House of Commons Hansard #158 of the 42nd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was report.

Topics

Bill C-307. Second reading

The House resumed from November 17, 2016 consideration of the motion that Bill C-307, An Act to amend the Controlled Drugs and Substances Act (tamper resistance and abuse deterrence), be read the second time and referred to a committee.

Controlled Drugs and Substances ActPrivate Members' Business

11:05 a.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Speaker, I rise today to speak to Bill C-307, an act to amend the Controlled Drugs and Substances Act (tamper resistance and abuse deterrence). This legislation proposes to allow the Minister of Health to implement regulations to restrict access to non-tamper-resistant controlled substances or classes of controlled substances. The bill also imposes an annual reporting requirement on the Minister of Health if no regulations are made “specifying controlled substances or classes of controlled substances that must have tamper-resistant properties or abuse-deterrent formulations”.

As we consider the bill, which is principally aimed at curbing prescription opioid abuse, it is important to remember how we arrived at the current overdose crisis, which has claimed an estimated 20,000 Canadian lives over the last 20 years.

For over two decades, opioids have been overused and over-prescribed by doctors for pain management and other causes, leading to many patients becoming dependent and addicted.

Canada has among the highest per capita volume of dispensed opioids in the world, totalling some 19.1 million in Canada in 2015 alone. That is up from 18.7 million the year before. This is about one opioid prescription written for every two Canadians last year.

Even though there are no credible peer-reviewed studies that demonstrate that opioids afford more benefit than harm for chronic pain, opioid use has been marketed beyond palliative care and cancer patients for regular use to people experiencing back pain and other common ailments.

Manufacturers, incorrectly, led prescribers to believe that addiction was a rare consequence of using prescription opioids long-term and that fewer than 1% of patients would become addicted. However, in reality, the addiction rate is estimated to be 10%, with 30% suffering from opioid use disorder.

In 2012, Purdue Pharma Canada, the manufacturer of the potent prescription opioid OxyContin, pulled OxyContin from the market and replaced it with OxyNEO, a tamper-resistant alternative that is difficult to powderize, snort, or inject. Purdue strongly supports changing legislative and regulatory regimes to mandate that over time the entire prescription opioid market be tamper-resistant.

Under the previous, Conservative government, Health Canada drafted regulations that would have compelled opioid manufacturers to make their oxycodone products, and eventually all opioids, tamper-resistant. However, the current Liberal government abandoned that plan in April 2016, on the basis that there is insufficient proof to back up claims that tamper-resistant formulations have positive policy benefits.

Health Canada concluded that requiring tamper resistance would not have the intended health and safety impact of reducing overall drug abuse. At the time, the Minister of Health told the Standing Committee on Health, “It would be wise if it worked, but the result is that the introduction of tamper-resistant products only serves to increase the use of other products on the market. You can't take a single approach to a drug.”

To be sure, independent expert opinion on tamper resistance ranges from the view that its application has very limited efficacy for addressing opioid abuse, to the view that tamper resistance is a counterproductive move aimed in part at extending the drug manufacturers' patent protections.

Testifying at the health committee's fall 2016 study of the opioid crisis, proposed by the New Democrats, Dr. Philip Emberley, director of professional affairs for the Canadian Pharmacists Association, said:

...we still see tamper-resistance as one solution, [but] not the only solution.... [T]here are some numbers out of the U.S. that say it has had some effect. However, we have to be very cautious of the unintended consequences, which may end up being even worse than what we were trying to prevent in the first place.

To understand these potential consequences, a U.S. study published in the academic journal JAMA Psychiatry looked at what happened in drug use patterns before and after tamper-resistant OxyContin came on the market. It found that abuse of OxyContin dropped significantly, from 45% to 26% of all users, but heroin use rose from 25% to 50% and effectively cancelled out any drop in OxyContin abuse. Many simply kept using OxyContin, and about one third of them found a way around the tamper-resistant formulation.

Another 43% were simply unable to crush the new, tamper-resistant pill, so they just swallowed it and got high anyway. Only 3% of those surveyed gave up the drug altogether when the new, tamper-resistant formulation came out.

Dr. Emberley's caution was reiterated at the health committee by one of Canada's leading drug safety experts, Dr. David Juurlink, who said this:

I think abuse-deterrent formulations are a good thing generally. You can crush them, and you can chew them, and you can get a much higher level in your blood than you would by taking them intact, but you can't powderize them, inject them, or snort them, but it is a mistake to think this is the way out of this problem. These products tend to materialize on the market as the patent on the original product expires, so a cynic might wonder if this is primarily a business decision.

The fact is that the primary route by which opioids are abused is oral. I know for a fact that physicians, when they hear about these abuse-deterrent formulations, think that these are somehow impervious to abuse. They are totally abusable. If you could snap your fingers and have them all be abuse deterred, great. It is not a major part of the solution to this problem, in my view.

At best, I could say that the impacts of tamper-resistant opioids are presently unclear. However, because New Democrats are unwilling to dismiss any potential tool to address the opioid crisis, we believe that this bill should be rigorously studied at the health committee, with extreme caution paid to the potential for unintended harm. Let me be clear. We will not hesitate to oppose this legislation if, based on the preponderance of evidence, we determine that tamper resistance is likely to be counterproductive.

Ultimately, New Democrats want a much more comprehensive response to the opioid crisis. Since last fall, our party has been calling on the federal government to declare opioid overdose a national public health emergency, because such a declaration would empower Canada's chief public health officer with the authority to open temporary clinics and supervised consumption sites on an emergency basis, and allocate emergency funding on the scale needed to comprehensively address the opioid crisis.

The Minister of Health has repeatedly dismissed our calls, on the basis that the federal government already has the ability to take these measures without an emergency declaration. However, here we are today, in April 2017, with no end in sight to the opioid crisis. The legislation to streamline supervised consumption site approvals remains stalled in the upper chamber, and budget 2017 fails to devote a single dollar in emergency funding to combat the crisis. Somewhat shockingly, budget 2017 also makes deep cuts to addictions treatment funding, when access to publicly funded programs is already appallingly insufficient across this country.

As the opioid crisis escalated in 2012, the Conservatives cut funding for addictions treatment by approximately 20%, allocating $150 million over five years. That is still $40 million more than the Liberals' entire allocation for the Canadian drugs and substances strategy just announced in the last budget. The Canadian drugs and substances strategy expands on the now defunct national anti-drug strategy's pillars of prevention, treatment, and enforcement to include harm reduction. In our view, that is a positive change, but it means a broader mandate with only 20% of the anti-drug strategy's funding.

With a federal reaction like this, one could be forgiven for believing that the opioid crisis is over. However, in my home city of Vancouver the crisis is getting worse by the day. Vancouver Fire and Rescue Services reported 162 overdose response calls for the week of March 20, a 56% increase from the previous week, when 104 calls were responded to. To date, in 2017, there have been 100 overdose deaths in Vancouver alone. There were 215 in all of 2016. If rates of overdose deaths continue at this pace, Vancouver could see nearly 400 deaths in 2017, double the number recorded in 2016.

In order to reverse this trend, the City of Vancouver is advocating for increased access to treatment-on-demand options. Apparently, this request has fallen on deaf ears at the federal level. Indeed, the Prime Minister seemed to acknowledge it last month when he visited Vancouver and pledged this: “It’s really important for all Canadians to consider that this is something we cannot continue to ignore, we cannot continue to stigmatize. We need to start addressing this as the real societal health problem it actually is.” However, as former U.S. Vice-President Joe Biden used to say, “Don’t tell me what you value. Show me your budget, and I’ll tell you what you value.”

Canadians do not need more empty words or broken promises from their federal government; they need real support to end the opioid crisis. I call on the Prime Minister to honour his word by taking emergency action to finally and fully address this immense human tragedy.

Controlled Drugs and Substances ActPrivate Members' Business

11:10 a.m.

Conservative

Rachael Harder Conservative Lethbridge, AB

Mr. Speaker, I am pleased to rise in the House today in support of Bill C-307 to give the Minister of Health the authority to require tamper-resistant forms of drugs that are being tampered with and then used for criminal use.

Canada is in the midst of a massive public health crisis related to opioids. Codeine, fentanyl, oxycodone, hydrocodone, and morphine have become household names, it seems, in the Canadian public, and of course this has a lot to do with the crisis at hand.

Whether it is diverted pharmaceuticals, fentanyl purchased over the Internet from China, or stolen horse tranquillizers, dangerous and lethal opioids are making their way onto the streets of Canada and the consequences are fatal.

The most alarming thing is how quickly opioids are growing, both in use and in the number of overdoses. To put things in perspective, the chief coroner of British Columbia told us at the health committee that illicit drug deaths involving fentanyl increased from 5% in 2012 to 60% in 2016.

This is not just a crisis that affects those who find themselves without a home. There are 55,000 Canadian high-school students who reported in September 2016 that they had abused some sort of opioid pain reliever in the past year.

In Ontario, in 2010, one in eight deaths of individuals aged 25 to 34 was found to be opioid-related. Families are being destroyed; lives are being lost; and all Canadians are experiencing reduced access to health and social services because of the resources required to look after this crisis.

For me, this public emergency hits close to home. Lethbridge is near the epicentre of this epidemic in Canada. Last fall, five men in my riding were arrested for possessing just over 1,000 fentanyl pills destined for the streets of Lethbridge. Several subsequent arrests resulted in police recovering hundreds more fentanyl-laced pills.

What has this meant for Lethbridge? Without being alarmist, we have seen organized crime in our city increase drastically, and the users of these drugs have made parts of Lethbridge no-go zones. There is a playground in my community where children used to enjoy playing regularly, and now it is known as "needle park". This is a place where children no longer play and parents no longer feel safe, because of the needles that are left on the ground.

Even for those not in direct proximity to drug dealers or opioid users, the effects of this epidemic are still felt. In Lethbridge, our first responders have all had to divert significant resources to address this crisis. This means that other crimes committed within our community are under-investigated or not investigated at all.

It also means that EMS responders are increasingly overworked as they respond to the spike in drug overdoses. It means that firefighters have to deal with increased risks when they respond to residential fires for fear that they could be dealing with a contaminated illicit drug lab or equipment thereof.

This is to say nothing of the increased burden on our social service agencies. Lethbridge has punched far above its weight when it comes to the Syrian refugees who have come into our community. This influx of refugees has stretched our resources to the max because of the lack of support from the Liberal government.

Many of these organizations have had to punch above their weight and are now starting to reach their breaking point. This is on top of the opioid crisis and the mental health crisis that results from the jobs crisis in Alberta.

My heart goes out to the mental health workers in my community for the remarkable work they are doing around the clock and the way they are trying to divert this issue. This crisis has a human face, as sons, daughters, husbands, wives, cousins, brothers, and sisters are all lost to lethal street drugs laced with these opioids. I recognize that the opioid crisis is multi-faceted, but Bill C-307 is one key step to cutting it off at the source.

Criminal enterprises have far too easy a time diverting legitimate pharmaceuticals to illicit street drugs. This is because the most common forms of opioid-based drugs are easily manipulated. Prescription pills can be ground down to snort, or the active opioid compounds can be extracted and used as a building block for different street drugs.

Tamper-resistant forms of these pharmaceuticals can take several forms to reduce the ability to manipulate and extract the drug. The physical properties of the pill can be used to make manipulation much more difficult, such as providing a drug that cannot be altered without neutralizing the opioid compounds, or a chemical can be included that counteracts the euphoric effect of the opioid if the drug is manipulated, either by grinding or by heating it, making the drug useless to street providers.

In June 2014, our previous Conservative government provided a notice of intent to industry. We announced that new regulations were coming that would require tamper-resistant formulations of specific controlled substances such as oxycodone. The intent of the former Conservative government was to reduce the diversion of opioids for illicit purposes to keep them off the streets. Sadly, the current government chose to overturn this decision, which has now had failed consequences on Canadians from coast to coast.

One youth who I had the chance to talk to in my riding took the opportunity to brag to me that he was taking his prescription drugs and selling them for $25 a pill. His chronic pain allows him lifetime access to these pills and it now serves as his main source of income.

Diverting these drugs to the illegal markets can be stopped. If we can stop this illicit secondary market for illegal pharmaceuticals, it will decrease one of the sources that make these street drugs so accessible.

I will be the first to admit that this is a complex issue and that this one change will not solve the entire problem. There are a whole host of changes required in order to stop opioids from ending up on our streets. Canada's physicians need to overhaul prescribing practices for opioids. Reducing the number of people with legal access to these drugs will also decrease the number of Canadians using illegal alternatives after their prescriptions end.

Furthermore, I am pleased to note that the government has taken a recommendation from Conservative members to now allow the Canada Border Services Agency to check packages smaller than 30 grams. This decision came out of a report that was written by health committee. The fact that this could not be done before allowed an unlimited supply of fentanyl to be mailed in small packages and enter our country so it could be sold on the street market.

I am also pleased the Liberals listened to health committee on the need to regulate pill press machines. These machines allow the toxic and deadly mishmash of chemicals in these street drugs to be pressed into professional-looking products that can easily be packaged and shipped. The new import controls on pill press machines is a good start, although more could be done.

Finally, we need to tackle the source of this problem at the root, which is the lack of treatment options for those who suffer from mental health problems. This makes them susceptible to using street drugs in the first place.

If the ongoing mental health crisis is allowed to continue in our city cores, on our reserves, and in our schools and universities, the drug crisis in our country will only continue to grow. The money in budget 2017 with regard to this issue is a good start, but a national strategy and further initiative is a must when it comes to mental health care in Canada.

Whether it is fentanyl, crystal meth, or the next street drug that is easily produced and cheap to buy, at the heart of all of these drug uses, this epidemic that we face, are people who are emotionally hurting. This is why the human face of this epidemic is so heartbreaking to acknowledge. These are vulnerable people who have chosen drugs because they do not have the support and necessary tools to take on life.

This is why I ask all members of the House to understand the further pain that opioids cause to Canadian families and to individuals. I ask members opposite to support this important legislation, Bill C-307.

Controlled Drugs and Substances ActPrivate Members' Business

11:20 a.m.

Liberal

John Oliver Liberal Oakville, ON

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.

Controlled Drugs and Substances ActPrivate Members' Business

11:30 a.m.

Conservative

Dave MacKenzie Conservative Oxford, ON

Mr. Speaker, I am pleased to participate in the debate on the private member's bill from my colleague, the member for Battle River—Crowfoot, Bill C-307. This is a bill to amend the Controlled Drugs and Substances Act and is intended to save lives.

The intent of this bill is to enable the federal minister of health to require specific controlled substances or class of controlled substances to have “abuse-deterrent formulations” and/or “tamper-resistant properties”. This will make these pharmaceutical substances more difficult to abuse.

Bill C-307 will make it possible for Canada's health minister to take immediate action whenever Canadians are being hurt or killed by a specific drug. We can do something, one thing, to help keep Canadians safe. We can do something when it becomes apparent that there is a deadly narcotic substance available that we no longer want available in its current form because it is dangerous and can be too easily abused. We can do something, by supporting Bill C-307. While this bill can apply to any substance under the two categories of drugs in the health legislation, this bill may in fact only be implemented on rare occasions, and yet it will help Canada's minister of health take swift action to save lives and prevent terrible suffering.

The government does have opposition to Bill C-307. In the previous hour of debate on November 17, 2016, Canadians learned of the Liberal government's initial response to Bill C-307, and we were disappointed. However, we hope that following today's second hour of debate, the Liberal government will agree to support sending this bill to committee for further study and consideration.

I want to address the reasons for opposing Bill C-307 from the parliamentary secretary to the Minister of Health. I want to remind everyone that abuse-deterrent and tamper-resistant technologies across the class of opioid medications are only one tool among many others to combat prescription opioid abuse.

Crushing and snorting of these powerful narcotics is often the gateway to other forms of abuse, including pill-popping and the movement to more dangerous illicit substances, such as fentanyl, carfentanil, W-18 and U-47700, especially for young Canadians. I am hopeful that we would do everything in our power to stem this tide.

Would all drugs be required to be tamper resistant? No, this bill will not result in only tamper-resistant drugs being available in the Canadian market. This is precisely the point. The United States is leading the way and moving forward to provide Americans with many drugs in a tamper-resistant form. This movement is supported by the Federal Food and Drug Administration, the DEA, and the Trump administration. Seven medications with tamper-resistant or abuse-deterrent formulations, with more to come, are now approved in America.

The parliamentary secretary did not report much of the growing body of evidence to this House in her speech during the first hour of debate. The speech she delivered did include references to a selective literature review on the benefits and risks of abuse-deterrent formulation, tamper-resistant medications.

The recently concluded health committee hearings and the opioids conference did not hear from all stakeholders, including actual pain patients taking these abuse-deterrent formulation, tamper-resistant medications; representatives from the industrial producers of abuse-deterrent formulation, tamper-resistant medications; nor any international and independent experts in the field of abuse deterrence. There is more consultation needed by the government. In fact, the health minister's public statements often acknowledge the value of wide consultation, and it is one of the orders in her mandate letter from the Prime Minister.

The government's opposition to Bill C-307 expressed by the parliamentary secretary did not follow another instruction to the Minister of Health in her mandate letter from the Prime Minister. That directive asks the minister to provide Canadians with science and evidence-based approaches to inform public policy. There is strong scientific confirmation of tamper-resistance technology and abuse-deterrent formulations. There are no maybes or guesswork about these technologies. They work. Tamper-resistance and abuse-deterrent formulation technology is here to stay. It is sound science. It is the future.

Increasingly, powerful medications will be available in the protected forms contained in Bill C-307. Someday, all powerful medications will be released to the public in these forms. These technologies are a product of the scientific advances of the western pharmaceutical technology. Doctors want to prescribe to their patients medications that will not harm them. Doctors want to prescribe to their patients medications that patients cannot hurt themselves with, even if they try.

Patients want their doctors to prescribe them medications that will not hurt them, even if they make a mistake while trying to follow the instructions on the prescription. Everyone wants prescriptive medications that cannot be cut up, crushed, and sold as drugs to be abused.

We can do this now. The technology does exist. We can protect ourselves and others right now. Someday our society will be able to protect our population from the risks and the harmful effects of strong medications that are being abused. This technology will be widespread and used on virtually all potentially harmful medications.

Bill C-307 proposes to provide our Minister of Health with the power to name a single substance and declare it unavailable to Canadians unless and until it is in a tamper-resistant or abuse-deterrent formulation. This would save lives every time that we find a particular substance is being abused with deadly results. The health minister could invoke this tool immediately and stop the loss of lives and terrible suffering at any time.

We have seen numerous drugs, one at a time it seems, being the latest drug of choice to abuse. Some of them are producing deadly results in large numbers. With the passage of Bill C-307, we could stop any of the newest drugs from being available for abuse. We could demand that they are are only made available in a tamper-resistant or abuse-deterrent formulation.

There is a question of costs, and the concerns about the possible increase in costs for public and private payers of medications with abuse-deterrent and tamper-resistant formulations have been addressed. The introduction of these products in the United States and Canada has been shown to drive down prescription volumes for these medicines. The result is that the costs remain the same, not higher.

Again, the parliamentary secretary did not provide us with the evidence of this fact; she reported that her government continues to be concerned about costs. However, the cost issue has been addressed, with evidence. There needs to be more up-to-date research on the facts and figures concerning the deployment of medications with both abuse-deterrent and/or tamper-resistant properties.

The federal government and the provinces have every cost-containment tool at their disposal today to rein in drug costs. The highly successful pan-Canadian Pharmaceutical Alliance is a very effective alliance that operates to set the best prices for public pharmaceutical plans. In turn, the work of the alliance also affects, and sometimes dictates, the prices in private plans. This system ensures that patients are getting medicines at affordable levels.

The provinces and territories have the power of bulk buying. There are numerous examples of medications available at reasonable costs and even lower costs following negotiations between governments and producers. The pharmaceutical firms can employ scale pricing if they know they will realize specific large numbers of sales over specific time frames. This common marketplace practice accommodates the costs to the consumer and makes abuse-deterrent and tamper-resistant medications available and affordable.

I remind all members of the House that every single opioid molecule known to medical science is already off patent. Regulations designed in the previous Parliament make it clear that any company can bring in a competing technology to any abuse-deterrent medication.

I am reminded frequently of the use of the term that we do not need 99 reasons for why we cannot do something, we only need one reason for why we can. This is one reason for why we can work to save lives across this country, by adopting Bill C-307.

Controlled Drugs and Substances ActPrivate Members' Business

11:40 a.m.

Conservative

Earl Dreeshen Conservative Red Deer—Mountain View, AB

Mr. Speaker, it is an honour for me to speak today to Bill C-307, and about the great work that has been done by my colleague from Battle River—Crowfoot. As someone who has spent a great deal of time with young people as an educator for 34 years, I have seen the effects and the terrible things that happen because of drugs. I do not think there is anybody in this House who is unaffected by that same type of damage. When we know there is something out there that could possibly help, this is critical. With the opportunities that young people have when they get hold of drugs, and the partying and other stuff that ties into it, we realize that the damage hurts many families.

The intent of Bill C-307 is to enable the federal minister of health to require specific controlled substances or classes of controlled substances to have either abuse-deterrent formulations, ADFs, and/or tamper-resistant, TR, properties. This bill would make these pharmaceutical substances more difficult to abuse and would make it possible for Canada's health minister to take immediate action whenever Canadians are being hurt or killed by a specific drug. Bill C-307 would help keep Canadians safe when it is determined that a particularly deadly narcotic substance that is available in its current form is too dangerous and can too easily be abused. While Bill C-307 could apply to any substances under the two categories of drugs in the health legislation, the provisions of this bill may in fact be implemented on rare occasions.

We are led to believe that the Liberals will someday announce a package of measures that they think will help combat the scourge of drug abuse in Canada. We also know that the Liberals are supporting legalized marijuana. I will have a lot to say about that in the future, again as someone who has seen the serious damage to families and young people that has taken place, especially to developing brains. We can only hope that when adopting this measure in Bill C-307, at a time in the future when the Liberals announce their further policies on drug abuse, maybe they will have something they can tie in to that. I heard one speaker earlier talking about discussions where there were a number of recommendations. We have to look at some of the other damages that exist as well, to find out exactly what is taking place.

Again, abuse-deterrent and tamper-resistant technologies across the class of opioid medication is only one tool among many others that are there to combat prescription drug abuse. Bill C-307 would do something to prevent the ability to crush, snort, or ingest powerful narcotics that have been taken from pills, patches, or sprays prescribed by doctors. We hear disturbing things about some prescriptions and how they get into the hands of young people, and into the hands of older people as well. Sometimes the drugs are being sold because people would sooner be in pain and get money for their drugs. They know that there will be problems down the line. These are the kinds of abuses that we constantly see.

This kind of drug abuse becomes a gateway to other forms of abuse, including pill-popping and taking too many pills in order to get high at parties. It becomes like a Russian roulette as to what people will take. Abusing drugs that are available from doctors or pharmacies also leads to abuse of more dangerous illicit substances, as has been mentioned before, such as fentanyl, carfentanil, W-18, and U-47700, especially by young Canadians.

Passing Bill C-307 into law would result in tamper-resistant drugs being available in the Canadian market. However, these are only drugs that we discover are being easily and widely abused. They could be identified by the minister of health and taken off the shelves until they are manufactured with tamper-resistant or abuse-deterrent properties. I believe that people who are in the business of making sure that drugs are safely presented to Canadians would be able to deal with this and be more than pleased to help in protecting young people, and all people who seem to have gone off the rails in this particular area.

We have heard a great deal of rhetoric and slogans and we have heard the review of newspaper clippings by Liberal MPs who have spoken against Bill C-307, but we have not heard any better ideas than what is proposed in Bill C-307. We have not heard support for research into tamper resistance. We have not heard the Liberals pursue Bill C-307 as part of their innovation strategy. I imagine the current Liberal government is searching for ways to spend billions of taxpayers' dollars or borrowed money on innovation, so here would certainly be an opportunity.

At the same time, in a very few laboratories in Canada and the United States, teams of scientists are working to make these pills and patches and sprays tamper-proof, and they are succeeding. They are all going to tell us that they may need more money and more funding so the research can be accelerated and expanded. They want to go faster and someday have many of the more powerful medications that a doctor would prescribe either difficult to abuse or impossible to abuse. Canada could be leading the way on the conversion of some of these drugs to a completely safe state.

The government needs to get to work. Canadians want to hear from acute pain patients taking these ADF and TR medications, from representatives from the industrial producers of ADF and TR medications, and from international and independent experts in the field of abuse deterrence. This is one of the critical and important things that we have to be aware of. More consultation needs to be done by the government. Instead, it seems bent on simply voting down Bill C-307 and abandoning the wealth of opportunities that this field of medicine can provide.

Canadians are being hurt and killed by drugs that are available, drugs that can be broken into and abused in such a way as to cause overdoses. We could prevent that. The Liberals do not want this. All of this anti-recreational drug talk is boring to the Liberals. They have better things to do with billions of borrowed dollars than to help prevent death and serious injury from the abuse of drugs. They are more concerned about legalizing marijuana.

We hear terrible stories of house parties where someone hands out crystals crushed from pills to young people, who try it. Some might get really sick or go into trauma, and hopefully someone calls 911. Most often, though, we hear about these deaths the next morning. Having seen and recognized how serious this can be, people realize that something has to be done.

In the health minister's mandate letter from the Prime Minister, she is told to consult with Canadians. That directive asks the minister to provide Canadians with science- and evidence-based approaches to form public policy.

There is strong scientific confirmation of tamper-resistant technology and abuse-deterrent formulations. The minister should get to work and put Canadians to work developing this field of science in order to protect our children from the powerful medications prescribed by our doctors and found in our medicine cabinets. Whether the government agrees to help or not, powerful medication will be available increasingly in the protected forms contained in Bill C-307. Someday all powerful medications will be released to the public in these forms.

I hope enough Liberal backbenchers will show backbone and vote in support of Bill C-307 so that it can be sent to committee for further study. I hope enough Liberal MPs do not listen to the dictates from the PM and the health minister and will vote in support of Bill C-307. These brave MPs will be able to tell their constituents that they at least tried to save the lives of young folks who are getting hurt or killed by abusing drugs that are already at home and in the family medicine cabinet. The supporters of Bill C-307 will be able to hold their heads high when they go home, because they will have tried to convince their government to do the right thing.

Everyone should get behind this effort. It is just one thing, but these things add up. They save lives and they prevent suffering.

Controlled Drugs and Substances ActPrivate Members' Business

April 3rd, 2017 / 11:50 a.m.

Conservative

Kevin Sorenson Conservative Battle River—Crowfoot, AB

Mr. Speaker, it is a pleasure to stand in the House and have the final say in debate on my private member's bill, Bill C-307.

The creation of my private member's bill came about from having a wife and a daughter who are registered nurses. Especially, my daughter came to me and said, “Dad, something has to be done.” I live in a small rural riding where we typically do not believe we have the same problems, difficulties, and issues that are faced in cities such as Vancouver, which we heard the member of Parliament talk about this morning, but the issue of prescription and illicit drug abuse has touched every riding in our country.

This is an issue that we all face in the communities we represent as hon. members of Parliament. It is 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 lives from young and indigenous Canadians.

I listened as the New Democratic member of Parliament from Vancouver stated that 20,000 people in Canada have died from opioid abuse over the years. There were 156 call-outs in that one community in Vancouver to the fire department or to 911 dealing predominantly with fentanyl and opioid abuse. Canadians expect that we would respond to numbers and issues like that.

Can any member of the House forget the headline on September 17, 2016, in the National Post, which read: “Eight overdoses in 13 minutes and one devastated suburb”? That article stated that they did not have enough responders to get out to the various eight overdoses in that span of 13 or 15 minutes. It was one small-time drug dealer who contaminated a batch of cocaine he made with fentanyl that caused the tragedy. The alleged dealer said that he had no idea what he had done.

Right now—and I do not even have it printed out yet—the CBC is carrying a story. In New Brunswick, an individual's former physician—and they name the individual—is being charged with drug trafficking. It is alleged the 35-year-old doctor wrote prescriptions for 50,000 OxyContin and OxyNEO pills, picked them up herself, and did not give them to the patients.

We have a crisis in the country. Emergency responders know that when there is a fentanyl overdose, they use naloxone to save the lives of victims, but in this case we do not know where those 50,000 pills were going.

Tragically, as we have already heard this morning, far too often when we open the papers in the morning—especially in British Columbia and the west, but more and more across into the east—the papers are reporting the deaths of those who have used a drug without knowing that it had been laced with something like fentanyl. Bill C-307 would help prevent so-called dealers from breaking into medication that is available to Canadians from pharmacies. It would prevent these clandestine drug manufacturers from adding the active ingredients from prescription drugs to another drug and causing them to be deadly. The bill would give the health minister the power to quickly act and remove some of these from their availability to people who would abuse them.

No one should be using drugs, yet we live in a society where peer pressure, life stresses, and many other factors cause people to abuse drugs. These people do not factor in the possibility of dying when they try those drugs.

It is time that Parliament responded.

Let me end by saying this. The Liberal government said in the last budget that it was going to have an innovation budget. These are exactly the things that happen when research and development goes out with innovation money, looking at a problem, and asking whether it can be made abuse-deterrent, whether it can be made in a formulation that cannot be misused by those who get their hands on it. Therefore, I would encourage the governing party to allow the bill to go to committee—not to make it law today, but at least to allow the bill to go to committee, where it can be studied and the benefits of this measure can be seen.

I thank every member of Parliament for their consideration of this bill. I encourage everyone to support it Wednesday evening, allow the committee to do some work on it, and report back.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

The question is on the motion. Is it the pleasure of the House to adopt the motion?

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Some hon. members

Agreed.

No.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

All those in favour of the motion will please say yea.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Some hon. members

Yea.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

All those opposed will please say nay.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Some hon. members

Nay.

Controlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

In my opinion the nays have it.

And five or more members having risen:

Pursuant to Standing Order 93, the recorded division stands deferred until Wednesday, April 5, 2017, immediately before the time provided for private members' business.

Suspension of SittingControlled Drugs and Substances ActPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

The House will suspend until 12 noon.

(The sitting of the House was suspended at 11:58 a.m.)

(The House resumed at 12 p.m.)

Business of the HousePrivate Members' Business

Noon

Winnipeg North Manitoba

Liberal

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

On a point of order, Mr. Speaker, there have been discussions among the parties, and if you seek it, I believe you would find unanimous consent for the following motion. I move:

That, notwithstanding any Standing Order or usual practice of the House,

(a) the recorded division on the amendment to the motion for third reading of Bill C-22, An Act to establish the National Security and Intelligence Committee of Parliamentarians and to make consequential amendments to certain Acts, scheduled to take place today, at the ordinary hour of daily adjournment, be further deferred to Tuesday, April 4, 2017, at the expiry of the time provided for Oral Questions provided that all questions necessary for the disposal of the third reading stage of Bill be put forthwith and successively without further debate or amendment pursuant to Order made Monday, March 20, 2017, under the provisions of Standing Order 78(3).

(b) the subamendment and the amendment in relation to Ways and Means motion No. 10 be disposed of as follows:

On Tuesday, April 4, 2017, at 1:59 p.m., the Speaker shall interrupt the proceedings, the question to dispose of the subamendment shall be deemed put and a recorded division deemed requested and deferred until the expiry of the time provided for Oral Questions that day;

On Tuesday, April 4, 2017, at the expiry of the time provided for Government Orders, the Speaker shall interrupt the proceedings, the question to dispose of the amendment shall be deemed put and a recorded division deemed requested and deferred until the expiry of the time provided for Oral Questions on Wednesday, April 5, 2017.

Business of the HousePrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

Does the hon. parliamentary secretary have the unanimous consent of the House to move the motion?

Business of the HousePrivate Members' Business

Noon

Some hon. members

Agreed.

Business of the HousePrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

The House has heard the terms of the motion. Is it the pleasure of the House to adopt the motion?

Business of the HousePrivate Members' Business

Noon

Some hon. members

Agreed.

Business of the HousePrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

I declare the motion carried.

The House resumed from March 23 consideration of the motion that this House approve in general the budgetary policy of the government, of the amendment, and of the amendment to the amendment.

Financial Statement of Minister of FinanceThe BudgetGovernment Orders

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

When the House last took up debate on the question, the hon. Leader of the Government in the House of Commons had used three minutes of his time.

Resuming debate, the hon. Parliamentary Secretary to the Leader of the Government in the House of Commons.

Financial Statement of Minister of FinanceThe BudgetGovernment Orders

Noon

Winnipeg North Manitoba

Liberal

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

Mr. Speaker, it is a pleasure to rise today to add some thoughts on what is a very important day. It is yet another day on which we recognize a budget that further advances what Canadians voted for just under 18 months ago.

What I would like to do is offer a bit of reflection. I think of where we were two years ago. At that time, people were wanting to see change. What they recognized was that the Conservative Party, under Stephen Harper, had lost touch with what Canadians really wanted to see happen. The New Democratic Party, I believe, got it wrong. We saw that in its policy of having a balanced budget. What Canadians wanted to hear from a political entity was what the Liberal Party was talking about. We wanted to see an investment in Canada and in Canadians to deal with the issue of Canada's middle class and those aspiring to be part of it. Time and time again, when I was talking with individuals, what they wanted was a sense of hope and a leader who would speak to them and listen to what they had to say.

The Prime Minister continues to ask members of Parliament to reach into their constituencies and to represent their constituents here in Ottawa, as opposed to representing Ottawa to their constituents. My colleagues in the Liberal caucus take that to heart. They believe that at the end of the day, we are here to represent the interests of our constituents. It is something we take very seriously. We continuously bring those ideas and concerns to our standing committees, to the floor of the House, to our caucus, to the numerous committees and subcommittees established through our caucus, and even to the evening events we attend, because we genuinely believe that the way we can continue to build a healthier and stronger Canada is to reflect the interests and will of the constituents we represent.

I want to provide an overview for the simple reason that if we look at everything that has occurred in the last 18 months, in comparison to the previous Stephen Harper government, there has been a significant amount of progress on a series of files. That can be clearly demonstrated. Canadians wanted real change, and they got real change. We have seen that change implemented in many ways and highlighted through our budgets.

It was literally weeks after the election that we heard about the importance of giving the middle-class tax break. That was one of the first pieces of legislation brought to the House, the tax break for Canada's middle class. We understood that there needed to be a sense of fairness. That is why we saw the1% of Canada's wealthiest taxed a little more and Canada's middle class given a substantial tax break. We understood that there are many individuals who are aspiring to be a part of that middle class and many individuals who needed that helping hand. We saw that in the first budget.

We saw increases in things such as the guaranteed income supplement. That was a substantial increase, to the tune of hundreds of dollars. I believe it is just in excess of $900 for some of the very poorest of Canada's seniors, many of whom actually live within the riding I represent. As I have said on many occasions, that initiative lifted literally tens of thousands, many of whom are from Winnipeg North, out of poverty situations.

We have talked a great deal about the Canada child benefit program, a program that, again, has lifted tens of thousands out of poverty. I am being conservative with those numbers. We could argue that hundreds of thousands of children have actually been lifted out of poverty because of that initiative.

Those are the types of things we are reinforcing and building upon in this budget. Those are the types of initiatives that have allowed Canadians to have more money in their pockets, increasing disposable income. We understand that a healthy middle class is good for all Canadians. The middle class and those aspiring to be part of it cultivate the economy and feed job growth. The more we build on the middle class, the more we will have a robust economy. I believe that the two have been moving forward quite significantly.

About two weeks ago, we heard some of the numbers and some of the trends. I am always a little cautious in regard to the numbers, but there was one that really stuck out: almost 220,000 jobs have been created in a six-month period. That is an incredible amount of growth in jobs, and most were full-time jobs. In fact, we will likely find that it is higher than in any time frame of six months in the previous decade. I believe that is, in good part, proof that things are moving forward.

Canadians understood that we needed to see a tangible investment in our economy, and what is better than to invest in Canada's infrastructure. This budget continues to reinforce what we presented last year, with a record amount of money, an historical amount of money, being invested in our infrastructure.

Just the other day I was reading a release that stated that the Province of Ontario, through infrastructure and transit, literally has about 200 different projects moving forward dealing with transit issues. Last year there was a desire to move quickly because of the Fort McMurray fire and the economy of Alberta.

I applaud the Minister of Infrastructure and Communities who has done a fantastic job of reaching out to the provinces and municipalities to identify the types of projects we can start acting on, all of which are important. Whether it is transit or social infrastructure, it is absolutely critical that we start investing as soon as we can in terms of building Canadian infrastructure. We all benefit when that takes place.

I am very proud of the fact that we have a Prime Minister who has recognized the importance of Canada's infrastructure. By recognizing it, he has also added the dollars that are necessary to make a difference. This is part of listening to different stakeholders, in particular the different levels of government. Municipalities were crying for resources. They need the dollars to improve infrastructure. I am glad and very proud of the fact that the government is responding, like no other government, to the need for infrastructure dollars. I see that as very positive.

We talk a lot about budgets and how we are using tax dollars, but it has gone beyond that in the last 18 months. I am very proud of the fact that we have a government, for the first time in many years, that understands that it has a strong national leadership role on important files, files Canadians want us to act on.

I would like to give a few examples. One is the CPP agreement. The CPP is one of those fundamental programs Canadians have grown to love and want to be there for them, whether it is today or in the years ahead. Our government actually moved forward in meeting with different provinces and territories and came to an agreement with our partners, which ultimately saw substantial increases in the CPP. That is about working with other governments. It also recognizes that decisions we make today impact people tomorrow. There will not be any immediate benefit per se, but in the long term, many workers in the workforce today will receive substantial increases when it comes to retirement, because this government made it a priority to change the CPP program and to work with the provinces.

In opposition, I called on the Harper government for years to work with the provinces to try to get an agreement. The Conservatives did not demonstrate any interest in that, and they were not able to ultimately deliver what I believe Canadians wanted to see.

We can talk about the price on pollution. The price on carbon is an interesting issue. When we had the conference on the environment in Paris, the Prime Minister and others attended. The Prime Minister came back indicating that Canada can and needs to play a leadership role. Shortly thereafter, provinces came on side, agreeing on the need to have a price on carbon. I thought it was really interesting that there were premiers of all political stripes, Conservative, New Democrat, and Liberal, and countries around the world that agreed that we needed to have a price on carbon. Only one real voice came out against it, which was the Conservative Party.

I made reference at the beginning of my speech to the Conservatives having lost touch with Canadians. This is a good example that highlights that the Conservatives are again out of touch with what Canadians truly want to see happen.

The price on pollution is needed, and the misinformation the Conservatives might try to convey is most unfortunate. What upsets me, to a certain degree, is that they try to give the impression that Ottawa generates revenue from this. This is, for the national government, revenue neutral. Ottawa is not getting a dime from the price on carbon. In fact, all it demonstrates is that Ottawa and this Prime Minister recognize the need to demonstrate leadership on this file, and that is the reason we have a universal, pan-Canada approach on this issue.

I have made reference in the past to the importance of health care to all Canadians. It is an issue on which Canadians identify themselves as being Canadian. They have a sense of pride in our health care system. As a former health care critic in the province of Manitoba, I think there is a great deal of room for improvement, especially in the management of health care, but what I recognize, and I recognized even back then, is that Ottawa has to play a role. That role goes beyond just handing over dollars. I am so proud of the fact that we have a Minister of Health who recognizes that.

For all Canadians, we now have a health care accord, with the exception of one province. Unfortunately, it is my home province that has not quite signed on, but I applaud all of those involved in making that happen, because I know it is important, not only to this government but to Canadians, and that is why it is important to this government.

We have a minister dealing with trade who is doing a phenomenal job working with his counterparts. We are very optimistic that we will see some sort of agreement on trade. The trade file has been really important to this government. We saw it with the World Trade Organization legislation. It involves dozens of countries around the world, and makes trade that much better for Canada. We saw it with the trade agreement with Ukraine, which was signed off by this Prime Minister. There is the incredible work done by the former minister responsible for international trade in getting CETA across the line. That is so critically important.

The bottom line is that this government has recognized how important trade is to Canada. Canada is a trading nation. We are very dependent on going outside of our borders. What we will find in the 2017 budget are initiatives which, much like in the 2016 budget, promote and encourage our companies to look at exporting to expand opportunities, because the more we engage in trade, the more opportunities there will be for Canada's middle class and those aspiring to be part of it.

Trade equals jobs. This government understands that and is working progressively to deal and to deliver. We have seen many announcements in different regions of our country that will further advance all Canadians.

I am proud to have had the opportunity to represent the constituents of Winnipeg North in speaking to what I believe they would say is a budget that delivers in a very tangible way.