having large quantities in people's homes and to prevent others from being tempted to take the medications after the patient's death.

We could also be more proactive when a patient dies. The pharmacy could request that the medication be returned so that it is not left in the home. That could prevent someone from searching and finding these drugs. There are several modest measures that we could put in place.

There are drugs, in pill form, that are available for a reasonable price and that limit problems. For example, there is long-acting morphine. Inside those capsules are tiny beads that are almost impossible to crush. Therefore, people cannot snort or try to inject them. This type of pill is sold at a fairly reasonable price compared to the tamper-resistant forms that can be used.

We can put several measures in place. I think that it would be worthwhile to move more and more toward tamper-resistant forms, particularly for molecules that are especially likely to be used by addicts and in cases where the molecules are already patented in their other form so to speak.

However, we must also not make it harder for patients to access medication. I think that my colleague's bill is balanced because it allows Health Canada to take action, but does not require it to do so. Health Canada would therefore have the freedom to determine whether the risks outweigh the benefits. It will have the flexibility to proceed if necessary. I believe that this approach is well balanced because it is cautious enough to provide some flexibility, which will ensure that patients are not deprived of treatment.

We must also give ourselves the means to act in the event that the benefits outweigh the risks.

I thank the House. I was pleased to be able to speak to this issue.

Controlled Drugs and Substances ActPrivate Members' Business

November 17th, 2016 / 7:15 p.m.

Conservative

Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC

Mr. Speaker, I am truly honoured to stand today and talk about Bill C-307. I want to thank the member for Battle River—Crowfoot for allowing me to second this bill, for supporting me in terms of the debate, and for bringing forward this incredibly important issue. He did an excellent job talking about what the bill is about, what it will do, and why he has moved it forward. However, I will talk about a few areas that I do not think have been covered yet in this debate.

We have a record. Often when we hear we are number one or number two, it is something that we are very proud of. However, we are not and should not be proud of this particular record. Canada and the U.S. are the world's heaviest opioid users, with the rate of overdoses and deaths increasing dramatically. In 10 months in British Columbia alone we had 622 deaths. I wrote these notes yesterday. I had to revise that. It is now 623. This is in British Columbia alone. Of those, 322 have been related to fentanyl. Over 2,000 naloxone kits have been handed out, which is the antidote. Therefore, there were 2,000 potential overdoses and death might have been prevented with the use of the naloxone kits.

Back in September, I spoke in favour of the member for Coquitlam—Port Coquitlam's bill, Bill C-224, the good Samaritan drug overdose act. At that time, I talked about a young man and his wife I knew. They had both died from an overdose, leaving behind a young baby. However, I want to give another face to this crisis. I think it is important to give faces to the crisis and that it is important for the government to hear this if there is any way that it will help. I will talk about some of the evidence later, but I hope the bill will at least go to committee to get the most up-to-date evidence and to really have it looked at.

There was a young man who lived in Kamloops named Paul. I knew Paul as a very young boy. He had the cutest little smile, and he was a hockey player. I watched him grow up from someone who tottered around on skates to someone who was very skilled in the arena. He was a very fine young man. I saw Paul in September. I was at a golf tournament. I had not seen him for a long time, and I chatted with him for a while. I asked him what he was up to. He had graduated from university, he had a job with the Investors Group, he had a girlfriend, he was smiling, he was happy, and he seemed to have the world by the tail. That was in September. In October of this year there was a wedding. Paul was a groomsman at this wedding and did his duties for the day. Then he made a fatal error. He kissed his mom, and he and four friends went upstairs to the hotel room and decided to ingest some drugs. That was a fatal mistake, a silly mistake, and the wrong thing to do. The groom noticed that his friends were missing and decided to go and find out what had happened to them. He went upstairs and five of them had overdosed on fentanyl. They were unconscious. What had been a joyous occasion ended in panic, mayhem, and tragedy. There were four who lived after being given the antidote naloxone. However, Paul's mom and dad had to come and say goodbye to him. This is our neighbour.

Today, we have the premier of British Columbia, we have the health minister here, and we have this conference happening. They have said that we are the face, the whole face, of this tragedy—and people need to recognize it is a tragedy. If it has not impacted members yet, we can only hope that it does not, because in the community where I am there is Ryan's mother, there is Jordan's mother, there are way too many who have tragically made a mistake that has ended in tragedy.

I do recognize that Bill C-307 is just one tool. We have talked about its tamper resistance and abuse deterrence. It is strictly one tool in the tool box, but it is a tool that could make a difference.

We have to have many strategies and I noted that one of the questions from the Liberals was about the importance of an overall strategy. Absolutely, we need an overall strategy, and I hope the conference over the next two days will get us to a better place with an overall strategy.

However, I want to point out that it did not stop the Liberals from moving forward with Bill C-224, which they recognized made sense. Again, I would suggest that it should not stop them from moving forward with Bill C-307 or at least taking it to the next step. We moved forward on naloxone, in terms of the nasal spray. We have moved forward in many ways. Just because there is a need for a comprehensive strategy does not mean that we should not move forward with this particular bill.

I heard the Parliamentary Secretary to the Minister of Health talk about the evidence and the balloon effect. To be quite frank, the evidence is actually contradictory. She talked about the worry about a balloon effect, but she did not cite references. I will follow up to see what her sources were.

The New England Journal of Medicine, which is a very respected publication, had a study where the new formulation decreased abuse from 35% down to 12.8%. That is one piece of evidence that needs to be taken into account.

A lot of work has happened in Australia, which has shown a significant decrease. The study focused on 606 people who had regularly misused opioids and due to the tamper-resistant and abuse-deterrent formulation, there was a significant decrease in the misuse, without the balloon effect that Liberals talked about as their reason for not supporting this legislation. The balloon effect was not there. There was not a shift, in this particular study, to using other drugs. There are a number of studies that have shown that is not an issue.

There was another study done by the National Drug and Alcohol Research Centre at the University of New South Wales. Opioids were used 3,500 to 4,000 times a month and once they established the tamper-resistant and abuse-deterrent formulation, it went down to 500 in terms of usage.

What I would tell the Liberals is this is such an important issue and they need to look at this very carefully. They need to vote for it, at least at second reading, because when it gets to committee, they will be able to review the evidence. When the Americans made their decision, they had a lot of evidence and moved forward. The previous minister of health for the Province of Ontario regularly asked for Canada to move forward with this.

We would be missing an opportunity to review the latest evidence. Concerns have been expressed around pricing. Again, things have changed over the last couple of years. As a result of studies done by the House of Commons and the Senate, they recommended we move forward. Those studies are a couple of years old now, so it would give us the chance to review this in light of new evidence.

To sum up, this is not the be-all and end-all and I am hoping the conference tomorrow and much of the other work will help us at least get a handle on this. The tamper-resistant and abuse-deterrent formulation has a very important role to play and we should not miss this opportunity. This is for Jordan, Hardy, and Ryan. Today the premier, with one of the mothers, laid out 54 pictures for the minister to see. These are 54 of the 600-plus who have died in British Columbia in the last few years, deaths that can be prevented.

I support this bill. Let us check the research and evidence and send it to committee to see where we are at.

Controlled Drugs and Substances ActPrivate Members' Business

7:25 p.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Before we resume debate with the parliamentary secretary to the government House leader, I will let him know that there are only about seven minutes remaining in the time allocated for private members' business this afternoon. Of course, he will have his remaining time when the House resumes debate on the question.

Resuming debate, the hon. parliamentary secretary to the government House leader.

Controlled Drugs and Substances ActPrivate Members' Business

7:25 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Mr. Speaker, I believe that my colleague was going to be replacing me. I had the good fortune of being able to ask a question. People are aware of my thoughts on this, and I will let my colleague continue.

Controlled Drugs and Substances ActPrivate Members' Business

7:25 p.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

I thank the hon. parliamentary secretary. I did happen to notice in my peripheral vision that the hon. member for Pierrefonds—Dollard was on his feet. My apologies for not having that cued up.

I believe he heard the same instruction. There are about six or seven minutes.

Controlled Drugs and Substances ActPrivate Members' Business

7:25 p.m.

Liberal

Frank Baylis Liberal Pierrefonds—Dollard, QC

Mr. Speaker, opioids are an important issue.

I personally happen to know a lot about the bill, because prior to becoming a politician, I had a medical device company, and we spent a lot of time developing pain management products and pain management devices. Many times people confuse devices with pharmaceuticals. I did not do pharmaceuticals. I did devices.

In that light, I had the opportunity to travel around the world to meet pain management specialists from many countries and understand the challenges faced by people who suffer from pain. What we strove to do was give people an alternative to opioids. Specifically, when it comes to palliative care issues, there could be opioid problems where someone is going to die. This happens a lot with some types of bone cancer, for example. It can be excruciatingly painful in the last six months, and people are then in a position of spending their lives drugged up, or they could be offered alternative tools. This is something that, as electrical engineers specializing in biomedical products, we worked to develop. I am happy to say that we were very successful around the world offering people alternatives to opioids.

The danger of becoming addicted to opioids is very real, and we should be, and we are, searching for solutions. As we speak, tomorrow and the next day our minister is having meetings with stakeholders.

What often happens with these issues is that we think there is a simple solution, and it does look simple at first glance, but there are challenges. My concern is moving forward without hearing the stakeholders, without hearing from the other ministers of health, without hearing from the physicians I know, the experts, and people working with the United Nations to make pain management a universal right, the right to avoid pain. There is a lot of work being done in this area and it warrants listening to those experts before we undertake any bill.

I do not criticize the idea. In fact, the overall objective is a good one, and it is one our government takes extremely seriously: How do we help people not become addicted? If we are going to take action to stop certain people from becoming addicted, we need to make sure that we do not inadvertently push up the price or take off the market or make it difficult for people who need them to get access to these medicines. This is an important and dangerous challenge if not done right.

Addiction is a disease, and that should be understood. Many times we tend to think of the person who is addicted as being weak-willed or not having strong character, and that is incorrect. It is an addiction, and it is a problem. I stand here lucky enough not to suffer from pain, so I do not feel I am in any position to ever criticize people who inadvertently become addicted because they have been in chronic pain for a long time. I have seen that. I have had people who have undergone procedures with devices I have made and designed tell me how it has changed their lives to not live in pain.

I say that to let people know that never should we criticize a person who becomes addicted to opioids. By the same token, when we take action to help them, we need to make sure that those actions are going to give us the results we want. In life, unfortunately, we have the law of unintended consequences. We set out to do something and inadvertently cause another problem. This is why, on such an important issue, I believe that our Minister of Health is taking the proper holistic approach. I believe it is right to hear from all these experts to understand which medications are more likely to lead to addiction and which ones are not. What are the dangers involved? What type of approaches, technological and psychological, should be taken? Sometimes we tend to think that the answer is always technology. That is not always the case. Sometimes it is a combination of many things.

I strongly suggest that we take the time to take this holistic approach. We listen to the experts from government. We listen to the experts from the medical field. We understand the challenges, and we move forward with a comprehensive approach while ensuring that we are monitoring the situation so we do not inadvertently cause a problem that we then try to backpedal on. Unfortunately, with addiction, if we do it wrong, we might condemn more people to all sorts of problems. We might make more addicts. We might have all kinds of issues that come from that, so we need to be extremely careful as we move forward on this issue.

For this reason, I agree with our government that this bill in its present form at this time is not ready to be supported. I do not say that it is a bad idea. I actually encourage the member for the thought process, and it is wonderful that we are talking about it. However, I want to move forward intelligently and very carefully. When we are talking about someone's health, if we get it wrong, there are serious consequences.

We stand here in the House of Commons many times and talk about this and that and joke around at times. Sometimes we insult and taunt each other. I do not agree with any of that, and I do not get into it. When we talk about bills of this nature that would actually impact someone's life, I always tell people that the person could be my mother, could be their brother, or could be someone's son or daughter. If we are cavalier about these things and we get it wrong, there are real consequences from these types of medical bills.

For this reason, I am always going to err on the side of caution and going forward intelligently and safely, because getting it wrong, I have seen. I have been in cases where patients have died from errors. This happens. We do not like to think about it. We do not like to believe it. It happens. Doctors, nurses, and patients are all human beings. They do not always get it right. In this instance, not getting it right can mean, in the worst case, death. It does happen. I have been there. I have seen it.

I strongly suggest, as we look to move forward, that we talk to everyone. Even when we do all that, it does not guarantee that we will get it right, but it would tell us that we did everything possible to get it right. That is all we can do in the end. We cannot do more than that. On these important issues, we can take the politics out of it. We can say that this is too important to play games. We play games in a lot of things, but in matters such as this, where it would impact people's lives, we take that responsibility as parliamentarians and representatives of our country extremely seriously.

That is why I am strongly suggesting that we go through the proper process and hear the experts. This is no guarantee that we will get it right, but we will have done everything possible to have done so.