Health committee  I have a couple of comments. If you look at the general population, it's estimated that 10% of people who use methamphetamine will develop a substance use disorder immediately, just with one use. Typically, it's 10% within a lifetime with most substances, but the reinforcing effects of the methamphetamine are very, very strong.

Health committee  The needle exchange programs have been going on for some time. Really, needle “exchange” is a bit of misnomer, I think, because it's needle distribution and needle recovery, and includes counselling and support, vaccinations and access to all the other services that are there. It's outreach and engagement with a community that is otherwise very marginalized and out of care's way.

Health committee  Right.

Health committee  It's less so. When that does happen, it hits the media very, very quickly. We have drop boxes, like recycled mailboxes, in high disposal areas. If you have a particular park, an alley or some place where you're finding needles, particularly in the spring when the snow melts, then that's where you need to have these disposal boxes.

Health committee  This is an extreme frustration. We have areas in the city, homes and addresses, where home care will not go. They say it's for occupational health and safety reasons, and these addresses get on a list that never gets revised. Essentially the inner city becomes blocked for home care services, because people won't go there to provide those services, and then they wonder why they go to the hospital in order to get basic care.

Health committee  I am not an economist, but I can tell you that most of the cost with regard to substance use disorders is the loss of productivity and the economic impact. When we look at the demographic in Saskatchewan, at least, it's older rather than younger now with regard to methamphetamine.

Health committee  Education involves all sectors of society, and one of the challenges we have is, yes, it is important to get that education to the public, particularly with youth, because with some of the potency of these drugs, particularly with illicit fentanyl, they try and they die. They don't have a substance abuse disorder.

Health committee  I couldn't agree with you more. In primary care, it's important to have health care providers who are meeting population health needs. At a primary care level, just as if you had an extensive older adult community, a geriatric community, you'd want services appropriate to that community.

Health committee  I think that every level of government potentially has a role. The question is what role they would have depends upon what enablers they have at hand. For instance, in terms of tax models that would be more federal or provincial, I would think. In terms of recognizing social impact from people who are making donations or philanthropic organizations that are getting heavily involved in this, if they're working with the health care sector and we're providing what's essentially an expansion of a health care need, does that social impact merit a higher level of a charitable tax credit than what they would get?

Health committee  The challenge, of course, is that particularly with these more potent drugs we have, with methamphetamine and the more potent opioids but also even with alcohol, the disruption in people's lives is such that it's difficult for them to hold jobs. They don't have the income. They go in and out of withdrawal.

Health committee  No question, there's absolutely no question at all. This is fundamentally a health issue. This doesn't mean that if they're committing crimes and are potentially a danger to public safety, there isn't a role for policing in this. Sometimes I've had patients whose lives were saved by a period of incarceration because the chaos was so severe.

Health committee  It's inadequate. Typically it relies on faith-based or community-based organizations to fill that need. It comes from people in recovery or from a particular religious or philosophical point of view who see this as an important service to the community and that indeed these individuals are worth investing in.

Health committee  It's very similar to what we've heard elsewhere, where there isn't adequate capacity with regard to accessing detox. Keep in mind that detox is not treatment; detox is simply the first step. Locally, people have to keep phoning until there's a detox bed available, so they need access to a telephone, and they need to have the persistence and the perseverance to keep on calling until a bed becomes available.

Health committee  It may have a role in rural and remote areas that are having problems accessing care, but it still is a capacity issue. Frequently what we see in more rural and remote areas is a primary role through non-insured health benefits, first nations and Inuit health, and the national native alcohol and drug abuse program, NNADAP, with their counsellors providing that within the community more on site.

Health committee  Thank you very much. The impact of methamphetamine on the prairies has been particularly devastating and certainly increasing year by year. I've provided a breakdown to you of the information on the supply side, the demand demographic that we're seeing with regard to the individuals who are using, the impact with regard to HIV, hepatitis C and IV drug use, keeping in mind that approximately 70% of the HIV that we see in this province is transmitted through IV drug use, driven primarily by opioids but increasingly by the injection of methamphetamine.