Debates of Dec. 10th, 2018

Opioid Crisis in Canada

[John Oliver]

Madam Chair, I thank my hon. colleague for her work on this file. It is a bit rich. For the entire term of the Harper government, the Conservatives did everything they could to suppress and drive down investments and harm reduction in treatment centres. In fact, they made it almost impossible to open safe consumption sites across Canada.

In budget 2017, we invested $100 million over five years to enhance efforts related to harm reduction and to strengthen the evidence base. In budget 2018, $231.4 million were additionally added to establish the emergency treatment fund, develop a national public education campaign, enhance the ability of front-line personnel to address, detect and intercept illegal drugs at the border and to accelerate and expand a timely national public health data and analysis system.

In our three years, we have moved this program far forward. Over 1,100 overdoses were successfully treated on site at these consumption sites. This government is making a difference. We have the right plan and we are moving forward with it. We need Conservative governments across Canada to get on board and help with harm reduction.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Chair, I want to give the parliamentary secretary another chance to answer the question posed by my colleague from Vancouver Kingsway, because he neatly sidestepped it.

First, no one in the NDP has made a claim that decriminalization is the only policy that will be a silver bullet to solve this issue.

Second, I remember the parliamentary secretary being present at the health research caucus earlier this year when experts from the field of mental health and addictions unanimously stated that decriminalization should absolutely be a tool the federal government employed as one part of a suite of programs and policies to combat this crisis.

Furthermore, the member for Vancouver Kingsway mentioned tackling this as a health issue and ensuring the supply of drugs people were addicted to were clean. That would address the parliamentary secretary's concern.

If he is not going to be in favour of decriminalization, is it the parliamentary secretary's position that the continued arrest of people for possession of illicit street drugs is the smart way going forward and is that his position for the 2019 election?

[John Oliver]

Madam Chair, I want to be very clear. The government is not looking at legalizing or decriminalizing any illegal drugs. Cannabis has already been addressed in Canada. As I said earlier, decriminalization does not ensure a safe quality supply of drugs. However, we are making much easier for care providers and others to get expanded access to alternative drugs other than opioids.

We have expanded access to methadone, opioid replacement therapies and diacetylmorphine, which is a pharmaceutical grade heroin, to try to provide alternative solutions for people with opioid addictions. Those are the steps we are taking.

[Celina Caesar-Chavannes, Liberal, Whitby, ON]

Madam Chair, the member for Sarnia—Lambton mentioned a couple of really great suggestions around pharmacists and nurse practitioners. As we think about the comprehensiveness of our approach, it is really important to think outside the box. I have listened to some of the debate about the education we have done.

I was recently at a movie, where I saw educational commercials about the opioid crisis. We are expanding into non-traditional spaces so the stigma is removed. We are looking to provide additional education.

One of the things we did really early on was provide $5 billion toward mental health. We are not just looking at what happened. We are looking at ensuring individuals have the services they need, especially for people who are 25 years and younger, and ensuring they have the treatment they need to recover and get out of what they are in right now.

Could the member talk a little more about the comprehensiveness of the strategy we are employing around this national tragedy?

[John Oliver]

Madam Chair, absolutely, we are focused on people who need treatment today, who are experiencing severe health issues, possibly leading to death. We have to take steps to stop the next generation or the next cohort of Canadians from becoming addicted to opioids.

As I have mentioned before, we are requiring mandatory labels on all prescription opioids sold in Canada, with increased pharmacist education and training, so that people are aware of the addictive or dependent nature of those drugs. We are moving to severely restrict the marketing of opioids to medical professionals, and are creating a dedicated team to crack down on offenders.

When it comes to the Canada health transfer and the current negotiations we have $5 billion going to the provinces to address mental health and addictions, so that we can stop the next generation, the next cohort of Canadians from developing a dependency on these opioid drugs.

[Tracey Ramsey, NDP, Essex, ON]

Madam Chair, the B.C. government has launched an investigation into whether criminal charges are warranted against the companies that are producing the opioids.

It really is something that I think the Trudeau government has been ignoring, that it needs to follow through on. We have to talk about the role that opioid manufacturers play in marketing these products to Canadians. It is time for the Liberals to launch a federal investigation to determine whether or not there should be criminal charges.

Does the member support the idea, and would he pursue this with the minister and the government to bring those charges at a federal level against the manufacturers of opioids?

[John Oliver]

Madam Chair, the Government of Canada is very aware of the B.C. lawsuit against the opioid manufacturer. That case is being studied and looked at. At this juncture, I think the government is interested in watching the B.C. government proceed with it.

If there is criminal activity happening in Canada, the government will not fail to take action to protect and defend Canadians from criminal action. That is where it sits right now, with an ongoing review and consideration of that B.C. lawsuit.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I appreciate the opportunity to speak in this take-note debate.

I have listened intently throughout the hours we have spent on this. I have to admit to my colleagues that I am surprised at some of the issues that we are talking about. I really want to thank my colleague from Central Okanagan—Similkameen—Nicola for allowing me to jump in as part of this debate today.

I was listening as the discussion was going on, and I really cannot believe that in this day and age we are talking about decriminalizing drugs, opioids, fentanyl, as well as the importance of safe injection sites. I want to take this opportunity to tell a personal story, something I have been through, and how I feel we are way off track on what we should be focusing on here.

We had lost touch with one of my best friends in the world. Less than two years ago, we actually had to break into her apartment, and when I saw her there, the look on her face and the condition she was in was permanently scarred into my brain. I took her to the South Health Campus in Calgary. The things that were going through my mind were not “I wish I could get her to a safe injection site” or “I sure wish that these drugs were decriminalized so she had better access to them.” As a parent of three kids, the things that were going through my head were, “How do I get treatment for one of my best friends in the world? How can I get her somewhere where she is not going to be doing these things again, whether it is safe or not? I want to do everything in my power to ensure that she no longer has to deal with this addiction.”

At the hospital, I could not believe the fact that, obviously, my friend had been in a very sorry state for several months. They had no bed for her, no treatment options. She was kept for a couple of hours, and thankfully, my wife and I took her home with us. We encouraged her to try to find some sort of treatment. We went back to the hospital. We went to the family doctor. We went to counsellors who we knew in our small community. Do members know how easy it was to access a treatment bed?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Chair, on a point of order, we have shown a considerable amount of courtesy to others when they are giving their debates. I am sitting right beside our hon. colleague and am struggling to hear what he is saying because of the other chatter that is going on throughout the House. I ask for the same amount of courtesy that we have shown others in this debate.

[The Deputy Chair, NDP, Carol Hughes]

As I mentioned earlier, everybody should have a right to hear what is going on in the House. I would ask people who are having side conversations to take them outside of the chamber.

The hon. member for Foothills.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I appreciate that. I hope that members in the House would understand the gravity of the situation and the reason we are having a take-note debate on this issue tonight.

As I was saying, I could not believe how difficult it was to get my friend treatment in our community. I am in a very rural riding, but we are not far from the city of Calgary. We have facilities in our communities, but for someone who was at death's door, I could not get her treatment that night, that day or even in the weeks afterward. We were put on a waiting list to get her into a treatment facility. As I am sitting here tonight, over the last few hours listening to members on either side of the floor, the NDP and Liberals, fight about decriminalizing these drugs or how many safe injections sites we should have, I cannot believe this is the discussion we are having.

I apologize, but I am being brutally honest tonight. The fact that the Liberal government has opened more safe injection sites than treatment beds in the three years of its mandate, I cannot believe what I am hearing. Again, I have to be honest with members.

I have a community in my riding that was called a state of emergency in 2015, because there were 347 opioid deaths in one year. This past November, it had 24 opioid overdoses in 48 hours. Having more safe injection sites or decriminalizing these drugs is not going to make this problem go away. I can guarantee that. What we have to do is put our priority in treating these people. When I hear about these being criminal issues and criminalizing this is not the right direction to go for these people who are addicted, decriminalizing that and ensuring that they have every opportunity to get a clean needle or reinject themselves another day is not the way to do it either.

I know I am going to hear questions when my time is up about what the Harper government did and why we took steps to make it more difficult for safe injection sites. In 2011, we were not facing the crisis we are facing now. I was not there in 2011, but I can tell members what I have experienced in my own life over the last couple of years, and I do not want to go home and go to another funeral for a friend who has passed away from a drug overdose.

Again, I just want to thank my friend for Central Okanagan—Similkameen—Nicola for splitting his time and letting me jump in on this debate when I just could not sit on the sidelines.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Madam Chair, it is a tragic story about the member's friend.

In the last budget, there was $150 million to immediately expand treatment options, and treatment should be a central focus. There was also money, of course, for an education campaign to address the stigma associated with seeking treatment, because it is not just about making treatment available. It is also about making sure that Canadians are seeking the treatment they need. We know that the number one stigma for those seeking treatment is actually the criminal sanction.

Therefore, I do not think decriminalization is a silver bullet. I do not think that removing the criminal sanction and then stopping there is the answer. However, once we have expanded treatment, and there is money to expand treatment, surely the answer is to make sure it is as easy as possible for Canadians to seek treatment. Members need not take it from me. They can take it from the Canadian Mental Health Association, the Canadian Centre on Substance Use and Addiction, the Canadian Public Health Association, the BC Centre for Disease Control and chief medical officers across the country.

If we care about saving our friends' lives, and the friend of the member, surely it is about expanding treatment options and making sure that people can seek the treatment that they need.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I appreciate the effort that my colleague has put into this, but I am speaking as a parent and for somebody in our community. I firmly do not believe that decriminalizing these drugs is the right direction to go in. I will be brutally honest and say that not one single constituent has said to me that is the direction in which we want to go. I would say it is the exact opposite.

I agree with the member's comment that we have to find ways to improve access to treatment, and that is the point of my intervention here tonight. I believe that should be priority number one. I do not believe we should be having this argument at this point in time on what the best step is: safe injection sites or decriminalization. I cannot believe that we are not having a discussion on how many treatment beds we can get open tomorrow.

[Linda Duncan, NDP, Edmonton Strathcona, AB]

Madam Chair, I appreciate the concerns that my colleague from Alberta is raising but he seems to be missing the point. That person who is waiting for a treatment bed, even if there are a lot more treatment beds, is still using. Would we not prefer that the person had a safe drug and a safe needle wherever he or she is using the drug?

I would also remind members about “Moms Stop the Harm”. Hundreds of mothers across this country are calling for decriminalization because the majority of their children have gone through treatment and guess what? It is like alcoholism. A person is an alcoholic for life. With opioids, people may go through treatment but they always revert. Therefore, people need access to a safe drug that they can take in a safe place.

I wonder if the member could speak to that.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I would absolutely love to speak to that.

I am glad that my colleague thinks this is so funny that we are having this discussion tonight. At least she can have some laughs at what we are discussing.

I can tell my colleagues that when I opened my friend's door, I was not laughing. I want to ensure that my friend—

[Some hon. members]

Oh, oh!

[Linda Duncan, NDP, Edmonton Strathcona, AB]

Madam Chair, I am rising on a point of privilege. I am deeply troubled that my colleague across the way would suggest that I think this is a laughing matter. No one heard one laugh from me on this serious matter.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I will just answer the hon. member's question in this way. She made the sentiment, “They are an addict for life.” How does ensuring that they have instant access to another injection stop that? If I am an alcoholic and you are going to give me free drinks all the time, does that stop my problem?

Again, you are saying you are not laughing but you are just shaking your head at me. I am telling you my personal experience and you are demeaning my personal experience. I am telling you what I am hearing from my—

[The Deputy Chair, NDP, Carol Hughes]

I just want to remind the member to address his questions to the Chair.

Resuming debate, the hon. member for Central Okanagan—Similkameen—Nicola.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Madam Chair, it is an honour to join the debate and speak on behalf of the constituents I represent in Central Okanagan—Similkameen—Nicola.

I will begin the debate by sharing an event that a father recently shared with me. Roughly one month ago, this father discovered some very serious drug paraphernalia in his teenager's bedroom. The drugs were opioids. There were small discarded baggies, needles, cookers and even a tourniquet, to all the more accurately target a bulging artery. Obviously, when needles and ongoing injections become involved, this all points to very serious drug use. This father was deeply traumatized by this discovery. Ultimately, to his horror and disgust, he would later learn that all of this drug paraphernalia did not come courtesy of the local drug dealer; it was all supplied by the local health authority.

Why would a health authority supply tools to enable successful drug use, he asked. It is a question that many ask when they learn about this little-known program. It is called a safe injection kit and it is increasingly used in areas where a safe injection site has yet to be established.

I am not here to debate kids being given safe injection kits so they can inject heroin. I am here to point out that many health providers are currently making it very easy to use drugs, but not so easy to get off drugs. In the Okanagan, as an example, there is one publicly funded residential youth detox facility for the entire region, with a wait-list to get in. However, for those who do manage to get in and are successfully discharged, they need a residential treatment facility. Once again, very few are available and all have long wait-lists. It is not uncommon for teenagers in the Okanagan to have to travel to Vancouver, away from their families, and support networks for drug rehabilitation. This is wrong on every level.

Many teens waiting to get in basically have one of two options: methadone treatment, which, in itself, is yet another powerful and addictive drug, or, more recently, Suboxone. However, in each of these cases, there needs to be either a clinic or prescribing doctor on these programs. Once again, there is a huge shortage of physicians who subscribe prescriptions for opioid maintenance programs.

To recap my comments so far, the local health authority hands out free kits to help people inject opioids such as heroin, but if they need a youth detox centre, they wait in line. If they need a rehabilitation centre, preferably immediately upon discharge from detox, once again they must wait in line or be prepared to travel 400 to 500 kilometres or more. If they need a Suboxone prescribing doctor, I wish them good luck finding one. More commonly, they might find a methadone clinic. Is it any wonder relapse rates are so depressingly high? We make drugs easy to use, but getting help not so much.

Now we have naloxone, because when people use powerful opioids, it is only a matter of time until they overdose. Naloxone saves lives. We see it increasingly distributed throughout British Columbia, but, ultimately, we have to take a step back and pause. We give away free kits to make it easy to use drugs, we give away free kits to help stop people from dying from a drug overdose, but the most important part, getting the help people need, is where there is a huge shortage and they must wait in line.

If a health authority can open a safe injection site, why can it not, at the same time, open a detox centre, along with a rehabilitation centre? Why are safe injection sites opening up at a much faster rate than detox or rehabilitation facilities? These are the questions we must start to ask and demand changes on. That is why I have joined this debate tonight on behalf of those families in my riding who are facing some of life's greatest challenges and families that have lost loved ones to an opioid addiction. Let us work together to create more services and find a solution.

I have heard some very passionate speeches here tonight and I know that many people have put considerable time and resources into them. Not all of us are at that level, but I hope we can all recognize there is a problem and through dialogue and exchanging of views, we can come to understand we want good things to happen in this country, but we need to recognize when people have legitimate concerns on both sides of the debate. I see there is some willingness here tonight and I hope that this debate can move forward in a way that we as Canadians can feel proud of and know that our children and family members can benefit from the work we do here tonight.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Mr. Chair, the member for Foothills spoke about the importance of expanding treatment options and in the last budget. We spent $150 million to expand treatment options. The next step has to be—

[Alex Nuttall, Conservative, Barrie—Springwater—Oro-Medonte, ON]

No, you didn't. That's not true.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

There was $231 million allocated and $150 million for treatment options, if I am being absolutely clear. The next step has to be ensuring that people are accessing those treatment options.

If I told the member that there is one solution exists elsewhere around the world, and that by changing one thing, they were able to increase the number of people seeking treatment by 60%, would the member support making a similar move to increase the number of people seeking treatment by 60%?

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Mr. Chair, I appreciate that. First, I have talked to the health critic from the Conservative side and she was at the committee last week where they were examining how much money has gone to it. The government, since it has come into power, has put about $50 million into this area and has pledged $200 million over a period of time.

The challenge we have in this country is that every province has a different approach and has its own unique jurisdiction. In some areas such as Northwest Territories, they have much different needs than the member across the way from Toronto. Simply looking at models that are done in geographically different areas with different legal contexts, with different jurisdictional backgrounds and saying to import an idea will solve it 60%, I would welcome that being the case.

Unfortunately, I have found in life it is never as easy as it sounds. All of the headaches are in the front end. Part of the reason we are here tonight is to share concerns and ideas and to try to find a uniquely Canadian way to proceed.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Mr. Chair, I completely agree that we need more addiction services.

I would like to share a statistic with my colleague. In the year following the opening of the supervised consumption site Insite, overdose deaths decreased by 35% within a 500-metre radius of the site, compared to a 9% reduction in the rest of Vancouver. The hon. member would like to see services improved and increased.

Based on that statistic, would he like to see more Insite sites or does he deny the results of that service?