Mr. Speaker, I rise to speak to private member's Bill C-307, an act to amend the Controlled Drugs and Substances Act. However, before I address the issues, it is a very special day for me. My son, Alexander Oliver, and his very good friend, Tiana Prince, have joined me in Ottawa. It is great to have them in our capital city with me for a few days.
The intent of Bill C-307 is to enable the federal Minister of Health to require prescription medicine, specifically opioids, to have abuse-deterrent formulations or tamper-proof, tamper-resistant properties. By doing so, it will make these drugs more difficult to crush, snort, or inject, reduce their potential for misuse, abuse, and diversion to our streets.
I strongly agree with the sponsor of the bill when he said that this issue was about public health, about saving lives and doing the right thing. Canadians are the second-highest consumers of prescription opioids in the world. Fifteen per cent of Canadians aged 15 years and older report using prescription opioids in 2013. It is estimated that about 10% of patients prescribed opioids for chronic pain become addicted. Furthermore, the increased availability of prescription opioids in households has meant that Canadian youth have begun using them for recreational purposes. Six per cent of youth aged 15 to 19 years indicated they abused opioid pain relievers in the past year.
These trends result in significant harms. In Ontario, one in eight deaths of individuals aged 25 to 34 years was found to be opiate-related in 2010. Similarly, there has been a substantial increase in the number of opioid-related deaths in Quebec, reaching almost three deaths per 100,000 persons in 2012.
The response to the crisis by the government has been rapid, and I am pleased to see an evidence-based, health centric focus on harm reduction return to our health policy and legislation.
The Minister of Health has already responded to the crisis through a five-point action plan that includes better informing Canadians about the risks of opioids; supporting better prescribing practices; reducing easy access to unnecessary opioids; supporting better treatment options for patients; and improving the evidence base and data collection. The minister also convened a two-day pan-Canadian conference on opioid abuse in November 2016, which generated many of the changes that were introduced to the House in Bill C-37.
Further, the Standing Committee on Health, which I am proud to be a member of, issued a comprehensive report and recommendations on the opioid crisis on December 12, 2016. In the committee study, the issue of tamper-resistant technologies did not emerge as a preventive strategy. During the course of its study, the committee held five meetings, in which it heard from a range of stakeholders, including federal and provincial government representatives, health care professionals, addiction experts, emergency front-line responders, representatives of first nations communities, and individuals with lived experience in substance abuse and addiction. These witnesses outlined specific ways to address the opioid crisis and implored the committee to make recommendations that would lead to concrete action.
The 38 recommendations focused on harm reduction; prevention, including training for physicians in prescribing practices and public education; treatment, including addiction treatment and improved access to mental health services; and law enforcement and border security changes. Tamper-resistance formulations were never documented in witness testimonies as an effective strategy.
Let me expand on this point.
One of the debate points over the proposed change to the law in Bill C-307 is about whether an explicit legislative authority is needed to require certain drugs to have tamper-resistant formulations. The government's position is that the current regulation-making authorities under the Controlled Drugs and Substances Act are sufficient already to develop regulations should the evidence demonstrate a need for them in the future. From this point of view, Bill C-307 is unnecessary.
Further, nothing in Bill C-307 would speed up that regulation-making process. The sponsor of Bill C-307 outlined many tamper-resistance technologies currently under development. The government strongly supports opioid manufacturers who wish to take proactive measures to make their medications harder to abuse. That is why it recently published guidance to drug manufacturers on what evidence was required to demonstrate tamper-resistant properties for prescription drugs.
It is also clearly the sponsor's view that the technology has been sufficiently developed in the area of tamper resistance and there is enough real-life evidence of positive outcomes to move forward with regulations. I would disagree.
First, tamper resistance has not been shown to reduce the rate of addiction, overdose, and death related to opioid misuse. Remember, a tamper-resistant opioid is still an opioid. Based on current evidence it is no less dangerous and no less addictive. Data from the United States and Ontario shows that opioid-related deaths continued to increase even after the introduction of reformulated OxyContin to the market. Further, as I stated earlier, this strategy was not recommended by the many experts from whom the health committee heard testimony.
Second, only a small number of people who misuse OxyContin pills crush them or dissolve them; most simply swallow them. Roughly a quarter of those who were misusing OxyContin before the tamper-resistant version was marketed continued to do so after its introduction. They did so by moving from inhaling or injecting the drug to, again, simply swallowing them. A sizeable population defeated the tamper-resistant properties, with information on how to do this available on the internet. Of course, those who misused by swallowing OxyContin continued to swallow reformulated OxyContin. Tamper resistance does not mean tamper-proof.
Third, tamper-resistant 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.
Fourth, and perhaps most important to me, the introduction of tamper-resistant technology seems to only reduce the abuse of one type of drug in exchange for another. The most common response to the introduction of reformulated OxyContin in the United States was migration to other drugs, including heroin and fentanyl. In the case of tamper resistance, it can result in a substitution or balloon effect. Studies already have found that prescriptions for hydromorphone and fentanyl increased in Ontario after the province restricted access to OxyContin, suggesting a substitution effect could been happening in Canada already.
Members are, of course, all aware of the deadly impacts of the current surge in fentanyl-related overdose deaths in Canadians. Because of the high demand for this drug, organized crime groups began importing illegal fentanyl as analogs from China. These are then transformed into tablet forms in clandestine labs in Canada, using pill presses and disguised as other opioids, such as OxyContin. The unknown potency of illegal fentanyl and other synthetic opioids, coupled with the fact the users are often unaware that they are taking illegally manufactured pills, has resulted in a dramatic increase in illicit drug deaths in Canada.
British Columbia has become the epicentre of the crisis. The percentage of drug deaths involving fentanyl increased from 5% in 2012 to 60%. In 2016, with the involvement of fentanyl doubling the rates of drugs in the province, British Columbia experienced approximately 60 deaths a month by August 2016 from illicit drug use.
We do not want to make uninformed policy decisions that could increase the substitution of OxyContin to illegal fentanyl. The substitution effect can also lead to higher risks of administration, such as injection, which is associated with the spread of hepatitis and increased risk of overdose.
I want the residents of my riding of Oakville to be protected from the opioid crisis and illicit fentanyl distribution. I want all Canadians to be protected from misuse of opioids. I have been meeting to discuss addiction and prevention with key agencies in Oakville, including the medical officer of health, service providers at the Halton Alcohol Drug And Gambling Assessment Prevention and Treatment Services, ADAPT, and, most recently, with the Halton chief of police, Steve Tanner. Tamper-proof has not come up.
I applaud the sponsor of Bill C-307 for the attempt to help address this crisis, but for the reasons stated above, I do not believe the bill would change the government's ability to respond to the crisis. Nor do I believe evidence-based research supports the underlying position taken by the bill.
Finally, I do not think the bill would help the vulnerable and at-risk people in Oakville.
For these reasons, I will not be supporting Bill C-307.