Debates of Feb. 8th, 2022

The Opioid Crisis in Canada

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Chair, I will try to reply in French.

I agree, the solution to overdoses of narcotics is indeed naloxone. I think that all first responders should be able to administer naloxone. It really is the right answer to overdose problems.

[The Assistant Deputy Chair, Liberal, Alexandra Mendes]

Resuming debate.

The hon. member for Foothills.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I will be splitting my time with the member for Kelowna—Lake Country.

It is unfortunate that I have to get up once again to speak about the opioid crisis in Canada. Unfortunately, it seems we are doing this on a fairly regular basis.

My colleagues will know that I am not necessarily one to stand up here and talk about statistics and that I try and focus on real stories and anecdotes, but the stats, especially for the province of Alberta, show that opioid deaths have increased substantially over the last couple of years, and suicides are a part of that. Just to put that in perspective, across Canada there were 1,700 apparent opioid toxicity deaths between July and September of 2020. That is the highest quarterly number since we started measuring these stats in 2016. That is a 120% increase from year to year over that same time frame the previous year. There were more than 3,300 apparent opioid toxicity deaths, representing a 74% increase just between the six months of October 2019 and March 2020. That is 1,900 deaths.

These are significant numbers. Yes, they are numbers but they are also friends, relatives, sons, daughters, mother and fathers whom we have lost. I know I am not the only one in the House, many of my colleagues and friends have also lost loved ones, friends and people who are close to them due to an opioid overdose or suicide. We knew this was a crisis going into the pandemic, but the pandemic has certainly exacerbated the mental health crisis we are facing in Canada, and as a result, the opioid crisis that comes along with that.

Over the past year, I had the honour of chairing a Conservative working group where we focused on the opioid crisis and mental health. We talked to stakeholders across Canada and around the world. We asked them what their insight and advice was to address this, what we were missing and what tools we were overlooking in our tool box. There are a couple of things I want to share in my speech that I learned from those stakeholders, from doctors, nurses, counsellors and family members who had lost loved ones, as well as from those who have been through opioid addiction and recovery.

What I learned is that there is no silver bullet. There is not one program that, as a federal government in partnership with our provinces and territories, we could implement tomorrow that we know would resolve the issue, this crisis. It is not a one-size-fits-all. We need a suite of programs and initiatives to address this crisis, but I think the most important thing is that we need to do it now.

Certainly, we heard some platitudes from the government. I do not want to make this overly partisan, but we heard from many levels of government that they understand it is a crisis, but very few are actually doing something about it. We have had emergency debates on it in the House in the past and I have not seen a lot of changes. That is concerning. We cannot carry on like this.

The one thing we have heard is that the programs have been underfunded and there has not been a true priority put on addressing the opioid crisis. When I say “underfunded”, I do not think, from what we have heard from stakeholders, there is a lack of funds going to some of these programs and initiatives that are out there. The problem is underfunding with respect to setting priorities. One of the things we heard from just about every single stakeholder we spoke with during the last year and a bit, going through this discussion, was that there are no metrics to measure which programs are successful and which are not.

We could take a shotgun approach and throw money at just about every program that is out there, but unless we have a way to measure what is working and what is not, we are wasting our time and money. That is what we heard from so many of these groups. It is not that we are lacking resources, but there are so many programs out there, Some of them are working and some of them are working exceptionally well, but some of them are not. We want to ensure that those that are getting the funds are doing a good job. It also empowers them to make sure they are using taxpayer dollars to the very best benefit.

Another example we heard from many of the stakeholders is the need for a 988 national suicide hotline. This would be a very easy solution that the Liberal government could implement immediately and the House could support unanimously. How can Canadians trust the Liberal government to take this seriously if it cannot even implement a simple 988 suicide hotline?

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

Madam Chair, the member and I have engaged on this subject in the past here in the House. It feels a bit like déjà vu, and many more people have died since.

Recently, in June, the expert task force on substance use recommended bold action on three fronts. I do not think this is sufficient, and I think we need to expand treatment options. We also know that thousands of Canadians are dying because of a poisoned drug supply.

As an interim measure to save lives today, would the member support a safer drug supply? This is not a permanent fix for down the road. We have to figure out a long-term solution, but what about the short term, as a matter of saving lives today?

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I appreciate that we have had discussions on this, but one thing is missing. I also appreciate what the member is trying to say. Some colleagues have brought up the Portugal model, for example, but the thing they forget to mention about Portugal, where drugs were decriminalized, is that it has invested substantially in treatment and recovery. The number of beds it has for treatment and recovery far outweigh what we have here in Canada. If we want to talk about decriminalization and safe supply, the first thing we have to talk about, which must be in place first, is a strategy and regime around treatment and recovery, and ensuring we have the resources in place for those who are going to need it.

[Lisa Marie Barron, NDP, Nanaimo—Ladysmith, BC]

Madam Chair, I listened to the member's speech, and I agree that real stories are important and that we should always bring it back to the people. What we know is that in the last six years, 25,000 lives have been lost, unfortunately. However, for years, the Conservatives have been trying to discredit clear and overwhelming evidence that supervised injection sites save lives. We want to talk about something we can do, and something tangible we can do is increase the safe supply and increase harm-reduction supports. Instead, we are seeing increased marginalization of the most vulnerable and the criminalization of people struggling with substance use.

I wonder if the member could clarify something. Does he agree that we need to increase harm-reduction supports in order to save lives?

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I appreciate the member's question, and I hope she listened to my speech when I said there is no silver bullet that resolves this problem. There has to be a suite of different programs, and harm reduction is one of them.

The issue that bothers me with this position is that harm reduction and an increased safe supply is the one and only solution. However, it is not a solution at all. All it would do is perpetuate addiction, unless we have a focus on programs that ensure there is a way to divert people who are using supervised safe injection sites to recovery and treatment. That is the key element that is missing in too many of these programs, and there is a perpetual cycle. We must be able to divert people who need it into treatment or recovery. Otherwise the cycle does not end.

[Marie-Hélène Gaudreau, Bloc, Laurentides—Labelle, QC]

Madam Chair, I heard my colleague talk about the need for statistics and monitoring.

I will repeat the suggestions I made in my speech, and I would like to know if he believes that they make sense.

When we talk about monitoring and intervention for overdose prevention and harm reduction, are activities that seek to provide information and raise awareness a good thing in his opinion? Do we need to improve medical and pharmaceutical practices for opioids and pain management? What does he think of access to integrated and adapted services for people receiving treatment for opioid use that requires the use of a drug, as well as training, research and assessment?

[John Barlow, Conservative, Foothills, AB]

Madam Chair, the member brings up a very good point. The pharmaceutical companies that have been peddling these opioids have to be held accountable. They are saying there is a 90% chance a person will not get addicted, but it is a ridiculous stat and we know the consequences of it.

Something I would like to propose is the establishment of a centre of excellence for mental health and addictions. This would be the hub where these programs would ask for funding and it would be funnelled through them. We would have metrics of success, and would also be able to hold pharmaceutical companies accountable for what should be out there and what should not. There would be consequences in place if they are misleading Canadians on the addiction levels of the products they are peddling.

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Madam Chair, it is an honour to be here late in the evening at this take-note debate to talk about the opioid crisis in Canada.

Sadly, overdose deaths outpaced COVID-19 deaths in British Columbia last year. Constituents from across Kelowna—Lake Country continually reach out to me about the mental health and addictions issues playing out on our streets. However, the opioid crisis also affects everyday families, and of course the biggest tragedy is the people who are struggling with addiction and the people who are trying to help them.

I have met with residents of Rutland, in downtown Kelowna, and other areas who see first hand the tragic impact that opioids and drug addictions have in their neighbourhoods. I have met with mothers who have lost a child to overdose. Their stories are heartbreaking, and I cannot imagine what they have gone through.

The government's continued response has been to push off the responsibility, and it has been left to our provinces and municipalities to deal with. There needs to be federal leadership on the opioid crisis, here in Ottawa. I am not new to this issue. I spoke about Kelowna—Lake Country's addictions crisis during my maiden speech in the previous Parliament. I called on the government to introduce actionable items that would deal with bringing those addicted into recovery while ensuring criminal accountability for keeping illegal drugs on our streets. Since then, I have told the government of families watching loved ones slip away, of the desperate need to fund recovery and treatment centres and of the struggling surges in rates of overdoses in my community and my province. We keep hearing from the government what we have always heard: hearts going out, action plans coming, awareness and moving forward. However, there have not been any specific actionable plans.

Kelowna—Lake Country and British Columbia are left with yet another year of tragic statistics. The year 2021 surpassed 2020 as the deadliest year for illicit drug deaths, and now, six British Columbians a day are lost, according to B.C.'s chief coroner. Kelowna has gone from counting drug deaths in single digits just 10 years ago to now having many dozen a year in my community alone.

I hosted a mental health round table in my community last year, and conversations were geared toward talking about addiction. There were many stakeholders there from my community and they gave really good input, which helped lead into our platform in the previous election.

I have talked to first responders, and they are exhausted by the continual calls of overdoses and seeing the tragedy every day. Let us recognize and thank them here today. They are on the front lines of the opioid crisis every day. B.C. Emergency Health Services responded to over 35,000 overdoses in 2021, an increase of 31% compared with the previous year and nearly triple the number it responded to when the government was elected in 2015. New substances with even more significant toxicity continue to appear in Kelowna, with a public health warning issued of a new substance just this past January.

There are a number of organizations, including those in Kelowna—Lake Country, that provide treatment in supportive living environments for those struggling to recover from addiction. They are trying to bring hope and healing to people so they can become productive members of society. However, many of these organizations do not meet government models to receive funding and have to self-fund in the community and rely on generous volunteers and donors. We need to use all the tools available, such as drug-treatment beds, community recovery centres and wraparound services.

The opioid crisis is a national emergency and an urgent health issue, and COVID-19 has made things worse. People have been isolated, out of work and unable to see friends and family. My community has been very clear about what is needed to help them. The federal government has received clear recommendations from British Columbia's municipalities, including Kelowna, while leaving them without much-needed treatment. We must act for the people who need recovery and treatment and act for the families and communities where we live. We must all work together in the House to help people and families, and we must act now.

[Élisabeth Brière, Liberal, Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health]

Madam Chair, since 2017, supervised consumption sites have had 2.9 million visits with no on-site deaths recorded to date, over 120,000 referrals to health services and 27,000 reversed overdoses.

Given these metrics, does the member agree that our decision to approve 37 consumption sites since coming into office was good and that we should continue this way?

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Madam Chair, this is one tool in the tool kit, and really it is the only tool that both levels of government have been using. Although it has been useful for many people and has saved lives, as we know, it is simply one tool. There are so many other tools we are not using.

When we look at the numbers that I cited in my speech, we can see how the numbers are increasing. It is not solving all of the issues. It is just one tool. We need to be looking at all other options out there in order to best help and resolve the situation.

[Denis Trudel, Bloc, Longueuil—Saint-Hubert, QC]

Madam Chair, I am pleased to participate in this evening's debate. My colleague is right. We are currently in the midst of a terrible crisis.

However, I do not agree with her that it is a federal responsibility. The opioid crisis is a mental health issue. Mental health to me means health, and health is a provincial jurisdiction.

Every day, young people, people on the streets of Longueuil, would like to see psychologists, but they cannot because psychologists are underfunded and there are none.

Does my colleague agree that health transfers should be increased? That would make it possible to increase mental health services for those who want them, to provide better working conditions for nurses, to foster hiring, and to provide support for people struggling with addiction. Health transfers must be increased. That is an inescapable fact. Ottawa has the money, and health is a provincial jurisdiction. The federal government must transfer the money.

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Madam Chair, again, we have to utilize all the tools that are available. They are provided through funding, and the federal government can be a leader on that. It is one of the reasons that, on this side of the House, we have been asking to increase the health transfers to the provinces. That is just one of our tools, and then the provinces can utilize it the best they can. We also have to look at national strategies that can be implemented across the country so there is some consistency as we go from province to province.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Chair, I think we all know in the House that prohibition did not work to reduce alcohol use and the war on drugs has not worked to reduce drug use. It is said that the definition of insanity is doing the same thing over and over again and expecting a different result. That is just common sense, because to address a problem, one has to correctly identify the cause of it. Experts in addiction tell us that the cause of drug use and addiction is pain and trauma. Therefore, arresting, jailing, criminalizing and adding pain and trauma to drug users will never work, and it has not.

Does the member think that criminalizing drug users and forcing them to purchase poisoned drugs from street dealers is something this Parliament and her party should continue to allow to happen in Canada?

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Madam Chair, if we want to back this up and look at the causes, let us talk about the drug dealers who are out there. Right now, we have legislation before the House that looks at reducing sentences for drug dealers for smuggling. If we are going to back this up and look at some of the causes, let us start where people are getting some of these very harmful drugs, and let us address it there as we are going through all these other steps.

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

Madam Chair, at the outset, I will be sharing my time with the member for Vancouver Centre.

I also want to thank the member for Yukon for ensuring that this take-note debate happened. I very much appreciate his advocacy and the health-focused advocacy that he has.

The sheer scale of this crisis is hard to fathom. We have lost 25,000 Canadians since the beginning of 2016. Every one of those has a personal story, of course, impacting many more family, friends, co-workers, loved ones and others, but it is not just opioid-related deaths. We should describe this problem as what it is: It is a poisoned drug crisis. I think a recent report from Public Health Ontario and the Ontario Drug Policy Research Network described it accurately as an opioid toxicity crisis, and we should all describe it in this way.

We know the laws on the books are ineffective. The police chiefs have told us the laws are ineffective, but it is worse than that. The laws actually contribute to these deaths because they push people away from treatment. We know that on the evidence. They stigmatize people and they push people away from treatment. What is worse, prohibition is the absence of regulation. When it is left to the black market, what we get is poisoned drugs and those poisoned drugs are killing people. It is prohibition that is killing people.

We know that it is getting worse, of course, in this pandemic. It was bad before the pandemic, but it is getting worse. What is the answer? I have heard colleagues say they do not know the exact right approach. I have heard the Prime Minister say that decriminalization is not a silver bullet, and it is not. We absolutely need to do everything we can to stop the scale of death. Let us listen to the experts. There was a recent substance use task force that included a police presence, that included a presence from mental health experts, and that included a range of different voices. Do members know what they called for? They called for bold action for decriminalization, and for a regulatory approach. Let us talk about regulating a safer supply and expanding that safer supply.

Do members know what the answer to a poisoned drug crisis is? It is ensuring that the drugs are not poisoned. It is as simple as that to save lives today. Decriminalization is not a silver bullet, but do members know what it does? It ensures that we treat drug use as a health issue, and that we encourage people to seek treatment.

I worry when the Portugal conversation comes up. By the way, Portugal still was probably more coercive than I would like, but if anyone wants to get up and support the Portugal approach, we should do that immediately because it would save lives. It not only removes the stigma and encourages people to seek treatment, but in Portugal they also wildly expanded treatment. That is also what we have to do, but not in steps when so many people are dying. We do it all at once.

If we want to talk about Portugal, I would push back a little bit on my Conservative colleagues. I would say that Portugal decriminalized and rapidly expanded treatment at the same time because it was facing a crisis. Do members know what we need to do? At the same time, we need to rapidly expand treatment options.

There was $500 million promised in a platform that builds up $150 million from a previous Parliament. We need to deliver that money in the budget to make sure there is evidence-based treatment. That should go hand in hand with removing ineffective criminal laws, and those are not my words but the words of police chiefs, that push people away from the very treatment we want to provide. We need a safer supply, because a poisoned drug crisis is killing people.

Members should not listen to me. They should listen to CAMH. Listen to the police chiefs. Listen to the experts on the substance use task force. Listen to every single expert who has looked at this issue with any seriousness to say what we are doing is killing people. Let us do something differently and, yes, let us do it all at once. This level of a crisis demands that we do everything we can, all at once, to save lives.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Chair, my colleague for Beaches—East York had powerful remarks. I have been deeply moved by the stories that the constituents of northwest B.C. have shared with me: heartbreaking stories about the loss of their loved ones, and particularly stories from parents who have lost their children. They plead with me to do something immediately in the House. I heard that urgency in my colleague's remarks. My colleague, the member for Courtenay—Alberni, has brought forward a bill that will come forward very soon in this Parliament for debate. It represents some of the very solutions that my colleague has outlined in his remarks.

My question to him is this, because I cannot imagine that he would not support my colleague's bill. What will he do to work with us to build unity in the House and pass this bill immediately, or as soon as possible?

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

Madam Chair, I have jointly seconded that bill. I will happily support that bill. I will support any legislation that moves us closer to a safer supply and that moves us closer to an evidence-based approach that treats drug use as the health issue that it is.

We do not treat gambling addiction with the criminal law. We do not treat alcohol addiction with the criminal law. However, we think this is different: It is an illicit substance, which is only illicit, by the way, because of past racist policies directed at particular communities if we track the history back in this country. We treat different levels of addiction very differently.

I am happy to support that bill, but fundamentally we need the government to put more dollars on the table, and we need provinces to take those dollars and to follow the evidence.

[John Barlow, Conservative, Foothills, AB]

Madam Chair, I want to thank my colleague. As I have said, we have had lots of discussions about this, and I certainly appreciate his passion.

However, many of the members in the House continue to mislead a bit on the comments by the Canadian Association of Chiefs of Police, when they talk about their support for decriminalization. The one key to their statement was that they would support decriminalization if police officers across the country had the resources to divert those who needed it into sufficient treatment and recovery, which does not exist right now.

Would my colleague not agree that it is critical, if we are going to go down this road, for the chiefs of police and police forces across Canada to ensure that proper treatment and recovery beds are in place first if we are going to divert people into those programs?

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

Madam Chair, I will say two things. I worked closely with the president of the Canadian Association of Chiefs of Police, Bryan Larkin, to ensure that a bill I introduced in the House had their support. By the way, that bill is now part of Bill C-5, and that bill has their support.

Regardless of new spending, that bill will have the support of the chiefs of police, and I hope it has the support of my Conservative colleagues. It is my genuine hope that we rally across parties in the House and we do the right thing.

Of course we need more money to expand treatment options. I would say I actually do not want police to be the first responders for what is fundamentally a mental health crisis in an individual's life. I do not think that is the appropriate response. I think Portugal is probably too coercive, and Bill C-5 is probably too coercive in that way. We should get police focusing on criminals, not focusing on people suffering from mental health problems.

Ideally, that is the answer. To the member's point, we absolutely need much more significant funding to expand treatment options. That is an area I think we could work together on.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Madam Chair, all evening, we have heard horror stories, but we have also heard some potential solutions.

As my colleague was saying, we also need funding, beds and resources. Education is important for stakeholders and for families, starting in early childhood. This will require an enormous amount of time, money and commitment.

The topic we are debating tonight is unfortunately one that comes up often. Where is the commitment? When will the government turn words into real action?

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

Madam Chair, far be it from me to commend the government for certain actions, but I will say that, on this particular crisis, we have seen significant action since 2015. We have seen an expansion of supervised consumption sites. We know that those save lives. We have seen hundreds of millions of dollars in funding, including to expand treatment options. We have seen the restoration of harm reduction as a central pillar of our drug strategy.

My criticism is different. It is not to say we are not taking action. Certainly we are taking much more significant action than past governments in this country, but there is the scale of the crisis: the number of people who are losing their lives. These are preventable deaths. If we change our policies, these are preventable deaths.

The government is acting, but is the government acting quickly enough, proportionate to the scale of the crisis? That is where the criticism lies.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Madam Chair, I am so excited to participate in this debate. I think my colleague just said it all. We talk about a crisis. A crisis sounds like something existential. This is real. In my province of British Columbia, 6.5 people a day are dying from preventable deaths. This is a mental health issue. This is a mental health problem, and there is a way to deal with it. We can talk about decriminalization, and we can talk about a whole lot of other things. The only thing that would stop people dying from a toxic, illicit supply of illegal drugs is a safe supply of drugs. That is it. That is simple.

Since 2015, we have heard from my colleague that our government has done a great number of things. We have expanded safe consumption sites, and we have been able to allow everyone to have naloxone readily available to them, for if they have an overdose. However, we have also learned some other things.

Things have changed since this began. Now, 70% of street users inhale opioids. They are not using them intravenously any more. They are inhaling them. We need to deal with that. We are finding out that about 35% of people who are dying from an overdose are dying in private homes. About 50% are dying in social housing, in hotels and everywhere else. Only a small percentage of people are dying on the street. This mythical figure we have of some homeless person lying in the gutter using opioids is not true. Clear evidence tell us opioids are being used by professionals, families, people with children and middle-class persons. It is killing them. We need to stop it.

I think our government has done a great deal. We have brought in naloxone, as I said. We have been able to increase the number of safe consumption sites, and we have been helping with field operations to deliver harm reduction in cities across the country. We have been doing all of this, but the number of people dying each day is increasing.

I wanted to point out that, no matter what we have to say about safe consumption sites, in the most recent report from British Columbia there were no overdose deaths in safe consumption sites. Of these deaths, 55% were in hotels and single-room occupancy housing and social housing, and 35% were in private homes. Let us get this picture right.

The majority of people who are dying from overdoses are men under the age of 39. These are people in the prime of their lives: productive Canadians whose lives have been lost. We have it in our power to prevent this, and what we need to do is go with a safe supply.

We need to look at how we provide the right kind of safe supply, though. Right now, in Vancouver and in other places across the country, you can get intravenous drugs given to you in small clinics that do not reach everybody.

However, if people are inhaling the drugs, we need to be able to look at using a drug that has been used for 25 years in Europe. It is called diacetylmorphine, or DAM. DAM has been used with success. People who are taking it are beginning to live productive lives. They are going to work, they are having families and they are doing normal things because they do not have to worry about dying. I think the most important question to ask is how do we get diacetylmorphine into the hands of the people in Canada who need it?

One of the big things we found out is that the provinces are unwilling to do this. They are afraid. The political risk for them is too high, so we talk about decriminalization as if it is a magic bullet. It has nothing to do with anything. What I would like to suggest is that the federal government has it in its power to use the substance use and addictions program to deliver small amounts of money to pilot projects, driven by clinical practitioners in their practices, by physicians and nurse practitioners through telehealth, and by other ways of getting inhalable diacetylmorphine into the hands of people.

It is simple. It is an easy thing to do, it is clinically proven and it is evidence-based. The outcomes are great in Europe, where they call it heroin-assisted treatment.

Let us stop having ideology about this and stop moralizing about this. Let us save lives, people. We have it in our power to do so.

If we allow for SUAP to be given to the clinicians and nurse practitioners who want to use it through telehealth and other ways of getting this out to real people, then we can save those lives.

[Laurel Collins, NDP, Victoria, BC]

Madam Chair, the toxic drug supply is taking lives. There has been a lot of talk tonight about the Portugal model. It has decriminalized the use of all drugs and unleashed a major public health campaign to tackle substance abuse, investing significantly in treatment and recovery. Crucially it decriminalized and, ever since, drug addiction in Portugal has been treated as a health issue and a social justice issue, not a criminal justice one.

I know the member of Parliament for Beaches—East York supports decriminalization. He just gave a scathing indictment of his government's lack of action on this issue. The member for Vancouver Centre just said that decriminalization has nothing to do with it. Experts disagree and the science disagrees. The member says that provinces are too scared to act, but her own province, my province, is asking the federal government for an exemption so that we can have a safe supply.

When Dr. Bonnie Henry, the public health official, is advocating for decriminalization, when chiefs of police are advocating for it, how can she say this has nothing to do with it?