Minister of Health
moved that Bill C-37, an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts, be read the third time and passed.
Mr. Speaker, it gives me great pleasure to rise on the third reading of Bill C-37. I am particularly gratified at the speed with which the bill has moved through the House of Commons. I want to thank all members, including all parties, who have been very helpful in agreeing to time allocation, agreeing to expediting the committee process, and the fantastic work at the committee level to move the bill along. This demonstrates the serious nature of the bill, and recognizes the ongoing opioid crisis and the need for urgent action.
Bill C-37 is one of a range of comprehensive responses to this very challenging issue. We are eager to advance the bill through Parliament to help protect the health and safety of Canadians and their communities.
It has been said before in the House that problematic substance use is an issue that affects Canadians of all ages. It affects people from all socio-economic groups. We should also point out that there are, however, particular groups that are excessively vulnerable to the risks associated with problematic substance use, people living in poverty, people who have experienced trauma in their lives, and indigenous peoples of Canada.
We are facing nothing short of the greatest drug crisis our country has faced. It is a national public health crisis related to opioids. For example, one may draw attention to the fact that in British Columbia last year more than 900 people died from overdoses. That was an 80% increase over 2015. The majority of those deaths were related to the rapid spread of the drug fentanyl.
Elsewhere in Canada, we are hearing from law enforce officials that there are increasing numbers of seizures of fentanyl and carfentanil.
Last week, we heard about the distressing number of deaths linked to opioids in Alberta. For example, in 2016, 343 people died in Alberta from fentanyl overdoses. That was an increase over 257 the previous year.
It is necessary that the Government of Canada use every single tool at our disposal to help turn the tide on this crisis. We need a policy approach that is comprehensive, collaborative, compassionate, and evidence-based.
Bill C-37 would further strengthen our government's response to the opioid crisis.
Lest there be any doubt that we are pulling out all the stops to respond to this crisis, let me review what we have done over the past year. It includes things like ensuring naloxone, which is the antidote to overdose, is available on a non-prescription basis across the country. That involved me ensuring that we had naloxone nasal spray available on an emergency order so it would be available to Canadians, and expediting the approval of naloxone nasal spray.
We also launched Health Canada's opioid action plan. This is a plan to improve access to education for both the public, as well as prescribers, to ensure that we support better treatment options, that we reduce access to unnecessary opioids, and that we expand the evidence base.
In the matter of expanding the evidence base and getting better data, we supported McMaster University to produce guidelines for prescribing opioids in situations of chronic pain. Those new guidelines are now available for consultation.
We overturned a ban on prescription heroin so doctors might use it through Health Canada's special access programs to treat the most severe cases of addiction.
We have supported the good Samaritan drug overdose act, which offers immunity against charges for simple possession for individuals so they will call 911 if they witness an overdose and they will stay at the scene to help.
We have also put in place a number of regulations to schedule fentanyl precursors for controlled substances, making it harder for illicit substances to be manufactured in Canada.
I co-hosted, along with the minister of health for Ontario, the opioid conference and summit. At that summit, we had nine provincial and territorial health ministers. We also had 30 other organizations. We produced a joint statement of action that had 128 commitments.
In addition, in collaboration with the provinces and territories, we have put together a special advisory committee that includes the Council of Chief Medical Officers of Health. This committee is very active at ensuring we have better access to data that is up to date about the state of the circumstances.
We also have a task force within the federal health portfolio to work with all federal departments in a comprehensive response to the crisis.
We funded the Canadian research initiative on substance misuse. It is providing now evidence-based guidelines for medication-assisted treatment.
In December, I joined the Minister of Public Safety and Emergency Preparedness in introducing Canada's new drugs and substances strategy. We reintroduced at that time harm reduction as a key pillar in drug policy.
I would like to talk now a bit about what we have done to support the establishment of supervised consumption sites. Early on, we granted an exemption to the Dr. Peter Centre in Vancouver to operate a facility, and we provided an unprecedented four year exemption to Insite to continue the good work it was doing.
For communities that have demonstrated a need and desire to have such a site in their community, we want to create an environment that will encourage applicants to come forward. That is why, pending passage of the bill, we have adjusted operational procedures in the interests of removing unnecessary barriers to the review and approval of supervised consumption sites.
Just last week, I was very pleased that we were able to issue exemptions for three new supervised consumption sites at fixed locations in Montreal. The time frame to approve these sites was unacceptable. It took a year and a half, and that was due to the onerous 26 criteria that existed under the previous legislation. However, finally we were able to get an exemption for them. These new sites, located in Hochelaga, Maisonneuve and Ville-Marie districts and operated by the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, will be able to provide care for people in those areas.
Health Canada has expedited a review of 10 pending requests for approval in other communities. There is an additional site in Montreal, three sites in Toronto, two in Vancouver, two in Surrey, one in Ottawa and one in Victoria.
Even while doing this, we have maintained the key essential criteria to ensure we protect the health and safety of staff, people who use drugs, and the neighbours who are in the areas of the proposed sites. We are working with all applicants to ensure that those applications are complete and that the department has received the necessary information.
Passing Bill C-37 will be so helpful to streamline the application process and it will be a big step forward for these communities.
Some have wondered why we have not declared a public health emergency. What I have said for months is that clearly we are in the midst of a national public health crisis of unprecedented proportions related to a growing number of opioid overdose deaths. However, the Federal Emergencies Act, which was formerly called the War Measures Act, is a tool of last resort. It is there to ensure public safety and security when a national emergency cannot be addressed by any other law. This act was not used in the case of SARS, H1N1 or Ebola. It is not the right instrument, but as I have already noted, we will make use of every tool at our disposal. We have already taken extraordinary steps at the federal level, and Bill C-37 is another essential step.
Bill C-37 needs to be passed without delay. This is not a political matter or an ideological matter; it is a matter of saving lives.
With the current growing rates of opioid overdoses and deaths, we have recognized there are gaps and weaknesses in the current federal legislative framework as it relates to controlled substances. To address those under Bill C-37, we will provide the government with the ability to more easily support the establishment of supervised consumption sites, a key measure in harm reduction.
We will also address the illegal supply, production and distribution of drugs. We will reduce the risk of diversion of controlled substances that are used for legitimate purposes to the illegal market by providing improved compliance and enforcement tools.
Bill C-37 would simplify and streamline the application process for communities that want and need supervised consumption sites. It would replace the 26 application criteria with the five factors that were identified by the Supreme Court in its 2011 decision regarding Insite.
It is important for all members to understand that Bill C-37 retains the need for community consultation, and it also adds increased transparency, making it a requirement for the Minister of Health to make public decisions on applications, including any reasons for denial.
To support these proposed changes, Health Canada will post information online about what is required in applications, how the process works, and the status of applications.
Supervised consumption sites are an essential part of a harm reduction measure. There is a vast abundance of international and Canadian evidence that shows that when they are properly established and maintained, they save lives and improve health without increasing drug use or crime in surrounding areas, they prevent infection, and, best of all, they provide a safe, non-stigmatizing, non-judgmental way for people to be introduced to the health care system.
Harm reduction measures in Bill C-37 complement a number of other actions that the government is taking to protect community safety. For example, the RCMP is working with the Chinese ministry of public safety to combat the flow of illicit fentanyl and other opioids into Canada.
Bill C-37 is proposing to prohibit the unregistered importation of pill presses and encapsulators, which would make it more difficult to produce illicit drugs and, in turn, keep these illicitly produced opioids and other substances off our streets. Bill C-37 would also give border services officers greater flexibility to inspect suspicious incoming international mail. As has been said before, just a standard-sized envelope can contain enough fentanyl to cause thousands of overdoses.
Before I conclude, I want to say a few words about treatment. It is absolutely essential to understand that we will not turn this crisis around by harm reduction alone. People need to have access to the broadest range of treatment options. Delivery of health services, including the treatment of addictions, falls largely under provincial and territorial jurisdiction. That is why I am very pleased to say that this fiscal year the federal government is transferring $36 billion to the provinces and territories to support the delivery of care. With the support of the Prime Minister, we identified new funding for the provinces and territories, in the order of $5 billion for mental health over the next decade, which will help people facing mental illness, including addiction.
We need to address the social drivers of the opioid overdose crisis. That includes things like poverty, social isolation, unresolved trauma, sexual abuse, and mental illness. It is widely understood that untreated mental illness is a common cause of addiction and early intervention is absolutely essential if we are going to counter such addiction.
I want to emphasize in the House that we need to include all four pillars in our Canadian drugs policy: prevention, treatment, harm reduction, and law enforcement. Prevention is so essential, as we understand that issues like social equity are absolutely important, cultural continuity, people having the opportunity to have healthy and safe childhoods, and making sure people heal from any unresolved trauma and grief in their lives, which might drive them to problematic substance use.
There is no single action that, on its own, is going to end this opioid crisis immediately, but Bill C-37 is an absolutely essential step in the process of moving to that end. We need a balanced approach. We need to work collaboratively with all other levels of government and civil society organizations. All Canadians need to work together. We need to have partnerships across the country, including, as I said, with provinces, territories, and municipalities that are very much engaged on this matter and, of course, indigenous leaders. We need to protect Canadians, to save lives, to address the root causes of this crisis, to give people hope, and to make sure that all matters are addressed in order to turn the tide of the opioid overdose crisis.
I encourage all hon. members to recognize the importance of this bill and to support its speedy passage through the House. I look forward to working with all members to that end.