Health committee  That's a good question and, of course, you want to take into account the folks who are working there and their health. I haven't given this thought. I think I would want to think about this a little bit. Certainly low barrier treatment is what we need. The more barriers you put up for folks who are already struggling, the more challenging it will be to bring them into safe places.

Health committee  I might just add one thing. Certainly, we have heard police officers here in B.C. say, “We can't arrest ourselves out of this situation.” Our public health folks here in B.C. certainly have the same perspective: As my Oregon colleague mentioned, substance use disorder is a chronic, relapsing disease and a medical approach will make a difference.

Health committee  Without a doubt. People who are suffering are criminalized and it doesn't help them. It fills the jails. It fills the courts. It gives the police way more work than they want, and at the end of the day it doesn't help them.

Health committee  Yes, even if we save 10%, that's 150 people.

Health committee  Certainly, one of the outcomes we see from substance use is folks living very marginalized lives. When they are in the throws of addiction or problematic substance use, they have marginal housing, they have no income and they have very little resources, so the infants of women who are pregnant are, of course, at risk.

Health committee  As I alluded to earlier, illicit drugs are manufactured in clandestine labs. Fentanyl primarily comes over from China, we believe. As you know, very small doses are needed compared with the amount people would have taken when they were using heroine. We believe that, for some reason, fentanyl is now being included in cocaine.

Health committee  It would laudable for the federal government to take a very health-focused approach, recognizing that problematic substance use is a disease. People come to problematic substance use for a number of reasons: childhood traumas, as Dr. Burgess mentioned, which we see a great deal of; the effects of colonization, which we also certainly see; other traumas that they've experienced through their life; or because it's what their friends were doing.

Health committee  Yes, absolutely. In B.C. we have an expedited toxicology policy, whereby the provincial toxicology centre will turn around toxicology results for us in 48 hours. It's the only service of its kind in Canada. We've worked with the lab for a number of years to get that in place. Once somebody's died, it tells us the substances in their system.

Health committee  The B.C. Centre on Substance Use has proposed what they're calling a “heroin compassion club”. It could be modified for other substances. This approach makes people afraid because I think their first reaction is, you're going to give illicit drugs to people. What it does is provide a safe place for people to get drugs that are uncontaminated—

Health committee  They would pay a modest fee. They would live. They would be provided with support and services, and they could see a way out to make their lives better, because to continue to force people to buy drugs off the street just leads to disease, disaster and death.

Health committee  Hello. Thank you. I did prepare a slide presentation. Unfortunately, there wasn't time to translate it. Some of you may have it. I'm not going to refer to it greatly because numbers are not very interesting when a person is talking. I'm just going to basically tell you the story of what we're experiencing here in B.C. from the coroner service's perspective.

Health committee  That's a very good question. There's a drug treatment court in Vancouver, and I haven't seen the data coming out of that. I know anecdotally from those who work in that field that they believe it's very successful. I can tell you, I have worked in the provincial correction system, and at the time I was there around 2006, 2007, and 2008, we found the same, that 63% of those in jail had either a substance abuse and/or mental health disorder, and generally both.

Health committee  Yes. First of all, and I don't want to harp on this, but we need to establish criteria, because we don't even know if we're talking about the same thing across the country. Is the data that Ontario is collecting around fatalities the same data that B.C. is collecting and the same as Nova Scotia is collecting?

Health committee  We need a definition that is standard, and I think it will require federal leadership to say here's the definition for the information we want to collect, and then the provinces and territories will start to collect it.

Health committee  Again, I would say that we need to have a definition. What is a drug overdose? Is it a prescribed overdose? Is it an illicit opioid overdose? Is it a cocaine overdose, a stimulant overdose? Those are all different substances and they have different solutions.