[Recorded by Electronic Apparatus]
Tuesday, April 22, 1997
The Chairman (Mr. Roger Simmons (Burin - St. George's, Lib.)): Order, please. We'll begin our session this morning as we continue our review of policies on the misuse and abuse of substances. We have a total of four groups of witnesses to hear from this morning. First, from Market-Media International Corp., is the president, Joan E. Gadsby.
Welcome, Ms Gadsby.
Ms Joan E. Gadsby (President, Market-Media International Corp.): Thank you very much.
The Chairman: What we would like to have from you, if you would like to give it, is the briefest of opening statements, so we can ask you a few questions. You may begin whenever you're ready.
Ms Gadsby: You haven't given me enough time. I've been working on this issue for six and a half years, and it's a very major health issue.
Ladies and gentlemen, I note that even in your terms of reference no mention is made of these particular drugs. I'm talking about tranquillizers and sleeping pills, which are prescribed to literally thousands of Canadians. In your study outline you make reference only to alcohol, nicotine, cannabis, cocaine, crack, LSD, heroin, and solvents. These drugs are insidious. These are doctor-prescribed drugs. The fact is that people become iatrogenically dependent. It's a major issue.
There are four elements of benzodiazepine prescribing. I'm referring now to my covering outline, where it speaks of unnecessary prescribing beyond short-term use, if at all, and I'm talking about two to four weeks.
The second issue is the serious and often dangerous side effects, such as paradoxical agitation, increased behavioural disinhibition, impaired new learning, decreased short- and long-term memory, impaired psychomotor functioning - many times leading to car accidents - rage, the appearance or worsening of depressive symptoms, and full-blown chemical dependency.
The third issue is the severity and extended duration of withdrawal effects.
The last one, which is very significant - and there is a fair bit of denial within the industry that this occurs, but that is not true - is the potential for brain damage, which may or may not be reversible.
I know what I'm talking about, because I was prescribed these drugs after my son died. I was a very young woman when this occurred. For 23 years I was prescribed Valium, Librium, Dalmane, Restoril, and Serax - daytime and night-time sedation. I almost lost my life. I stopped breathing in February 1990. As an intelligent woman, a business woman at the peak of my career, working with four of Canada's largest food companies, and as an elected official for thirteen years, I did not know the effects of these drugs. I went back to my doctor and said ``I want off''. He would not help me off. I had to search elsewhere to get help. I have spent, quite frankly, the last close to seven years of my life regaining my health. I've been off those drugs for six years and eight months.
This is a very committed effort on my part. Financially it has created... I have gone through close to $1 million to regain my health, in lost income and by selling investment property I had in North Vancouver to maintain my lifestyle. I have also gone through a year of cognitive retraining to deal with the neuropsychological deficits caused by these drugs. I think you can appreciate my commitment.
But I am not alone. That's why I'm bringing this information to you this morning. If the committee members would look at the material that was circulated to them this morning...
I live on the north shore, North Vancouver in particular. Further into the presentation dated November 20 this year, I have some statistics on the north shore. These can be applied right across this country.
What this essentially shows in the bar graphs is that first of all in British Columbia, 23% of our seniors are on these drugs; that's 23%. For north shore seniors it's 27%. For north shore senior women it's 30%. For north shore senior men it's 20%. These are seniors over the age of 60. I'm not that old, but I could have been one of these people who are drugged.
The most recent figure I've seen is a Canadian Medical Association figure that shows that 11% of Canadians are on these drugs. That's Canadians. Kids aren't on them. Kids are on Ritalin, if their parents are foolish enough to put them on Ritalin. In any event, this is a national problem with considerable implications.
I understand you've had a presentation from the Canadian Medical Association. In a package I've included for you also you will see a research paper by Dr. Mark Berner. It's entitled ``Benzodiazepines, An Overview''. This particular research paper, which is an excellent research paper, was done in April 1982. At that time Dr. Mark Berner identified the serious implications of these drugs.
On the bottom of page 234 he states that there is no evidence to support their long-term use and that they are equally effective in short-term treatment. That's basically it.
He goes into the effects - the sedation effects, drowsiness, judgment, implications for impairment when driving motor vehicles, suicidal thoughts, ego-alien suicidal ideation, where ``patients felt `driven' as if by some outside force to commit suicide without the concomitant wish to die''. Further on you will see about uses in pregnancy, uses with the elderly, interaction with alcohol. The last page, 240, refers to cognitive and psychomotor impairment.
What's clear and worth reading is this:
The successful and rational treatment of any patient requires an understanding of the whole person. To merely prescribe drugs for the relief of stress-related symptoms, without an appreciation of the patient's physical and psychosocial situation, constitutes an abrogation of responsibility on the part of the physician. Such an approach ``medicalizes'' the problem...
The reason I brought this particular research article is that Dr. Mark Berner, whom I've spoken to on the phone, wrote this article when he was at the University of Western Ontario. I'm a graduate of the University of Western Ontario and I've worked on my MBA out at UBC. He has emerged as the chair of the expert advisory panel dealing with guidelines on the use and safety of benzodiazepines in the treatment of anxiety and insomnia. Mr. Chairman and members of this committee, we're talking about guidelines the CMA should have put in place a long time ago.
I am part of a benzodiazepine action group. As a result of a lot of publicity we've been getting on the west coast, we have been advised of 15 people who have lost their lives just in the last few months.
I am a former board member of Lions Gate Hospital in my former aldermanic role. A lot of the emergency admissions at the hospital are from overdoses. They can be in combination with alcohol, but nevertheless they are overdoses.
I do appreciate your understanding in giving me a bit more time. I also want to refer to what I personally am doing in bringing out colleagues who have been affected as I have been - either they have been personally or their families have been. We've put together a call to action proposal, of which you have the basic contents in front of you, with some recommendations, an identification of the obstacles and the solutions. This has been as a result of my hundreds of conversations with five key stakeholder groups. I'm going to touch on that in a minute.
I have in development an awareness-driven documentary with Jack McGaw, formerly of W5, as my co-executive producer. I also have a book proposal out that shows my experience before pills, while on pills and since. It will also incorporate a fair amount of the research. That is to be followed by a film similar to I'm Dancing as Fast as I Can, but it will be a lot more specific about what people really go through in withdrawal. Next we have been promised by the former head of pharmacare, Mike Corbeill, $50,000 for a conference on benzodiazepines.
I am very action-oriented. We don't really need to know anything more; we need to do something about the problem.
The publicity campaign has started. I appeared on CBC's 50 Up in November. They shot me running. I run two and a half miles every morning on the sea wall. That's what saved my life. But there will be more extensive publicity. I have newspaper articles I can show you. There is lobbying. I have also met with Senator Ray Perrault about initiating Senate hearings.
If you would turn to the page entitled ``Benzodiazepine `Call-to Action' Group Resource Centre'', it gives you an idea of what our objectives are. We can save millions of dollars in the health care system and improve the quality of life of thousands of people. We need to create a high level of awareness about this problem to deter physicians from over-prescribing benzodiazepines and to provide consumers with all the necessary information.
We have people out there who are hooked on these drugs, many of them for years, just as I was. They need the help and the infrastructure in place to get them off these drugs.
One of my recommendations - and I strongly believe in this, and I vehemently ask this committee to follow through on this - is similar to the initiative that is under way in the U.S. right now with the tobacco industry, i.e. that a percentage of the profits of the pharmaceutical companies would be applied to putting an infrastructure in place, that they would not bury their heads in the sand.
One of the documents you have in front of you is a $250,000 PR piece that appeared in The Globe and Mail about four weeks ago, and that's incorporated here, too. Essentially, the pharmaceutical industry has stated right in their material, which refers to Dr. Coambs, who is a researcher at the University of Toronto:
On the next page you will find the history of the benzo problem. None of this is new. These drugs were prescribed in the late 1950s, 1960s, 1970s and 1980s. We've done a chronological search and summary of the major studies and the key people in the industry. It's all there. They include the World Health Organization; the Compendium of Pharmaceuticals and Specialties; the U.S. National Academy of Science; Ruth Cooperstock, who was with the Addiction Research Foundation and who is now deceased, I understand; Dr. Joel Lexchin, who I'm sure you heard of, who wrote the book The Real Pushers: A Critical Analysis of the Canadian Drug Industry; the British Journal of Addiction; the B.C. Drug and Poison Information Centre; the B.C. Medical Association, and Dr. Sydney Wolf in Washington, D.C. I had the opportunity to speak before the Women of Vision, Leadership for the 21st Century Conference, and I met Sydney Wolf. They've done good work. The therapeutics initiative in B.C., through Dr. Jim Wright, is excellent.
The federal industry committee, which the Minister of Health, Joy MacPhail from British Columbia appeared before, has brought a message in terms of the industry.
In terms of obstacles to getting the benzo problem reduced - please follow through with me, I'll do this very quickly - there have been lots of studies and little action. What do we need to do? We need to redirect research funding toward action-oriented strategies, help for dependent persons and public awareness to prevent new people from getting hooked.
The second point is that prescribing guidelines are not being followed. We talked earlier about the CMA putting some guidelines in place. The CPS guidelines, for example, for Dalmane and Serax, specifically stated in 1978 that safety and efficacy for long-term use had not been established and that it was for short-term use only. Yet that is not what is being done by the doctors.
The disciplinary action at the CMA level and in respective provincial medical associations must be followed. The Colleges of Physicians and Surgeons right across this country provincially need to do their job.
The next item is doctors' lack of ongoing education. Again, the responsibility there is for the College of Physicians and Surgeons to undertake the necessary upgrading for the doctors to buy in.
I've been in marketing all my life, and in a nutshell what happened was that the pharmaceutical companies, quite frankly, marketed the hell - pardon the expression - out of these products. The doctors bought in, and they've continued to prescribe these drugs. The offending doctors are in the age group of 50 years and over who don't want to change.
As for lack of legal accountability, in Britain there have been 5,000 legal suits launched against pharmaceutical companies and doctors on this same issue. The average person cannot afford to launch a lawsuit, and it should be the final course of action. But that is another area.
The next point is the lack of information provided to the consumer, clear product warnings with full disclosure of potential side effects. If somebody told me that 23 years down the road I was going to be affected by cognitive impairment... My brain is my best asset, yet I have not been able to function as I used to.
I have supporting evidence from research. The latest has been done in Sweden at the Karolinska Institutet.
Most people, I'm sure, would never take these drugs.
The next point is what the pharmacists can do about the problem. They need to have the time and not be driven by their fee on prescriptions.
The seventh point is the high demand for the drug and a multifaceted education process.
The eighth point is withdrawal. A lot of doctors do not understand withdrawal. They do not understand withdrawal. That needs to be trained with the doctors.
Ninth, what can be done? I suggest the U.K. experience. What happened in the U.K. was that doctors wrote to their dependent patients and said, we're going to take you off. As a result of their efforts there was a 30% drop in consumption over six months and millions of dollars were saved.
We have a minimization of the problem by government, drug companies, and doctors. Awareness can be created through conferences, seminars, etc.
The eleventh point is objective prescribing advice to doctors. What is in place now on the north shore, where I live, is that a pharmacist has been hired and goes one-on-one - it's called academic detailing - to the doctors to show them the effects of the drug, so they will know.
There is the conflicting relationships among profit-motive drug companies, research and development funding, and the lack of help to individuals harmed by this infrastructure. One of the key recommendations I'm bringing to you people this morning is that the pharmaceutical companies also need to be held accountable. I'm recommending that a percentage of the profits - and I'm a person who has earned her living in this area, but in the food industry - be redirected to the problems they help to create.
The thirteenth point is alternatives. People don't need to take drugs. It's really a healthy lifestyle issue.
The next point is financial resources directed to the problem. Money is needed. There is a lack of coordinated and combined efforts.
Mr. Chairman, I do apologize. I've used up a lot of time. But this is important. I'm not going to go away. I'm going to go away today, but I'm not going to go away. You're going to hear me speak about this more and more right across this country and internationally until something is done about this problem.
I sincerely believe that when I almost died in February 1990 God kept me alive to help carry this message and to help other people. Fortunately I have two beautiful daughters, who still have their mother today. As I was leaving yesterday on the plane, my youngest daughter, who is now 26 and in the film industry, said, ``Mom, I'm really proud of what you're trying to do to help others''.
I appreciate your time and your attention and patience. I'll be pleased to answer any questions. I am available to act as a consultant to the federal government and provincial governments. I have a communications person who works with me.
Our group also needs money. I have about $100,000 of my own money tied up in my research and some of the development work.
Thank you very much.
The Chairman: Pauline.
Ms Pauline Picard (Drummond, B.Q.): Good morning, Ms Gadsby. I would like to thank you for your very interesting presentation. Please, excuse my ignorance, but first of all, I would like to know what Market-Media International Corp. is. What is its role, what are its objectives and what is your role?
Ms Gadsby: That is my business, Market-Media International. My background is large corporate marketing. I've worked with four of Canada's largest food companies: Colgate-Palmolive, Scott Paper, Kelly Douglas, and Southland Corporation.
Market-Media is a company that I developed. Its objectives are basically to be involved in marketing, government relations, public affairs, corporate communications. That company is not really operating right now. I have spent the last number of years of my life getting my health back, as you heard me say earlier. That's just my company name for business purposes.
I'm here as the key advocate of the Benzodiazepine ``Call-to-Action'' Group, as I've stated in my covering presentation.
Does that answer your question?
Ms Pauline Picard: Yes. You have told us why you are interested in tranquilizers. Is that part of a study that you were commissioned to conduct as part of the services you offer or is it a personal study because the issue is so important to you?
Ms Gadsby: It is a personal study because I personally have been affected. I'm probably one of the top experts in the world now in the area of benzodiazepines, which are tranquillizers and sleeping pills. I got involved in the research to find out, quite frankly, if I was going to live. Going through withdrawal, I thought I was going to die, and I have newspaper clippings from our papers that record that.
Basically I have a combination of research papers from throughout the world. I brought just a few samplings of them with me this morning, including Mark Berner's. I have clippings, for example, and research articles. ``Cognitive Impairment in long-term benzodiazepine users'' is a U.K. study. ``Drug-Induced Cognitive Impairment'' is another study. I have met with the doctor on this one, who is with the Pacific Medical Center in Washington. ``Sedative hypnotic dependence: Neuropsychological changes and clinical course'' is a paper from Sweden. It's a four-year follow-up of 50 patients with primary dependence on sedative and hypnotic drugs.
I'm not hooked up to the Internet because I'm a hard copy type of person, but with everything I touch, if something affects me I try to do something about it. In this case, this whole issue has made a mockery of my life and I am anxious to help other people. I'm not alone. In our benzodiazepine action group there are now 200 members in Vancouver, and this will be a national force.
Ms Pauline Picard: Ms Gadsby, briefly, and in concrete terms, how can we improve control over the use of this drug?
Ms Gadsby: There are two issues here. First, you have to deal with the doctors. These drugs are legally prescribed by doctors, so the doctors have to be educated to know the effects of benzodiazepines. Some of them refuse to. They need to be told short-term use only. The Canadian Medical Association guidelines say 10 to 14 days.
The question of whether they're needed at all is there. Remember, there are a lot of bottom-line dollars going to pharmaceutical companies.
So you have to get the doctors on-side to do something about the problem, to help other people who are on the drugs get off. That requires a lot of money in terms of infrastructure to take people through the detoxification process, to take them through the recovery.
So doctors are number one, and the pharmaceutical companies are also number one. The pharmaceutical companies marketed the heck out of these products, with billions of dollars in sales and millions of dollars in profits. The profit structure in these is high. The pharmaceutical industry has the highest equity return on investment of any manufacturing industry.
My recommendation is that a percentage of these profits be allocated to dealing with this problem. That's what's needed - money. If they can spend $250,000 on a 21-page glossy in The Globe and Mail... They have in here too that knowledge is the best medicine. This is their PR effort with a video. They say they want a partnership opportunity, yet when you phone them it's just a PR effort.
So there are two key elements here. The doctors have to be addressed. The doctors need to stop prescribing. They need to be disciplined in terms of the monitoring process. There's a triplicate prescription thing out in British Columbia. And pharmaceutical companies have to contribute.
Because there is a growing awareness about the problems with benzodiazepines, tranquillizers and sleeping pills, they're now trying to push the Prozacs of the world, the antidepressants. On a chart, tranquillizers are showing a bit of a downward turn, but Prozac is going this way. Those are I.M.S. data. I.M.S. is a major health care statistical company located in Montreal and in Toronto that provides some of this data.
This has to be stopped.
The role of the government here - and that is something else I'm sorry I didn't mention there, but it's written - the health protection branch of the federal government... I talked on the phone to Dann Michols, who heads this up. I said, Dann, all that's needed is a letter to the doctors to say ``for short-term use only''. I've spent thousands of dollars calling federal bureaucrats on this issue. I haven't heard back from him yet. He's getting a call today, when I'm in town.
The role of the government, the health protection branch, is essential to get this letter out to the doctors. Where the pharmaceutical companies are not self-regulating, the government needs to step in. Minister Dingwall is aware of what I'm attempting to do in this area.
And for the consumers, we need education. As an educated woman, I didn't know. I was too busy raising my family, earning a living, and planning for my future. I trusted my doctor.
The Chairman: Let me welcome John Duncan. He's not a regular member of the committee, but we're glad to have him.
John, go ahead.
Mr. Harbance Singh Dhaliwal (Vancouver South, Lib.): He's a regular guy.
Mr. John Duncan (North Island - Powell River, Ref.): Yes, I'm a pretty regular guy. Thanks, Herb. I just wish Paul would quit reading the newspaper over there.
In your paper you're talking about this action they took in the U.K. where they actually followed up with patients who had been on these drugs for a time. That seemed to have some successful results. Was that initiative government sponsored or was that an initiative of the medical association? How did that come about?
Ms Gadsby: It was government sponsored. Because of the billions of dollars spent in the area of prescription drugs, it was government initiated.
The repercussions of this, though, were many. Aside from cutting down on consumption, the infrastructure that was to be in place... When people go off these drugs you have to cut the pills down selectively a quarter, a quarter, and a quarter, and you can be into a month or two of cutting the pills down. Then you go into what's called an ``acute withdrawal stage'', which can last weeks to months, and you can go into protracted withdrawal, which can last several years. But in this case this was effective, and we're saying to follow the lead.
Mr. John Duncan: Let's take a population of seniors, and let's say you have them all in one room and you explain the fact that a percentage of them are hooked. What is the typical response? Is it normally denial? Does someone else have to...? When do you figure out that you're hooked?
Ms Gadsby: In my case you heard me state that on February 2, 1990, I overdosed, not knowingly at all. It just happened. I stopped breathing. I was taken to the hospital and I ended up in ICU. I had no idea. It was only by chance, a couple of weeks later, that I was talking to another woman, who said ``Benzos; you're on benzos''. I went back and my doctor told me if I went off benzos my hand would become crippled - which is a bunch of BS.
The thing is that the education has to be there. This is a strategy. I would love to work with the federal government on a strategy to do this.
This may be startling to many of you, but when I was going off the pills for the first time I could not see the delineation of the clouds. These things suppress your nervous system and dull your senses. I could not see the detailed clouds. I could not see the pistils and stamens in flowers. I could not feel the back of my teeth in my mouth. In other words, you're so numbed you don't know what you're missing.
I burned my ankles with a heating pad because my feet were cold. I had blisters and I didn't know. This is going through withdrawal.
So to me the best strategy for getting these people off is to say, this is the quality of your life now, but look at what it can be. It takes a heck of a lot of determination to do this. Quite frankly, some older people may never get off these drugs. They will never be able to give them up.
Mr. John Duncan: That same population is also very susceptible to other substance abuse, such as alcoholism. So I do rather agree with you there.
Ms Gadsby: But my point is that one has to try, and it's not just seniors. We've had calls from people as young as 22 up to 79. You have both men and women. I know personally of two CEOs in Vancouver, men, who have not been able to return to their careers because of what has happened to them. You do have a slight gender bias in terms of females: the ``little housewife'' syndrome.
But the fact is that this does not have to happen.
I brought with me, for example - and I will leave these with your clerk, Mr. Chairman, because it's significant to do so. Again, I do apologize for the time I'm taking, but this is a very, very serious issue.
Health Canada, way back in 1979, came out with It's Just Your Nerves. They knew about this problem in 1979. You'll recognize the old stereotype about women. It speaks about women's use of minor tranquillizers and alcohol. At that time it was identified. It speaks of tranquillizers - short-term use for relief of anxiety, drowsiness; long-term use and tolerance development, psychological and physical dependency, memory loss, impaired judgment, unexpected reactions. It's all here.
Mr. John Duncan: I would like to talk for a minute about Ritalin. You mentioned Ritalin. I'm aware that in my own community a growing number of children are being prescribed Ritalin in the school system, and it seems to be socially accepted. It's brand new to me and of course I don't know a lot about it, but this is obviously something very significant. I don't think my community is special in this phenomenon in any way. What is your recommendation on that substance with our children?
Ms Gadsby: It's a major concern. Ritalin is just the forerunner for more benzodiazepines and Prozac.
One of my colleagues is a Dr. Susan Penfold...and please don't get me wrong. I know how to pick the right doctors, the good, tuned-in doctors. This Dr. Susan Penfold, Mr. Duncan, is somebody... I can give you her name and phone number.
Ritalin is given to hyperactive kids, but the same concerns that relate to benzodiazepines do have some application to Ritalin. That is not my area of expertise, quite frankly, but it's the same kind of thing. We are drugging our youngsters in the same way as we have drugged and are drugging our adults.
Mr. John Duncan: So you're saying Ritalin is not a benzodiazepine?
Ms Gadsby: Not in the normal sense. Again, I can't speak for Ritalin per se. I know about these others.
The Chairman: I added time and then some. Joan, thank you very much for coming.
Ms Gadsby: I just wanted to mention to you that I'm going to leave a whole package of files of newspaper clippings. That was from the Toronto Prescription for Hell: Survivors of Benzodiazepine Addiction Speak Out - what a person went through. There are newspaper articles from the coast. There are articles about car accidents. Car accidents cause... There's a lot of stuff here. I will leave it with you.
The Chairman: Thank you. It will go to the research people.
Again, thank you very much.
Ms Gadsby: Thank you for your time.
The Chairman: We now invite to the table the next group of witnesses who have agreed to meet with us this morning. From the Alcohol-Drug Education Service we have Art Steinmann, the executive director. It looks as if he has at least one cohort with him, who I'm sure he will introduce.
Mr. Art Steinmann (Executive Director, Alcohol-Drug Education Service): This is Karl Burden.
The Chairman: All right, whenever you are ready, Art, proceed.
Mr. Steinmann: Mr. Chairman and committee members, thank you for the opportunity to be here to present to you on this issue of alcohol warning labels. We're here to urge the adoption of mandatory health information on alcohol containers.
The Alcohol-Drug Education Service is involved in education and prevention activities. We've developed a number of unique education and prevention programs that are used primarily in B.C., but also somewhat more widely.
In 1994 we formed a coalition. This is all outlined in the brief you have in front of you: ``Consistency for Consumers: Warning Labels on Alcohol Containers''. At the back of that brief you'll find a list of over 80 organizations that have agreed with our position statement and are supporting us in lobbying for warning labels on alcohol containers.
One of the groups is Concerns Canada, and I'm pleased that Karl Burden, a member of our coalition, can be here today to join me in the presentation.
I have worked in alcohol and drug education for about 20 years. Similarly, Karl has worked in the field for about 18 years. We're here to say, as alcohol educators and prevention workers, that education by itself is not the whole answer. One of the things the liquor industry will tell you is that you don't need warning labels; you just need to educate people. We're saying you need both.
I hope you will take a close look at the brief. We don't think labels are to coerce people but to inform them. Consumers have a right to the information.
There was a push for alcohol warning labels in Canada 20 years ago. More recently, in 1988, the United States adopted alcohol warning labels as a mandatory measure in every state. Today Canadian alcohol products that are manufactured in Canada must all bear a warning label when they are exported to the United States.
I have here a product that's actually imported from Portugal. It goes to the United States and on the back of it is a mandatory warning label about the dangers of drinking during pregnancy and the dangers of driving with alcohol.
Molson's Canadian and all of the Canadian manufacturers now put a similar label on Canadian products that go south of the line. As Dr. Hedy Fry said to the House in 1996, I believe it was, what's good enough for Americans is not good enough for Canadians. Why are we not doing the same thing for our kids and our people in our communities here in Canada?
In 1991 the Yukon reached the point of being so frustrated with the issue that it developed its own little warning label, and here it is. It's an add-on sticker that is stuck on the product at the liquor store. It's very time-consuming and fairly expensive to do that - not a very efficient method. Given that our manufacturers in Canada are already labelling for export, it would not be a big job to have them do it for local product.
In 1987 the group Karl is with made a presentation to this committee on alcohol warning labels. In 1992 - and some of you will remember this report - Dr. Stan Wilbee, a member of this committee, and his subcommittee did a thorough investigation into fetal alcohol syndrome. Two of their recommendations dealt directly with the need for alcohol warning labels.
In 1992 the then health minister, Benoît Bouchard, responded and called for pilot testing of alcohol warning labels in Canada. Money was set aside and there was work to be done, but I'm sorry to tell you that as of today, really nothing has materialized from those pilots. They never got off the ground. It hasn't happened.
We're also here today to say we don't believe we need more research. I'll show you in a minute that there's a lot of research. We think it's time to get on with the job.
In 1994 the Northwest Territories also developed an add-on sticker label because they believed it is that important.
In 1995 provincial health ministers in Canada unanimously wrote to Diane Marleau requesting that there be mandatory alcohol warning labels in Canada. There is agreement among all the health ministers. It's actually the second time that has happened.
In 1996 the honourable Paul Szabo, a gentleman here on our committee, introduced a private member's bill and worked very hard on that bill. That bill made it to third reading and it survived the prorogation of Parliament, which I understand is a pretty unusual state of affairs. I think that demonstrates the broad support. All parties supported that bill. Unfortunately it did not get beyond the committee and made into law, but we're hoping that will happen.
I have with me today a letter from our Attorney General in British Columbia. It was written just a couple of weeks ago. It says B.C. has led the push for alcohol warning labels in Canada and it still supports it and it is looking to this committee to take action on it.
Why do we need labels? Well, the history shows there's a lot of support and people are behind it. Another reason is that it's already done for the United States.
Another reason is the scope of the alcohol problem. I'm sure you've heard a lot on this already. About $18 billion a year is related to substance abuse in Canada. Some 6,000 to 10,000 deaths a year are related to alcohol abuse. In one year 966 people died from alcohol poisoning.
I would suggest to you that most people, especially young people, do not even know that if you drink too much booze too fast - it's a toxic substance - you can kill yourself, and kids do every year. It's happening as we sit here. I don't know of any other product that has such toxicity and such potential yet is not carrying not only warning labels but many other regulations.
Our coalition developed five reasons why we support alcohol warning labels.
Alcohol is a drug and may be addictive.
There is evidence of risk to the fetus when a pregnant woman drinks alcohol. Again, I'm sure you've heard a lot on this tragedy of fetal alcohol syndrome and fetal alcohol effect. If warning labels prevent one FAS child it will be worth it financially, economically, socially, spiritually, or in any way you want to measure it.
Drinking and driving is still a leading cause of death, especially for youth.
Seniors are especially vulnerable to the side effects of mixing alcohol with medications. We've just heard quite a moving presentation on our reliance on prescription drugs, and we know most seniors do not even know their tolerance to alcohol diminishes when they hit age 60 or 65. Introduce medication and all the other complexities of being a senior, and you're in a very high-risk situation.
Alcohol consumption may lead to health problems and chronic illness. In the United States the Center for Science in the Public Interest, in Washington, put forward seven reasons why there should be warning labels, and as I've already mentioned, warning labels are mandatory in all of the United States.
Alcohol is responsible for massive and widespread costs. For many, even moderate consumption poses health risks. Many people have limited awareness of the short- and long-term effects of alcohol use.
I really want to underline that point to you, if I may. Karl and I are both in the business of educating people about alcohol. We are amazed, with our 38-some combined years of experience, at how many misconceptions, myths, and misunderstandings exist, not only among young people but among adults.
The liquor industry will tell you everybody knows not to drink and drive, that everybody knows alcohol can hurt you if you're pregnant. I would suggest to you very strongly that in fact is not the case. Not only that, but young people are coming up through the system every year and a lot of teenage pregancies and a lot of FAS kids are happening with very young people, and a lot of kids do not know the affects of alcohol. A lot of seniors do not.
Numerous consumer products already wear their warning labels. I have here a sample of a warning label. I don't know if any of you know what that's from. If you can read it you can see it's taken from a snowboard. Skis have warning labels on them. Here's a coffee cup, which has a warning label on it that says ``caution, contents hot''. There is, of course, the labelling on medications and tobacco, which we're very familiar with. Many other consumer products bear warning labels and health information.
The other reasons the centre gave are that warning labels serve important informational and educational functions. As part of the broader prevention efforts, specific health warning labels raise awareness of alcohol problems and help consumers change unhealthy behaviour. Health warning labels for alcoholic beverages has wide popular support.
In terms of popular support, in the United States it has hovered around 80% to 90% of people favouring warning labels. There are 18% who believe warning labels have affected their own drinking. Compared with other prevention policies, warning labels were among the most popular. Eighty-seven percent of the respondents in this study felt that alcoholic beverages should have warning labels about the possible health hazards.
Our primary reason for arguing for warning labels is not just that they are effective, because there is conflicting data, but we believe consumers have the right to the information. However, a lot of studies have suggested that in fact they have been effective. Subjects prompted to notice the warning labels drank less alcohol.
I won't read all of these items. It's concluded that the early outcome results are consistent with a small impact on behaviours of warning labels. How many other prevention measures do we know that can report behavioural change?
These are all studies that were done comparing Ontario, interestingly, to the United States where warning labels are mandatory. I'd like to suggest that this province shouldn't be a control group any longer, and neither should Canada. We should have warning labels in Canada.
The evidence goes on and on. As I say, there's a lot of research to suggest that warning labels are effective. They reach heavy drinkers. Even homeless people are reporting they're reading them and being affected by them.
I'd also like to point out that the use of warning labels is a classic example of a good health promotion, harm reduction strategy. It's very cost-effective. It would cost the government almost nothing. It's non-intrusive. It's already expected among the population. If anything, there's a large group of people who are surprised they aren't on there already and wonder how alcohol has escaped this so far. It has wide popular support.
It's not an extreme measure. We're not asking for huge death warnings to be plastered all over the product. We're asking for some basic, sound, objective health information. It's cost-effective. It reaches many people, and it reaches them repeatedly. These are the hallmarks of some of the best health promotion, harm reduction strategies you could possibly implement.
Failure to label alcoholic products suggests that alcohol is safe for all people at all times, and we know that's not the case. People who argue against alcohol warning labels will tell you they do not change attitudes or behaviour. We've already pointed out that there's quite a bit of evidence to suggest that in fact they do, that it'll take from other efforts. Labels are quick, easy to implement, inexpensive, reach many, and they're sort of a first step of prevention.
We're not suggesting labels by themselves are the answer, but they are one key part. Don't reach so hard to reach. In fact, some of the studies are finding just the opposite, that they will not be read. There's quite a bit of evidence to show they are being read. I must, if I may, allude to Paul Szabo's comment to me that it's interesting the alcohol industry is introducing the date of the product on the label so you'll know that it's a nice fresh product. Why would you do that if people don't read the labels?
The wine industry wants to list the health benefits of wine. Where? On the label. No one reads the label, right? We know people read the label. That's clear.
Next is that it could create alarm among consumers. If it's done properly, there's no need for that whatsoever. People in Canada are used to warning labels. Young children are learning the symbols for corrosion and poison from a very young age all the way up. It's clear that if it's done properly, that need not be a concern.
The next item is concern that the labels will become overloaded with too much information. Again, we can priorize and we can put the important information on there. Some will argue it's not new information and we are saying not everybody does know - not evenly, not consistently - and they are not reminded of it.
I would like to point out that it has been almost ten years since the United States made warning labels mandatory. I never thought it would take Canada this long. I really hope we will get on with the job.
Warning labels support education. With the national drug strategy in the state it's in, with provincial funding for preventive education in the state it's in, education needs all the help and support it can get.
A few years ago we almost banned cheese in Canada. Do you remember that? My understanding is there were a handful of deaths - I think two or three - in California, and we almost took cheese off the shelves for a time. Alcohol kills thousands of people every year and we don't even have the courtesy to put on, right at the point of purchase, that here's what this product could do to you.
We know putting alcohol labels on products could save us millions of dollars. We don't believe more research is needed.
I'll end by telling you of a woman I know who drank during her pregnancy because she did not know better. Nobody had ever told her. She's an educated, well-informed person. This was a few years ago. When her son was a teenager he demonstrated all the signs of fetal alcohol effect. He overdosed on a mixture of alcohol and other drugs. She is convinced it's due in large part to his reduced abilities because of the damage that was incurred when he was in the womb.
I would like to urge that this committee is in a position to move this issue ahead and to get Canada to the place where health warning labels are on the products of alcohol containers.
Karl Burden is going to make a few brief comments and then we'll take any questions you might have.
The Chairman: They will have to be few, because you've already just about used up all your time. We have four witnesses this morning.
I'll hear from Karl in a moment, but let me say to the committee that in addition to hearing two more sets of witnesses I want to get the committee's direction, which should take three or four minutes, on the issue of the tobacco regulations. We may have to deal with that this week too, but that depends on what kind of direction I get from you.
Karl, could you make it brief, please.
Mr. Karl Burden (CEO, Concerns Canada): I'll be brief. I appreciate the opportunity to speak to you on behalf of Concerns Canada, and also another member of the coalition, the Association to Reduce Alcohol Promotion in Ontario.
I'm here to support the coalition's position and I'm not going to speak more definitely than that, other than to share with you the fact that I've been, as Art has noted, in the field of prevention for eighteen years. I came out of a teaching career, having taught in both elementary and secondary. One of the things that disturbed me when I first entered the field was that time after time when we were dealing with prevention programs, drug education programs, researchers would tell us that from their research findings these programs were ineffective.
After a while I began to do some assessment of this. Fortunately I was able to negotiate and talk with some of the researchers. Over time we got a consensus among many of the researchers in Canada that while individual addiction programs, drug education programs, may not in themselves be effective, what has been effective and is effective is a combination of many different approaches targeting the same issue.
I raise that point because I think alcohol labelling is another nail in the coffin in trying to help the public in Canada understand that alcohol is a product that has to be used with discretion. We know labels on an alcohol product may not be the solution for all our problems. We are not trying to say they are. But we do know that when this message is added to many of the other messages being transmitted in society we do change behaviour.
So that's my first point. The second point is just by the way, as it were. It's worthy of note that virtually all household products with sufficient toxicity to kill a six-year-old are labelled with a skull and crossbones. However, a twelve-ounce bottle of spirits, which has such toxicity, does not currently carry such a label. This is in spite of the fact that a significant number of alcohol-related poisonings occur among young people and children every year in Canada.
Because of the time I'm going to stop, but those are my two points.
The Chairman: We are out of time, folks. I've also just learned that there's a caucus meeting here at 11 a.m. so we have to be out before then.
The witnesses have been interesting but long-winded. They have taken up the time we should have had for questions. So unless there is a burning question, I suggest we move on to the next set of witnesses.
I thank the witnesses for coming. We have the benefit of your testimony plus any other information you've circulated to us, and that will be taken into account by the researchers.
Mr. Paul Szabo (Mississauga South, Lib.): Mr. Chairman, this is not a question. I'd just like to thank the gentlemen for coming forward and reminding the committee of some important issues.
We do have a bill before this committee, Bill C-222, which is related to this and might help us if we were to deal with it. I think it's important particularly from the standpoint that the Minister of Health and the Canadian Paediatric Society announced on October 16 of this past year a joint statement on FAS. For the record, we should acknowledge that it says that the wisest strategy for women who are trying to have a child or are expecting is to abstain from alcohol during their pregnancy. That is a very significant statement, and I think it is consistent with the requests that have been made for health warning labels, particularly with reference to the potential risk to pregnant women.
Thank you very much, gentlemen. It's been helpful.
The Chairman: Thanks, Mr. Steinmann and Mr. Burden.
We now invite the next witness, from Dalhousie University, Christiane Poulin.
Dr. Christiane Poulin (Principal Investigator, Faculty of Medicine, Dalhousie University): I'm delighted to be here.
As you know, substance abuse is a major determinant of health in one way or another. It touches us all in Canada, if only because the economic costs of substance abuse are so high, some $18 million in 1992. But we hardly need percentages and dollar signs to tell us how important the issue is. Our everyday conversation, our literature, our music, movies and news media are rife with stories that touch on the topic, and usually those stories are quite tragic.
What I'm bringing to you today is the perspective from the Atlantic provinces. My presentation focuses on adolescents because that is a particularly vulnerable group in our population.
In the past three years Newfoundland and Labrador, Prince Edward Island, Nova Scotia and New Brunswick have managed to do what other regions in Canada have not been able to do: we set aside our differences and cooperated in order to obtain the solid information we need for policy and programs that address adolescent drug use. We pooled our resources, and by resources I don't mean dollars. I mean a few dedicated persons in each of the provinces, in agencies with intersecting interests in substance abuse, including health, education and law enforcement. We produced an innovative, cost-efficient, accurate, state-of-the-art survey for our purposes.
What we learned through our 1996 provincial surveys is that substance abuse is pervasive among adolescents. In all four provinces more than half of adolescent students use alcohol and about one-third of students smoke cigarettes in the course of a year. On a positive note, in Nova Scotia the prevalence of the use of alcohol, inhalants, prescribed tranquillizers, cocaine, heroine and barbiturates was about the same in 1996 as in 1991. Also, about 37% of students reported no drug use whatsoever, and that percentage hasn't changed in the past 5 years.
What you have in front of you is the highlights report of Nova Scotia. I've deposited with the clerk the full reports of the other three provinces. I was told this should have been in French. My Province of Nova Scotia does not have the budget to translate. In any case, we did this on a shoestring budget, so I'm proud of what I've been able to give you.
Our survey uncovered some rather unfortunate news. It revealed a marked increase in the prevalence of cigarette smoking and of the use of all hallucinogens as well as non-medical stimulants from 1991 to 1996. In Nova Scotia cigarette smoking increased by 9% in that period, from 26% to 35%, and 9%, I would suggest to you, is difficult ground to recover.
Of special concern is that more than 7% of adolescent students smoke more than 10 cigarettes a day. That's important because 10 cigarettes a day costs a lot to the adolescent who has very little disposable income. That pattern of heavy cigarette smoking increased 50% since 1991.
Cannabis use has nearly doubled in the past 5 years, and now almost one-third of our adolescent students report using cannabis. Furthermore, the percentage of students who use cannabis more often than once a month has nearly tripled, from 4% in 1991 to 12% in 1996.
Up to this point I've been speaking of each drug as if an adolescent were using only that specific drug. In reality, among adolescents the behaviour of drug use often involves several drugs. This diagram, and you have a copy of it in your brief, shows patterns of multiple drug use in Nova Scotia in 1996. The areas are scaled accurately. We see that students rarely report tobacco use without alcohol use. We also see that, practically speaking, all adolescents who use cannabis also use alcohol. So we have here patterns of multiple drug use.
The various patterns of drug use involving alcohol, tobacco and cannabis, the big three, are associated with various levels of risk. Students who report using alcohol but not tobacco or cannabis tend to use alcohol infrequently, don't get drunk and don't have any alcohol-related problems. That's the area that's just plain yellow. Those kids use alcohol in a low-risk fashion. They are growing up. They're going from childhood to adulthood and learning how to use alcohol in a manner that might actually benefit them in the end.
In contrast, adolescents who use alcohol, tobacco and cannabis report the most frequent use of cannabis and the largest number of cigarettes smoked daily. Those students get drunk on average once a month, and they have at least one alcohol-related problem. Multiple drug use involving all three drugs therefore appears to be associated with a particularly high risk of harm. Of great concern is that the percentage of students who use all three drugs has nearly doubled in Nova Scotia, from 12% to 22%, from 1991 to 1996.
The 1996 survey asked if alcohol or drug use had resulted in harm. Among adolescents harm doesn't mean things like cirrhosis; it means things like damaging things, injuring oneself or not having enough money to buy other things. Here's one student's experience, which is particularly poignant. She said, a lot of people who are under the influence of alcohol may get pregnant like I did, all because I was not in control.
The prevalence of harmful consequences is a key outcome measure for harm reduction strategies. Here we have a diagram that shows the percentages of adolescents who consume alcohol or who have alcohol-related problems in terms of a risk continuum.
In 1996 46% of the entire adolescent student population in Nova Scotia used no alcohol and therefore was not at risk of self-induced harm. Another 27% of adolescents used alcohol without a problem, and those adolescents can be considered at low risk of harm from their use. However, 27% of adolescents had at least one problem, and 7% reported three or more alcohol-related problems. Those adolescents clearly used alcohol in a manner that placed them at moderate to high risk.
Finally, how do the four Atlantic provinces compare in the prevalence of drug use? The prevalence of drug use is similar across the four Atlantic provinces except for cannabis, LSD and non-prescribed stimulants. For those three drugs Nova Scotia and New Brunswick are similar, and the two islands - P.E.I. and Newfoundland and Labrador - are similar. The prevalence is much higher in Nova Scotia and New Brunswick than in the remaining two provinces, so we have a dichotomy. For example, cannabis use was reported by about 31% of adolescents in Nova Scotia and New Brunswick, whereas in P.E.I. and Newfoundland it was 23%.
Not only that - the increased prevalence of drug use in Nova Scotia that I spoke about earlier is also something we observed in the Atlantic region. Smoking and the use of hallucinogens were much more common in 1996 than they were in 1991.
The Atlantic provinces ``done good''. We worked together and got some information. We also arrived at four recommendations that all of us adopted on the basis of the surveys. You'll find the four recommendations on page 11 of the Nova Scotia report I gave you.
I'd like to emphasize the third recommendation. With the marked increased in drug use and multiple drug use, the policy imperative becomes not only the prevalence of use but also the harmful consequences of use. Clearly there's a need for integrated school- and community-based drug prevention programs with goals, strategies and outcome measures capturing the full spectrum of patterns of use and levels of risk amongst the various subgroups of the adolescent population. Importantly, adolescents themselves need to be heard in their perspectives about this kind of approach.
However, there is very little information - in fact, I'd say there's a lack of firm evidence - about the effectiveness of such approaches. So demonstration products need to be developed, implemented and evaluated.
Given the upswing in drug use among adolescents and the need to examine existing strategies and develop new approaches, the end of Canada's drug strategy seems to us ill-timed and inappropriate. In the Atlantic provinces, where the federal government is considered a key partner of the agencies that address substance abuse, the closure of the national strategy is viewed as an abandonment. I use that word because it was actually what was told to me by my colleagues, my partners, in the four provinces.
Substance abuse is a complex determinant of health that demands attention to all its facets. We believe that continued federal involvement and funding are needed to address substance abuse, not just for law enforcement but also for prevention, treatment and research.
The Chairman: Once again I ask the committee to keep in mind that we're under the gun and we have another set of witnesses. Perhaps you could keep your questions and responses brief.
Ms Pauline Picard: I have no question.
The Chairman: Paul.
Mr. Paul Szabo: With regard to partnerships in the work done so far, have you tried to work with the beverage alcohol industry? Or do you feel your strategy should be independent of the alcohol industry?
Dr. Poulin: I personally have inquired, because it's a very seductive source of funding, isn't it? I mean, it's there. I think it would be very difficult to broach the topic of harm reduction with the industry as partners. I think it would be virtually impossible for adolescents because it would be seen as too much of a conflict of interest.
We have opted instead to work together, the Departments of Education and Health, and just to continue the hard work we've been putting into this. We are in desperate need of resources, but we manage to put things together a bit at a time.
Mr. Paul Szabo: I raise that because the Brewers Association of Canada is currently running a contest of sorts where they have gone to schools and they are offering them cash prizes for coming up with clever marketing, etc. But you used the words ``conflict of interest'', and I tend to agree with you. Sometimes it's not a good idea to ask the fox to take care of the hen house. I'm pleased your program is maybe looking for the alternatives rather than risking mixing messages.
Dr. Poulin: Yes. I understand that for adult programs, for example, the literature produced by provincial agencies...do collaborate, do partner with the industry. In that case it's made very clear in that literature that the industry has contributed in some way. That in itself would not -
Mr. Paul Szabo: One last question. In Ontario a report recently came out...it's based only on 1992 data, though, and I don't understand about the big lie. It basically says that over the last decade of study the progress has been very significant but the curve is starting to level off in reduction of problems associated with misuse of alcohol. Oddly enough, they found that for the first time in a decade the incidents have gone up in some areas, and it doesn't have to do with kids, it has to do with those in the next generation, up into their thirties, because - and they are speculating - our concentration has been so much on young people that we forgot to continue to remind those who are beyond that. As an example, they gave the awareness level of the designated driver program.
Dr. Poulin: I'm a bit amazed at that. I'm sure all of us have given attention to adolescents. From our perspective, with these major increases we need to redouble our efforts with adolescents. I don't know what is happening with that in-between generation. That's a tough one.
Mr. Paul Szabo: I'm sure we'll continue it.
Thank you. You are doing a great job. That's angel's work.
Dr. Poulin: I'll bring the compliment back.
Are there any other questions?
Sir, may I address one issue that was brought up before on the issue of Ritalin. Ritalin is a stimulant used to treat attention deficit/hyperactivity disorder. It acts paradoxically. It calms kids down. In our province, for example, we've seen an increased use in the non-prescribed stimulants, of which Ritalin is one, and also in prescribed stimulants. We have a triplicate prescription program, and coinciding with this and corroborating this information is that the number of pills and number of subscriptions have doubled in the past two or three years, as measured by our program. So we see that as an issue.
Now, the door there is the physician, because it is the physician who has the triplicate prescription and it is the physician who makes the decision whether or not to prescribe Ritalin as part of the management. Certainly we are looking at that in more depth.
The Chairman: Thank you very much, Christiane, for coming. Again, the researchers may well be in touch with you about additional information as they prepare their report.
Now I invite to the table the representatives from the National Coalition for Health Freedom.
We welcome you. I think you know the routine by now. The longer you talk, the less time we have for questions. We ask you to keep in mind that any written presentation you have is considered part of the evidence of the committee anyway, so there's no need to read all that to us, because we all read reasonably well or pretend to do so. But if you have some points you would like to highlight and then give us an opportunity to put a question or two to you, we would be happy to do that. Who is in charge down there?
Ms Miriam Hawkins (National Coalition for Health Freedom): I could lead off.
The Chairman: Miriam, would you also introduce the people at the table for the record, please.
Ms Hawkins: I thank the committee very much.
I would like to introduce some speakers I think you will find very interesting on a couple of different subjects, but relating to the same whole. Dian Nicholson was the campaign director for the campaign against drunk driving in Washington. She has a great deal of experience with NARCANON and some alternative therapies for addiction treatment. I think this will allow us to bring some discussion into the area of alternative therapies, natural medicine, herbal therapies, orthomolecular medicine. We're seeing some very interesting results in addiction treatment, support.
Shelley Seguin is with Ottawa's Rideauwood facility. It's a clinic. Actually, Dian is with the Kulhay clinic in Toronto and is a therapist herself. Shelley has quite a lot of experience in this area. If you saw her biography, you might know she herself was able to overcome addiction and is now helping others using natural therapies and support.
You may know Dr. Michèle Brill-Edwards from her extensive work with the health protection branch. I have invited her today to elaborate on the difficulty the wider health community has had with Health Canada in its application of its mandate to protect the health of Canadians, to promote preventive health measures, and so on.
I might just introduce these speakers with the fairly critical situation I think we find ourselves in Canada. Many people have turned to natural medicine and are now facing a situation where drug identification numbers are restricting the availability of these substances and we see international regulations, which may create binding trade agreements for Canada, taking these products off the shelves in such a way that Canada will be unable to bring them back in.
Last night I rode in a cab to the airport in Toronto and the fellow driving the cab was telling me how he broke his hand, he went back to Ghana, his dad wrapped it up with herbs, it was better in three weeks, and how that wouldn't have happened here. You won't be able to get such products here if we allow our health protection branch to continue in the irresponsible manner I think it has in introducing a cost-recovery system, because of which I think you're going to see legal suits. I understand an injunction is planned, class actions are planned, against the federal government in this area.
I think we're going to have quite an interesting discussion on Michèle's organization, the Coalition of Canadians for Accountable Government, which we have joined. The National Coalition for Health Freedom has joined this organization, and Michèle is here on behalf of the Alliance for Public Accountability because Canadians are very tired of what Health Canada has really not accomplished and because they are giving us something other than what we want.
I'm going to leave all this stuff about all the politics of the Codex Alimentarius. I'm sure you already have quite a bit of information, and I plan to supply you with much more, if you have time, of course, to get into all this.
I'll leave it to Dian to head off with her presentation.
Ms Dian Nicholson (National Coalition for Health Freedom): Before we came up here, Miriam leaned over to me and said ``We're in a hurry; try to tighten it up.'' There's so much to say and so much needs to be said.
A recent Newsweek article states that over the past four years drug use among American 14- to 17-year-olds has increased by an astounding 80%. That's nasty, and we're in trouble. After having seen the ravages of the first few decades of the century, Einstein said, ``It has become appallingly obvious that our technology has surpassed our humanity.''
We have robbed ourselves of any real security any of us might seek for our future. We have poisoned our planet, created a world run by technology. We've elected governments that push our children to learn more technology while 75% of our families are splitting up, leaving our children with no grounding in how to love and live with each other.
Anybody who has worked in the trenches of drug and alcohol abuse will tell you it is not a pretty picture. They will tell you of the sadness we feel when a client falls off the wagon. Failure is a much more familiar face than success, and slow suicide is not an easy thing to watch.
It's difficult for you folks to understand things at second hand. You are just too distanced from the problem to get an understanding of it. So I want to give you one brief little picture of what an addict is about.
They don't want to feel anything. These are people who are seeking anaesthesia for their life - not for a headache, not for a sore back, not for a sinus problem, but for their life. They are rife with fear and pain and guilt and shame every sober moment and they are seeking anaesthesia. Most of them will never get well, and those who do will always see an addict staring back out of the mirror.
We know what the results of these addictions are, but in 1990 an advisory committee convened to report to the Government of Ontario its recommendations for drug and alcohol treatment directions for the 1990s. Unable to claim any real success in rehabilitation statistics, they resorted to a recommendation that since they had found it unrealistic to expect a cure for addiction, they should aim all their efforts at damage control and consider lowered consumption or cross-addiction to less harmful drugs to be a success. In short, they declared the patient terminal and opted for palliative care.
One of the problems in the rehabilitation of addicts is the fact that most drugs, like other toxins, are fat soluble and up to 10% of their residues wind up getting dissolved in the fat globules in the bloodstream and get stored in the fatty tissues. Every time a bit of that drug-laden fat metabolizes, the addict experiences a mini-high; a mini-version of what he was going through. It might be just like a memory, but it's enough to make him crave and it's enough to make him relapse and use again.
An all-natural therapy has been available for decades. It removes these residues from the body, eliminating this barrier to recovery. I have watched it work. Client after client reported a wonderful, tangible feeling on the day they first felt clean. Withdrawal therapies that were all-natural eliminated all but minor discomforts of withdrawal.
One person came in on crutches from hospital. Methadone withdrawal had just about crippled her with pain. The next day, under this therapy, she was walking easily and had an appetite. She and I ate Chinese food together. I thought I was seeing miracles. I had never seen turnarounds like this.
This proven, well-researched, readily available process is generally shunned by the rehab community and others. A strong dislike of its author, L. Ron Hubbard, decrees that even such a pearl as this shall be rejected. As an non-Scientologist myself, I found this judgment prejudicial. It is my opinion, and I would hope others share it, that it is easier to reclaim a live Scientologist than a dead drug addict. Nevertheless, I never saw or heard of any client pushed or encouraged to join Scientology or its church.
Two years ago Women's College Hospital was granted $2.5 million to research just such a method to remove toxins stored in fatty tissues. I was stunned by this wasteful irony, and I wondered what happened to the Hippocratic oath, which states in part:
I have to ask, why is the Nazi regime a source of medical direction if Hubbard's method goes unrecognized? Is this not on its own a terrible irony?
The scenario looks even more ludicrous when we see that heroin was first used as a cure for opium addiction. Then methadone was introduced for heroine addiction. Now there's clonidine, the current fad in methadone withdrawal. This anti-hypertensive or blood pressure reducing drug has a major drawback: it has a lot of side effects, six of which require immediate medical intervention. When the methadone finally clears the system enough, all that heroin residue is still in the body fat. You don't need a medical degree to guess what happens next. All of this, rather than admit that maybe old Ronnie came up with something the rest of us missed.
It is a fact that 6% of the population of North America buys more than 50% of the alcohol sold. This statistic comes from the Center for Science in the Public Interest, which you heard of earlier, in combination with those from the Addiction Research Foundation in Toronto. This being the case, alcohol abuse earns the alcohol industry more than half of its corporate profits. We can therefore conclude that reducing the incidence of alcohol abuse is not high on the ``to do'' list of alcohol producers, and we can bet they don't sponsor any anti-abuse programs that work, either.
Frightening, indeed, is the fact that those with addiction problems are regarded by many as income potential. Even more frightening is the thought of government complicity, or at least its complacency. The fuel that feeds this cycle of destruction is nothing more than our own lassitude.
Anyone open to the obvious has to know that if a drug treatment system exists, it must be for the benefit of the addicted or it would not have a reason to exist. If it is truly there for the addicted, shouldn't that system try everything in its power, regardless of source, for their well-being? And if it doesn't, what does that say about how we treat the afflicted? There are hundreds of natural therapists in Toronto alone, and their offices are bustling with clientele who keep coming back. These patients aren't all crazy. Like anyone else, they're interested in results, and they're taking responsibility for their own wellness and saving us all money, despite others' concerns.
Certainly it is clear that any derision aimed at traditional and natural therapies has been generated by interests vested in allopathic therapies. We are in the midst of a marketing war, and as a result, the unwell are being threatened not only with the loss of their right to choose their therapy but also their right to benefit from that therapy insofar as is possible.
Traditional therapists have rarely kept clinical records throughout the ages and so do not provide the data fix the technical world uses to make decisions. But while the allopathic community, including the health protection branch and the Ontario Medical Association, demands that millions be spent on testing natural treatments, we have to remember that available data shows no one ever died from an overdose of tahebo, no one ever got addicted to valerian root, and no one ever had an adverse reaction to a homoeopathic therapy.
We who are charged with the betterment of the state of well-being of our compatriots must do no less than remain open to all meritorious solutions. But merit must not be decided by those whose interest is vested in competing therapies. It must be decided in truth, for there is only one interest: health. If that is indeed our goal, then we must necessarily consider the results natural therapies have provided for thousands of years and the reasons these methods have not been lost. We must consider that people only pay twice for what yields results, and the public loves natural therapies.
We must remember that the only loser in this equation is the heavy-billing allopathic community, which couldn't be too pleased at the thought of making room in the ivory tower for us heathens. As far as this therapist is concerned, I have to go along with my mother, who often told me you can't argue with results.
Ms Hawkins: I'll now ask Shelley to speak about her experience.
Ms Shelley Seguin (National Coalition for Health Freedom): First, a disclaimer: I'm here just representing myself, not as a representative of Rideauwood Addiction & Family Services, although Rideauwood certainly has a holistic approach to healing addictions, and I do have some leeway within my job there to recommend certain things to people. I'm pretty moderate in terms of my background around herbal medicine.
Let me describe how I became interested in herbal medicine. I am in recovery myself from chemical dependency. I've been in recovery since 1980, so that's 17 years. The drugs I used and abused were alcohol and stimulants. My recovery, initially, was certainly with medical advice. For instance, for the headaches I had in withdrawal Fiorinal was prescribed. This is quite addictive, it's codeine, so I then became addicted to codeine. These are things I was ignorant about. Like many recovering addicts, I certainly drank a lot of coffee, which probably contributed to the headaches I got, but I didn't know that at the time.
I later developed chronic fatigue syndrome, which I believe - this is not what a doctor told me - was a result of the stimulant use I had earlier on. Stimulant use affects the adrenal system, and when your adrenal system is burnt out you become very exhausted.
The treatment for chronic fatigue syndrome that was suggested to me was anti-depressants and muscle relaxants for muscle pain. At this point in my recovery I had discovered alternative therapies and I was already using herbal medicine just as a nourishing, tonifying support for my physical well-being, so when I was prescribed anti-depressants, muscle relaxants, and anti-inflammatories I knew there to be alternatives. I used these alternatives in recovering from chronic fatigue syndrome.
Today I'm well. I have lots of energy and I keep up a pretty hectic pace, and I attribute it to natural therapies. I made use of massage therapy. I made use of a naturopath who prescribed homoeopathic medicines. I used not very toxic, simple tonifying herbs such as stinging nettle, which might sound pretty nasty but is a wonderful food. It rebuilds the adrenal glands, the kidneys, and the immune system. I made use of things such as Siberian ginseng, which is a very wonderful tonic. I made use of relaxing herbs such as lemon balm and camomile.
These things have helped me a great deal, and I was able to save myself the expense and also the considerable confusion I see with clients I work with who are changing from one anti-depressant to another and finding they're not working. I'm not saying there's not a time and place for anti-depressants. I'm simply saying I chose not to use them. I have seen people go through quite a bit of frustration. Maybe if I hadn't been helped I would have resorted to those, because I was really quite unwell.
What I use with people in my practice is alternatives for people who have insomnia, alternatives to sleeping medications, which chemically dependent people can't safely use. They are highly addictive. I'll recommend simple things such as catnip tea or camomile tea. People often get a lot of headaches in early withdrawal. There are herbs that can help with that. With muscle tension, people who are chemically dependent cannot safely use muscle relaxants. Medications like that...
Also, many of the people who I work with and who are in early recovery, because of their chemical dependency, don't have jobs, don't have health plans, and cannot afford expensive prescription medication. This gives them a fairly inexpensive, easily accessible alternative, one I would hate to see made inaccessible to people.
That's the background I'm coming from. I have some training in herbal medicine, about seven years' worth, but I consider myself a fledgling herbalist, not a fully qualified one, so I don't recommend the more controversial herbs. I would refer someone to a herbalist if it were something more iffy. That's where I'm coming from today.
Ms Hawkins: Maybe Dr. Brill-Edwards could follow up now with an overview of the health protection branch and some of the problems therewith.
Dr. Michèle Brill-Edwards (Alliance for Public Accountability): Good morning, ladies and gentlemen. I'm Dr. Michèle Brill-Edwards, a former senior regulator with the health protection branch. As you know, I've been asked to speak this morning on behalf of a coalition of groups that have joined together within the last few weeks for the specific purpose of requiring, as citizens, that there be an investigation of the health protection branch.
The broad group is called the Coalition of Canadians for Accountable Government. The National Coalition for Health Freedom is one member of that group. The group to which I belong, the Alliance for Public Accountability, is another member of the group. There is a wide array of groups, the Canadian Health Coalition, the Canadian Haemophilia Society, and other groups relating to natural products. Together these groups represent, we estimate, in the hundreds of Canadian citizens.
Time is short; let me cut to the chase. The key issue before your committee in all these representations is the uneven application of the law, the uneven application of the Food and Drugs Act. The Department of Health, its minister, and its civil servants are mandated by law, through the enabling legislation, the Department of Health Act, to administer the Food and Drugs Act, to protect the public from health hazards and fraud in the use and abuse of drugs, foods, cosmetics and devices.
That duty is not being properly undertaken. The reason we have this huge coalition of citizens who want an investigation of the health protection branch is that those citizens recognize unfairness when they see it. They recognize illegality when they see it.
What we have now is dereliction of duty to apply necessary legal safeguards to high-risk products such as prescription drugs, blood, mercury amalgam, and by contrast an overzealous regulation of low-risk natural products such as cheeses. You've just heard this morning two groups wondering why it is that the literally millions of people in Canada affected by alcohol, a high-risk product, are left unprotected while the department, in its wisdom, last fall was all hot to trot to ban natural cheeses, which had been used in Canada safely for many years. Does this not strike you as very similar to the situation in which we have a department that is so overzealous with its inspections that it is at this time, across the country, shutting down small producers and retailers of natural products because their products lack a DIN number, yet the department has testified before the Krever commission that it lacks the resources to inspect the Red Cross blood centres properly? Does that make sense to this committee?
We are here to try to convey to you that this uneven application of the law cannot continue. We are not asking as citizens, we are not beseeching as citizens, that the health protection branch be investigated. We are placing the committee on notice that as citizens we have lawful expectations that the department will serve its legal mandate to apply the Food and Drugs Act evenly and fairly and soundly. That is the essence of what I am here to propose to you.
The letter you received from the coalition on Friday gives more detail on what I have just said. That is included in the documents being presented to you now. I would ask that before you dismantle or dismiss the committee before the election, one of the members of this committee put a motion for the investigation of the health protection branch to determine whether the branch is in fact jeopardizing Canadian lives and causing the waste, if not fraud, of millions of dollars spent on health products through its uneven, unsafe application of the Food and Drugs Act.
The Chairman: Thank you. Certainly before I as a member of the committee could support that motion I would need to have some more information about why the health protection branch...there are a lot of other agencies out there we should maybe be investigating too, if we had the substantive evidence.
So my first question is for Dr. Brill-Edwards. If this is such an obvious development, the unequal application of the law, why? Is it lack of resources? Is it just basic stupidity? Is it somebody with another agenda? Why is it happening? Why is it so rampant, if we are to accept your allegations? Why is it going on? There must be a reason.
I rely a lot on what I call the law of averages, that for every malicious person over there, there must be some normal people over there, too; for every stupid person over there, there must be some competent people over there; for every spendthrift over there, there must be some people with an eye to spending the money appropriately. Why? Is it stupidity? Is it a shortage of funds? Is it some other hidden agenda? Why is this going on such that it would demand an investigation, in your view?
Dr. Brill-Edwards: The succinct answer is that this is going on because the health care industry, including the pharmaceutical industry in this case, has become the tail that wags the health care dog. I spent 15 years overall in the health protection branch, and I can assure you your assumption is correct: there are people in the branch who are well-informed and conscientious and who put the public interest first. I can equally assure you, and I have the facts and am willing to be placed under oath to testify, that those individuals are not heard, and at times that leads to decisions that are not only unwise and unsafe but also illegal.
My professional reputation is on the line when I say these things. I recognize that. I am trained to speak with discipline, to check every word as I am saying it. I challenge you to have me come before you and fully answer your question without the limitation of today's clock.
The Chairman: It's not a challenge I'm interested in - we're slightly off subject, to start with - but I raised the question because you had put some things on the record, and I thought they ought not to go unchallenged.
Dr. Brill-Edwards: Would you give me the time to speak, for example, to the calcium channel blockers? I'm at a disadvantage.
The Chairman: Sorry, we -
Dr. Brill-Edwards: You have asked me a question under a very tight time constraint. What limitations are you putting on my answer? I can certainly give the evidence immediately and very briefly. Do we have two minutes?
The Chairman: First of all, understand how this exchange evolved. About 26 minutes into your presentation you dropped this one about the need for an immediate investigation before the committee does anything else, and I said -
Dr. Brill-Edwards: The members have received this recommendation as a letter to each of them in their mailboxes on Friday.
The Chairman: I don't deny that. I'm saying I think it may well be outside the purview of what the committee is trying to do right now, and my reason for interjecting was just to give some balance to what you were saying, to elicit some information from you. What I heard from you is that the hidden agenda or the driven agenda is that the health industry is telling the department what to do. That's the short version of what you said.
You were with the department for 15 years.
Dr. Brill-Edwards: Yes.
The Chairman: Why aren't you with them any more?
Dr. Brill-Edwards: I resigned in order to speak publicly about the abuses I witnessed within the department that were jeopardizing Canadian lives. I did so publicly and have continued to do so.
The Alliance for Public Accountability had press conferences after which the minister agreed to an investigation of the branch, which did not occur. At the time of my resignation in January of last year, the minister was questioned in the House and promised an investigation, which was not properly conducted. We have recently submitted a brief and presented before the committee reviewing Bill C-91. We are doing all in our power to bring to the attention of the government activity that is wrongful and illegal.
We place you on notice that you are aware of this. It is up to you to consider under what framework you might deal with this. I couldn't agree with you more that now is not perhaps the time and place, but there must be a time and place.
Ms Hawkins: There's legal action pending, so it's just a question of how the committee wants to deal with it and how the government wants to deal with it. Certainly, one might want to prevent the legal action that is planned or somehow stem or mitigate the damage that might be done to the government, because there are several groups banding together to pursue this very avenue through the courts. So it's really a question of how the committee decides to proceed. It's really immaterial -
The Chairman: With respect, Miriam, it's not at all a question of how the committee decides to proceed. The committee decided that months ago. The committee is dealing with a fairly defined issue, a review of drug policy, and it's not here either to protect the hide of government or to castigate it. We're not a government committee, we're a House of Commons committee, and this committee has its own mandate.
You were asked to come here right now because we want to get your views on the issue of drug policy in Canada, not particularly on what lawsuits you have going or what you think of particular departments of government. I believe you've taken advantage a bit of an opportunity that ought to have been used to talk about the drug policy review to air other laundry.
Ms Hawkins: We came here to talk about the access to natural medicine, which is being choked off by Health Canada. I don't know how else to present it except to talk about the various methodologies that are much more successful than the twelve-step programs and the other ineffectual programs that are being used. Natural therapy works. Herbal medicine and allopathic medicine are at opposite ends of the paradigm in this case. Certainly health protection branch is approving drugs that are making people sick and banning herbal medicines through the use of the DIN system, which is a trumped-up cost recovery system that is not to the advantage of consumers and that is killing off small businesses.
You can go at this from many different angles, but it is relevant. It is relevant that because of health protection branch and Health Canada's uneven application of the law we are losing access to natural therapies that work. I'm hoping it's apparent to the committee that this is all a package. This is to be seen together.
These are the therapies that work for addiction. There is a lot of evidence, and we'll be happy to supply the committee with lots of material about natural therapies for addiction treatment. But we can't continue to apply this to addicts; people can't get it if they need a drug number and the cost goes up, because a monopoly is being created by the drug number system, which we see happening.
The largest health food store in Toronto is the Big Carrot. Half their products are under black tape right now because they don't have DINs on them. Only a dozen companies will be left producing natural medicine. By the end of April Big Carrot has to remove all those products from the shelves.
Why can health protection branch hire 100 people or whatever it is to go around to health food stores across Canada to put so much energy into getting rid of natural medicine? There's no evidence that anybody is hurt by it. There is none. Yet we know in the United States 100,000 people die from prescription drugs every year. The statistics about what prescription drugs do to Canadians are enormous. We have lots of evidence. There's a complete imbalance in the situation.
Whether the committee wants to look at it any further in this context or not... I was hoping that because we are also talking about solutions to addiction and because the solutions are being cut off by Health Canada it would be very meaningful to the committee. I think it's very relevant. I'm delighted we have the ability to show you... This stack of books here has lots of references in it. We have all kinds of material.
Ms Nicholson: I have another stack in my briefcase, and there are more. There are thousands. Traditions become traditions because they work, not because they don't work. Nobody ever got hurt by this stuff. Our so-called ``protection bureau'' is not exactly protecting us from stuff that hurts us and it is taking away things that don't. This is stupid.
The Chairman: You're here in the first place because you have those stacks. We've seen you as having resources. We wanted to pick your brain a bit. My admonition was only that you stick to the subject. If you have lawsuits, this is not the place to talk about them.
Ms Hawkins: I'm not here to present a lawsuit. I'm just letting the committee know what is out there.
The Chairman: My plea was to stick to the subject.
Paul, do you have a question?
Mr. Paul Szabo: Just very quickly. It's a very important subject. Does the panel believe there is any role for Health Canada to play in making sure natural or herbal products are safe for Canadians to consume? The DIN system is what has been used. Is there some alternative, or are you suggesting that anybody who wants to sell these products should just be able to do it?
Ms Hawkins: Maybe Dr. Brill-Edwards could handle that first.
Dr. Brill-Edwards: Mr. Szabo, a hundred years of regulatory law says Health Canada not only has a role, it has a legal duty to ensure Canadians are protected from health hazards relating to health products, including natural products. So it's not a question of the discretion to choose to do something or not. They have the duty.
Mr. Paul Szabo: But with regard to herbal products -
Dr. Brill-Edwards: Hang on a second.
Mr. Paul Szabo: - they want to apply the DIN system, and you're objecting to that. Is that the idea?
Dr. Brill-Edwards: No. You notice I didn't use the term ``DIN''.
A witness: Perhaps I could answer as well.
Dr. Brill-Edwards: I just would like to complete what I'm saying. The DIN system has been in existence for a very long time. For herbal products the department virtually ignored the situation for many decades. It was actually a frustration to the inspectors of the branch that many products were marketed without any scrutiny whatsoever.
What has happened recently is that the department has brought in a system of cost recovery whereby they gain money for examining the applications for these drug identification numbers. That appears to be a reasonable move on the part of the department until you look carefully at the effect of what is going on. This cost-recovery, aggressive system has been introduced very abruptly. It's having the effect of putting people out of business. It's having the effect of removing drugs with a reasonable safety record from - -
Mr. Paul Szabo: So you don't want the DIN for herbal products.
Dr. Brill-Edwards: No, hang on a second. No one is saying there must not be a DIN. What we are saying is it must be applied fairly. What is the process they are paying for?
Mr. Paul Szabo: Do all DINs get charged the same fee?
Dr. Brill-Edwards: The important thing to understand is that the fee that is assessed is the same for all producers, but the producers are not all the same. Some are very small concerns who are put out of business by - -
Mr. Paul Szabo: Affordability.
Dr. Brill-Edwards: - a $50,000 sudden application of a new policy.
Mr. Paul Szabo: I think I understand.
Dr. Brill-Edwards: Okay. I would like to add a further thing. How does this fit into the grand scheme of things? This is very much like putting the small cheese producers out of the market. It is so that larger concerns can take over the market. The natural product market is an emerging market in pharmaceuticals.
Mr. Paul Szabo: Could you tell me how much the DIN fee is for one product?
Dr. Brill-Edwards: It is $570, and if you have 10 of them - -
Mr. Paul Szabo: For distribution throughout all of Canada, we're talking about $570.
Dr. Brill-Edwards: Yes, but there can be a cumulative effect. For example, a small producer in the west was recently shut down because the DIN numbers were not there instantly, and he's faced with a $60,000 instant bill. That puts him out of business.
Now, the Treasury Board guidelines for the introduction of new policies, DIN included, are that when you change either the policy or the administration of the policy, you must give fair warning to citizens to allow them to adjust their business practice. You can't just arbitrarily apply a law that damages people for no improved reason. If there were a real safety hazard, if we had Canadians dying, then I would be the first to say immediate measures are required. But all people are asking for is time to adjust, time to have a say in what is going on and protection from a branch that appears to be eliminating the small players in order that the large multinationals can come in and take over what is looming as a very lucrative pharmaceutical market.
Mr. Paul Szabo: You've confused me, because it sounds to me as if you're talking about a DIN for a distributor as opposed to a DIN for a producer. This is very confusing probably for a lot of people, and we should make sure we don't mix apples and oranges or multiples. This is complex enough, and I hope you'll be able to provide all members of Parliament with information and maybe concentrate on individual issues rather than letting them flow together, because sometimes it may be misunderstood.
Dr. Brill-Edwards: I think you're right that this is a very confusing and complex area. But if there's one message the committee should take home today about DIN numbers, with all the emotion and the rhetoric that's involved right now, it's that the DIN number is hollow. There is no safety process that has any meaning. When you go to the health food store and you buy a product that has health protection branch's DIN number on it, there is no assurance that what is on the label equates with what is in the bottle or the box.
Mr. Paul Szabo: But if you have a DIN, you can get it recovered through your insurance. If you don't have a DIN number, you're in trouble, right?
Dr. Brill-Edwards: I'm talking about... You've just said that you want to talk to policy. If this is not drug policy in Canada, what is? If we don't know that when a drug is labelled and is on the shelf, it's really in the box...
Mr. Paul Szabo: Thank you, Mr. Chair. I think we should advise the panel that they're welcome to submit any additional information in writing or otherwise for the committee's consideration.
Ms Hawkins: It's a very large issue.
Mr. Paul Szabo: Yes. Please feel free to submit anything you want.
The Chairman: I want to thank the witnesses. You've opened up an area that was not relevant in my view, but also an area that was relevant. The latter we're going to focus on a little bit more. I've just spoken to the researchers and we'll be in touch with you.
You can appreciate that the role of the chair is to try to keep this fairly focused, or else we can get off on many other tangents. We do thank you for coming.
I ask the committee to stay for a moment. We have an issue that we've been aware of, the tobacco regulations, but I only became aware since coming into the room this morning that it would be desirable for us to do something about them in the event that this is our last week here.
Here is the situation. Because of one of the amendments to the bill on tobacco, it is required that the tobacco regulations not only be reviewed by the committee but be then approved by the House. There has to be a decision in this committee and the House has to take a decision once it gets our report.
That puts us, as a committee, in a very tight timeframe if we want to do anything before the House dissolves. That's on the assumption that it might dissolve this week, if you hear all the rumours. If it doesn't, then we can deal with this next week.
With that possibility, keep in mind that if the committee doesn't address the question of the regulations, then they're in limbo until a new parliament strikes a new committee. I understand that the regulations cannot be implemented.
I don't expect you to be an authority on the regulations, but I can short-circuit them for you in a moment. There are two things about them.
First, much of the effort to curb smoking among youth is spelled out here in terms of the regulations. That's the principal reason, I'm told, for wanting to get them sooner rather than later.
Secondly, while in the normal course of events I could see us calling witnesses on these regulations, I am told the following by the department this morning. I'm told the Canadian Tobacco Manufacturers' Council, the one group that could be expected to object to this scheme of regulations, had a couple of particular concerns when the regulations first came out. I'm told these have been accommodated and I'm told the council is now prepared to give a letter indicating it has basically no objection to the regulations.
I therefore propose the following: that we consider having a meeting of the committee in which we call witnesses from the department, who can then speak to us on the issue of the Canadian Tobacco Manufacturers' Council. After we have called these witnesses we would want to consider voting to put the regulations through or not put them through, as the case may be, so we could report to the House.
That's one alternative. The other is to do nothing and leave them in limbo until another parliament deals with it.
I repeat, all that is predicated on the assumption that this could be our last week here. If we have next week to deal with it, obviously there is no problem.
Mr. John Duncan: I have one quick question. Do these regulations require only House approval? The Senate is not involved?
The Chairman: I don't know, John. From my conversation with somebody from the health department this morning as soon as I came here, I understood it would require a report from this committee and adoption of that report by the House. So I don't think the Senate is involved, but I don't know.
Mr. John Duncan: My point is that if the Senate is required we're really past the time when it's useful to deal with it after today anyway, I would assume, if this is our last week.
The Chairman: Excuse me, the lady from the department to whom I spoke earlier - would you mind just putting that question to somebody in your department? Is there a role for the Senate here before the regulations can be implemented?
Okay, we will have that answer in time.
Mr. John Murphy (Annapolis Valley - Hants, Lib.): If we were to bring some departmental people in - that, I assume, would be tomorrow... By the time Friday comes we have to get this on the agenda in the House of Commons somehow.
The Chairman: I think we ought to be realistic with ourselves. The only way we're going to deal with this is if we can do so in a meeting, because getting a quorum is going to become increasingly a problem as the week goes on. I have asked the clerk to reserve time both this afternoon and tomorrow afternoon just in case one of these times is suitable for somebody around the table. But these are all contingency plans.
Mr. John Murphy: That's all I'm saying, Mr. Chairman.
The Chairman: I'm not married to any particular solution on this one. I would like to accommodate -
Mr. John Murphy: If we were to go for the solution of having hearings, could we get this thing to Parliament by Friday? That's all I'm asking.
The Chairman: Let me say it again. I think if we're going to deal with it - because the choice again is to leave it in limbo or to deal with it -
Mr. John Murphy: I understand.
The Chairman: - if we're going to deal with it, I think we're going to have to do so in one meeting of a couple of hours, hear the witnesses from the department, then have a quick look at the regulations and do a motion. The other alternative is to do nothing.
Mr. Harbance Singh Dhaliwal: Mr. Chairman, first of all, as for me personally, I'm not available after tomorrow morning, really. I have to be in Vancouver for other functions, so I'm really not available.
The other thing is that my feeling is that time is really of the essence. There's going to be tremendous difficulty, first of all, in getting a quorum. I don't feel very good, having given it this much time, about having to rush it through in the next day or so, unless there's a very good reason the department can give us, and a good reason why they haven't brought this forward before. There was no reason why we couldn't have dealt with this at the end of last week or Monday, yesterday, or why we couldn't have been looking at this concurrently when we were looking at the act.
I feel you're pressuring the committee into passing things quickly. I know we've spent a lot of time on the tobacco bill, and we worked very late to put that through. We worked very late and worked very hard on the committee to get it through. I don't feel very comfortable, to be honest with you, to be put in that position once again, particularly when it seems an election may be called any day.
The Chairman: Just a bit of information on one aspect of what you've said. We could not have done it concurrently, because it was only the amendment by Rose-Marie Ur that required us to do it in any event, and that amendment came after the fact, after we had dealt with it in committee.
The second thing is that the committee has actually had the regulations for a week or so, but we were advised we could nothing about it until the Senate dealt with it, which it did last week. That's why it's coming before you now. When we were here last week it was still before the Senate. The Senate didn't deal with it until Thursday evening, I believe. So this is the first opportunity on which we could have dealt with the issue.
The answer, John, is that it does not have to go to the Senate.
Ms Pauline Picard: I agree with Mr. Dhaliwal. This is a very serious bill. We worked very hard when we heard witnesses. This is a health issue that affects the people we represent. Adopting regulations at full speed does not seem very professional. I can't work this way.
Members of the Official Opposition and everyone else are busy. I won't be here Thursday. If we have no choice and we must work, we will have to do it tonight or tomorrow. I have a lot of trouble understanding why we are being forced at the last minute at the 11th hour adopt regulations we have not studied. We are going full speed ahead. What will we look like in the eyes of our constituents, when we are trying to show them how seriously we take these issues? I do not agree with adopting these regulations expeditiously. We will have to find another way.
Mr. Paul Szabo: Mr. Chairman, just so I'm very clear on this, because there may be a way to deal with this... We pass legislation and regulations are normally the purview of Order in Council approval, which these have received. This has already gone through. In the absence of a resolution that was inadvertently slipped through the House to require that Order in Council to come through this committee before the regulations could go forward, it's actually a technicality that they are before us in the first place. By their very nature regulations are very detailed, right down to the size of a sign and the boldness of letters and things like that. We now also have full knowledge that the tobacco industry is challenging the legislation and this is certainly not going anywhere.
So I tend to agree with Madame Picard. It would not be reasonable to ask members to go through this process, but in fact we would never have been required to do this except that there was this motion that slipped through in the House without a vote. It was simply on division. Most people weren't even aware of what was going on at that time.
Mr. Chairman, I'm suggesting that rather than having the legislation, including the regulations, which have been passed by Order in Council, together and available for the courts, it would be useful to have the committee simply discharge its responsibility as required by that motion that was passed, Madame Ur's motion...that it simply have this committee's review before they go forward or have that one other step.
I don't know if it's in order, but I would like to move that the regulations as passed and recognized by Order in Council simply be adopted without further review by this committee and reported out today.
The Chairman: John Duncan.
Mr. John Duncan: Not being a regular member of this committee and hearing the case that has been presented by Mr. Szabo, could I get independent verification or an independent statement from...? Do we have legal counsel here or anyone -
The Chairman: We don't, but -
Mr. John Duncan: - to tell me that's really what has transpired? I'm here representing my party and I'm taking you at face value, but I wanted to have some... Could the chair confirm that is the case?
The Chairman: What I can do is refer you to one of the documents. You were given three documents, and the thinnest of the three has a cover sheet in French, but up in the corner it says JUS, meaning Justice, 1996, etc. Can you get him a copy of that document?
Mr. John Duncan: Thank you.
The Chairman: The answer to the question you're asking is in French on the first page, but if you flip the page, you'll get the answer in English. It says that notice is given that the Governor in Council, cabinet, proposes... So what Mr. Szabo said on that point is accurate, that the cabinet has dealt with it and is now proposing... This is the notice that went into the Canada Gazette. So cabinet certainly has dealt with it, and that attests to that fact right there.
Are you with me?
Mr. John Duncan: I follow you now. My follow-up question is, did the amendment that was passed in the House originate with a whole different focus of intent?
Mr. Paul Szabo: If I may, Mr. Chairman, it was a report stage motion by Mrs. Ur. Normally, the regulations are done by Order in Council and the committee doesn't ever see them, they just happen, and she had a motion to the effect that before they reach their final resting place, we want them to duck into committee and let the committee, if it deems appropriate or whatever, have an opportunity if there's something there they feel they have to deal with.
Technically it is here, and the committee can decide just to accept them as submitted or if there is some reason to do work and start looking at the size or type of signs or whatever and some of the other details that are normally not dealt with in the legislation itself, we can discharge the responsibility by virtue of the fact that we acknowledge receipt of the regulations as approved by cabinet and at this point have no further matters to deal with, and just simply report them back. I think that's a useful way to deal with it simply from the standpoint that we now know it's going to the courts.
Mr. John Duncan: But is the practical effect of this committee not accepting your motion that these cannot proceed despite the Order in Council, or would they still proceed without us?
Mr. Paul Szabo: I think my motion is basically that we deal with it right now and pass them back without any further work on the regs.
Mr. John Duncan: I understand that.
Mr. Paul Szabo: The alternative would be to find some way in which we could have a quorum and deal with them in the detail members want to. I'm suggesting that I for one don't want to do anything other than to acknowledge receipt and return them to the House.
Mr. John Duncan: I understand your motion, but I have a question. I'm not sure who I'm asking, but my question is, if we don't approve Paul's motion, is the practical effect that despite the Order in Council the regulations cannot be effected?
The Chairman: That's what I was told on the telephone this morning by a representative of the Department of Health.
Mr. John Duncan: If the legislation is being challenged in any case, what is the downside to that? There's no downside. Why deny the duly passed motion or amendment in the House, or subvert it, I guess, through the actions of this committee, if there's no downside to not doing that? Is that your argument?
The Chairman: Herb.
Mr. Harbance Singh Dhaliwal: Mr. Chairman, with all due respect to my friend and colleague Mr. Szabo, there is an amendment, a resolution, which was passed in the House. We have to respect that. Whether it got slipped through or it was inadvertent or whatever, we have to respect the resolution of the House, which was that we review them.
I do remember that in this meeting when we were evaluating the tobacco bill there was concern by members, saying this committee should review it because of the powers given to the minister under the tobacco bill, that it was important for this committee to review it. That was discussed, I remember. It was a concern put forward by a number of members.
The amendment passed in the House. Under that amendment we are required to review it. What Mr. Szabo is saying is that we not review it, we just pass it on. I don't think we're complying with what passed in the House if we do that, and we're not carrying out our duty as a committee as put forward by the tobacco bill with the amendments that were passed. So I think the motion, which is really not to review it and just pass it on, is out of order.
The Chairman: I do not hear a consensus. I'm with Mr. Dhaliwal. I would have to seek some advice on whether the motion is in order -
Mr. Harbance Singh Dhaliwal: It's not.
The Chairman: We can get into the technicality of whether it's in order or not, but more to the point, we don't have a consensus around this table or, in my view, enough good information. I've made an effort this morning through a total of three calls to the department on this issue and we seem to be no further ahead. My view, based on what I've heard from all sides, is that we don't have a consensus and we leave the matter where it is.
Mr. John Duncan: May I ask one more question for clarification? Are all the regulations under the Tobacco Act or are there more than one set of regulations under the act, of which this is only one part?
The Chairman: I would extrapolate that these are the regulations, and if at some point they wanted to add to them they would have to go through the process again.
Mr. Paul Szabo: About other Order in Council matters that come before this committee, such as appointments, if they come back we have, in our wisdom, decided not to do any reviews. We do not bring candidates for appointment before us for any conversation or checking whatever. We accept the Order in Council without detailed review. That's not a shirk. It's basically to understand that we have neither the resources nor the knowledge nor the time to go through all the things that come forward.
The motion I understood was posed by Madame Ur was simply that this committee have the opportunity to look at the regulations. But if we do not like any of these regulations they would simply go back to cabinet for changes and they would keep bouncing back to us.
So, Mr. Chairman, if we were to follow the same approach, such that the committee, in its wisdom, said ``We've received them, thank you very much; you've asked us to do something and there's not much we can do to change it'', we send the message back that we have it, that we do have an opportunity if anybody here has a burning and pressing thing they want to talk about on these regulations and they should raise it, but if not, this committee should simply send them back.
Mr. Chair, I have posed a motion. I think the chair has to rule on whether the motion is in order. I would submit that the fact that we have done this with regard to Order in Council appointments - anything coming under Order in Council - and have not done any review whatsoever means it should be in order and that the motion has to be voted on at this meeting, unless someone can rule that this motion is out of order.
The Chairman: First of all, let me tell you the timeframe. Another committee is coming in here at 11:45 a.m. We thought earlier it was 11 a.m. but it's 11:45 a.m. So we have to be out of here literally in five minutes or so.
I should also alert you that these regulations were referred to committee a couple of weeks ago under Standing Order 32(2), which basically says a minister or his parliamentary secretary, in this case Mr. Volpe, can refer to a committee any paper that relates to an issue at hand and so on and so forth. That's how it got to us.
It didn't get to the committee under the requirement of the bill as amended by Mrs. Ur. It's the same principle, but... If we assume it's here in the spirit of what she moved into the bill, then here is my suggestion.
I make the distinction that the referral to committee of Order in Council appointments gives the committee the option, whereas under the clause introduced by Mrs. Ur there's a requirement on the committee to review these. It's not ``you may do'' but ``you will do'', basically. So I would suggest the motion would more properly serve the purpose of the act if you put in some wording such as that the committee is deemed to have reviewed the regulations and reports them back to the House. Then we can go back and say they have been reviewed.
Mr. Paul Szabo: That's simply language, for me, and if it facilitates the motion being in order I accept it.
The Chairman: We should get a decision on that motion and leave it at that. The motion byMr. Szabo is that the regulations are deemed to have been reviewed by the committee and are hereby reported back to the House.
Mr. John Duncan: We're usurping the House, and saying it's deemed to have been reviewed is a falsehood. It hasn't been reviewed. I think this is an impossible motion to support.
The Chairman: Okay. Are there any other comments?
Ms Pauline Picard: I agree with the Reform Party member.
Mr. Harbance Singh Dhaliwal: I agree with your statement. I don't think it's in order.
The Chairman: There are two issues. It certainly is in order. It can be in order without your supporting it. That's another issue.
As a member of the committee, I'm uncomfortable not with the motion but that we're in this kind of situation this morning, where we can't do our duty and are searching around to find some ways to get out of doing our duty, it seems to me. That bothers me.
Mr. John Murphy: My understanding is that the reason they came back here was specifically that we review them - nothing less.
The Chairman: That's right.
Are you ready for the question on Mr. Szabo's motion?
The Chairman: I think we're going to leave that issue right there. Thank you for your indulgence on that. We tried.
The meeting is adjourned