Health committee  Thank you. I'll be brief, as per the chair's request. Of course, we do keep up with this discussion as it evolves. We just had a discussion very recently with another member of Parliament, and I guess the question is what harm are we trying to resolve? What are we trying to fix by regulating something?

Health committee  I was referring specifically to the prescribing of benzodiazepines for women as one area we are looking at. All of this is on the basis of less than ideal and fulsome data; however, we are seeing some representation of effect in the fact that women are disproportionately if not much more significantly prescribed benzodiazepine than the male population, the question being whether this is an optimal prescribing rate and what effects would flow through with respect to these women.

Health committee  What we've seen with that, since it is over 10 years, is that we went from being number six in the world in per capita use to number two, and I don't think we want to be number one—that's the U.S. What we've seen with that 200% increase is a very similar doubling of unintended overdose deaths, a doubling of access for treatment services around opiates in particular, in a treatment system that I would suggest was already very much under duress or under stress to accommodate its existing clients.

Health committee  Certainly. There are two things. One is that your government is already at the table with First Do No Harm. They were part of the development of the strategy and were able to provide that commentary. Of course you are familiar with the commitment for the ministers of health, so that's important as well.

Health committee  I'm sorry; that may have been my fault.

Health committee  Yes, and it's entirely one of the tenets or principles of the strategy. As you read through it, you will find that the challenge is whether this is a harm reduction strategy or a strategy that reduces harms.

Health committee  I'm saying that the strategy has a variety. To ensure that we have everyone at the table and that we can all focus on the common signal, we're talking about how to reduce the harms related to.... And that is a very clear element throughout: you'll see a lot of recommendations in here that are consistent with the term “harm reduction” that you're referring to.

Health committee  Okay. If I could step back a little bit, I think the point was made—I perhaps introduced the issue earlier—about alcohol and treatment. In Canada we have what's called the national framework for action, which is meant to be a national, pan-Canadian blueprint for how we can deal with alcohol and other drugs.

Health committee  We're assuming that the physician is properly trained in the issues of a particular drug. The medical community who sat at the table with us has indicated that there isn't sufficient education, certainly around the issue. Second, there's the fact that veterinarians receive far more training around pain management than physicians for humans do.

Health committee  I'll start with the easy ones. We haven't costed it out. In terms of what this entire thing would look like, fully costed by all levels of government for all engagement, we haven't done that.

Health committee  No. I say “no” because the answer that we would likely get from a lot of people would be, how long is a piece of string? Rather, as co-chair of the process, I'm interested in knowing who's prepared to put what on the table, now that we know where we need to go.

Health committee  Correct. There are two things. Because we are not the government and therefore cannot commit governments at any level, or the others, we have said two things. One is that we will push through toward implementing a process around the action streams, and that's what Madam Robeson referred to earlier.

Health committee  It would be for our agency to support the implementation of the teams—

Health committee  —so that we have the people actually coming to the table, supporting their work. We often don't know what we know in this country. Part of this challenge is ensuring that there is adequate knowledge to practise and a follow-through around the knowledge exchange practices. It's all been costed out in terms of our role and how we'd support the partners.

Health committee  Hopefully that was a one-minute round, because that's a long and tough question.