SNUD Committee Meeting

SPECIAL COMMITTEE ON NON-MEDICAL USE OF DRUGS

COMITÉ SPÉCIAL SUR LA CONSOMMATION NON MÉDICALE DE DROGUES OU MÉDICAMENTS

EVIDENCE

[Recorded by Electronic Apparatus]

Wednesday, December 5, 2001

• 0923

[English]

The Chair (Mrs. Paddy Torsney (Burlington, Lib.)): I'd like to bring the meeting to order.

We are the Special Committee on the Non-medical Use of Drugs. We are here to consider the factors underlying or relating to the non-medical use of drugs and to hear your ideas about how drug policy in Canada could be improved.

Just to identify who everybody is at this side of the table, I'll present Marilyn, our researcher, and Carol, our clerk. Randy White is the Canadian Alliance representative and member of Parliament for Abbotsford. Libby Davies is the NDP representative on the committee and is the member of Parliament for Vancouver East. Dominic LeBlanc is a Liberal member and he is from Moncton, New Brunswick. I'm Paddy Torsney, the chair of the committee, and a Liberal member from Burlington, Ontario, not far from Toronto.

Our witnesses today are, from the Vancouver Area Network of Drug Users, Earl Crow, who's the president, and Dean Wilson; from the Downtown Eastside Youth Activities Society, John Turvey, executive director of Street Services; from the B.C. Persons with AIDS Society, Naomi Brunemeyer, director of communications; and from AIDS Vancouver, Warren O'Briain, director of community development, and Thomas Kerr.

I'll ask you to speak to us for about five or ten minutes each. The more time we have for questions and answers the better, so I encourage you to try to use a bit less than ten minutes. We'll hear from all the witnesses, and then we'll go to questions and answers with the members of Parliament.

Earl, you're up.

Mr. Earl Crow (President, Vancouver Area Network of Drug Users): Dean Wilson is going to speak on behalf of the users.

The Chair: Oh, fine. Dean, you're up.

Mr. Dean Wilson (Spokesperson, Vancouver Area Network of Drug Users): Hi. I had the worst nightmare this morning. My disk drive broke, and I could not copy my speech. I got some of it down here, but we're used to this.

The Chair: Not to worry.

• 0925

Mr. Dean Wilson: Good morning, ladies and gentlemen. It is a pleasure to speak to you this morning on the subject of the non-medicinal use of drugs.

I've been an addict since I was 12 years old, so I feel that as I reach my 46th year, I'm competent to speak on the problems drugs present to individuals and their communities.

I live at ground zero of Canada's drug problem. The downtown east side of Vancouver has been demonized as a neighbourhood filled with corruption and hopelessness, when in fact it is a community of caring and concerned people. We must be allowed to respond to the crisis in a way that will fit with our neighbourhood and not with the moral and ethical rhetoric I've heard some of you speak.

I honour Ms. Libby Davies, for I know her tears of pain have washed the sidewalks of the downtown east side. She has spoken out many times for the need for heroin maintenance, safe injection sites, and low-threshold methadone. It is time for you to listen. She cannot do it alone.

HIV-AIDS and hepatitis are two diseases that are part of a declared public health emergency that has been called in the downtown east side, yet you have failed to act and, in doing so, have literally sentenced me and my brothers and sisters to death. HIV-AIDS prevalence rates rival those of sub-Saharan Africa, and we're 100% saturated with hepatitis C—I repeat, 100%. There's nobody down there who doesn't have it. These diseases and others such as tuberculosis will eventually cost the health care system untold millions of dollars.

What is particularly maddening is that it is all preventable. Overdose rates rival those anywhere in the free world. We lost 147 last year. In broad daylight last Saturday we lost a 16-year-old aboriginal youth, a young male with a whole life ahead of him. It's becoming unacceptable. What we need here is action. The mayor's got it right; we have the framework for action. It's been written, and it includes all four—enforcement, prevention, treatment, and harm reduction strategies—but it's time to act.

Health Minister Rock came into our neighbourhood three weeks ago and said that if he could get all four onside, we could start opening safe injection sites. We have the police department onside, the mayor and the city administration are obviously onside, and the feds are onside. Right now, Lorne Mayencourt from the province said he's onside, yet the Minister of Health says he wants to wait a little longer. Well, every day we wait, we lose one more person. Every year a 757 crashes into Main and Hastings, yet the full weight of the Canadian government is not helping our neighbourhood.

We'll send $1 billion worth of people over to Afghanistan, yet we lose as many people...since 1993 we've lost as many as in the World Trade Centre towers. It's unacceptable. If you were to lose three friends a week, I think that you would be upset and alarmed and that you would start doing something about it. These are Canadian citizens. We may have the common thread of being very poor, but the fact is that we do not cause the social ills in the downtown east side; we use drugs as a coping mechanism for those social ills.

I've heard that you've listened to Paul Kennedy, Canada's representative to CICAD, talk about the great deal, the Project North Star and that. I feel that the DEA and the CIA and their “drugs for guns and money” bullshit should not dictate our health system and that Canada has to be autonomous when making our decisions.

I know that at the end of the day you have to go back and play to your constituency, just as I have to go back and play to mine. But the fact is that every community must be allowed to decide in their community how to decide to deal with the drug problems. We have to allow, on the downtown east side, heroin maintenance, safe injection sites, and low-threshold methadone. You must go back to Ottawa and decriminalize small amounts, not just of marijuana but of all drugs. You're criminalizing half a million Canadians over moral and ethical values that don't fit any more in my neighbourhood than mine do in yours.

If you came down to get elected in my neighbourhood, you wouldn't get elected. If I came to your neighbourhood, I wouldn't get elected. I think that with Canada being such a diverse and multicultural neighbourhood, we have to allow every community to decide what to do.

It's time to act. It is no longer time to hide behind reports and more research. We've lost 3,000 people since 1993. That also means 3,000 mothers and fathers and probably untold thousands of brothers and sisters who probably still look at a picture every goddamn morning.

• 0930

I'm going to end my speech because I'm swelling up with the rage of the downtown east side right now. But it is time to act with safe injection sites, heroin maintenance, and low-threshold methadone. These have worked. Last year in Switzerland there wasn't one overdose death. In Frankfurt, where they were up to 400 a year, they're down to 22. I tell you, it may be controversial today, but so was needle exchange and methadone—controversial last year, status quo this year.

You'll be known as heros if you act. Follow the mayor's framework for action, and you'll all be known as heros. Libby Davies is a hero in our neighbourhood.

Thanks very much.

The Chair: Thank you very much, Mr. Wilson.

Mr. Turvey.

Mr. John Turvey (Executive Director, Street Services, Downtown Eastside Youth Activities Society): Well, my presentation will certainly be a marked departure from some of the previous stuff.

I am basically an individual who supports the decriminalization of drugs. I don't know if that's in my paper. I submitted a written brief, and I'll speak to a few portions of it. It was something I tried to jam in while I was doing my job, so it's somewhat haphazard. I tried to keep to the points you identified as ones you wanted to have addressed.

I founded the first needle exchange in Canada in 1988, and I remember when we decriminalized the borders and deregulated and when free trade came in. Then all of a sudden we were hit with an incredible influx of hard narcotics because we could no longer exercise the limited protection borders used to offer us. One of the most appalling things for me was to see the lack of any scrutiny of that impact. What I saw as the beginning of the real dilemma for the downtown east side was the deregulation of borders. All those kinds of initiatives did...we have a situation where only one port container in 100 in Vancouver gets any kind of scrutiny.

That whole thing was removed. Our community became saturated with top-quality heroin, and I can go back to the days when we had five overdose deaths in one day. In terms of research, I'm somewhat disgusted with the federal government. Here they do these initiatives that have fairly self-evident ramifications and that appeal to the public for whatever purpose, but do they scrutinize these or do anything to monitor what the dynamics or impacts are of withdrawing regulations at the border, withdrawing our port police, or things like that? No, they don't.

The federal government is in fact one of the mapsters of our demise in the downtown east side for doing that. I'm not a prohibitionist. It just seems totally unreasonable that they didn't monitor or try to monitor those kinds of impacts. I'm a bit stunned as to why there isn't any kind of federal research that goes with those kinds of things.

The other thing that really bothers me about the federal government...and in our community there are certain blocks. It's just chalked up. Certain blocks belong to certain organizations. There are one or two blocks that belong to a certain organization, and the drug traffickers who traffic largely in crack in that community are from countries other than Canada—one specific country.

Almost all of them have refugee claims. When we pursued that with the police...and the reason our agency pursed this with police—there were maybe 50 or 60 young adult males all involved in trafficking crack cocaine—was that we were losing all our young girls on the street into relationships with these drug traffickers from outside the country, who did in fact have refugee claimant status.

We were told by the officers in the immigration department of Canada that even convicted drug traffickers were making refugee claims and that those convictions for drug trafficking weren't of a serious enough nature to constitute some kind of breach of their claim for refugee status.

We find that in fact the federal government does not have control over their immigration services here in Vancouver, and that's the reality we're dealing with.

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Just this week we heard from some of Vancouver's city police officers, and in fact there is a new surge and a new arrival of more young drug traffickers from that country hitting the streets of Vancouver, likewise claiming refugee status. I think that's the federal bailiwick. If you could address or try to address some of those situations, it would be appreciated.

Did you ask in your papers if there is a role for police? I think there's a role for police, but I certainly don't think it's in busting the individual addict. I tend to go with Dean, that the decriminalization of small or drugs for personal use is a given. But one thing that happens in our community, when the research shows that 25% of the addict population in the downtown east side has a clinical diagnosis of mental illness of some sort and there's conjecture that most likely another 25% in fact suffer from mental illness, is that it's a playground for predators. Predators of all nature come into our community and prey on people who are addicted.

So we have the predators on the street that prey on people who happen to be addicted, but then we also have entrepreneurial predators: businessmen who pay you fifty cents on the dollar for your welfare rent cheque; businesses that will pay you fifty cents on the dollar for your food vouchers; drug stores that in fact buy cases of Ensure from people suffering from HIV and AIDS, who need this food supplement to restore strength to their body, and in fact take it and sell it for a portion of its value to the drug stores, and likewise with syringes. We even find condoms that we give out to sex-trade workers ending up in corner grocery stores being resold.

These are all roles and emerging roles. In your paper you ask what the role of law enforcement would be. I think these are some of the roles of law enforcement. I think what happens in a population that's so densely packed together is that real bucks can be made by entrepreneurial predators exploiting the circumstances and the situations of those individuals who are addicted, and I don't see any kind of consistent, gainful approach by the Vancouver city police to really deal with these kinds of issues.

Also, you asked numerous times about the nature of research and what kind of research the federal government should be doing. Well, I'll tell you what you're not doing. The Vancouver intravenous drug-user study historically has been funded through the U.S.; it hasn't been funded by you guys. Very little gets funded by the feds, to the point that, when we look at the addict population out in the streets at night, there has really been no thorough audit of who those individuals are and what kinds of needs they constitute. So in fact, when we go off and plan, we're doing that kind of silly planning where you plan for what you think you see but not really what you know you're looking at. So there are a lot of really not well-informed kinds of initiatives taking place in our community.

Also I sent papers, or faxed them to you, indicating that in B.C. we now have 7,200 people on methadone. It is the most prescribed drug in British Columbia. It is likewise one of the top three in Ontario. But I think we're at just about 800,000 prescriptions in B.C., whereas Ontario is at some 900,000 prescriptions, and the population is certainly much greater in Ontario. This is just an indicative kind of reality of B.C. yet again. It becomes the place that leads the pack among provinces in terms of access to their methadone maintenance program. These inconsistencies in how you gain access to those programs can often lead to migration patterns, people shopping across Canada for services, for access into programs.

• 0940

Those dynamics do happen. Again, that reflects on the lack of audit on who is on the streets of Vancouver, where they come from, and what their needs are. That has never happened.

I hope I have a few minutes to speak about something that our agency and I have dilemmas with. We hear about safe injection sites. I haven't been to Europe, but I certainly exercise all sorts of cautions around safe injection sites. We started our needle exchange, the first in Canada, in 1988. We were marketed as the proverbial bloody silver bullet. We quickly found out that we couldn't arrest the AIDS epidemic, and there's no needle exchange in the world that solely can provide that function.

Harm reduction is only effective when it's part of a continuum of care, which Frankfurt has and most European countries that have injections sites have: treatment on demand, detox on demand, life-skills training, appropriate housing, things like that.

I have all sorts of issues around injection sites that these guys hear me mutter about all the time, but do I really oppose them? No. Where I'd put them is where the overdose deaths are happening in the downtown east side, in rooming houses. I'd have health rooms in just about every rooming house and hotel in the downtown east side.

The other thing is, and it really raises the question, that we're experiencing, in one of the studies I have, 30 overdose deaths in the west end of Vancouver in one year alone. That is pointed out in the year 2000 epidemiological study here.

So my fears are, first, that injection sites are going to bring more people into our community. Vancouver has 1,000 police officers; Frankfurt has 3,300. They have a law against public drug consumption. I see in the mayor's document that he wants to open discussions on creating a law of that nature. But in fact, do we have the law enforcement resources in our community to ensure that people do that?

One of the other major concerns I have around safe injection sites is that we'd certainly need more than one. Fully 30% of our population still injects powdered cocaine, sometimes 20, 30, 40, 50, sometimes daily. Often these individuals won't even walk across the street for a needle. So compulsion management, for a lot of these folks, is really minimal.

My fear around injection sites is that it has been marketed as a panacea to drug overdose, disease transmission, and drug activity on the street, and I really wonder if it's going to be the silver bullet for all these collective initiatives.

There's one other thing, and then I'll close.

I really get frustrated with experts, and I really think they talk out of their butts most of the time. We are headed into a dilemma in our community. You again ask in your paper, how is harm reduction seen in your community? What is your role as the federal government in educating the community around harm reduction?

We were at a meeting last week where now one of the considerations for needle exchanges is not to exchange, but to distribute. We gave out 3.4 million needles last year, and we recovered more than that. But now we're asked to not just exchange, but to distribute. The total that's being considered here for the downtown east side is 10 million. That's what's happening from the supposed experts, and that's what we have to go out and sell to our communities.

Part of the argument is, well, there has never been an identifiable transmission of HIV or hepatitis C from accidental needle puncture, but again, that really skirts the issue of the ensuing trauma for parents and individuals who experience those punctures and have to go to hospitals and wait 30 to 90 days to see whether they've contracted any kind of viral contamination and also to enter into prophylaxis.

• 0945

I think right now our needle exchange is going into a kind of reality where, if these kinds of things proceed like this, then in fact we're going to be experiencing a backlash. Twelve years after we started the first needle exchange, we're going to be experiencing even a stronger backlash to our present one.

The final thing is I hear accolades for the mayor, I hear accolades all around Vancouver, but I think that most of our political leadership has missed the boat. Most of our addicts in the downtown east side don't just pop up out of the asphalt; they come from communities throughout Vancouver.

The Vancouver intravenous drug user study had 1,400 addicts during six-month semesters. One time they did it, 70% of those people left the lower mainland. This is a highly mobile group—and here I sit, and North Vancouver and Burnaby still don't even have a goddamn needle exchange. I think our leadership sucks big time. I think we've really missed the boat, and by missing the boat what we've created is an ambiance in the lower mainland that forces addicts into the downtown east side, not solely for drugs, but to secure certain kinds of services for their addiction.

It plays right into containment. I think a lot of the initiatives we're dealing with right now have more to do with containment than with enlightened approaches to drug addiction.

Thank you.

The Chair: Thank you very much, Mr. Turvey.

And now, Ms. Brunemeyer.

Ms. Naomi Brunemeyer (Director of Communications, B.C. Persons With AIDS Society): Hi, my name is Naomi Brunemeyer, and I have been asked to speak today on behalf of the B.C. Persons With AIDS Society.

BCPWA is the largest consumer-based organization in western Canada and has over 3,600 HIV-positive members. The mission of BCPWA is to empower HIV-positive individuals through mutual support and collective action. Over the past five to seven years BCPWA has experienced a dramatic shift in its membership, with an increase in HIV-positive injection drug users. Therefore we thank you for this opportunity to speak to you today to talk about not only reducing HIV transmission but also reducing the general harms to individuals and the community associated with injection drug use.

At present there is no clear consensus in the addictions literature or among practitioners as to the definition of harm reduction. As presently used, “harm reduction” may be a broad or a narrow term with multiple meanings. Some people would restrict harm reduction to policies and programs that focus on reducing the adverse consequences of use, without necessarily restricting use per se. One of the major challenges we will face in implementing a coordinated and comprehensive set of policies with respect to drug use is in establishing a common definition for harm reduction.

I believe national political leadership is required to endorse the statement of harm reduction that focuses on reducing harm to drug users and community rather than reducing drug use. This is stated in Canada's own strategy on drugs. Furthermore, I believe a public education campaign is necessary to eliminate misconceptions that subscribing to a harm reduction strategy means condoning illicit drug use.

National leadership will also show that potential abstinence-based prevention programs and models for non-users and using harm reduction prevention models for at-risk and current users are not mutually exclusive and therefore can be legitimately used in tandem.

I believe also—critical to success in addressing the problems of injection drug use—a continuum of harm reduction strategies, including both low- and high-threshold models, must be implemented. However, today I will focus on those strategies that place priority on reducing the negative consequences of drug use for the individual, community, and society, even while the user may continue to use drugs, at least for the present time.

These services are usually termed as low-threshold services that are easily and immediately accessible to street drug users. These services may focus on either individuals who wish to continue to use drugs or those who potentially may become individuals who wish to quit using drugs.

I'd like to just go through four different services.

Needle exchange programs have been discussed. They provide a point of first contact between health care professionals and many drug users whom we normally aren't able to access. While the primary goal of a needle exchange program is to usually exchange one used needle for a clean needle, other services can be provided and accessed at the same time, such as obtaining condoms, referrals, or counselling for basic health care needs. For drug users who are HIV-positive, this contact with health care professionals allows them the opportunity to learn more about their disease.

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Eliminating the need to share needles prevents HIV infection to the individual and the community. It can also lead drug users to other treatment options. They also ensure that needles are disposed of safely.

Health Canada itself has concluded that in addition to preventing HIV infections, needle exchange programs are not responsible for an increase in the number of injection drug users and also not responsible for lowering the age at which persons inject drugs for the first time.

But potential barriers to accessing clean needles must be eliminated to adequately discourage the sharing of needles at all times. With the use of cocaine, which is apparently a preferred injection drug here in Vancouver, the frequency of injections is actually higher than that of heroin throughout a day. Therefore access to clean needles needs to be more rigorous. We recommend that clean injecting equipment be made readily available through all clinics, pharmacies, agencies working with drug users, and potentially police stations.

They're most successful when additional services can be accessed and it's not just a machine that dispenses a clean needle. But this service also needs to be decentralized; it needs to be widespread. As my colleague John Turvey said, it cannot be just focused on the downtown east side. To meet the needs of drug users where they live it needs to be flexible and have longer and later hours of operation.

We've also touched base on methadone maintenance programs. Methadone is a prescribed, legal heroin substitute that is apparently less habit-forming and is used to make contact with heroin users, stabilize them, and eventually reduce their dependence. The methadone maintenance program reduces the chance of overdose, given that the substance is controlled by a physician; reduces the transmission of diseases like HIV and hepatitis C; decreases crime associated with the need for drugs; and decreases the consumption of drugs in public.

Without too many impediments, methadone treatment can provide contact with heroin users who normally are inaccessible to provide them with additional services. Again, HIV-positive drug users need to be accessed in some way to provide them information on treatment or support services.

However, there are many barriers that need to be eradicated so that increased numbers of drug users can access this treatment, including the restrictive rules and procedures that are currently in place; a lack of societal integration due to having them in specifically confined places instead of decentralized; user fees and dispenser fees; and too few physicians currently being licensed to prescribe. These barriers result in clients not being maintained on levels of methadone sufficient to prevent heroin use; therefore, they continue to use heroin.

I believe as well that methadone therapy must be available for incarcerated individuals. Increased research needs to be initiated to find an opiate replacement therapy, similar to the methadone therapy, for cocaine drug users.

Something we haven't touched on yet is heroin-assisted treatment. The rationale for using heroin itself as a method of treatment—actually prescribing heroin from a physician to a drug user—is to reach highly marginalized street populations of heroin users who don't respond to conventional methadone treatment.

Many methadone treatment users have reached a point where they are accepting that they would like to quit using drugs or have been diverted into the program. That means we're still missing an entire population of wilful heroin users. If you made heroin readily available with a prescription, you would perhaps eliminate some of the other issues, such as overdose, HIV infections, etc. These are again particularly vital to HIV-positive drug users.

The last thing I'd like to touch base on, as a program, is the safe injection sites that have been talked about today—highly visible in the media over the last few days. The definition of a safe injection site—I'm not sure if it's ever been clarified for people—is a legally sanctioned and supervised facility where drugs can be injected that are previously obtained, and where they might be provided access to other health care services, in addition to sterile equipment.

The Vancouver injecting drug users study that's been quoted already today makes a strong case for the need for safe injecting sites. The project, as stated, has recruited over 1,400 drug users. Some of the statistics they found were that 28% of users shared a needle; 75% of users reported injecting alone at least once; 10% experienced a non-fatal overdose; 14% of users reported injecting in a public space; 25% of addicts reported needing help injecting; and 18% found it hard to access sterile needles. It was also found that those who needed help injecting were twice as likely to share needles, and those who found sterile needles difficult to access were three times as likely to share needles.

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A safe injecting site may combat some of the issues that were raised in the Vancouver injection drug users study. As well, it would eliminate the public shooting gallery issues that we have currently. I believe that claim that safe injection sites promote drug use and increase the number of drug users is unfounded. In a number of jurisdictions where safe injection sites have been implemented the actual total number of people using drugs has decreased.

The outcomes in other jurisdictions have already been touched on, but if you hear it 17 times you might actually remember it. The Swiss strategy of implementing a continuum of care services of both low- and medium-threshold services resulted in a dramatic decrease in the use of drugs publicly out on the street. It increased the need for intensive drug treatment because people, once they came in contact with basic health care needs, made a decision that they wanted to quit using drugs. And between 1988 and 1998, 65% of drug users were in some form of treatment. In Frankfurt, Germany, they focused on low-threshold services, and again the results were that there was no visible public consumption of drugs. The HIV rate among injection drug users decreased from 25% to 14% and the reduction in overall drug use was 30%.

While there is considerable evidence that the harm reduction strategies detailed in my presentation are effective, there is often an issue in locating these types of services within the community. These services need to be decentralized but there tends to be little commitment from municipalities and communities to advocate for them. It challenges the people in those communities to seek treatment, and there's not necessarily evidence that drug users will relocate to seek treatment. As well, drug users need access to community resources and services. They need to be integrated into society to become functioning.

Therefore I believe that national leadership is required to publicly acknowledge the underlying factors that contribute to substance misuse and the responsibility of the community itself to address injection drug use. In order to understand the complex nature of addiction and the diversity of communities affected by drug use, perhaps communities may be more likely to advocate for their own treatment centres. And I believe this needs to be facilitated by all levels of government.

In closing, I would like to strongly recommend that you continue to involve people with addiction concerns, drug users, and consumers of treatment services to play an active role in the design and implementation of these services.

The Chair: Thank you, Ms. Brunemeyer.

Finally, we have Warren O'Briain and Thomas Kerr from the AIDS Vancouver network.

Mr. Warren O'Briain (Director, Community Development, AIDS Vancouver): Good morning. I'm here today to speak on behalf of AIDS Vancouver. I'd like to thank members of the committee for giving me this opportunity to present my organization's view on public policy as it relates to injection drug use, harm reduction, and HIV/AIDS.

Since 1983, AIDS Vancouver has been a community leader in HIV/AIDS prevention, education, support and advocacy. We're proud of our heritage, of our roots in the gay community, and of our many accomplishments, and we honour the lives of those who fought and those who continue to fight for the rights and needs of people living with HIV and AIDS. AIDS Vancouver's mission is to alleviate individual and collective vulnerability to HIV and AIDS through care and support, education, advocacy, and research.

AIDS Vancouver has adopted a population health framework to guide the development of its programming and advocacy priorities. A key concept in the population health framework is evidence-based decision-making; that is, creating a rational basis for setting priorities and establishing strategies. We believe the decisions we make at AIDS Vancouver must be supported with data on the health and social needs of our clients, the capacity of the community to respond to HIV and AIDS, and the effectiveness of interventions. We also hope that the federal government will base drug policies on evidence supported by data on the health and social needs of Canadians.

In the last five or six years the epidemiology of HIV/AIDS and the socio-political environment in which we work have changed dramatically. In this presentation I will focus on how changes in the epidemiology of HIV/AIDS have caused us to begin searching beyond Canada's borders for new and innovative solutions to the HIV epidemic among injection drug users in this city.

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As you are by now no doubt well aware, British Columbia is in the midst of a public health crisis involving injection drug users. Soaring rates of disease and death, and the associated health and legal costs, serve as distressing indicators of drug-related harm within our province. Health authorities estimate that of the 15,000 British Columbians who inject drugs, this year nearly 150 will contract HIV/AIDS and many more will acquire hepatitis A, B, or C, tuberculosis, or any of the variety of sexually transmitted diseases.

By the early 1990s, overdose deaths had become the leading cause of preventable deaths among British Columbian men between the ages of 30 and 40. By last year, more than 1,500 current or former injection drug users had registered for services at AIDS Vancouver. According to Canada's Auditor General, in her report released yesterday, the economic cost of drug use in the country, including health care, which includes HIV, AIDS, and hepatitis, lost productivity, property crimes and enforcement, is estimated to exceed $5 billion annually. Clearly, there's a need for urgent action.

Despite provincial funding for drug and alcohol services in British Columbia, government reviews indicate repeatedly that the current level of service delivery is inadequate. A 1998 review of alcohol and drug services in Vancouver, completed by what was then known as the Ministry for Children and Families, concluded that there are major problems with existing service delivery, particularly in terms of accessibility, scope, and the number of services available. The report states: “The impact of the lack of adequate resources cannot be overstated.”

The simple fact is there is not enough of anything; there are waiting lists for everything, and we are chronically underserving many. There is not only a need for more of the same, but new and innovative approaches need to be developed to attend to emerging trends and issues.

While the scope of the problems resulting from illicit drug use in British Columbia is disturbing, evidence from Europe, and more recently from Australia, provides reason for optimism. Several European cities have been successful in reducing drug-related problems similar to those experienced in Vancouver. Recently, as I'm sure you all know, the City of Vancouver adopted the four-pillar approach employed in European countries to address problems of drug use, as outlined in the document A Framework For Action: A Four Pillar Approach to Vancouver's Drug Problems. AIDS Vancouver applauds the City of Vancouver for developing and adopting this comprehensive approach, and for leading public dialogue and public discourse focused on new solutions to a very longstanding problem. The four-pillar approach coordinates and balances the four pillars of enforcement, prevention, treatment, and harm reduction.

While most of us have a good understanding of the prevention, treatment, and enforcement pillars, harm reduction is not always so well understood. Adopting harm reduction as one of the four pillars means accepting the fact that drug use does occur and will occur, and developing responses that reduce the harm this causes, both to the community and to individuals.

Critical to the success of the harm reduction pillar is the comprehensive strategy that includes low, medium, and high-threshold services for drug users. For example, an extended hours clinic structured as a street-based drop-in service could be categorized as low threshold. At the opposite end of the spectrum, an acute care setting with highly developed admission protocols would be classified as high threshold. Developing a truly effective continuum of services will require innovative and augmented services at both the high threshold and the low threshold ends of the service spectrum.

At AIDS Vancouver, we have advocated particularly strongly for the inclusion of harm-reduction-based, low-threshold programming. Evidence clearly shows that such programs can be highly effective in preventing HIV and AIDS, preventing the transmission of other blood-borne pathogens, and in some cases preventing death from overdose. Examples of low-threshold harm-reduction-based programs include needle exchange, peer-based education, safe injection facilities, methadone maintenance that's structured in a low-threshold way, and prescription heroin programs. At AIDS Vancouver we believe the continuum of services available in our city should include this entire list.

In this presentation, however, I'm going to focus specifically on AIDS Vancouver's support for a pilot of safe injection facilities, facilities that we believe, contained within this comprehensive framework, could form one vital component of a well-developed, comprehensive response to addictions in all four pillars. What exactly are safe injection facilities? Safe injection facilities are controlled health care settings where drug users inject drugs under supervision and receive health care, counselling, and referral to health and social services, including drug treatment.

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Evidence from Europe suggests that safe injection facilities can provide a cost-effective means of engaging the most marginalized and at-risk drug users and help to address the following objectives: one, improving the overall health of drug users, including reducing the incidence of overdose and disease transmission; two, reducing the harm associated with illicit drug use—for example, crime, discarded needles, public drug use, these things that affect entire communities; three, increasing appropriate use of health and social services by drug users; and four, reducing health, social, and legal incarceration costs associated with drug use.

Evidence also indicates that safe injection facilities contribute positively to the outcomes associated with treatment, enforcement, and prevention. For example, in Frankfurt, which we've all been talking about this morning, hundreds of clients are referred directly from safe injection facilities to drug treatment each year, and the total number of drug users in detox, abstinence-based treatments, and methadone programs has increased since safe injection facilities were implemented.

By bringing drug users indoors, off the streets, and ultimately out of the drug market, safe injection facilities also help free up police to arrest dealers, rather than street-level users. Safe injection facilities also contribute greatly to prevention efforts, as primary activities include the promotion of safe sex and injecting practices within a population at high risk for contracting and spreading disease. Safe injection facilities also serve as ideal locations for the trial of new and innovative health promotion initiatives.

Claims that safe injection facilities promote drug use and increase the number of drug users in a given locale are unfounded and contrary to existing evidence. In municipalities where safe injection facilities have been implemented, the total number of people using drugs has decreased, with the biggest impact occurring in the open public drug scene.

As mentioned previously, rather than promoting drug use, safe injection facilities have contributed to an increased number of drug users entering various forms of drug treatment.

AIDS Vancouver is advocating for a comprehensive response to the drug problem in British Columbia. AIDS Vancouver maintains that safe injection facilities are a necessary component of a more effective strategy and that any remaining questions concerning the effectiveness of safe injection facilities in British Columbia can best be answered through trial and rigorous evaluation. To this end, AIDS Vancouver is supporting the implementation of an 18-month pilot of two safe injection facilities in Vancouver, as outlined in the proposal prepared last year by health care researcher Thomas Kerr, who's with me here today, for the B.C. Harm Reduction Action Society.

Based on local demographics and advice from local and European experts, the proposal suggests two safe injection facilities should be opened simultaneously in order to manage the anticipated demand for these innovative services. The proposed safe injection facility model will offer a range of services including primary health assessment and care, health education and referral to health services, provision of sterile injection equipment, supervision of injections and needle exchange, psycho-social assessment, counselling, and referral to social services, peer-based education, counselling and support, and access to nutritious snacks.

Safe injection facilities, as outlined in the proposal, would be staffed each day by a team of five health care professionals, including nurses and other staff trained in emergency response.

Rigorous trial and evaluation are required to determine whether safe injection facilities are appropriate in the Vancouver context. Evaluations will examine the design and delivery of services, target population reach, service quality, achievement of intended results or outcomes, and cost effectiveness.

Following a forum held at Simon Fraser University on June 18 of this year, where presentations were given by a number of legal scholars and experts, the legal status of safe injection facilities in Canada is much clearer. There are four different legal options available under which a pilot of safe injection facilities could proceed. The first two involve using existing mechanisms to gain exemption from current laws. A third involves forming administrative agreements, and the fourth involves amending the Controlled Drugs and Substances Act.

It is important to stress that a safe injection facility pilot would not violate any of the international conventions to which Canada is a signatory. In fact, several states signatory to these conventions have incorporated safe injection facilities into their continuum of health services.

• 1010

At AIDS Vancouver we were truly encouraged when Health Minister Allan Rock visited Vancouver last month and outlined his willingness to move forward, with provinces and local governments, in implementing safe injection facility pilots.

At AIDS Vancouver we recognize that demonstrating the health benefits of programs, such as needle exchange, peer-based education, safe injection facilities and heroin-prescription programs may not be enough to persuade some Canadians of their value and importance. We recognize that public health imperatives and approaches based on best available evidence have at times had to take a back seat to political or ideological considerations.

However, in Vancouver, over the past year and a half, we've had a vigorous and thorough public discussion on possible solutions to our city's drug problems. Through political leadership and public education, we've seen the growth of solid support across the city for our city's four-pillar approach. More and more citizens are beginning to understand that not only will drug users and their families and loved ones benefit from such approaches, but innovative new programs can improve communities in concrete tangible ways.

It is time to broaden this public discourse to include all Canadians. I for one am convinced we can do a better job. The time to act is now.

On behalf of AIDS Vancouver, I thank you for this opportunity to present.

The Chair: Thank you.

Thank you to all the witnesses for very articulate presentations with lots of good ideas.

I'm sure we have lots of questions. We'll go around the table at least once. We have until 11 o'clock. If the question is asked to somebody directly, that person will start the answers. If other people are interested in adding comments, if they can just give me a nod or something I'll try to keep track, and we'll have other people answer. Don't feel you need to answer if it's really not something you want to answer. Then we'll go around the table and try to go around a second time.

Mr. White, why don't we try five or seven minutes?

Mr. Randy White (Langley—Abbotsford, Canadian Alliance): Thank you all for coming. They were very interesting presentations indeed.

I just want to ask a quick question of John, and then go on to some more relevant questions. John, do you think early use of marijuana leads to use of cocaine and heroin?

Mr. John Turvey: No. In fact, removing marijuana from the whole criminal justice system is something I would support. I just don't see those kinds of progressions with a lot of our youth.

I certainly see young people coming in at the entry level using hard drugs, but very often there are other variables that play a much stronger role than marijuana use in their progression of drug use, like peer pressure, exposure in the family to substance abuse, and unresolved trauma in their own lives. Factors like that contribute a lot more strongly, in a lot more pronounced fashion, in moving them to hard drug use.

Mr. Randy White: Okay. Thank you.

There are many contradictions we hear across the country on all of this drug issue. Some people addicted would say just the opposite to what you said. Some people would say just no way for safe injection sites, others would say yes. I think there's a mixed message out there all over the place that holds governments and many other supporters back.

This committee is responsible for making recommendations to the House of Commons, and in doing so has to try to get a national strategy in place that works at the street level.

If you're looking at a blueprint for the country, I'm wondering what you folks think of a blueprint that calls for safe injection sites, methadone maintenance, condom exchange, needle exchange, heroin-assisted treatment, and so on and so forth. Keep in mind these are national guidelines and you're dealing with Abbotsford, Penticton, Prince George, Halifax, Charlottetown, Corner Brook, Newfoundland, and so on.

• 1015

I want to know if you think the concepts you're basically talking about in the downtown east side somehow fit in other areas.

Mr. Warren O'Briain: Yes, I'm happy to respond to that.

First of all, I think it's important to remember it's estimated that 100,000 Canadians use injection drugs. They don't all live in the downtown east side; in fact, they don't all live in British Columbia. It's an issue that is national in scope.

Having said that, last year I sat on the Government of British Columbia's addictions task group. It was struggling to come up with a kind of basket of recommended services that were going to be appropriate in both Williams Lake and downtown east side. Obviously there is no blueprint that fits every community.

Our recommendations at that time to the provincial government were really structured around a very comprehensive range of services that needed to be available, while understanding that local communities had to have the ability to look at that basket of service options, if you will, and choose those services that were going to be most effective at a community level.

Obviously the spectrum of services in the downtown east side, or even in the city of Vancouver generally, would look a little bit different from what they would in a small community. We have Canada's largest open drug scene in our city. We need to respond to that.

Folks in Williams Lake, to choose another community, may have different issues to respond to. We need that flexibility and we need the legislative framework that allows us to have that flexibility.

The Chair: Thank you.

Next are Dean and John. I'll go in order because I had Dean first.

Mr. Dean Wilson: Mr. White, I agree totally with Warren. We have to allow each community to develop on their own. What will work in the downtown east side will no more work in Clearbrook or Abbotsford, and vice versa.

I've been across this country many times in the last couple of years, talking to addicts in all different areas, from rural right to the inner cities. You always get a different response. What do they need?

John mentioned he doesn't like experts. I don't either. The real experts are us. We know what's going to work for us. We've had so many things crammed down our throats and money wasted on us. We've told you, “Don't do that, it's not going to work”. The fact is we have to allow the flexibility for every community to decide what fits. I'm sure the communities—and this will build community development—will do the right thing.

Just one more thing on your gateway theory: I could prove that apple pie was a gateway drug.

Thank you.

Mr. Randy White: Certainly giving you heroin would. Right?

The Chair: John, and then Thomas.

Mr. John Turvey: Yes. Just briefly, I was addicted to heroin when I was 13. I grew up in the Fraser Valley in the Bible Belt, and that's where my addiction happened. I'm more than aware that in some communities there are programs they will support and programs they won't.

I think the challenge for this committee is to make recommendations to level the playing field in Canada. There's at least one province in Canada that has nobody on methadone maintenance. It's quite stunning. I can actually see how drug policies in Canada, like non-returnable indictable warrants, have led to the ghettoization of high-risk people into certain communities.

People migrate to communities like Vancouver, where police won't bust you for possession frequently, things like that, and there's just a more liberal attitude or a more tolerant attitude. If you ever did a profile on the addicts in the downtown east side, they would confirm that. People who say that kind of migration doesn't happen just don't know what the hell they're talking about.

• 1020

We need to offset penalizing communities for adopting liberal policies. It's crucial that there's a level playing field in Canada. The dilemma for this committee is to make recommendations that are going to be somewhat acceptable, because to not deal with the North Vancouvers and the Burnabys would mean those communities would put their heads in the sand. In fact, their people do come to our needle exchange in Vancouver. That migration and ghettoization of high-risk people is a factor, and to neglect that would mean you're irresponsible in your role. So your challenge is deciding what has to be out there.

One thing about Europe, besides the esoteric initiatives we're hearing about here, is that they have developed the meat and potatoes of a continuum of care—detox, treatment, adequate skills training programs, methadone maintenance programs, and things like that.

If even in that context we had a level playing field, with those items all across Canada so people could get those services on demand, I think that factor in itself would be beneficial and would be a good starting point.

I think there are incredible inequities right now in Canada in different communities. There are inequities in the lower mainland, and likewise across Canada. It's evidenced in our population in the downtown east side.

The Chair: Thank you, John.

We have Thomas and then Naomi.

Mr. Thomas Kerr (Health Researcher, AIDS Vancouver): I would just like to respond to the question of whether we need these services throughout Canada.

I think we just have to look at the best evidence we have on injection drug use, which tells us there are approximately 100,000 Canadians who inject drugs, but only a third of these people live in our three largest cities. The question is where are the other two-thirds?

A local report done by Bognar, Legare, and Ross that reviewed injection drug use in the lower mainland concluded there is a small downtown east side in every community—areas of easy access to drugs, coupled with poverty, violence, and social dysfunction.

That said, I would just like to add that last year I was a member of an international research team that examined 18 safe injection facilities in three European countries, as well as other low-threshold services. What we found is that there's an immense amount of flexibility in the actual services themselves, so the amount of resources invested in safe injection facilities, for example, varies greatly depending on where they're implemented.

I actually think John's suggestion that a small safe injection facility be put into downtown hotels was a fantastic idea. This might be one of the best ways to get adequate coverage. That said, we've also recently had the provincial medical health officer of the Sunshine Coast, I understand, suggest that safe injection facilities are needed there.

Well, what do we need there? Do we need 15 safe injection facilities with 20-seat capacity? No. But what we could do is put in a very small room with four seats for the people who do need to come and inject under medical supervision.

Certainly there is opportunity to use these services in flexible ways, and it can be on a small-scale basis in small communities, or on a large-scale basis in large communities.

You mentioned there seems to be considerable disagreement concerning these services throughout Canada. For me, this is a difficult issue, because as I speak to experts—and when I say experts, I mean people with histories of drug use, people providing services, or people who are leading researchers in this area—I think there actually is considerable agreement.

Where we get disagreement is with a number of small community interest groups. For example, in the downtown east side, we have the Community Alliance. What's the basis of the disagreement? Well, we have claims such as that needle exchange doesn't work. This was one of the claims made by this group.

Do we consider this informed disagreement? I would say not. There's no academic debate over whether needle exchange works. One only has to look at the meta-analysis that has been done throughout the world to show that needle exchanges don't work. People aren't really asking this question any more, yet we have small community interest groups who are able to use their resources to engage in public education activities that really mislead communities.

So while there is disagreement and some debate, I really can't honestly say it's incredibly informed debate. I would suggest we look at some of the agreement and consensus in documents like Reducing the Harm Associated with Injection Drug Use, and find that the experts really do agree.

• 1025

The Chair: Thank you, Thomas.

Naomi.

Ms. Naomi Brunemeyer: I won't go on about the continuum of care and allowing communities to define their own treatment strategies, because I think that's been adequately covered. However, I don't think you would just put legislation out there on treatment without an active public education campaign. So I wasn't sure if part of your question talked perhaps about the resistance of different communities to these sorts of initiatives.

I think that would come with national political leadership, with the House of Commons having buy-in, with people believing these strategies work. It has to filter down from a national level all the way through to the public. I think it's really necessary for political leaders to get onside, to buy in, to publicly recognize that these initiatives work, and that can filter down to a community level as well.

The Chair: Thank you, Naomi.

Thank you, Mr. White. We'll now turn to Ms. Davies.

Ms. Libby Davies (Vancouver East, NDP): Thank you very much, Paddy.

I'd like to thank you all for coming this morning. You all made excellent presentations, and I know all of you are really involved in the front lines working with and representing injection drug users. I know you've been to so many hearings and conferences and have gone through all the reports, but it's really important that you came here today to speak to the committee, and I'm very glad you did.

We've had a lot of debate and discussion about the four-pillar approach, and I think you've all mentioned it one way or the other today. For those of us who support that, I just wanted to give a little piece of information, which is that we actually have a new ally in that campaign.

There was a report released yesterday by the Auditor General of Canada, and in chapter 11 of his report—

The Chair: Her report.

Ms. Libby Davies: Sorry, her report. In chapter 11, dealing with illicit drugs, she said Canada's drug strategy calls for a balanced approach in four key areas: control and enforcement, prevention, treatment, and rehabilitation and harm reduction, adding that despite the call for this approach, balance has not been defined, and 95% of the $500 million spent annually by the federal government goes toward enforcement.

Then there's a direct quote: “Let's make sure that our investments in efforts to address this problem are effective”.

This came out just yesterday, and I think it's yet more evidence that despite the good intentions of Canada's drug strategies, there has not been a balanced approach, and it has been mostly focused on enforcement, which brings me to where we are today in the debate.

I visited the safe injection site demonstration on Saturday, and I found it really quite amazing for one reason—it was so simple. We're talking about something that does not cost a lot of money. I found it very illuminating to walk through the room with Fiona, the public health nurse, and she told me the steps that people go through. This is very low-budget, yet it is so incredibly effective. It just drives me crazy that we can't do it. It seems to be hitting us in the face.

We all support the four-pillar approach, and we've talked ourselves to death about needing treatment on demand, user-accessible treatment, because a lot of the treatment facilities are not user accessible. We've talked about all those things, yet I wonder, because in a perfect world, everything would move ahead at the same time. It would be totally balanced and it would all move ahead as it should. But it doesn't work like that, as we know. Some things move ahead in advance of others.

I have this idea that if we could get a safe injection site, because of the evidence you've given today about how it does provide that low-threshold connection, it would actually motivate us and propel us—compel us—to get to providing treatment on demand, for example, because then you have that contact with people.

I think some of you said this happened in Frankfurt. It was the safe injection site that actually caused the demand and the resources to be put in place, for different kinds of treatment models and accessible treatment.

So I'm just thinking that through in my own head and thinking we can wait until everything's perfectly lined up and say we're going to move all these things together, but it seems to me that low-threshold intervention is what is critically needed right now. It may actually force us to then provide the resources for the other things that are required. I would ask you to respond to that. How do you see it?

• 1030

The Chair: We'll start with Dean.

Mr. Dean Wilson: What's really interesting is this. I was talking to Werner Schneider, the drug policy czar for the city of Frankfurt. I met him many moons ago. He mentioned that the downtown east side actually has more services right now than Frankfurt did when they started out with their health contact centres.

I think it's the fact of getting everybody on the same page and stopping these turf wars. These budget cuts have everybody isolated, trying to save their own butt. We have to demand that everybody has to be accountable, that we have to work together. We have turf wars in the downtown east side, but it's the shortage of health care dollars, and we can pay now or we can pay later. I think it's time to ask who's accountable, what outcomes are coming out, and let's fund those people, let's get at it.

As you say, we're not talking high tech here. We're talking about a room with some chairs in it, with some good people, with safe injection sites. That's all. I think we can start whipping this into shape. We have a number of outstanding services happening, and in fact there are representatives here at this table right now.

So I think it's time we all get on the same page, start working with each other, and start some of these initiatives that seem controversial. And once that happens, I think we'll see tremendous outcomes.

We keep saying, as you mentioned, we have to have this in place, and this box over here and this box there. We have the boxes in place. We have to open up a couple of more controversial things.

The Canadian Institutes of Health Research have fairly well said that they are going to fund the first Naomi trials, the heroin trials. I think a safe consumption room, an expanded needle exchange.... John and Judy have been doing some wonderful stuff with home delivery. We have to start thinking outside those boxes and start saying let's get at it.

I think we'll be able to handle it, no problem.

The Chair: Before we go to John, perhaps I can remind everyone in the room, including the reporters, to turn off their cell phones. It will be better for everybody.

John.

Mr. John Turvey: In 1988 we started the first needle exchange and then the senior medical health officer for the City of Vancouver, John Blatherwick, gave me assurances that in fact he'd talk to politicians in the province and there would be adequate treatment available. I'm certainly glad I didn't hold my breath since 1988.

We run the youth detox in the downtown east side of Vancouver. This is for 24-year-olds and under. We turn away 38 young people for every one we bring in.

I think Dean is absolutely right. You go down the street and you have a lot of what I call front-end loading of services. Does that community really have the capacity to transition people from an activity at street level through detoxification into a treatment facility and possibly right out of that community into their home community? No, we don't, and it's for a variety of reasons.

Number one, there isn't adequate treatment in the province that's accessible for high-risk individuals and for the diverse need. Women really get screwed to the wall in terms of the treatment continuum. It doesn't exist. Children, likewise. I don't think we've developed enough resources in this province regionally so that after we have people go through detoxification and treatment...often where they come back to is the downtown east side, and very often that ends up facilitating relapse.

So I think there's lots of stuff we could still do right now. People have to understand there are very few initiatives of a positive nature we could direct at this target group that wouldn't have the result of saving lives. From day-counselling to good meals, from condom distribution to needle exchange, from injection sites to methadone maintenance, from detoxification to housing, any of these, they're all going to have an incredible positive potential and are likely translate into lives saved.

• 1035

I think we have to stop saying that certain programs have silver bullet capacities. It has to be thought of as a continuum of care, and that's really my belief.

Politicians love injection sites. Politicians love needle exchanges. Gordon Campbell was the mayor of this city when he funded the first needle exchange in Canada. It was good. It looked good. There's a real thing about profile and marketing the proverbial silver bullet to the public.

We can keep on extracting initiatives out of the continuum of care. If we're going to have a continuum of care that encompasses harm reduction—that includes needle exchange, injection sites, heroin maintenance, methadone—we should say that given that they're there and we move ahead, we have to move ahead on all grounds at once.

Thank you.

The Chair: Thank you, John.

Warren.

Mr. Warren O'Briain: First of all, I read the section of Sheila Fraser's report released yesterday, and I thought, I am so glad there is someone who is talking about the fiscal aspect of this issue. My question to you is what other $500-million-a-year program does the federal government have with so few tangible results?

[Editor's Note: Inaudible]

A voice: —

The Chair: It's to help him with Sheila Fraser, actually.

Mr. Warren O'Briain: That's frightening.

I heard an interview on CBC talking about how do you explain safe injection facilities to fishermen on the east coast? Well, I wonder how folks explain a $500-million-a-year program that has so few tangible results, given the current fiscal environment. I think that would be a challenge, in my neighbourhood anyway.

To pick up on your point, Libby, beyond safe injection facilities, has the range of low-threshold services that are happening in other jurisdictions driven the development of new and appropriate programming? From my visit along with Dean and Thomas and someone from the Vancouver city police, a psychiatric nurse, and the public health nurse, from all of us who visited Frankfurt for a week last year, the answer is yes, they do. They do drive the development of new services, and that was Frankfurt's experience. Having some low-threshold services to try to deal with this huge public injection scene that had been determined as a driver in pulling young people into injection drug use to begin with—they're the gateway thing for you.... Having a big public injection scene with all the drama around it did in fact drive the development of better upstream services.

Now, we like to talk about how comprehensive things are in Frankfurt and other cities. They really are. It's fairly amazing, but it's not perfect. It's far from perfect. The example I'll give is something John alluded to in his initial presentation. In Frankfurt they haven't yet dealt well with the number of people who are living with concurrent addictions and severe psychiatric problems.

When we were there we heard from the police, from the education people, from the drug coordinating folks, from the public health folks, from the political leadership in that city about how, finally, through these low-threshold services, there had been a real spotlight put on their lack of ability to respond with in-patient, psychiatric assessment and care services.

This was a population who had fallen completely through the cracks. Quite frankly, there was this multi-system, multi-level government initiative going on to try to bring, kicking and screaming, the in-patient, psychiatric care services up to speed so that they would respond, in an effective way, to people living with multiple issues.

So that would never have been highlighted. It would never have been part of the public debate, the public discourse, the public policy development stuff had there not been good low-threshold services there and available with reliable people raising a stink, saying we're missing this group and this a problem for the whole city.

The Chair: Thank you, Warren.

Earl.

Mr. Earl Crow: I want to say I'm not a politician. I'm not a researcher. I am not a health care official. I'm a street-level drug user. I've heard lots of things here that I hear year after year. It's the same things. We come and talk, yet people continue to die.

• 1040

St. Paul's Hospital is still full. There are no beds in St. Paul's. My brothers and sisters are in there because of TB. All of this has to be addressed, and it's great that you get to listen today. How far it will go, I don't know.

I do think that the downtown east side is a unique community. There are reasons for that. We have the hospital closing, and all of their patients are forced to the downtown east side. Then they pick up a drug addiction as well. So I find that it's unique in that way.

We talk a lot about safe injection sites and heroin maintenance programs, and I think they have to be put in place. People are dying every day.

We read about the four pillars. It's a great paper. You can read it and read it and read it. The only pillar we see on the downtown east side is enforcement. It shouldn't be a war on addiction or on users. It's health care that has to be looked at, because my brothers and sisters are dying down there. There are girls working on the streets who are 15 years old. Because they're wired to heroin, they are performing acts with men for $10. It has to stop. These people are not junkies or street gutter trash. They are people.

That's it.

The Chair: Thank you, Earl.

Naomi.

Ms. Naomi Brunemeyer: I want to focus on why something like a safe injection site may be a potential first contact for drug users. I think we may be able to think about it, but we haven't really put it out there. These people are not people we can contact through e-mail. These people are not people we can phone. These people do not have a fixed address. They are transient. We need to have somewhere they know they can go to so that we can address all the other issues they have. These are not easily accessible people. We have 3,600 members in BCPWA, and out of them, there are 1,900 people to whom I can actually mail a magazine containing treatment information. The rest of them are slipping through the cracks. Safe injection sites create an atmosphere in which the actual user feels comfortable, and that's why you can use them as a springboard to providing the additional services. It's that point of first contact that allows for the rest of the continuum of care to be implemented.

The Chair: Thank you, Naomi.

I have Thomas, John, and Dean on my list. Hopefully, that will be it.

Mr. Thomas Kerr: I want to comment on a couple of points raised about low-threshold services. I'd like to share with you the results of some data collected in Switzerland. The Swiss looked at the reach of their system of care when they had a number of what we call medium- and high-threshold services, such as abstinence-based treatment, that sort of thing. They looked at how many active drug users they were actually reaching with these services. They asked, how many can we engage? It came out to be about 20%. In the U.S. the figure is lower. It's set at about 5%.

That begs the question: what are we doing to reduce harm to the other 80% to 95%? With the absence of low-threshold services, I don't think we're doing much.

When the Swiss then complemented their medium- and high-threshold services with a range of low-threshold services, including additional needle exchanges, outreach activities, which are currently done by John Turvey's organization, additional safe injection facilities, and needle exchanges in prison, they found that they were able to make contact with almost all active drug users.

The other very interesting consequence of this implementation of low-threshold services was that it actually increased the number of people in medium- and high-threshold services, abstinence-based programs, from 20% to 55%. So not only do these services help contact all these people who aren't currently being reached, but the data show that it really performs a gateway function. If we really support people getting into treatment, then we need these low-threshold services. I think the data show that.

• 1045

On the subject of safe injection facilities, I couldn't agree more with John. I think there are very serious dangers in advocating anything as a panacea. We really need the whole picture. Although I've been active in researching safe injection facilities and promoting their implementation, I would not suggest that they are going to be a silver bullet and solve all our problems.

That said, why might we move ahead with the implementation of a safe injection facility now? I think there are a few reasons. It's funny, but one of the reasons only came to me this morning as I was listening to my colleagues speak. I think a safe injection facility will really help change the social climate in the downtown east side and other communities with open drug scenes.

How will this happen? Right now the community sees injection drug users all over the streets. They co-opt blocks. They're in alleys, and there are discarded needles everywhere. Ironically, while the safe injection facilities were implemented in Europe originally to address fatal overdoses and HIV infection, one of the most consistent effects of the 18 facilities we studied in Europe was that they decreased the number of people injecting in public.

I think the safe injection facilities represent a win-win solution for the community and the drug users. It helps give drug users the health care they need, but it also takes drug users off the street and helps make our communities safer. What does the community currently do when they see injection drug users all over the streets? They say please give us more police so that we can get these people out of here; it's interfering with our businesses. Yet we know that this solution doesn't work, so we need to look at another way to address the community's concerns. I think that implementing a number of safe injection facilities will help do that, because it will decrease public drug use.

The other reason I think we need to consider implementing a safe injection facility is that it is a mechanism that provides a very effective and immediate response to overdose. We certainly have a serious problem with that. In European cities safe injection facilities were implemented after there were overdose rates of say 100. People thought this was a huge problem. Their overdoses are classified as preventable deaths, and they felt they needed a radical public health intervention. We've been averaging over 300 a year since 1996, and nothing has happened. In fact, safe injection facilities are classified under the national drug policy as survival assistance measures, and I would encourage the committee to think of them in that light.

The Chair: Thank you, Thomas.

John.

Mr. John Turvey: I think we're at a three-year low in terms of overdose deaths right now, and this year might be the first year in ages when we don't break 100 overdose deaths in Vancouver. I'll leave this report with you, which really breaks it down.

That's all I have to say.

Mr. Dean Wilson: I have just two quick points.

First, I want to remind everybody that the downtown east side is seeding epidemics across Canada, especially on reserves and in other inner cities. Last year at Calgary's harm reduction conference, it came out that the number one reason for serial conversion to HIV-AIDS in Calgary was that person had been in the downtown east side in the last six months.

One other point is that last year Justice Minister McLellan released $100 million for the supposed drug strategy. The very next day $95 million was taken up by these bullshit drug courts. This is just another enforcement measure.

We have to get down to where the people are. We have to drag those 80% out and get them involved.

Thank you.

The Chair: Thank you, Dean, and thank you, all of you.

I'll now turn to Mr. LeBlanc.

Mr. Dominic LeBlanc (Beauséjour—Petitcodiac, Lib.): Thank you, Paddy.

I want to echo a bit of what Libby said. Your presentations were all interesting and very valuable for me and the other members of the committee. I appreciate your taking the time to come down and be so honest with us. It's an issue I'm learning about at this table and from some of the literature I've read. It's not an issue I was exposed to much before my election and my joining this committee. I appreciate very much the time you've taken and your honesty and insight.

I'm going to pull a little bit of a Stephen Owen here, Paddy. Stephen Owen, a colleague of ours, was here on Monday, and he put a series of questions to people individually. But I would invite those of you who have something to add to please do so.

• 1050

The safe injection sites.... I've learned a lot from your presentations. We have to keep defining this in health terms to keep it away from an enforcement issue. One of the challenges we have is that the safe injection sites become the sexy media picture; they become, for people who know very little about the issue—and I certainly put myself in that boat—the focus because they are dramatic.

As for the continuum of care that you've spoken about, this is a way to broaden the discussion, and we can hopefully play a role here. These injection sites are the first point of contact for health advice and referrals, if people can understand this. When you hear about a safe injection site you tend to think that this is all they do—somebody's there supervising safe injections—whereas your presentations have made a contribution to broadening the discussion as to how these sites fit into the continuum of care.

In speaking to people last night we heard again that the continuum of care seems to break down at certain parts along the continuum—the lack of beds in detoxification facilities, the lack of spaces in rehabilitation programs, the 36 people who get turned away for every one who gets in. This alarms me in the sense that we may end up, with all the goodwill in the world, with a safe injection site, but nowhere to refer these people. This feeds into the problem of doing no more than providing safe injection sites.

I'd be interested in your reaction as to whether this is an accurate description. What happens once we get these people into some of these facilities? How do we help them? Specifically, what can the national government do?

You have to appreciate that the national government has a limited role in the provision of health care services. Provinces—and particularly a province like Quebec—guard very jealously their right to deliver all the health care services. I happen to think this is a mistake. My own view is the national government should do more.

So what specifically could the federal government do to help you broaden the continuum of care and make sure that it is in fact the continuum of care and not of bureaucratic confusion?

I have a very specific question. Naomi, you talked about prisons and methadone availability in prisons. I visited a prison in New Brunswick where we saw some inmates who were on methadone programs. We're going to a prison tomorrow. I'd be curious about any statistics you may have on inmates who may be on methadone programs in prisons and also inmates in federal prisons who have HIV or AIDS. My sense is that this is quite an alarming statistic, with a lot of it coming from sharing needles in the institutions. I'd be curious to hear about this.

Also, John, you talked about economic predators. I found this interesting. The downtown east side—I've been there two or three times, and last night as we drove to different events. It's not an area of the country I know, I'll be honest. We're going there this evening, and I'm looking forward to it.

Can you give us a quick demographic profile? You gave the example of refugee claimants being involved in the drug trafficking. Do you have some sense of the demographic profile of this area and how these economic predators fit in? This was interesting to me that you have business owners who feed on some of the addiction issues.

So here are a bunch of questions. Sorry to do this, but I appreciated your presentations very much.

The Chair: Thank you.

Probably almost everyone wants to speak, but I do have John first.

Since John, Dean, and Earl wanted to answer the first question, maybe we can....

John, speak about anything you like.

Mr. John Turvey: In terms of making contact, our needle exchange makes literally tens of thousands of referrals. They tried to research the needle exchange at one point but couldn't get a big enough group to study who didn't use the needle exchange.

Thinking back to a few years when the HIV epidemic just exploded in our community, for harm reduction to work there has to be an element of optimism for the individual. You remove optimism for the individual and the individual's life and the commitment to harm reduction is radically reduced. People won't walk across the street for a needle; they'll share with somebody. Those kinds of things start to happen.

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What we were experiencing then.... We had people at that point, who actually were interviewed by the press, who had intentionally infected themselves with HIV just to get benefits. But this happened because there was just no light at the end of the tunnel for those individuals. There was no goal to achieve, nothing to resolve the dilemmas of their addiction.

This is one thing we have to ensure, that we instil in this process an element of optimism. Otherwise harm reduction isn't worth a pinch of coon shit. It just doesn't work if people don't feel somewhat good about it.

Also we have to make sure we have a system that can accommodate addicted people in a user-friendly fashion, be sensitized to them and bring them into detox and treatments based in a functional reality. Those are big things for me.

Economic predators....

The Chair: Actually, John, can I stop you? Can we go to the other two witnesses on needle exchange, then come back to the economic predators?

Mr. John Turvey: Sure. No problem.

Mr. Dean Wilson: I'd actually like to respond to a couple of things, Mr. LeBlanc.

On what can the federal government do, it can demand in the Canadian Health Act by withholding transfer payments that the provinces do their goddamned jobs. I'm sick and tired of this. While we talk here, people die.

We have a framework that both Canada's drug strategy and our municipal government have arrived at that's going to work. Yet what do we do? We keep hiring 80 more cops, which is $8 million. I could run a safe injection site, add ten more detox beds and probably 50 treatment beds with that $8 million those 80 cops took up.

Second of all, I don't want to cut in anyone's grass here, but in the prisons the federal government has got to get the two-tiered methadone program. In British Columbia, under the B.C. corrections act, you can actually start a methadone program once you go in. You cannot do this in the federal prison system. Of all inmates who do two years or more in a British Columbia jail, 30% are HIV positive after they go in, and 100% are hepatitis C positive.

We have to start offering needle exchange within the correction systems, both federally and provincially, and we have to get the two-tiered methadone program within the federal corrections system.

The Chair: Thank you.

Earl.

Mr. Earl Crow: As for the safe injection sites and referrals to treatment and detox you were talking about, we have no safe injection sites today. We do have treatment and detox today, and they are not working, or they work for only a small percentage of individuals. After the doors are open for them and they come out of detox and treatment, they are let back out into a society they aren't ready for. They're not educated to go back into a job. There are no follow-ups on these individuals, so they end up back out on the street. This is why you end up with a drug user maybe going through 11 abstinence periods before he finally gives up the drug.

So as of today we don't have safe injection sites, but we do have treatment and detox programs, and they are not working.

The Chair: Okay.

Now I have Warren and Thomas on this issue.

Mr. Warren O'Briain: I'm on the roll for the federal government issue. Is that where we are?

The Chair: Yes, that's where we are.

Mr. Warren O'Briain: Okay.

I think there's a huge role for the federal government. I appreciate your comment about the division of powers and so on. Let me just run through four things that give some additional....

First of all, there's the idea of leadership on public discourse. I'm thrilled that you're learning a lot and you're going to be visiting the downtown east side and getting an understanding of some of Vancouver's problems. I think it's essential that Canadians from coast to coast begin to learn about the issues we all face when 100,000 of our citizens are using injection drugs. So number one is leadership.

Number two—and this is a little more specific—the federal government does have a role to play in funding research and in the rigorous evaluations of pilot programs and other innovations. This is part of your mandate.

Role number three involves ensuring respect for human rights for all Canadians, including drug users. We haven't even gone into the issue of human rights in this discussion today, but it's a huge issue. I hope the committee is really going to explore this down the line. There's a very, very direct role for the federal government to play there.

Finally, it's the role of the federal government to ensure that federal tax dollars are spent on approaches proven to reduce both the supply of and demand for drugs. I would send you right back to the Auditor General's report. She outlines the problems. It's the federal government's responsibility to explore what it can do with those very precious dollars to really make a difference for Canadians.

The Chair: Thank you, Warren.

Thomas, what are your comments on this one?

Mr. Thomas Kerr: Particularly on the point...

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The Chair: The federal role and/or needle exchange.

Mr. Thomas Kerr: Needle exchange? Okay.

In terms of the federal government role, I would just echo what Warren would say about the opportunity to engage in more public education activities. I also think there's a need for more funding for research. As John mentioned earlier, our cohort study in the city, which is internationally recognized, is funded by U.S. sources and is now threatened.

There's also a need to do more capture and recapture studies to try to address some of the questions John raised earlier about where these people come from, how many live here, this sort of question.

We also have very limited moneys available right now to do real, proper research on treatment outcome. Instead what we have is small organizations that are given very limited funds to do program evaluations, which really lack the rigour to determine effectiveness. What are people left to do but to come out with a positive evaluation so that their funding is continued? It's a biased process.

The other point I would like to make is that I would like to see the section 56 exemption in the CDSA made more user-friendly. I understand that it gives the federal health minister the power to exempt any person or persons from any provisions in the clause. This is a really serious issue for organizations that are providing care to people, such as palliative care settings, where people continue to use drugs. Currently, we're banning people who use drugs from care facilities. These tend to be the most at-risk individuals. We can't provide care for them because care providers fear being arrested themselves for aiding and abetting any one of a number of criminal offences.

When we recently asked the federal health minister about a section 56 exemption for a particular intervention, we were told that we would first have to get full municipal approval, provincial approval, and approval from the police before we could even begin a process. This seems quite onerous to me. It would be nice to see some facilities being able to work through the section 56 exemption quickly so that they could provide care to people who continue to use drugs.

There was a question about HIV prevalence and needle exchange in prison. I'll just quickly respond to that now.

What we know is that HIV rates are approximately ten times higher in prisons than they are in the general public. Prevalence rates are about 7.7%, and hepatitis C rates are between 28% and 40%. A recent study done by the BCCDC street nurse program in the local prison found that 20% of women in the prison continued to inject drugs while in prison, and that 82% of these people reported sharing needles.

Ms. Libby Davies: 82%?

Mr. Thomas Kerr: Yes, 82%.

The Chair: And what was their prevalence rate?

Mr. Thomas Kerr: I'm not sure what the prevalence rate was in that particular study.

The Chair: I guess it would also be before and after.

Mr. Thomas Kerr: Yes. I'm not sure they established the causal links, but I think those prevalence rates are pretty disturbing. There's obviously a need for expanded needle exchange in prisons.

I have a number of documents here on the topic that are produced by the Canadian HIV-AIDS Legal Network. I think we can submit these.

The Chair: Please make sure our clerk gets a copy of those so that they are distributed.

Mr. Thomas Kerr: Yes.

The Chair: Naomi, you're next on prisons.

Ms. Naomi Brunemeyer: I'm actually going to take this opportunity just to address two points on the role of the federal government.

In the pillar document that all of us have been referring to, which I hope you have a copy of, one of the goals was to determine responsibility at the different levels of government. It clearly, in a very nice table format, indicates the role of the federal government. Two points that haven't been mentioned are that Human Resources Development Canada is providing employment and training programs and housing and shelter, with services for drug users. So there's some additional support that the federal government can offer within a continuum of care.

I just wanted to reiterate exactly what my colleagues have said about the prevalence of HIV in prisons. There are a lot of additional issues around advocacy for HIV-positive inmates: access to treatment, the regimen that they need to have with HIV medications not being fully sustained in a prison environment, nutrition. All those issues are still there. In addition, methadone treatment needs to be maintained at a specific rate in order to prevent heroin use. An incarcerated atmosphere is not conducive to that.

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The reason there is a high prevalence of sharing of needles within the prison population is that it's so subverted. It's not a public thing that people are allowed to go and do a methadone program. So it becomes something subverted, something that they do and share and are very quiet about. That's why HIV and hepatitis C prevalence rates increase after criminals are incarcerated.

The Chair: Thank you, Naomi.

John, you're now going to address the refugee issue and the economic predator issue, which I was fascinated by.

Mr. John Turvey: Yes. I'll also highlight some of the role of the federal government, with your faulty organized crime bill.

Nobody ever talks organized crime. I talk organized crime because we give out 3.5 million needles. If every one is worth ten bucks, in terms of drug use, that's $35 million. If they use it twice, it's $70 million. So there's that out there, that our needles represent $70 million in the illegal drug trade. Plus, the crack-using population is of such a nature and so compulsive that they represent that too.

So we're looking at a multi-million-dollar drug industry that takes place, believe it or not, in the poorest postal code in Canada. I'm talking $1 million to $3 million a week. We have a law enforcement organization that has their heads up their ass and will spend their time running around busting chicken-shit addicts on the street level. You could be blind on our streets and make drug busts. It is not difficult. You really could. You fall over it.

What we need, and what we hear all the time from law enforcement, is that they're looking at the upper echelons. Well, we're still waiting. I'm still waiting for their sight to go above the horizon here, because it's just not happening. It's a multi-million-dollar trade.

Now, go down on that street tonight. Start at Victory Square. That guy just got convicted, the guy who ran the Stadium Inn Boys, which was an east coast group of fellows—white, racist—who, the rumours are, took care of a few of the non-whites who were farther down, opposite Woodward's, who dealt in crack, who came here from other countries. You'll see that. As you go down the street, there are certain parts of our street where you can do that. Oppenheimer Park is controlled by certain drug elements.

What certain of the bigger criminal organizations do is they never appear in our streets. They never appear. You know who those organized crime people are, because they're the same all the bloody way across Canada, right? But they never appear and their front people do it for them.

We have hotels and rooming houses that are taken over by drug traffickers. Even addicts say to me, “Keep the dealers out of hotels. Once the dealers get into rooming houses, they go to shit.” And they do. They go to shit. So you have whole rooming houses that are just taken over and become virtual shooting galleries, sex trade operations, and OC, organized crime, is there.

Do we have a handle on it? No, we don't. Do the police even look at it and assess it? No, they don't. Yet the volume of dollars out there is so bloody staggering, just in terms of drug dollars, never mind the crimes that are committed to get the money to buy the drugs.

We did a paper in our community some years ago called “Steal and Pawn, Dusk Till Dawn”. A bunch of the community agencies got really pissed off and wondered why the hell, besides our three pawn shops, all of a sudden we had over 50 second-hand stores in a one-mile radius, which pushed gas lawnmowers, and there isn't a goddamn lawn in the whole neighbourhood. It's because everybody was out plundering everything because the drug trade was out of control.

Does this ever get addressed? Does the federal legislation around organized crime get utilized in an effective manner, when it comes down to where the rubber meets the road? No, it doesn't. So you have a multi-million-dollar industry that's being driven by professionals in organized crime, and you have governments at all levels—not just you guys—at municipal, provincial, and federal levels that don't do a goddamn thing about it. It's really appalling.

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It attracts really sophisticated players, and it attracts that kind of muscle. So when you go down there tonight you'll see elements of that, as you move through the community. It used to be the drug trade in our community was a fairly anarchist operation, in that anybody who could bring it in all of a sudden found themselves in business. It's no longer like that.

A lot of our drug overdose deaths happen when a new player comes into the marketplace, wants to move some inventory, and decides not to cut their heroin. They put it out in the marketplace with very high levels of purity, just to get part of their business going and to move their inventory.

So you guys should really be making recommendations, giving some scrutiny to that, and talking to law enforcement officials to find out what federal tools they really need to come in and address that.

Let's just leave all that aside for a minute. In this nice ambience of total chaos and criminality that takes place, we have entrepreneurs. We have store owners who sell cocaine and heroin. I'm on Ray-cam Community Centre's board. There was a corner store, a mom and pop operation, where they even had their children selling heroin and cocaine to people who came in. I think members of his family still got the business licence.

This happens throughout our community. We hear rumours—it just keeps on going—of cigarettes brought in from Ontario because they're cheaper, repackaged, sophisticated stuff in 40-foot trailer trucks. It just goes on. The community just thrives on it.

There are people who buy rent cheques. Listen to this; this is a good one. You're an addict, you're really addicted, and you get your rent cheque for $325. You go to this hotel operator and he gives you fifty cents on the dollar for your rent cheque, but now you're homeless. So you're out there in the middle of the night, but do you go in for emergency housing? There's not a hope in hell you'll go for emergency housing. If you go for emergency housing, your worker will find out that you blew you rent cheque and will administrate your payments.

So a lot of the nocturnal, street-level addicts are people who've been exploited by entrepreneurial predators. Does our local law enforcement really see this as a priority because it's placing people in even higher risk and in fact squandering taxpayers' money? No, it isn't a priority.

We have an environment where law enforcement has backed off somewhat in addressing the street-level addict. But have they been able to move in and come up with initiatives to make sure all the entrepreneurs in the community are honest and forthright in the nature of their operations? No, they haven't.

So we have a whole community that's corrupt. Virtually anything gets sold down there. We have second-hand stores that just buy computer stuff. It just goes on in our community. Even our needles we distribute, put out or exchange end up getting sold. Condoms end up getting sold. There isn't an item in the community that isn't part of the marketplace down here.

The Chair: But John, the rooming house owner or the apartment building owner takes the cheque and cashes it. Do they list the person as being there?

Mr. John Turvey: Yes. There are fabled stories of rooming houses that rented whole floors that didn't even exist. There are rooms that most likely were rented three, four, or five times in some hotels.

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The Chair: I'm asking this because I don't know the answer. Why would someone cash their cheque for fifty cents on the dollar there, versus going to—

Mr. John Turvey: It's not made out in their name; it's made out for their landlord. They give it to their landlord, but they don't obtain the service—i.e., they don't live there. So the landlord gets to rent your room because you're not there, and pays you fifty cents on the dollar. We had one site, just out of the community, where this guy was investigated. There were eight or nine people in this one house all paying this individual, who was paying them fifty cents on the dollar.

The Chair: On the issue of Boost, condoms, Ensure, and those other food supplements, people who are operating supposedly legitimate businesses are reselling products.

Mr. John Turvey: Listen, the corruption in the community by legitimate businesses, I don't know—

The Chair: Well, they're really not that legitimate—

Mr. John Turvey: The money that can be made is staggering. We have 7,200 people on methadone maintenance here in B.C. It costs us $7.66 million per thousand. We have methadone maintenance programs that pay other addicts finders fees. This might not be illegal, but—

The Chair: What do you mean by finders fees?

Mr. John Turvey: Finders fees, like if I take—

Mr. Dean Wilson: If I go from my pharmacy to a second pharmacy, that second pharmacy will give me $25 to leave my pharmacy so he can fill my prescription at $7.66 per transaction plus two cents per millimetre. It's big business.

Mr. Earl Crow: If I bring a friend to my pharmacy, they pay me $20.

Mr. John Turvey: So the drug industry is criminal and the services that are servicing the drug industry are likewise. If they're not criminal they sure stink, and should be put on your rose bushes. They're really rotten and corrupt.

Just bear with me for a minute. I don't think anybody has genuinely tried to assess the impact of that kind of ambience on the addicts we're all berating and somehow chastising. We're saying “You should get your bloody lives together, straighten up and fly right”, when they're functioning in an environment where the corruption is so entrenched it permeates just about every part of their existence. So you can just about bet your money that relapse is a sure thing for a lot of these folks.

The Chair: John, we are going to have some business leaders come before us next, so I have to ask this. Pharmacists are members of provincially regulated organizations. They're business owners and get together in different kinds of organizations and establish some rules. Has any attempt been made to have them self-regulate it?

Mr. John Turvey: I don't think these are upstanding sturdy members of the Vancouver Board of Trade. They don't strike me as that. A lot of these folks are pretty nefarious characters.

The Chair: But if it's the pharmacists, they have to be legally registered.

Mr. John Turvey: I faxed you a study the health board did on methadone maintenance programs.

Mr. Earl Crow: Excellent.

Mr. John Turvey: It's an excellent study, and touches on a lot of these issues around methadone maintenance.

Mr. Dean Wilson: You can't sell black market methadone on the streets in Vancouver because the heroin is so good and so cheap. Yet they keep saying we're selling to the black market. The only corruption is with the pharmacists. I can't give it away; nobody will take it.

The Chair: Okay. We are well over our time now. If we can just wrap up, I have Dean and Warren. If people have other questions, we'll have to invite our witnesses to communicate with us after the meeting. I apologize. It's been fascinating and helpful.

Dean.

Mr. Dean Wilson: Just on a couple of closing things, John talked about organized crime, but in a lot of cases it's organized government. This is why I feel we have to really start at the ground level and start helping out. Drugs are not going to go away.

I was involved in importing dope into Canada many years ago. In fact, one shipment was allowed through by the RCMP. The DA told them to do that because the money was going back to the phalangists in Lebanon, and they decided that side had picked that day to beat the shit out of somebody else. That is the kind of stuff we're up against, and why I'm very particular about bringing things up about Project North Star and stuff like that.

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The Canadian government, including enforcement, must be autonomous. We cannot take the war on drugs any longer, because they are the ones who are way up there, they're the ones who are flying the dope around, yet we're the little guys getting busted. As I say, organized crime is organized government. You had Paul Kennedy from CICAD here, our representative from CICAD. Four people from CICAD have actually been busted in their own countries for illegally selling dope and that.

There's corruption at all levels. I think the top levels are really.... We can't stop them; drugs are here to stay. Therefore, we have to take the person out of it. I am going to Randy's constituency tomorrow for 35 days for treatment; I've had it myself. But dead people don't detox. We have to keep people alive long enough, until they hit my age, and say “No more bullshit”. But I mean it. I am dead certain. You must take my urgency back to Ottawa with you. I'm losing a friend a day here, and it's unacceptable. Just say no to the war on drugs.

Thank you.

The Chair: Thank you, Dean.

Warren.

Mr. Warren O'Briain: In conclusion, just to build on the economic thing John was talking about, I want to draw your attention to testimony from a witness who was in front of the Senate committee on illegal drugs a few weeks ago here in Vancouver. He was a very young man, just out of adolescence, named Rob Hall, who grew up in a loving family on the west side of Vancouver and who developed an addiction to injection heroin while he was in high school.

Rob Hall talked about how it's easier to get access to heroin in this city for someone who's a high school student than it is to get access to alcohol and how home delivery or dial-a-dope operations are faster in delivery than when you call for a pizza. For all the humongous problems in the downtown east side, this is an issue that has extended to many parts of our city.

I want to leave you with a paraphrase of a quote from billionaire New York financier George Soros. He's someone whose politics I don't generally agree with, but I think the idea is good: if you can produce disposable pens for three cents each and then, because they are forbidden, sell them for $9.50 each, all the armies in the world will not be able to stop the trade in disposable pens.

The Chair: Thank you, Warren, and thank you all for your passion, for your insight, and for taking the time to spend time with us, educate us, and infuse us with your passion.

Dean, I'm sure that I speak on behalf of all members when I say that you've made a very big impact on us. We really do appreciate your time, and we wish you much success with the various organizations you are working with, and Dean, we certainly wish you lots of success for the next 35 days. Take care.

I'll suspend for about two minutes, colleagues. We're going to be really badly off track if we don't get right on it.

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• 1137

The Chair: I'll bring this meeting of the Special Committee on the Non-medical Use of Drugs back to order.

We have with us as witnesses, from the Vancouver Board of Trade, Glenn Young, the co-chair of the Downtown Eastside Task Force—he's also president of International Tradewind Strategies, Inc.—and we have Dennis Farrell, chair of the Property Crime Task Force; he's also co-chair of the Downtown Eastside Task Force. That's a lot of task forces.

Mr. Farrell.

Mr. Dennis Farrell (Chair, Property Crime Task Force; Co-chair, Downtown Eastside Task Force, Vancouver Board of Trade): Thank you very much.

My colleague Glenn and I are the chairs of what we call the Vancouver Board of Trade Downtown Eastside Task Force, and I say we call it that. The reason for the task force was a request from the mayor of Vancouver, Philip Owen, who approached the Board of Trade and asked us to review a report the city had generated called “A Framework for Action: A Four-Pillar Approach to Drug Problems in Vancouver”. The request was that we review the report, meet with individuals knowledgeable on the subject, gather additional information, and prepare a response for consideration by the Vancouver Board of Trade board of directors.

The task force itself is comprised of a number of individuals, most of them with a variety of business backgrounds. Indeed, just as an aside, one of our members was himself a substance abuser and is the CEO of quite a successful Vancouver company; he's going to publish a book within the next month or so called From Skid Row to CEO. It should be very interesting reading.

However, we interviewed a number of people, and we've done very much as you are doing right now. We've tried to get people who are knowledgeable, and we've had people who were addicted to drugs. We've had police officers. We've had health professionals. We've had members of the judiciary, we've also had members of the teaching profession appear, and we've had some very candid observations.

We've also had a chance to interview Mr. Rennie Shenkey, who was here and who is one of the sponsors of the Frankfurt injection facility, and there was an Australian gentleman, Mr. Trimingham, who's a very passionate speaker as well. His son overdosed on heroin in Australia, and he has his particular views. That's just to acquaint you with the fact that we have interviewed a number of people.

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As a consequence of the process, we prepared a report with recommendations. Many of the recommendations, incidentally, correspond to the questions you've asked in your terms of reference. The report itself was handed to the clerk. I'm not going to get into all of it, but I've asked my colleague Glenn to perhaps give you some perspective on what it contains.

Mr. Glenn Young (Co-Chair, Downtown Eastside Task Force, Vancouver Board of Trade): We basically addressed the four-pillars approach described in the report Mayor Owen had presented, and we provided feedback, a response to it. The four pillars, as you know, are prevention, treatment, enforcement, and harm reduction. We had very strong Board of Trade support for two of those four pillars, prevention and treatment, and we support the enforcement part as well. We have some problems with the harm reduction side, given the testimony we heard. We have some issues with specific items.

I won't go over the details of our response, because it's been submitted to the committee, and you can look at it at your leisure. We also added a fifth pillar in respect of the downtown east side. We felt that the economic redevelopment of the area was also an important key to solving some of the local issues, particularly the problem with drugs. Legitimate businesses could drive some of them out.

With respect to the poorer people in the neighbourhood, one of the myths is that they're not willing to work, which I don't think is true. The opportunity hasn't been presented to them. How can we get them into the workforce, and what kind of economic development strategy can we use with the downtown east side that's sustainable and that is good for that community?

One question people ask is why is the Vancouver Board of Trade interested in the downtown east side. Quite frankly, the downtown east side is part of Vancouver, and we all live here. You will find that some of our business members live in the downtown east side, because the downtown east side goes all the way to Commercial Drive and is a much broader region than the Main and Hastings part we always talk about.

When we talk about the downtown east side, the discussion tends to revolve around the Main and Hastings issues, but we have some of our very high-level members living in the downtown east side, though farther toward Commercial. We are concerned about the downtown east side because it is part of our city, part of our fabric. Regardless of whether we're self-employed or we work for someone, whether government, international corporations, or local corporations, we live in Vancouver, and we are concerned about the overall fabric of Vancouver.

The obvious thing you talk about is crime. Crime happens in the downtown east side from the drug trade, but those who break into cars don't generally break into a car in the downtown east side. They break into a car in Shaughnessy and in the west end. It's a problem for everybody, so that's why we're very interested.

One of the solutions we thought would really help is to try to find an economic development strategy that would help the downtown east side. We have done that in the past through a number of different initiatives. I can go into that later on if you wish, but relative to what we're talking about in terms of the drug problem in the downtown east side, we very strongly support a prevention and treatment orientation.

While people speak very passionately and eloquently about people who are having problems with drugs and there are lots of spokesmen for them, what we like to think about is our future, our children, and how we keep them away so we don't get into a situation where they may be dependent on drugs. We all agreed that the best way to do that would be prevention and some form of promotion telling people about the wrongness of drugs, one very much like what the federal and provincial governments are doing in relation to tobacco.

Treatment, we felt, was important as well, and we strongly support and endorse that pillar. While we can prevent people from getting into drugs in the future, we should also help those who are involved with drugs currently and get them out of the cycle.

As to enforcement, I will defer to Dennis to talk about that. He's much closer to the enforcement side than I am; I'm more on the business side. Economic development is one of the pillars we really and strongly endorse and would like to add to the downtown east side issues.

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In terms of our response, we have problems with two specific issues. One is the needle exchange. We are concerned about the form that it is taking currently, because it's not really an exchange, it is a distribution. I have personally seen handfuls of needles handed out from the back of a truck in the downtown east side. We have testimonies from other cities that have done a successful needle exchange in very different formats than what we're doing. So we're not totally closed to the idea, but we have some serious concerns about the way it's being done right now. If the government is pursuing that, there should be further research into how it should be done properly.

We have very strong problems with safe injection sites. Part of the issue is that it appears that we actually condone the use of drugs as an acceptable alternate lifestyle. We have a problem with that. We don't accept that as an alternate lifestyle. Secondly, from a more practical point of view, we heard testimony from addiction experts and people who run similar organizations outside of Vancouver, and it came to our attention that in fact the safe injection sites probably would work for heroin addicts but not so well with cocaine addicts. We have a cocaine problem in Vancouver, and it was pointed out to us that safe injection sites are not the right solution for cocaine addicts because they need to inject a lot, versus heroin addicts.

I'm not an expert on it. I defer to the expert witnesses who appeared before us—and Dennis probably knows a bit more about that as well. So the essence of it is that we support 85% to 90% of the four-pillars program. We set that in writing, which is part of the response that we submitted to the committee. We also told the mayor, obviously, and council that we do support in principle the four-pillars program, and we've added the fifth pillar, which is economic redevelopment.

Dennis...

Mr. Dennis Farrell: Thank you.

As my colleague indicated to you, the report is fairly comprehensive, and he has done a very good job in summarizing it.

One of the things that concerns me right now is that currently in the media there seem to be two lines of thought or two issues debated. One is the decriminalization of marijuana, and the other is the safe injection sites. In our view, the almost exclusive focus on these two issues tends to more or less convey a message that there is a liberalized drug policy perhaps being considered by the Government of Canada and that substance abuse is a lifestyle choice, that it's something that's okay.

We believe the focus of our national drug strategy should have as its cornerstone the strongest possible message of primary prevention of drug use and increased efforts to reduce the effects of drug use. It should renew rejection of the idea of drug use as an acceptable alternative lifestyle and should encourage efforts to improve the availability and the adequacy of treatment, including, in the most severe cases, mandatory treatment.

We know a consistent, comprehensive, and durable preventive program can be effected. All you have to do is look at the seatbelt legislation, the drinking and driving legislation, and particularly the results that have taken place with respect to tobacco. I think the people at Health Canada really have to be congratulated with that campaign, most particularly the recent campaign that has to do with mild or light cigarettes. We feel that if the team that is responsible at Health Canada for formulating and implementing this particular preventive measure were dragooned into doing the same thing on the whole issue of illegal drugs, our country would be very well served.

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According to the information we've had, there hasn't been a publicly funded prevention campaign at the three levels of government since 1988. We think that really is a dreadful state of affairs, because the prevention campaign, as Glenn has stated, is aimed primarily at those who are most susceptible, and our young people are the people we want to reach.

As far as harm reduction is concerned, I think the best example of harm reduction is the availability of treatment, and we have to look seriously at the adequacy and accessibility of our treatment system. We interviewed Dr. Perry Kendall, who I think is the head of the Vancouver/Richmond Health Board, and quite frankly, we couldn't get an idea of how many treatment beds are publicly funded in this city. I don't think anybody can answer that right now.

If we go to some of the European models that have been exposed to the media and to all of us, and if we use a proportional ratio, Vancouver should have about 800 treatment beds. We know that we don't have anything near that. I'm speaking of publicly funded treatment beds; I know there are many privately funded treatment beds, and we've heard from those people.

From a business perspective we must ask ourselves, if we adopt a more liberalized drug policy, which might include reneging on some of the international agreements or treaties that we've signed, how will that affect our trading relationships with other countries, and particularly with the United States?

Madame Chairman, being from Burlington, you know there's a great deal of difficulty right now, particularly in the automobile industry, in bringing merchandise or goods across the border to fuel the production lines of the various automobile manufacturing plants. This is a key issue right now, and our feeling is, if there were a more liberal drug policy in Canada, it very well could affect the delays that are experienced at the border now.

That's in essence what we wanted to say. We wanted to focus our response on prevention. As a group, we are unanimous in believing that prevention is very much something that has to happen. It hasn't happened, it's not happening, and we would like to see the initiative taken by our federal government in sponsoring and dealing with that issue.

Thank you very much. We're prepared to answer questions.

The Chair: Thank you. We do have some time for questions.

We'll hear first from Mr. White.

Mr. Randy White: Thank you both, Dennis and Glenn, for coming here. I've been sitting here for three days wondering about the perception that communities like Fort St. John, Terrace, Revelstoke, and Fernie would have on a discussion like this, given that we're here in Vancouver, and only in Vancouver, not in those other areas, which we have to get to or have to hear from, because there seems to be some kind of focus on something called “harm reduction” and something called “We need a safe injection site right now; that will fix it.”

I disagree with that concept, because some things you hear about.... I've just heard “heroin-assisted treatment”, giving people heroin. I've heard about home delivery of drugs, condom exchanges, safe shoot-up sites, and needle exchanges, and I've heard very little about rehabilitation, detox, the need for consistency, numbers of rehabilitation facilities, and so on, relevant to the discussion on this harm reduction stuff. I've heard more of this than the other. Surely, the objective is getting people off drugs, not continuing on drugs.

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I want to ask you how the Board of Trade, or any businessman in this country, buys into a concept called harm reduction. What, in your mind, is harm reduction, and where does it fit in the scheme of things in society? That's where I'll start.

Mr. Dennis Farrell: Perhaps I will take a crack at that.

I agree with you that treating people who are victimized by drug abuse is absolutely critical. Also, though, I think what's absolutely critical is trying to prevent young people from becoming involved in the drug issue in the first place.

Insofar as harm reduction is concerned, I said we had a number of people who spoke with us, including Mr. Shenkey. We've also had a chance to speak with some of the people who visited the Frankfurt site and have reported back on that. I'm not an expert on addiction. The people who were here before you, John Turvey and some of his colleagues, certainly are, and they're probably a lot more knowledgeable than I am.

As a layman, I've been told that the problem drugs here are heroin and cocaine. Heroin is a different type of drug from cocaine; heroin is a depressant, and cocaine is a stimulant. If someone who was a heroin addict were to use a harm reduction site or a safe injection site, and if that person were subjected to expert advice—people who would try to convince that person, if not today then perhaps tomorrow, that they can help them, take them out of this situation and get them into a treatment facility to defeat their addiction—that would be great.

The fact of the matter is that we know that a lot of the problem in this area is cocaine addiction. We know that the cocaine addict uses the drug many times a day. Simple arithmetic tells us that if there are 5,000 or 6,000 people using cocaine actively every day, and if they have to each use that safe injection site every time they inject cocaine, this hotel wouldn't be big enough to house them all.

In our view, the issue is treatment. We're not trying to be cold-blooded or hard-hearted. We believe that treatment is the essence of how we're going to deal with these people, treatment for those who are addicted, prevention for those who may become addicted. We know that 5% to 6% of our population have maybe a preponderance to what we might call an addictive personality. We don't want those people to be ignorant of the message that they shouldn't be using any type of drug.

Mr. Randy White: Okay.

I want to get in one other question here, and I'm not sure how much time I've got.

The Chair: Quickly, then.

Mr. Randy White: I address this to Glenn.

I was with a couple of addicts one day on the street, and some of the downtown businessmen. I asked the obvious question: “Where do you get your money to survive?” One of the addicts turned to one of the businessmen and said, “I steal from him”. I have records here of people with anywhere from 30 convictions to 100 convictions. Time and time again they go into a courtroom and they'll get a $300 fine for trafficking, then they'll get a suspended sentence. You know, it's up and down but it's never anything serious.

What does the businessman think, when there are so many people out there coming at him? In particular, how does he react to someone saying “I'm just going to steal from you. If I get caught, I'll go through the turntable system and come back out and steal from you again”? What is the plight of the businessman? Where is the end, in your mind?

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Mr. Glenn Young: Obviously, the property crime issue in Vancouver is very big on our agenda. We're very concerned about it, because without a nice safe place in which to live and do business, we will not have business and we'll not encourage people to come here.

The Board of Trade is very, very strong in supporting the drug court issue. We went to Portland and we spoke to them. You know, nothing is perfect. They have problems with it there and they're working it out, but at least they're doing it.

We feel the same about the drug court here. Our concern is that while we can put in a drug court system, we don't have enough treatment beds to put the people in. We certainly don't see the criminal act of an addict as criminal intent, in the sense that they steal to feed their habit, so it's not.... Well, it is not appropriate to put them in jail, but we should give them a second alternative, which is to offer them treatment to remove them from the habit, however that's possible. The drug court system has the ability to do that. That's what we see as getting these people out of that cycle.

You're quite right, we were very upset about it when we heard stories. We have people who have 96 convictions and they walk away. They're going to continue to steal. And maybe what we should be focusing on is not so much incarcerating them but going to the root of their problem, which is defeating their addiction. Therefore, perhaps we should solve the addiction problem by putting them into treatment facilities.

I know the federal government has moved considerably on the drug court issue, but we're still concerned that what backs up the drug court is the treatment beds. If we don't have adequate treatment facilities, the drug court is stymied. It can't do anything. It has no place to put these people.

That would be the answer. If anything, all levels of government need to work closer together to solve the treatment issue, as Dennis said earlier.

Getting back to harm reduction, we see prevention as a major pillar of the harm reduction program. I think that business people—notwithstanding the current economic climate in which we hear the business analysts all saying doom and gloom and woe is me and we're all dying and we're all going broke—by nature are entrepreneurs. They're all optimists, because if they're not optimists they're not going to be in business. Maybe they'd get a job with the government. But as business people, we look to the future. We look squarely into the vision of our business, the vision of the society we live in, and we look to the future because the future is where our profit or our benefits will come from.

Prevention is really about the future, and what we want in Canada is to prevent our young people getting involved with drugs. Yes, we will lose some, that's right, but we want to minimize the number we lose. That is what will happen through prevention, through education, through public campaigns. However we do it, we need to get the message to the students and to the young people that drugs are not good. It's very similar what we're doing with tobacco. We're telling people today that tobacco is not good for you. Maybe we should be doing the same thing here.

In terms of harm reduction, then, we see prevention as a major part of harm reduction. We have really encouraged all levels of government to seriously look at it and, as Dennis said, formulate some kind of campaign to create a harm reduction environment or prevention environment.

The Chair: Thank you, Mr. Young.

Ms. Davies.

Ms. Libby Davies: Thank you very much, Paddy.

Thank you for coming today.

I'm sort of concerned about this issue that keeps coming up, that harm reduction or what's perceived to be liberalizing Canada's drug policies is going to promote a drug-use lifestyle. I think particularly Mr. Farrell mentioned this, that this is somehow contradicting the need for treatment and for intervention. Yet I have to tell you that every single witness we've heard from, particularly the ones this morning, who spoke very passionately about what's called low-threshold harm reduction interventions, also spoke about the need for accessible, available treatment on demand.

I think there is a lot of information out there that shows us that when you have the low-threshold interventions.... In fact we had a researcher here earlier, Mr. Kerr, who pointed out that in Europe the provision of these low-threshold services actually led to an increase in the kinds of treatment programs that were available. So it actually had a positive effect on that.

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I think there's a lot of misinformation about safe injection sites and other measures. In fact, I don't know if it was yesterday or the day before, but Inspector Kash Heed, who is the head of the police department vice and drug squad, told us that an estimated 82% of the police budget is spent addressing problems associated with substance abuse. Economically, this is a massive issue.

Then he went on to say:

Trial-supervised injection facilities involve digression from the strict requirements of law. Yet this controversial measure needs to be part of the discourse about harm reduction. The main objective of supervised injection facilities is that they allow intravenous drug users to inject in a safe, hygienic, controlled, and discrete environment rather than in the public.

This is from an inspector from the police department.

There are a lot of opinions out there, and I think a lot of people have anecdotal information or their own beliefs and so on. At the end of the day, does the Board of Trade believe we should be making our decisions based on what's called evidence-based decision-making? Does it really have to be decisions that come from evidence, whether it's from other jurisdictions or what happens in our own city, that will cause us to make the kinds of decisions we need to make?

I think there's so much information. You both said you're not experts, which I appreciate you saying. We have expert reports inches and feet high that I think are telling us very similar things about what we need to do.

As the Board of Trade, do you rely on that? Do you believe that a very important thing is to base it on the evidence rather than just the hearsay that we often communicate?

Mr. Dennis Farrell: Let me correct one thing. I didn't mean to convey to you that I believe the liberalized drug policy encourages drug use. I'm saying that it sends the wrong message to the people we really want to keep away from the drugs—the young people. That is my only point.

I would like to come back to your other very interesting question. When the research was done for the mayor's four-pillar approach, the research was done primarily in Switzerland. The evidence that was obtained there, if you want to call it expert evidence, formed the basis of the four-pillar approach. Sweden, which has diametrically opposed or opposite ways of doing things, was not mentioned in the report. So if you ask a lay body such as the Vancouver Board of Trade which one they would support.... I personally have a very good knowledge of the Swedish experiment versus the Swiss experiment.

Ms. Davies, about three years ago, if you will recall, we had a conference in the downtown east side—and I believe you were present—where they had an expert from Switzerland and an expert from Sweden disagreeing with one another. So when you say “evidence”, what is evidence? What is the factual evidence? That's how I would answer your question.

I mentioned a minute ago that in some instances mandatory treatment would be something we should consider as a country. I'm not speaking as a health professional; I'm speaking as somebody who logically sees some of the poor people who are victims in your constituency. I think perhaps that's how we can best help them. I don't know that, though.

Ms. Libby Davies: Sweden often gets held up as a contradiction...or it's another way to shoot down harm reduction. Perhaps we need to get more information on this. My understanding is that their policies and their programs are driven from a very different perspective in terms of dealing with alcohol substance abuse issues. So it may be a different environment, and I guess this is part of the problem.

In terms of an open public area where drug use is going on, I think Frankfurt has actually been a very useful example, because they were dealing with a situation that's very similar to what we're now confronted with in Vancouver. Interestingly, the debate there and the qualitative change that took place actually came from the police department.

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I think there are all kinds of nuances to this, but I take it that the Board of Trade has supported the four-pillar approach overall. Is that correct?

Mr. Dennis Farrell: Yes...and adding, as Mr. Young said, the fifth pillar. The fifth pillar can't take place without the other three or four being in place, obviously.

Mr. Glenn Young: I'd like to respond to the issues of evidence. I'm not in the legal system, but we as business people take reports and research very seriously, because that's our business. We rely on the success of our business, based on what the experts tell us. And we have heard from both sides, so we have heard most of the evidence and we have come to the conclusions based on evidence that was presented to us.

I want to read you our response to the four pillars relative to the low-threshold support programs. This is item 17 in the four pillars, and I quote:

We would support the establishment of accessible, low-threshold support programs or day centres for addicts in neighbourhoods outside of the Downtown Eastside provided that on-site drug use is not tolerated and provided that through these centres there is access to counselling and treatment.

So we do support a level of low-threshold unit, but we do find that some of the problem is the concentration in the downtown east side, so we have to find a way of dispersing the population. We don't have the answers, but all we know is that if I were a drug dealer, the downtown east side can't be any better place for me, because you've concentrated all my clients in one spot. I don't even have to move. As a businessman, I have to deal with distribution centres, networks, that's all around the world, so my business is very complicated. I would very much love the federal government to bring all my clients into one spot so I don't have to move.

So I think we do support, to a degree.... We're not unsympathetic. The Board of Trade and the business community have always been painted as the nasty bad guys who'd rather all these drug people just go away and die. That isn't true. We feel they're human beings as well, and we are part of the community.

The Vancouver Board of Trade is made up of about 60% or 70% of small businesses, like myself. I'm a three-person business and we have a lot of small businesses. And the people who did the research on our response are all small-business members. So we do care and we do want to work. There are things we can't agree to, but so be it.

Ms. Libby Davies: Is that response to the recommendation saying you don't support any low-threshold centres in the downtown east side?

Mr. Glenn Young: No.

Ms. Libby Davies: I think you read out that they should all be outside—

Mr. Glenn Young: Outside, yes.

Ms. Libby Davies: —so you wouldn't support any in the downtown east side.

Mr. Dennis Farrell: Oh, yes.

Mr. Glenn Young: I don't think that was the intent, but we would like to have it dispersed. I think that was the intent.

Ms. Libby Davies: Okay.

The Chair: Thank you.

Mr. LeBlanc.

Mr. Dominic LeBlanc: Thank you, gentlemen, for your presentation.

You said something about economic development in that part of this great city being important. I think you're absolutely right. One of the things we've heard increasingly is that one of the root causes of many of these addictions is economic despair. I come from Atlantic Canada. If we can give economic opportunity to people, it reduces an awful lot of social problems. So I'm very sensitive to that, and I congratulate you for saying so.

You also said, Mr. Young, that you think it's important to look to the future and to be an optimist and that's what successful business people do. I was struck by the presentation this morning from some of the people before you, and I think you saw some of their evidence or their testimony. I'm trying to think of a way for us to give some optimism to some of these people as well. Economic development is certainly one aspect we can all do together...and opportunity.

The optimism for some of these addicts we've heard about and seen is a fleeting concept. One of the things we can do perhaps to give them optimism is to give them better health care. And I'm a big believer that the prevention you spoke about is important as well. I think we could put more money into prevention resources. We saw that yesterday in a group of people we met who desperately needed more resources.

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If successful entrepreneurs are those who take risks—and it's a cliché, probably because it's true, that the greater the risk, the greater the payoff, the return on the investment—I'm wondering if it's not time, as part of a comprehensive package of the four pillars.... The fifth pillar, prevention, I think is interesting. Although prevention is part of harm reduction, to put a focus on that I think is very valid.

I'm wondering if it's not also time to take a risk on some of these harm reduction approaches, while being conscious that the risk be taken in a broader context of prevention, of access to proper treatment, which I think is a big problem. We've heard over and over again that harm reduction, if it means safe injection sites alone, won't solve the problem. But if it's part of a step or a road to a healthier lifestyle, do you not think your members might be sensitive to that risk leading to a payoff?

It's in our economic interests to do so. If you look at the economic costs of deteriorating health, of HIV and AIDS, we could lower your corporate taxes a lot if we didn't have to pay all that money in health care to these people. So surely your members would be pleased to have lower EI premiums if we can better manage the health crisis that we see in certain parts of the country. Is that a valid argument?

The Chair: Mr. Young.

Mr. Glenn Young: I think you're absolutely right. I would refer you to an article I circulated to our members when we first looked into the downtown east side issue. It was published in the Harvard Business Review, of all places, by an author, Michael Porter, who the federal government knows. He is an economist with the Harvard Business School. He wrote a paper called “The Competitive Advantage of the Inner City”. He analysed the U.S. inner-city problem, which is very similar to the downtown east side. We're not that dissimilar to the U.S. He identified a lot of these issues and he looked at it from the economic point of view and the social aspect as well, because social is part of the economic. I remember when I took my first economics course and they told me the study of economics has nothing to do with dollars and cents, it's the study of human behaviour and social consequences, etc.

I would refer you to that if you get a chance. It's about a 17-page document. It's very worth reading and it was published in the Harvard Business Review in the May-June issue of 1995.

I think the point on economic issues is well taken. We're not so much saying no, you shouldn't do this because of this, that, and the other thing, although we do have some problems with it, which we've already identified; rather, we're saying don't do it exclusively of the other programs. There are lots of people advocating for the other side, which is the safe injection. If we sit here and listen to all the other proponents who argue for the injection sites and the harm reduction sites, and nobody is arguing the prevention and treatment side, we're going to have a very unbalanced, as you identified, program. So we're here to argue that we have to focus on the prevention side and the treatment side.

In terms of the value of work and self-esteem, I think that's a valuable thing. I don't know if you heard testimony from Ken Lyote, who's from the downtown east side and was a dumpster diver for many years. He created a little business on the downtown east side and he's helping the people in the downtown east side to create businesses for themselves. The board will support that. The board had, through a campaign about two or three years ago, rallied a lot of our members to provide a lot of resources to the downtown east side. These were management resources, not so much dollar and cents financial resources, but business planning resources to help businesses in the downtown east side in terms of how they could develop a viable business down there.

Quite frankly, for example, our financial institutions, our banks, volunteered 2,500 hours of consulting time to the area, which was never used up. We have since found out why: we ran too fast and too quickly and overran the business community in the downtown east side—the legitimate business community, may I add as well.

So we do support the revitalization of the area, but we don't want it to become a concentration, or the place you go to for safe injections. I think you're quite right, there's a lot more research that has to be done, and I think we need to look at it in a rational, reasonable way. And through building the optimism in the area, it's starting to give them some work that they can do, given their skill level. I know that UBC has put a training centre in there. They were very much criticized for it, but I think we all, as various components of our society, offer what we can to help.

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The Board of Trade represents the business community. Our constituency is business, so we can help on the business side. We're not social workers, we're not experts in drugs, we're not a lot of different things. But we can help within our constituency, in what we're expert at. UBC has done the same. They're educators, so maybe they can provide some skills they can use down there. So we all have to do our part.

I think the Porter article, when you read it, identifies very clearly some of the potential roles the government, the business community, and the social community, the people who presented before us, can play. We all have a role to play in making the inner city better.

I think we have to clearly define what our roles are, how we're going to do it, and how we proceed with it as best we can. And I think you're right about the risk: everything we do has a component of risk; it's how we manage the risk that's important. The premise of business is not so much that we're afraid of the market because of the risk; it's because we know the risk and we manage the risk. I think that's what we're trying to get at: we know this area has these risks, so how do we manage it? How can we make it better, and how can the business community take part in making that area better?

In this community we're always painted as the bad guys. We're afraid to go to the downtown east side because the headline is going to say “Vancouver Board of Trade invades downtown east side”, and we become the economic predators. But that's not what we want. We want a safe society, a safe city, a city we can be proud of as business owners, because people will come to visit, and when they come to visit—guess what?—they bring in money and it's good for business. It's good all the way around.

I learned something when I was in Portland, from the chamber of commerce in Portland. This was a business community talking, and they said we have to get into the cycle of thinking that it's not that business is good for society, it's a good society that's good for business. So we have to focus on that. How do we make our community better? A good community is good for business. It's not that a good business is good for the community, but a good community is good for business.

Thank you.

The Chair: Thank you, Mr. LeBlanc.

Mr. Young, I have a couple of questions for you. Do you have a venture capital fund, a little micro-lending initiative that you have going, such as the Women's World Banking model or the Calmeadow Foundation's? Has Martin Connell come out and given you some advice about setting up small amounts of money, say $1,000 loans, that are recirculated through the community? Has that been done?

Mr. Glenn Young: We've looked at it through Mr. Jim Green, who used to work for the previous government in B.C. We had quietly worked with him and tried to bring precisely that type of program. He started the Four Corners Bank, which has its problems, and I don't profess to know what those problems are. But we looked at the idea of having venture capital and some kind of a capital base.

We looked at a project called the “first opportunity target area” from Oregon; again, we learned a lot from Portland. They used this program to build their convention centre. The convention centre was built just outside Portland in a low economic area, and they used what's been coined as FOTA, which is the acronym for first opportunity target area, to create employment. The idea of FOTA is that as a government-funded agency they would purchase from that area first in their first opportunity to buy.

The Chair: I'm talking about micro-lending so that if someone wanted to start up a little business and they needed $300 to start it they could get that money and then they pay it back, and then someone else borrows it and they get their business going.

Mr. Glenn Young: I see. Yes, I think there were some projects planned. We haven't been directly involved with it, but we have heard presentations from them. As to the success rate, I'm not sure, but I have heard—

The Chair: I'm just surprised. If you have banking people around the table who want to give hours, why can't they cough up a little dough and get some things going?

Secondly, are freight forwarders and the terminal owners at the port members of the Board of Trade?

Mr. Glenn Young: Some of them are.

The Chair: And have you worked with them to try to initiate a policy of bonding the individuals who work there so that there is in fact security at the port to prevent containers arriving full of drugs, or partially containing drugs, from getting access to the streets of Vancouver?

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Mr. Glenn Young: I'm not aware. Do you know of any, Dennis?

Mr. Dennis Farrell: No.

Mr. Glenn Young: No, I'm not aware of any discussion. We do have a separate committee that looks after transportation, but I have not heard that aspect of it.

The Chair: Clearly the drugs are arriving here. They're arriving, in good measure, through the port and through containers. Clearly the federal government has a role. We heard from the people in Montreal, and were quite disturbed by it. I would think, as member organizations, there would be an opportunity for them to initiate change within what their practices are, who the people are, and to tell us what else we need to do to either enhance the law or help break some of the crime rings that are operating there. It clearly is a problem. Anything you can do to bring your private sector members onside in terms of creating some demand would be helpful.

I have another question. I think you were in the room when we heard testimony about some of the unscrupulous business owners, particularly the pharmacies. Is there work within the Board of Trade, working with the pharmacists' associations and the pharmacy associations and things, to crack down on this behaviour and to self-regulate it?

Mr. Glenn Young: We haven't worked with the pharmacy associations because we know of the activities in the downtown east side. I've been to some of those hotels as a guided visitor. We know of some of those rather seedy operations, and we would like very much to move them out, because they occupy space that we would rather have legitimate business occupy. But we have not, that I'm aware of, worked with the pharmaceutical people to do this.

The Chair: Mr. Farrell.

Mr. Dennis Farrell: Specifically with the pharmaceutical people, I'm not aware of any work with them.

One of the things that was done, when we looked at the whole issue of property crime, is we prepared a report about three years ago and addressed it to the provincial government, because it's within their jurisdiction, and strongly recommended a change to the Pawnbrokers Act. The Pawnbrokers Act was enacted in 1912, I think, and it's still in effect.

I think it was John Turvey who indicated what's happening in terms of pawnbrokers. Some are scrupulous and adhere to the law, there's naturally no question about that. The Vancouver police have recently developed an online system we've helped finance that deals with the flow and the tracing of goods through pawnbrokers. When you have an unscrupulous group, and we know that some of them open at midnight and close at eight o'clock in the morning, they're not pawnbrokers, they're just dealing with stolen merchandise.

We've asked the provincial government to amend that statute. It was a previous provincial government and they did not do so; they refused to do so actually on the representation of some of the mayors of the Union of British Columbia Municipalities. Why that rejection was there I really am not aware of, but that's one of the things we think is very important.

Another very important thing we dealt with was the issue of returnable warrants, because there are a lot of people who are in the downtown east side who don't come from here. They come from other parts of Canada, and they should be going back to those parts of Canada, quite frankly. But that's another level and that's another issue.

There are a whole series of things we could go on and on about, but I know you're limited for time and we wanted to make our point.

The Chair: Certainly we'll follow up on the pawnbrokers one.

Do you think it's possible that you might be looking to talk to the pharmacists to figure out what you can do about this poaching business, which we were discussing this morning? Because ultimately, you are paying, as taxpayers, for the dispensing fees and for this methadone. If we have people acting in such a despicable way, I would think it's in your interest as business owners to say enough already, this is not a proper use of our health care system. And if these guys can afford to pay someone who needs methadone $25 to be poached from their neighbour, then the $7.88 or $7.66 dispensing fee is too much. There is something wrong there, and I would think that, because they are a self-regulated body, there have to be some tools that currently exist that you could bring to bear.

Mr. Dennis Farrell: I don't disagree with you at all. You have to understand what the Board of Trade is. The Board of Trade is a voluntary participation organization, so we're not—

The Chair: With a lot of influence.

• 1230

Mr. Dennis Farrell: Some influence, but we do not have a regulatory capacity, which I know the pharmacists, the lawyers, and the doctors do have.

It would seem to me this type of untoward behaviour—which is criminal behaviour, quite frankly—should be brought to that regulatory body, to have these guys put out of business. That makes common sense to me. And if it is a fact, I think the police are the people who should be dealing with the issue and bringing it to the attention of that regulatory body and doing something about it.

The Chair: Well, maybe if both our letters to the minister hit the desk at the same time, we can get somewhere.

Mr. Dennis Farrell: That's a good point, and certainly I will take it back to our group, and we will discuss it among ourselves. But we don't have....

To the best of my knowledge, Glenn, I have never had anybody from the pharmaceutical industry.

Mr. Glenn Young: No.

Mr. Dennis Farrell: As I say, we're a voluntary participatory organization.

The Chair: Okay. We really appreciate your coming here. It was my desire to make sure you were here, and I'm sure all of us around this table are glad to have your input.

I had a chance while you were speaking and while my colleagues were questioning to read your presentation dated March 1 to the mayor. Based on our experience visiting a couple of sites yesterday where treatment is taking place, I'm so appreciative that your report mentions, probably about five or six times, the desperate need for increased treatment facilities and for longer-term treatment facilities in this province.

It just seemed to me, based on the one facility where we went last night, while they were doing great work they didn't have the tools or the money, and they were actually talking about the possibility that next week the board meeting might suspend their operations.

I just couldn't figure out—and we were talking about it on the bus—why would you even bother wasting $1,000 if you aren't going to bother to deliver the rest of the services? Why did anyone build the facilities if no one was going to invest? It was so frustrating.

The good news is we met some amazing kids at the one youth facility, and they filled us with all kinds of hope and optimism, because their eagerness and their ability to articulate what's needed was extremely promising.

Mr. Dennis Farrell: If I could just add to that, there are some private treatment facilities that are very successful. One of them is an organization called InnerVisions. It's based in Coquitlam. You may want to invite the head of that to speak to you. His name is Billy Weselowski. Don't ask me to spell that—InnerVisions.

The Chair: Okay.

Thank you very much to both of you. We're going to ask these witnesses to leave and ask all three of the next witnesses to come to the table, because we are well behind schedule. Thank you very much.

Colleagues, our next three witnesses are, from the British Columbia Civil Liberties Association, Lindsay Lyster, who's a policy director—Lindsay, welcome; and as individuals who have just been added to our list this morning, Thia Walter, who's a family member and coordinator of Life is not Enough Society, or LINES; and from VANDU, Ann Livingston, the project coordinator.

We are the Special Committee on the Non-medicinal Use of Drugs—I'll get that right at least once. We have, just to put us in context, representatives from three political parties here, although the committee is composed of all five.

We have Randy White from the Canadian Alliance; he's here from Abbotsford. We have Libby Davies, who is here from the New Democratic Party and is a member of Parliament for Vancouver East. Dominic LeBlanc is a Liberal member of Parliament from Moncton, and I'm a Liberal member of Parliament from Burlington, Ontario, which is near Toronto.

We will give each of you five or so minutes to speak and then we will have some questions and answers. If there's something that comes up following this meeting, you're more than welcome to send us additional details or ideas, and that's something we encourage.

• 1235

Lindsay, you're up.

Ms. Lindsay Lyster (Policy Director, British Columbia Civil Liberties Association): Thank you very much, Madam Chair, and thank you to this committee on behalf of the B.C. Civil Liberties Association for this opportunity to speak with you.

Very quickly, the B.C. Civil Liberties Association is a private non-profit society. It's Canada's oldest and most active civil liberties organization. The association is involved in public education; in debate on government policy and legislation, appearing before committees such as this one; and in legal advocacy. It has an extensive record of advocacy in defence of the constitutional rights and civil liberties of British Columbians and of Canadians as a whole.

Specifically with respect to the area of drug use and the application of the criminal law in the area of drug use, the Civil Liberties Association has an equally extensive record. As far back as 1969, the association made submissions to the LeDain commission, a commission of inquiry into the non-medical use of drugs. In 1995, the BCCLA made submissions to the Senate's standing committee on Legal and Constitutional Affairs regarding what was then Bill C-7—what is now the Controlled Drugs and Substances Act.

Copies of those submissions, as well as of another paper, have already been made available to the committee. I don't know if they've been forwarded to members of the committee as yet, but they are with you. I'll leave those with you.

Since 1969—for over 30 years—the B.C. Civil Liberties Association's position has consistently been that the criminalization of the possession and use of drugs ought to be eliminated. As I'll discuss in greater detail, the basis for our opposition to the criminal prohibition of the possession and use of drugs is twofold. There are two main principles that I'll refer to.

The first is respect for personal autonomy. In our view, respect for personal autonomy demands that the state not interfere with the personal choices that might be made by individuals for the purposes of imposing a particular morality upon them.

The second principle—and it really follows from the first—is that in our view criminal law prohibitions can only be justified where the conduct that's going to be criminalized presents some serious risk of harm to others or to society as a whole. It's our view that the evidence does not support the proposition that the use or possession of drugs presents the risk of such serious harm to others.

In fact, it is our view that our current criminal law regime in the area of drug use and possession shows that the harms associated with the criminalization of drugs far outweigh the harm that might be caused to society by the use of drugs in the first place.

I'm going to turn briefly to the discussion of the first principle; that is, respect for personal autonomy. In our view the essence of a free and democratic society subsists in the liberty of individual citizens to make decisions for themselves about what constitutes the good life. That is a proposition that has been held by the Supreme Court of Canada to underlie our Charter of Rights and Freedom. Justice Wilson in the Morgentaler decision said: “The state will respect choices made by individuals and, to the greatest extent possible, will avoid subordinating those choices to any one conception of the good life.”

Each of us has a sphere of privacy within which we believe you ought to be able to decide what you wish to believe and how you wish to behave. Within that sphere of privacy you are entitled even to make decisions that the rest of us might disagree with and that might be personally harmful to you.

We say that to impose criminal sanctions on drug use and possession is to interfere in the most strident way the state has available to it, namely the imposition of criminal law actions, with a personal decision. And we say that to use the criminal law power is simply insupportable in this area.

The second principle we believe ought to be applied in this area is the harm principle. As I said before, what we mean by that is that criminal law sanctions are only appropriate where the conduct in question poses

• 1240

We refer in the written statement I provided you to the 1969 report—again this is 30 years old, but it's still appropriate—of the Ouimet committee on corrections, Toward Unity: Criminal Justice and Corrections, where three criteria were adopted for determining the proper scope of the criminal law.

The first criterion is that no act should be criminally proscribed unless its incidence, actual or potential, is substantially damaging to society.

Secondly, no act should be criminally prohibited where its incidence may adequately be controlled by social forces other than the criminal process. Public opinion may be enough to curtail certain kinds of behaviour. Other kinds of behaviour may be appropriately dealt with by non-criminal legal processes—for example, by legislation relating to mental health or social and economic conditions.

Thirdly, no law should give rise to social or personal damage greater than that it was designed to prevent.

We say the application of those three criteria to the question of possession and use of drugs leads to the conclusion that criminalization cannot be supported and that, rather, other mechanisms, which this committee has heard a great deal about, such as education, prevention, treatment and harm reduction programs and regulations ought to be employed instead. It's not that we say the state has no legitimate interest in or ability to act in the area of drug use, but that the criminal law is not the appropriate mechanism for the state to act.

Briefly turning to each of those three criteria, in the first we say that there's no persuasive evidence that drug possession or use, in and of itself, is substantially damaging to society. In fact, we believe it's more likely that the evils we commonly tend to associate with drug use, such as attendant criminality or antisocial behaviour, are much more likely to be caused by the criminalization of drug use and possession rather than drug use itself.

Certainly we say that in the absence of solid proof that drug use itself is causing societal harm, the imposition of criminal penalties cannot be justified. We would say that the onus must lie upon those who would justify the use of the criminal law in this area, rather than the other way around.

In this area, I think it's very important to remember that while we tend to focus, and appropriately, on those for whom drug use is causing severe and dramatic and tragic consequences in their personal lives—which we only need to drive down to Main and Hastings to see, but we can see it in Kitsilano, Shaughnessy, or any other neighbourhood in this community as well.... We focus on those for whom drug use has become a severe problem in their lives, but the fact is, the evidence shows that the vast majority of persons who use what are currently seen as illicit drugs do so on a recreational basis, and it doesn't cause any major difficulties in their functioning and lives.

In that regard—and no doubt you are already aware of this—there's a very useful paper on this point, which was prepared for the Senate committee on illegal drugs, namely Illegal Drug Use and Crime: A Complex Relationship. It has some very good factual evidence on that point, which I would direct your attention to.

Insofar as there is a small minority of drug users who are suffering these tragic consequences, it certainly makes no sense to have a blanket criminal law that applies to all persons who might possess or use drugs, even those for whom it isn't causing any particular problems. We say what ought to be targeted as far as the criminal law is concerned is criminal behaviour that might be consequent upon drug use, and so of course, just as we have laws against drunk driving, we ought to have laws against driving while impaired by a drug. So it's not, again, that the criminal law has no appropriate role. We say, though, it should focus on the problematic behaviour, not the use or possession of the drug in the first place.

The second criterion is very important in this area, and that has to do with other appropriate responses. Again, I'm not an expert in addictions research and I probably can't offer you any particular expertise in this area, but the Civil Liberties Association certainly believes society's resources would be much better spent in this area, not on the high cost of enforcement, prosecution, and punishment of persons for drug offences, but rather on education designed to educate the public about drug use, treatment, and rehabilitation programs for those individuals who wish to enter them.

We do not agree with mandatory treatment programs, but we certainly think there ought to be far greater resources being spent on the availability and accessibility of treatment and rehab programs and on harm reduction programs for those persons who are not yet—or never, perhaps, unfortunately—wishing to enter into treatment or rehabilitation programs. So we think those are all much better uses of the public purse as opposed to the law enforcement in this area.

• 1245

On the third criterion, having to do with whether in fact the imposition of criminal law sanctions has, on balance, more benefit or more harm, it is our view that the imposition of the criminal law in this area clearly causes more harm than good. Again, this committee will have already heard about some of those deleterious consequences.

I list them at the bottom of page 4 and the top of page 5 of my statement. These include the imposition of criminal records, with all of the attendant harms that causes for people when they're trying to travel or trying to obtain employment; the creation of a criminal drug subculture in which users are forced to participate in order to obtain their drugs; the maintenance of a lucrative criminal drug industry, with all the horrible consequences upon that; the creation of a marginalized class of persons, with probably impaired access to public programs such as, in particular, medical care; and the vast expenditures of financial and human resources on the so-called “war on drugs”.

I have only had an opportunity to scan it quickly, but as I'm sure you're aware, the Auditor General came out with a report yesterday, and one of her chief areas of concern was with respect to the vast amounts of money being spent by Canada in the area of drug strategy, the vast majority of which is being spent on the supply side, the enforcement side, rather than the demand side, and with no means of tracking whether it's of any benefit. In fact I would say, insofar as we have evidence, it would show that there is no benefit.

We list a number of other concerns at the bottom of page 5. Given the concerns about time, I won't go through all of those. I'll will leave you with those.

We say, on balance, the current approach to dealing with the problems associated with drug use clearly isn't working. If it was, we wouldn't be having this committee, and the Senate wouldn't having the committee it's having. Clearly, it's not working. We say it's long past time to try another approach.

The Civil Liberties Association is very heartened to see a growing awareness amongst the public and amongst politicians at all levels, including yourselves, of the problems in our current strategy with respect to the problems associated with drug use. We congratulate this committee for taking the time that it is to try to look at this issue.

Apparently you had Inspector Heed testify before you on Monday. I wasn't aware of that, and I don't know what he said to you that day, but his testimony before the Senate committee, among the other things he had to say, was that the Vancouver police department has, as a matter of policy, chosen not to pursue charges for the simple possession of all drugs, not just marijuana, and has urged the removal of criminal sanctions for marijuana use in particular. I say, if the front-line workers who are trying to fight this war on drugs are saying that, we know it's not working. We certainly commend the Vancouver police department for its statements in that regard.

To sum up, it is the sincere hope of the B.C. Civil Liberties Association that this committee will take advantage of the present opportunity to make recommendations for a principled and systematic reform of our nation's drug laws, reform that will see the removal of all criminal sanctions for drug use and possession as part of a much larger strategy to deal with the issues and problems raised by the use of drugs in our society.

The Chair: Thank you, Ms. Lyster.

Ms. Walter.

Ms. Thia Walter (Coordinator, Life is Not Enough Society (LINES)): Good afternoon.

I'm Thia Walter. I'm the mother of a long-term, hard-core drug addict. I live and volunteer in the downtown east side. My son is now 37 years old and has been addicted to heroin, and at times to cocaine as well, for 12 years. I'm somewhat appalled at some of the stuff I've been hearing.

First of all, I would tell you that the rental scams are a very tiny and almost insignificant part of homelessness. They were more of a problem two years ago than they are now, because of action that was taken by the ministry, and so forth. I can tell you that my son is one of those who is homeless, and I hold the provincial government and the justice system directly responsible. He is only one of thousands I work with and interact with all day, every day, seven days a week, and I am very angry.

Mr. White, you talked about the need to punish these offenders. I agree with you. If you're going to screw up, you should be punished. If you're screwing up because there aren't any options, then I think it's time to create some options.

• 1250

On October 17 at seven o'clock in the evening the court released my son and another offender, who had been shuttled in for their appearances from the $40 million remand centre in Port Coquitlam. They were not allowed a phone call. They were not allowed food, because they were neither a prisoner nor a guest. They were being processed. They were dumped out the side door in the downtown east side still wearing their short-sleeved red cotton shirts and pants with “B.C. Corrections” on them and told goodbye. They had no money or ID.

They were not allowed a phone call. These are two people who were at least two months clear of drugs. Where did they have to go to make a phone call for help? They had to go across the street to the downtown needle exchange.

I had been waiting and waiting. I had given the information on where to contact me or his lawyer. I finally came running, and we met at the nearest restaurant. My son was able to change his clothes. The other fellow was something of a surprise. I fed them and I gave what change I had to both of them. I arranged for my son to go to the emergency shelter, Dunsmuir House. I arranged this, not the MPA or the probation officer as the court ordered, but me, because they all went home at four o'clock. The other offender sauntered down the street in the dark toward Main and Hastings, hoping he'd find his girlfriend so that he could at least get a change of clothes. This is the kind of treatment that is going on.

I am so proud of some of the politicians who lately have taken a specific stand, such as Allan Rock, and, even when we have a lot of other issues, Philip Owen, who is the mayor. They are saying that we need safe fixing sites and heroin maintenance. The thing that bothers me is that $5 million is being spent on drug courts to punish these people. Nobody can figure out how to move their personal belongings into court with them.

The other thing that bothers me immensely is the fact that homelessness is hardly an issue of scamming landlords. What it really amounts to is that you do not have enough money to pay $350, $360, or $380 for a cockroach-and-mouse-infested room because you're under administration and they're already taking $10 a month off of you for each and every past damage deposit you failed to get returned. The whole thing is that they can't afford the housing. They can't afford anything.

Within five days he was wired again. He has a massive infection in his hand. He has been in contact directly and indirectly with at least twenty of the wonderful, well-funded organizations downtown or the departments and so forth, and not one of them has ever asked, “Do you have a place to stay? Can I help you?” No. It's, “Hey, you just used up your five days at this shelter. You can't come in tonight.” Or, “You don't have ID. You can't come to this shelter because we won't get paid for you. Besides, the police want to check on warrants, and we can't provide that if we don't have proper ID.” So you stand out in the rain even though you're a body in front of them. I'm saying that we need to deal with the basics.

• 1255

When we talk about things such as injection sites and heroin maintenance, please don't consider them harm reduction. Harm reduction has become a trendy little term. It has become a trendy business, and a lot of drug pimps are now in the business of harm reduction. Please call it what it is: an emergency health action. If you want to have a continuum of care, you have to have someone continuing, and if they're dead, they ain't going to continue.

My little office is located in one of those terrible places the Board of Trade people were talking about. It's called the Sunrise. It's where the very hard to house are housed. We need desperately to have far more of these. Instead, there's a freeze on those units. They were emptied out for renovating, 1,100 of them, and they are going to sit empty while people are on the streets. This is not sane.

When we go to our politicians, we find that they have courage and foresight and that they've done their homework. They turn it over to the bureaucrats and something happens along the line, because it never quite gets done.

More than three years ago almost $1 million was given to our area for a resource centre for drug addicts, primarily because they weren't allowed in the multi-million-dollar Carnegie complex. What happened? We don't know. But now, after three years, Carnegie is going to be running a street program out of the space they're calling the drug contact centre, where maybe four or five people can fit in, have a coffee, and get the hell out. What they're doing on the street is buying, selling, injecting, and dying, and a contact centre is not going to help. They have the information, and if they don't, they're not going to go to a contact centre except to get coffee.

What I really want to see happen is for us to separate harm reduction, the four pillars, and the continuum and deal with health emergencies. We desperately need help. They say, well, do it all over the place. If twenty people in Prince George run into the street and five of them get into an accident, that's really terrible, and you should do something about it. But if there are 2,000 running into the street in one block in this city and 200 or 400 of them are dying.... In October there were 11 drug-related suicides.

You're trying to tell me that it's a choice. Believe me, my son and others like him may like to pretend it's a choice, but when you are sick, hungry, dirty, and homeless and you've betrayed your family and lost all of your belongings, that's not a choice, and you go right back and do it again. I've had 40-year-old men cry on my shoulders after 89 days of being clean in an abstinence-based program and then thrown out because they've failed.

I'm saying that we need to deal with the real experts: the people who are doing it. I just recently did an in-depth survey. Because the street people trust me, they do answer. We have some amazing statistics. The average cost of a drug addiction is somewhere in the neighbourhood of $3,000 a month.

If you don't give a damn about people, maybe we should be giving a damn about money, if nothing else. If you can supply heroin or stimulant maintenance, it's a first step toward closing that gap. Then you can start looking at all the other things. You can put up sobering centres. It has been six years, and we're still waiting for those. But we now have Daytox, which seems to be to provide employment for the 12 A and D workers who were hired by the health board.

I'm saying that I'm very frustrated. If it sounds as if I'm yelling at you, I'm not. Please don't take it personally. I'm frustrated. I have an infection in my hand as well, and I think I'm probably on the edge of shock and will have to leave soon.

• 1300

I want you to understand how very important this is, that we're not talking about Sam, Joe, Jacob. We're talking about human beings, human beings with thoughts and ideas and caring. They need to eat, they need to breathe, they need to have water, they need to have a place to go to the bathroom. They don't have that. Then the only thing they have is drugs.

Thank you.

The Chair: Thank you, Ms. Walter.

Ms. Livingston.

Ms. Ann Livingston (Project Coordinator, Vancouver Area Network of Drug Users): I'm going to be very brief.

I organize people who use drugs. I'm the project coordinator at VANDU. I developed a model of organizing that's flexible enough to work under the terrible conditions that people live in in the downtown east side. The reason that people who use drugs are speaking here today is that there is a drug user group in Vancouver. If there wasn't, they wouldn't be here, I would contend.

If you agree with the ideas put forward a number of times that each region needs to look at its own drug problem, then each of these communities, I say, needs to be willing to form a user group that can determine and help implement that harm reduction. The federal government can go a long way to seed these groups. The way I like to view it is that women would surely be included in creating and implementing programs for women, as would native people or gays. Just entrench this in your mind: we will fail; we have failed. We have a nightmare on our hands, and we have not ever included drug users at the table.

I think VANDU's methodology and reputation in the community show that they're really quite thoughtful and responsible people who like to do a lot of research. We have 1,000 members. You can't keep people from joining our group. It's a very attractive thing for people who use drugs to get involved. The model I use is that you view them as a group of citizens who come together to solve a community problem.

There is kind of a warning that I have to put as a little star on this, because there's a huge misperception in people's minds that an AIDS service organization or some other group that's out there already can do this work. I'd like to point out that if service providers like AIDS service organizations and needle exchanges, which are certainly scattered throughout our province—whether they're throughout Canada, I don't know, but every region, of course, has its own thing—were going to do this work with users, they would have done it by now. So I'm going to push you. I want you to make this one recommendation for me.

The most important part of a user organization is the methodology. Whatever little bit of funding you give to them to start holding the meetings, you keep facilitating and saying we need someone to make these decisions. You're going to have to form a steering committee. Then you're going to make the decisions around the funding. No, we're not going to just spend it all on heroin or something. It's within the context of what we've agreed to with the government to get this funding.

The methodology that I'm encouraging is that either the user groups can function without funding or that part of the methodology that the federal government seeds them with is that they go forth and find their own funding. VANDU certainly did this. We started a group with no funding, and we're able to lobby quite legitimately, because we've had such a significant voice of users coming forth and going to the health board. I don't know how happy the health board is that they've done it, but they have. Actually, I do think they're happy about it. It's a showcasing kind of thing.

There was just recently—they're still here—the NAATAF conference, the North American AIDS Treatment Advocacy Forum, and 20 people wanted to come and see what we did downtown last night. So I'm a little burnt out. It's sort of the profit in your own back yard thing. I think we're quite internationally renowned, or nationally anyway.

Currently, Health Canada funds what they call community-based hepatitis C and HIV prevention initiatives. I want to just point out that this money currently is not going to user groups. We did get a little bit of it, but it was our understanding that when your group is called the Vancouver Area Network of Drug Users.... We were approved for the funding in April, and we were still going through the process until December, when we received our first cheque. We hope we've gone over the hump for all future user groups so that they're considered legitimate health initiatives, because they are. In other countries like Australia, they're doing them with their AIDS prevention. So we've gotten a bit of Health Canada money.

• 1305

I also want to point out really carefully here—and I'm not sure quite how to put this—that the Fraser Valley and Abbotsford region had 17 overdoses. I think it was in the year 2000. Prince Rupert had a very high overdose rate one year. I think seven or ten people died. For a town that size, it was very significant. Nanaimo had 13. Nanaimo will range between 10 and 20. Victoria had 18. I've heard as high as 23 in Victoria. Kamloops had ten, but I think they got into the teens in one year. So I'm encouraging the idea that Nanaimo needs to look at....

You wouldn't believe it. I am the lady down the street. I've never used drugs in my life. You put the meeting on, and the users all kind of say, “What's she, from the church? What is she, a nut?”, but they all come around. It takes some time. After a while, I'll keep saying, “So what's happening, you guys? What can you do now? How did you guys ever stay alive? You're homeless.” Then we have this idea that we're going to build on strength, which I'll tell you is very cheap to do, but it's also very warm and fuzzy.

You walk in a room and someone wants to know, “You're an expert, so come on, cough up. Let's hear what's going on.” I'm here to record it and then we're going to take it to the government. You know what I mean? There's a very attractive way that it goes.

I think Kamloops can solve its drug user problems. It will probably have to be seed money over more than one year. There are some rumours of this going on with Health Canada about some national conference, but it's been stalled out for five years and we're getting really tired of it being stalled out for five years.

So if you could just do me a favour and put in the recommendation.... If you do agree with the idea that New Brunswick.... I don't know; wherever people are from, they're worried: “What's Fort St. John going to say?” Let's find out what Fort St. John has to say, because we can and it's not costly.

The Chair: Thank you, and thank you to all of you.

We do have a little bit of time for questions. Actually, that's kind of a lie. We don't have any time for questions, but I think we'll take some time for questions, if we could do quick five-minute rounds.

Perhaps, Mr. White, you can start.

Mr. Randy White: I'll even be briefer than that, Madam Chairman.

I want to ask Ms. Walter something. You said your son is addicted. I'd like to know if you know how he got addicted, where he got addicted, and where he is now. Also, do you think it could have been prevented?

Ms. Thia Walter: No. He was 25 years old. It's a myth. The majority of those we interviewed as IV drug users in fact began their addiction at 25 or so. Some were 30. Some had businesses.

The whole idea of prevention is that if you take away the glamour from illegal drug addiction, then kids aren't going to be turned on by it. If you go to the schools and say “Hey, you're going to get hooked if you use marijuana”, they know that isn't true. So if that isn't true, maybe it isn't true about heroin, maybe it isn't true about crack, maybe it isn't true about the other things. They come on down, or they talk to the dealer in their own schools.

The whole idea is that if we can make addiction become so routine, a medical treatment, like they do in Merseyside, it just doesn't have the same kind of glamour for kids. Then you're not wasting your money on teaching kids how this person has sores all over their face and you would have sores on your face, too. When they go down there, they don't see that many people with sores on their faces; they see the extreme cases, and they know the difference.

We need to be a hell of a lot more honest and we need to deal with the addiction at its present stage before pouring out a lot of money for DARE programs and so forth into prevention at the school level. That's not where it's at, believe me.

Mr. Randy White: Thank you.

The Chair: Ms. Davies.

Ms. Libby Davies: Thank you very much for coming here, Thia and Lindsay.

We have a lot of testimony. With the bit we've heard, we realize we're just scratching the surface. I think we're all aware of that.

• 1310

I do want to say something about VANDU, though, because I think VANDU is the first user-based group in Canada, maybe in North America. I don't know. I simply know from my own experience with VANDU, because many of the members of VANDU are constituents in Vancouver East, that it has actually been VANDU that has sort of made a real transformation in the debate. Before that, drug users were so marginalized and so totally out of the picture they were never heard from. First of all, they didn't even know where to go, whether it was the health board or city hall. So I think that organization and the model you've used has actually changed the debate, it really has.

We're now all used to seeing Earl and Dean and others come to hearings. I've been at many conferences where VANDU members have been front and centre. But that's only been in the last four years, maybe.

Ms. Ann Livingston: VANDU was formed in 1998.

Ms. Libby Davies: In 1998, okay, so three years or thereabouts. I think the idea of providing, and really it's not a lot of resources.... You guys operate on a shoestring.

Ms. Ann Livingston: We're cheap.

Ms. Libby Davies: Yes, you're cheap. But it is very important. I think it addresses issues that we hear in other communities. Dominic has talked about what happens in his community. But allowing drug users to have their own sort of voice and to come together actually really changes the kind of debate that takes place. I wanted you to know I support that.

Thia, I actually think you have gotten at a lot of stuff today. I've heard you many times. You're a very powerful speaker. Today you've really gotten at something that has been implicit in everything that's taken place in the last three days, but you've made it kind of more explicit. I am referring to the issue of poverty, what happens to people when they are so driven to the edges of society. When we talk about the basics, we haven't really talked enough about that in terms of housing or food or just having a place to be, or a washroom and all of those things.

Your brief was excellent, too, from the Civil Liberties Association. If there was a question I had, it's to do with.... We've had a lot of debate about needing to have a big national strategy, which is important, but it's also important to have a local strategy. I wonder if you feel there is public support now in Vancouver, because of all the work you've done, to kind of move forward on some of these elements that maybe are more controversial. What is your reading of that in terms of how it has changed over the last three years?

Ms. Thia Walter: I believe we have come a very long way at the top levels, at all three levels of government. We are basically floundering once they're being implemented or being looked at in terms of implementation. Many of the five programs that are being developed and opened by the health board provide little or no real treatment for users. But they're great window-dressing. This is not to put them down. I think they don't have the direction and the real understanding that comes with the urgency. They need to separate the two: one is treatment, the other is an emergency health initiative. Those two should be separated. They should not be considered all one thing.

Ms. Ann Livingston: I would say the same thing. The public health emergency that was declared has still not been acted on, and I think some people—

Ms. Libby Davies: Was it November, 1998?

Ms. Ann Livingston: November, 1997.

Ms. Libby Davies: It was 1997. There was actually a public health emergency declared by the health board.

Ms. Ann Livingston: I mean, we're asking, could we bring a legal case? This is as serious, certainly, as suing the Red Cross around the blood scandal. We're getting up into the thousands and thousands of deaths. I think they're preventable, and I think Thia's got a very good way of approaching it. I hadn't thought of it that way, either.

What I'd like to say is when they go from the point of.... You know, you put something into somebody's hands, then suddenly it's about whether the nurses on duty have enough safety features in the building, rather than about whether they can deal with our people.

Well, I don't give a damn. I'm not afraid of any of them. We're not afraid of any of them. But there's this kind of way that by the time, you know, someone's good intentions.... Allan Rock threw a million bucks at it. Libby camped out in his office. I mean, it was really concerted screaming that went on. Yet three long years have passed.

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It's simple to open the bloody doors on a building. I mean, we were just freaking at them. They gave it to the health board and then it just becomes this endless hanging around. They actually hired a full-time worker to do nothing but PR on this item, and yet there are 200.... It's so crowded downtown—you'll see. It's just packed with people on the sidewalk. And that is getting worse and worse. The more talk there is and the more stuff that is supposed to be happening, the actual street situation gets worse and worse.

Four years ago, her son wouldn't have been in that bad a condition. It's bizarre for us to come and tell you this, because it doesn't seem like this is what should be happening. The more public dialogue, the more liberalization that appears to be going on, the worse we're finding it at our end.

It's lovely, a new contact centre, but I want to know who's barred right off. You can't bar anyone from those damned places; they're meant for people who are the most at risk. After all, they're the ones who are spreading disease.

The Chair: Thank you. Ann, I understand you're going to be with us this evening—

Ms. Ann Livingston: Yes.

The Chair: —so there'll be more opportunity to see things firsthand.

Mr. LeBlanc.

Mr. Dominic LeBlanc: Thank you, Madam Chairman.

Thank you for your presentations. It has certainly been a great conclusion to a very interesting morning, and I appreciate very much what you've said.

I have a few specific questions for Lindsay. I've read a lot of the Civil Liberties Association publications. I think you do a lot of good work. You provoke a very interesting public debate around a whole bunch of issues, and you do have a long proud history, in many ways, of leading governments on a number of issues.

I was surprised to hear you talk—it's a frequent discussion, I suppose, from the Civil Liberties Association—about criminal law imposing morality. That's an easy way to.... Someone's morality is somebody else's crime. My own view is that criminal law is all about an expression of society's morality. I mean, bigamy is in the Criminal Code as being illegal, and that's an expression of Parliament's morality, in terms of putting bigamy in the Criminal Code. So my own view is that criminal law is, in and of itself, as an expression of society's morals, probably in need of reform. Certainly on the drug issue probably more than any others, there is need for change. But to say that we can't impose morals.... The criminal law is the imposition, in my view, of morals as expressed by Parliament.

You talked about the criminalization of drug use and drug possession. I'm sensitive to that argument as well. The argument we get is that the criminal power is the easiest power to invoke for Parliament to pass a national law affecting things like drug programs. It was the case with abortion for many years. That has since changed, but the criminal law becomes an easy and simple way for Parliament to enact legislation. And because it's a federal power, because it applies in every small community and big city across the country, it becomes an easy target.

Would the Civil Liberties Association advocate that these substances, if they're decriminalized—possession and use of drugs—become legal substances? In other words, it can be decriminalized but remain a controlled substance. It can be illegal but decriminalized. Alcohol and tobacco are obvious ones.

A final question, and this is more intellectual curiosity of mine. You talk about Inspector Heed, who was very compelling yesterday, talking about how the Vancouver police just decide not to enforce certain offences or press charges. From a group such as yours that is surely in favour of the rule of law, don't you find it strange that a police force can selectively decide not to enforce a law that Parliament passed? Inspector Heed's a great police officer, but I didn't realize he was voting legislation in Parliament.

I would think you'd be alarmed about police forces deciding at any given time to simply enforce this law because the people in the area are fed up with it. Don't you find that a bit alarming?

The Chair: I am sorry, but before Ms. Lyster answers, I'm wondering if I could thank Ms. Walter and Ms. Livingston for coming today. We'll see you later. And if there's anything else you want to say to us, we're more than happy to receive your testimony.

Ms. Thia Walter: I'll just leave this. It's sort of a chronicle about what did happen.

The Chair: Don't you worry, we'll take care of that. Thank you very, very much, and good luck.

Ms. Thia Walter: Good luck to you, too.

The Chair: Thank you.

Ms. Lyster.

Ms. Lindsay Lyster: Thank you.

There were a number of questions there. I'll try to address them all. If I miss any, please let me know.

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In terms of the use of the criminal law powers being the most obvious way for the federal government to legislate in this area, it's true—it is the easiest way to legislate in this area. But I think if you look at decisions of the Supreme Court of Canada in cases like Hydro-Québec, we've seen on the court's part an appetite or an appreciation for allowing the federal government to use the criminal law power as a support for regulatory regimes. In the Hydro-Québec case that had to do with environmental regulations. So there are ways, I think, for the criminal law power to be utilized as the superstructure under which you can create a regulatory scheme.

We certainly do not propose these substances be entirely unregulated. You used the example of alcohol and tobacco. Those are models that could be looked at in terms of how to regulate these substances once you've decided the use of criminal law penalties is an inappropriate way to try to control their use. Clearly, it is an inappropriate way to try to control their use, so what can we look at instead?

So we certainly do say a regulatory approach would be more appropriate, and we support that.

In terms of the problem of the selective enforcement of the law, of course the police are granted a wide discretion on an individual basis—do they give me the speeding ticket or not? I'm only five kilometres over the speed limit, so maybe they won't ticket me. A certain amount of discretion on the part of—

Mr. Dominic LeBlanc: I don't want to interrupt you, but there you've compared speeding to the criminal offence of drug possession.

Ms. Lindsay Lyster: I'm just using it as an example of how the police use, properly, discretion in terms of when and how they enforce offences.

We do, however, have a concern about the situation we have, at least in Vancouver. It's very irregular across the country, as I believe the committee has heard, because in some communities, Canada's laws are not enforced, while in other communities they are enforced with full rigour. We have a lot of concern about a situation where you have a law on the books, a law some people believe isn't a good idea, isn't working, and you get that selective enforcement across the country. We don't think that's an appropriate situation to have.

We commend the Vancouver police department for doing what they can within their jurisdiction, but we don't think, as a matter of principle, that leaving it to individual police departments or individual police officers is the way to go. Far better to get the right law on the books, a law that can be enforced, that will be enforced uniformly across the country. We see that as a regulatory system, rather than the kind of criminal law prohibition system we have in place currently.

The other issue you raised was the role of morality in the criminal law. The Civil Liberties Association's position is that morality doesn't have any place in the criminal law. What has a place in the criminal law is the prevention of harm to society. Obviously, there's some overlap with that. The things we see as harmful we tend to see as harmful because of the moral history, the moral traditions, we have. If it's just that we think it's not a good idea for you to alter your mindset by using a drug, that we think that's immoral, we don't see that as a basis for the imposition of criminal law.

Mr. Dominic LeBlanc: What about being married to two people at the same time? That presumably falls right within your purview of privacy.

Ms. Lindsay Lyster: We have some concerns, frankly, about the polygamy provisions of the Criminal Code, a matter I'm not going to get into today.

Mr. Dominic LeBlanc: No, but does the Civil Liberties Association think that maybe polygamy should be okay?

Ms. Lindsay Lyster: We've written the Minister of Justice on that very issue, sir.

Mr. Randy White: Now, I'm interested.

The Chair: It's your anniversary; you'd better not be interested.

Ms. Lindsay Lyster: No, but obviously that's not within the jurisdiction of this committee. Some things aren't. Everything else in life....

In order for the criminal law to be properly imposed, there has to be proven risk of substantial harm to society as a whole. That's what we see as being the lynchpin of the proper use of the criminal law.

I think historically, if you look at occasions when we as a society have attempted to use the criminal law beyond where there is a risk of substantial harm to society as a whole being proven—you've used the example of abortion—we see that the criminal law doesn't work. If you look at alcohol, in the past when there were criminal prohibitions on alcohol, it didn't work. So it is our view the historical record tends to demonstrate that where we try to use the criminal law for that purpose, it is ineffective, and in fact it backfires.

Mr. Dominic LeBlanc: Thank you.

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The Chair: Following on that and the example with alcohol, would the BCCLA suggest we should set up—I forget what they're called in B.C., but in my province they're LCBOs—something to distribute drugs and do testing? At certain points, for the LCBO you used to have a card, and a spouse could report another spouse, and you could get your card pulled and you couldn't get alcohol. Are you proposing a regime like that, or what?

Ms. Lindsay Lyster: Well, I think there are a number of regimes that can be looked at. Certainly from the point of view of my association, we need to take a further look at the kinds of regimes that would be appropriate, and I think this committee needs to do further work looking at the kinds of regimes that would be appropriate.

There are a number of models. An appropriate model might be something like a liquor control board, certainly with respect to soft drugs like marijuana. Another appropriate regime might be something like what we see in the Dutch model, with the coffee houses, where you can have regulatory control through the business licensing system.

There are a number of regimes you might look at, and I think it's something my association, frankly, is going to be doing some further looking at. As we prepared for our submission before you today, it was very clear, in our view, that the underlying principles we say should be applied—namely the respect for personal autonomy and the harm principle—really mandate the conclusion that the possession and the use of drugs ought not to be made criminal.

How those principles apply when you get to the question of distribution is not so clear. Certainly at a pragmatic level it does not help if the possession and use of marijuana is decriminalized and regulated but you have to involve yourself with the criminal subculture in order to buy it. That doesn't help. So we need to look further, I think, at how you gybe the decriminalization—as we say, there ought to be freedom for the use and possession of drugs—with how you then deal with the distribution and other issues.

The Chair: I would hope you could do some work on that, because certainly, since I became chair of this committee, everyone in every airport seems to think they should just tell me to legalize it. What happens then? Or how does it work? We know it's Hezbollah and Real IRA and Taliban who are distributing this stuff—there are some pretty nasty actors in organized crime involved in this. I don't want teenaged kids interacting with these people; there's a whole bunch of other bad behaviours and illegal activity they can end up in.

I don't think it's enough to say “decriminalize” without saying “and this is what we're proposing”, because I don't think it's fair—in the same way that while some people in the country... And certainly I'm supportive of having made the medical use of marijuana available, and we're going to do testing and everything else. It seemed difficult to me that we would say to constituents, “Well, it's now illegal for you to possess, but by the way, if you're really sick, go out in the street and buy.” That's a problem.

So we've put the second stage in there—it took us a bit of time, but we've done it, and that's really important—and the testing to make sure there are actually health benefits. But to say just decriminalize.... I'm nervous about that, without somebody doing some of the work on what the system is for distribution.

Ms. Lindsay Lyster: I agree with you entirely. It's not enough alone to decriminalize use and possession, because you have to look at how that intersects with the acquisition and distribution. I think the example you give, Madam Chair, of the morass faced by the people who have the exemption for the medical use of marijuana but then have to engage in criminal activity in order to acquire it really highlights the point. It's not the last answer on it, but certainly the liquor control board model is one model to look at; the Dutch coffee house model is another. I think in the case of persons who are addicted to drugs—not just users, but who are addicted to drugs—the kind of heroin maintenance Ms. Walter referred to may be something we need to look at.

Obviously, these are all things that require further research from the medical point of view and others. I think we have to be open to looking at all of those kinds of schemes and others, in order to ensure that the continuing victimization and re-victimization of people who use these drugs is not perpetuated.

The Chair: Lastly, you heard Mr. Farrell earlier talking about the potential trade implications for changes in policy in Canada—and certainly with our biggest neighbour, where there are some governors who are moving in the direction you suggest, but most are not. You mentioned Amsterdam, or the Netherlands. They actually have kept their laws on the books because of the international treaties.

So again, it's a case of what the international framework is. Does BCCLA work with counterparts in the United States? For example, are you aware of some of those implications and how we can start tackling some of those, should we choose to go to what you've suggested today?

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Ms. Lindsay Lyster: The whole question of exactly what Canada's obligations are under the international treaties is a thorny one, and I'm not an international law scholar, so I'm not going to pretend I have all the answers there.

One thing I would highlight there is that yes, you're right, the Dutch have kept the law on the books, apparently because of concerns about their obligations under those treaties to which they're also signatory. That's not an ideal situation, for the reasons Mr. LeBlanc has mentioned. I don't think it does the administration of justice and respect for the law and for law enforcement officials any good to have a law on the books that everybody knows, with a wink and a nudge, isn't actually being enforced. We don't support that. It might be that's the next-best solution we can get to; I hope it's not.

One thing I do know about the international treaty obligations is that our obligations under those treaties are subject to our own constitutional and legal principles. That's a rider that exists in the treaties. There's a good argument to be made—and in fact my association will be making this argument as an intervener before the Supreme Court of Canada next year in a case called Malmo-Levine—that in fact it is unconstitutional to criminalize the possession and use of marijuana. I won't before you go into all of those arguments; we'll be making them before another place.

We certainly believe, and at least one judge of the B.C. Court of Appeal agrees, that there are good arguments to be made that in fact our constitution does not permit the criminalization of use and possession, at least with respect to marijuana. If in fact that's the case, then we're entitled to decriminalize—in fact, have to—and our treaty obligations would not be any restriction on our ability to go there.

The Chair: Okay, thank you.

I'm sure all of us would love to talk to you for hours more. It's been great for all of us to be here in Vancouver and to have witnesses of the calibre we've had over the last three days.

Thank you to our technicians behind and our interpreters for making sure everything's available in both official languages.

Thank you for being a great representative of BCCLA; it's been fascinating.

Thank you, colleagues. We are going to adjourn. We will go to Abbotsford tomorrow and resume. We have a site visit this afternoon and this evening. Given that it is now 1:30 and we're supposed to leave in half an hour, maybe we can leave in an hour.

A voice: Take some time and have some lunch.

The Chair: Okay, so if we can agree to meet downstairs at 2:30, we'll call them and tell them we're going to be 15 minutes late.

Thank you very much. Thank you to everyone who participated and listened, and thanks to the media for getting our message out.

The meeting is adjourned.