:
Good afternoon, everyone.
As you know, the elected chair, Ms. Smith, resigned today, which means the position of chair of the committee has become vacant. So it will come as no surprise to you that your first task today will be to elect a new chair of the Standing Committee on Health.
[English]
As a reminder, pursuant to the Standing Orders, the chair must be a member of the government party.
I'm now ready to receive motions for the chair position.
The clerk and I will put together a letter. We'll send it around for review by the committee, so they think it's appropriate, and then we'll forward it to .
Good afternoon, ladies and gentlemen.
We have a full slate here today. We have four different groups that are going to be presenting. As you know—I'm sure you've been briefed—you each have 10 minutes to present. We'll carry right through. Once we get close to 10 minutes, I'll put my hand up so that you will know you're getting close. But I'm sure your notes are put together in such a way that you're going to be right on the 10 minutes.
We'll start with the Department of Justice. We have Mr. Saint-Denis and Ms. Goldstone. Whoever is presenting can start.
:
Since the Department of Justice Canada heads the national anti-drug strategy, it's a pleasure for me, as the acting head, to be here today to say a few words about the strategy.
The strategy aims to contribute to safer and healthier communities through coordinated efforts to prevent use, treat dependency, and reduce production and distribution of illicit drugs. The strategy is a collaborative effort involving 12 federal partner departments and agencies, with $515.9 million allocated for this current five-year cycle of 2012-2017.
[Translation]
The strategy includes 22 programs that are delivered through three action, prevention and treatment plans, managed by Health Canada. Public Safety Canada is responsible for enforcing the act.
[English]
The strategy focuses on illicit drugs, as set out in the Controlled Drugs and Substances Act. Since the launch of the strategy in 2007, misuse of prescription drugs has emerged as a significant public health and public safety issue, resulting in addictions, overdoses, fatalities, and crime.
Prescription drugs are often obtained from the medicine cabinet of a friend or a family member. They're also being diverted and distributed through many of the same illegal channels that are used by illicit crime groups, that is, organized crime. Prescription drugs are obtained through armed robberies and break-ins of pharmacies, fraudulent use of the health care system, such as double-doctoring and forgeries, sales by individuals taking advantage of the lucrative street markets, and illegal Internet sales.
While some federal departments address misuse of prescription drugs as part of their mandates, it requires a policy authority expansion to use some of the national anti-drug strategy money towards addressing this important issue.
In the 2013 Speech from the Throne, the Government of Canada committed to expanding the NADS policy authority—I say NADS for national anti-drug strategy—to address prescription drug abuse. There's also been strong consensus among stakeholders, including first nations groups, medical and research communities, and enforcement and pharmaceutical communities, that collaborative action is needed.
Paul.
:
I would like to thank the chair and committee members for inviting me to speak to you on prescription drug abuse and its impact on public safety.
My department is responsible for the Enforcement Action Plan, which is a part of Canada's National Anti-Drug Strategy. This responsibility means that we have to work in close cooperation with various partners, among them the Royal Canadian Mounted Police, the Department of Justice, and Health Canada, so as to ensure that government interventions in the fight against drugs are coordinated, in particular as regards marijuana grow-ops and clandestine laboratories that produce synthetic drugs such as ecstasy.
[English]
Within this role, Public Safety has sought to continuously address new and emerging issues impacting public safety with respect to drugs. In recent years, there is increasing evidence to suggest that the illicit use of prescription drugs is a major public safety concern in Canada.
From an enforcement perspective, the criminality associated with prescription drug misuse includes fraudulent use of the health care system, pharmacy robberies, drug-impaired driving, and more traditional drug-trafficking activities, both by criminal organizations and individuals looking to profit from a lucrative street market. Meanwhile, these licit drugs challenge traditional supply reduction approaches.
Public Safety has worked closely with the Canadian Association of Chiefs of Police drug abuse committee over the years to raise awareness about this issue impacting our communities. As many of you know, the illicit use and/or misuse of pharmaceuticals, in particular, narcotic opioids, has become an issue of increasing concern with the impacts on public safety and the community well-being. In fact, trends indicate rising rates of recreational misuse of prescription drugs by our youth, the majority of whom obtain these drugs from family medicine cabinets or from friends.
This is why, in June 2011, Public Safety hosted a national workshop on the illicit use of pharmaceuticals, in Vancouver, attended by over 100 participants representing federal, provincial, and municipal law enforcement, as well as health officials, including physicians and pharmacists. The goal was to facilitate multi-sectoral discussion and to increase the overall understanding of the issue of pharmaceutical misuse from a public safety perspective.
Following the workshop, Public Safety invested in a pilot project in the Niagara region to hold a prescription drug drop-off day in May 2012. The goal of the event was to safely dispose of unused or unfinished medications in order to limit the possible misuse of these medications. This initiative was very successful. In just one day, 4,000 kilograms of medications were collected, including 835 oxycodone pills, over 3,400 Percocet and Oxycocet pills, over 5,000 codeine pills, and 23 fentanyl patches.
Building on the success of this particular pilot, Public Safety supported the CACP in implementing their resolution to hold a national prescription drug drop-off day and to mobilize law enforcement efforts. Public Safety held a workshop and developed a handbook—I think copies of the handbook were given to members, Mr. Chair—targeting a new law enforcement to support them in their first national annual drop-off day held in May 2013, so earlier this year. This handbook, which has been shared internationally, highlights current prescription drug return initiatives in Canada and is available on both the PS website and the national anti-drug strategy website.
In line with this national day, Public Safety, in collaboration with Health Canada, put forth a resolution at the UN Commission on Narcotic Drugs, on behalf of Canada. This resolution was adopted on March 15, 2013, by the commission. It called on member states to promote initiatives for the safe, secure, and appropriate return for disposal of prescription drugs, in particular, those containing narcotic drugs and psychotropic substances under international control.
Public Safety has also worked closely with the Canadian Centre on Substance Abuse, the CCSA, in the development of the national framework on prescription drug misuse. Specifically, in collaboration with the Canadian Association of Chiefs of Police drug abuse committee, they led the development of the enforcement pillar for the CCSA's strategy, First Do No Harm: Responding to Canada's Prescription Drug Crisis. We are currently in the process of developing an implementation plan of this pillar.
[Translation]
I thank you for having given me this opportunity to give you an overview of the role my department plays in the National Anti-Drug Strategy, and for the work you have done up till now to manage the issue of prescription drug abuse.
I would be pleased to reply to your questions. Thank you.
:
Good afternoon, Mr. Chair, and first of all congratulations on your election to the position of chair.
Honourable members of the committee, thank you for inviting the RCMP to participate in these proceedings. I am happy to be here today with my colleague and partners.
I am Inspector Jean Cormier, and I currently hold the position of director of the federal coordination centres within the RCMP's federal policing program at national headquarters. The federal coordination centres provide subject-matter expertise to many of the enforcement initiatives supported by federal statutes.
[Translation]
Today I am accompanied by Corporal Luc Chicoine, who is one of the RCMP's Drug Initiatives National Coordinator at RCMP National Headquarters.
Thank you for the opportunity to say a few words about the RCMP's engagement with this important issue, as well as our relationship with the different partners from the Canadian government involved in addressing the issue of prescription drug abuse.
[English]
Prescription drug abuse is a serious problem affecting citizens of our country. The misuse and abuse of prescription drugs has always been present, but recently it has become increasingly prevalent and therefore requires the attention of all of us. Non-medical use of prescription drugs is the third-most prevalent form of drug abuse among Ontario students. Information from Health Canada estimates that it is at 16.7% just behind cannabis at 22% and alcohol at 55%.
[Translation]
The misuse and abuse of prescription drugs has devastating impacts on the citizens of Canada. It is important to note that this issue is felt across all age groups, races, social classes, incomes, ethnic backgrounds and genders. The misuse and abuse of prescription drugs directly affects the Canadian population as a whole, our businesses, communities, and our international reputation.
One of the dangers posed by prescription drug abuse is the false sense of safety users have, as it is prescribed by doctors, manufactured in regulated facilities and provided by pharmacists. However, when these prescription drugs are misused, they come with the same devastating impact as other illicit drugs.
[English]
It is important for law enforcement to work collaboratively with domestic and international partners to identify, prevent, and detect the diversion and trafficking of prescription drugs by pursuing those who engage in such activity. The RCMP and other domestic police services are often the first responders to incidents of prescription drug abuse. Education and training of officers is an important step in properly addressing the situation.
[Translation]
We believe that information-sharing between different private and public partners is crucial in addressing this problem.
The National Anti-Drug Strategy promotes a three-pillar approach—prevention, treatment and enforcement. The RCMP is an active participant within the National Anti-Drug Strategy so as to deal with the problems related to prescription drug abuse.
[English]
The investigation of abuse or diversion of prescription drugs is complex and challenging. In spite of this, the RCMP in concert with its partners is focused on two of the national anti-drug strategy pillars—prevention and treatment.
All RCMP officers are technically responsible for investigating illicit drug-related activities. We do, however, have officers such as Corporal Chicoine here who have special training in drug investigation who are also considered subject-matter experts. These resources also have a responsibility to investigate illicit activities related to prescription drugs. There are some of these trained resources situated in all provinces and territories across Canada.
[Translation]
Although international cooperation has come a long way in establishing standards to prevent and detect prescription drug abuse, such as the elimination or further restriction of certain prescription drugs, continued effort and a sustained focus must be maintained.
The RCMP believes that everyone has ownership and a role to play in the prevention of prescription drug abuse.
[English]
It is our belief that focusing on prevention by raising the level of awareness within our communities, including our health care practitioners, of the misuse and abuse of prescription drugs will assist in conducting successful enforcement action that will suppress criminal activities. The RCMP is committed to efforts to detect and deter prescription drug abuse, which has a negative impact on Canada and the well-being of Canadians.
I thank you and look forward to answering your questions.
Good afternoon, Mr. Chair, and members of the committee.
l'm pleased to have the opportunity to appear before you today to provide input into this committee's study on the government's role in addressing prescription drug abuse.
Mr. Chair, as Commissioner of the Correctional Service of Canada, or CSC, I oversee the operations of Canada's 53 federal penitentiaries, 16 community correctional centres, and 92 parole offices and sub-offices. On a typical day during the most recent fiscal year, CSC was responsible for 22,762 offenders, of whom 15,056 were incarcerated.
It will likely come as no surprise to this committee that substance abuse within the offender population is an ongoing problem. Our data indicates that approximately 80% of offenders arrive at federal penitentiaries with a history of substance abuse problems, many of whom have had issues with more than one substance. Equally concerning, it has been determined that drugs or alcohol were a factor in the crimes for which roughly half of the offender population were convicted. This statistic has remained constant over many years.
Within federal penitentiaries, my front-line staff have the responsibility of addressing the serious threat that drugs pose to the safety and security of institutions on a daily basis. Without question, reducing the supply of illicit drugs has been a priority of my organization. Through measures such as drug detector dogs and enhanced security intelligence, CSC has focused on preventing drugs from entering our institutions, and in turn created an environment that is both safer for our staff and inmates as well as more conducive to the effective rehabilitation of offenders.
In addition to initiatives that seek to reduce the supply of drugs, CSC has been equally determined to reduce demand for drugs. To this end, CSC provides drug treatment and substance abuse programs that assist offenders in their rehabilitation and in addressing the criminogenic risk of substance abuse. Indeed, CSC is widely considered to be an international leader with respect to its substance abuse programming and treatment.
Mr. Chair, CSC is certainly capable of providing insight into both illicit drug interdiction and treatment. However, where CSC may be most helpful to this committee is on the subject of actually administering prescription drug delivery in a very challenging institutional environment.
As this committee may be aware, CSC is mandated to provide essential health care services to all federal inmates. As part of this mandate, CSC must ensure that offenders are afforded reasonable access to required prescription medications. As this committee can no doubt imagine, managing the distribution and administration of prescription drugs to a client base of federal inmates presents a unique challenge due to the high risk that offenders pose in terms of abusing these medications.
Given this risk, CSC has created a system that limits the potential for these substances to be abused but maintains a high level of medical care. The most notable element of our policy framework is the Correctional Service of Canada's national formulary. This document, by which all federal penitentiaries must abide, provides a tool to physicians and pharmacists to encourage the selection of optimal and cost-effective medications. The formulary, which is produced by health care professionals and updated twice each year, provides a list of medications that CSC is prepared to provide to federal offenders when medically required.
By extension, any medications that represent a potential risk for an institutional setting are excluded from the formulary, and if that is not possible for medical reasons, restrictions are placed on how the drug is prescribed and administered.
Of particular relevance, the formulary also provides information for specific drugs in terms of available alternatives, how they are to be safely distributed to offenders, in what dosage and in what supply, for what duration, and under what circumstances.
I believe that the means by which CSC safely delivers prescription drugs to federal inmates is of direct relevance to this committee's study. Although consideration for time prevents me from providing specific details regarding these policies in my opening remarks, I'd be pleased to answer any questions this committee may have on this subject.
Thank you, again, Mr. Chair, for the opportunity to appear before you today.
First of all, thank you to the witnesses for being here today. I'm interested to hear your presentations and what each of your departments is doing.
Mr. Bhupsingh, you mentioned in your brief that there's increasing evidence to suggest that illicit use of prescription drugs is a major public safety concern. Could you table any documents you have that actually give us that evidence? I don't know whether you're talking about polls or reports that have been done, or surveys. I'm not sure what you're referring to, but if you could table that with the committee, it would be very helpful.
The other thing that strikes me in hearing the presentations today is when we hear about what's taking place in terms of the drop-off day. I have no problem with the idea that there's a national drop-off day, and that we're involved in organizing it, and that there was a resolution at the UN, but it seems to me that to focus on a policy of appropriate return is sort of after the fact. I didn't hear any of you speak about what we do in a systematic way to prevent abuse in the first place.
In B.C., we have systems within our pharmacare program and through pharmacies where checks and balances are in place to ensure that people aren't shopping around for prescription drugs. It's hard to know whether any of your departments, or Health Canada for that matter, are involved in trying to promote something like that on a national level.
My question is, why are we focusing so much on after the problem has already happened, as opposed to putting systems in place?
Mr. Head, you said you do have systems in place. Maybe you can address that in terms of what we can learn from that, but I am concerned that we don't seem to have any systematic way of dealing with this issue. It seems to me that looking at it solely from a law enforcement argument is missing the boat. We need to look at how the system itself, in terms of the dispensaries, ensures that we're minimizing, as much as possible, any abuse from taking place.
Could any of you address that?
First of all, in my reference to the increasing trends we're seeing in pharmaceuticals, prescription drugs, a lot of that is just what we see in terms of investigations. In new cases coming before public prosecutions, etc., we see an increase. Those are the trends I'm talking about.
Mr. Chair, a number of studies referenced in earlier submissions, by Health Canada, by other members, are clear. We see a growing trend in this. What I'm suggesting is that we don't see anything different, at least from a public safety perspective, to counter that trend. With respect to systemic abuse, I would say that I'm from the law enforcement community, but I know Health Canada—and Health Canada was here last week—was talking about a number of systems they're attempting to put into place.
I am not the best placed to comment on an upfront, systematic approach to this. What I can speak to is that in addressing some of the law enforcement supply-reduction concerns, we're moving forward, and we think that, ultimately, take-back days and those types of initiatives can have an effect. I know that's not a systematic system such as you're talking about, but in terms of addressing some of the law enforcement concerns, we think that's an appropriate way to intercept some of the supply.
:
I have a couple of observations, Mr. Chairman.
One is that, as I recall, the health representatives when they were here pointed out that Canada is the second-highest consuming nation of prescription drugs. That means that the number of drugs that are circulating is high indeed. And they're circulating through legitimate means; these are drugs that are being prescribed. So when we talk about a systemic problem, there may be an issue there with respect to the proper prescribing of drugs.
A lot of the drugs that are prescribed end up sometimes being stolen, sometimes being misused. There's theft of drugs from pharmacies. I don't think that a systemic regulatory approach would solve or correct or prevent thefts from pharmacies, thefts from homes, thefts from elderly residences where drugs are stolen.
:
Thank you very much, Mr. Chair.
And thank you to our witnesses for being here.
I have a number of questions, so I'd appreciate reasonably concise answers, if you could. I'd like to start with Public Safety.
There's some talk about grassroots, getting into community groups and so on to work with them. I think it would be fairly common sense to attack it at the lowest possible level—community groups and so on dealing with youth and keeping the youth off drugs.
Can you speak to the level of coordination with community groups? Do you have any examples of that? Does big pharma have a role to play in that on the education side?
:
One of the things we're looking at.... I agree, Mr. Chair, that there are probably a number of ways we can go at it with respect to, I would say, almost awareness, at a number of different levels.
The problem we're seeing on the law enforcement side is that this ranges from some nexus to organized crime in some ways, down to just individuals. In dealing with the individual aspects of it, I think you're right, there's probably an opportunity for us to start some awareness campaigns that are grassroots, in local communities. I think that on a go-forward basis that is something we'll look at.
With respect to pharma, there probably is a role. What could be done? Ultimately there are a number of things, in terms of discussion with them, control mechanisms, etc. Again, that's part of the solution.
But the focus for us is really about awareness, number one, that this is a growing issue, and then number two, attacking this probably at a number of different levels, including the grassroots and individuals and you guys.
:
I can add to that, for sure.
We have a number of different awareness programs. One of them is the aboriginal shield program, which targets in principle the aboriginal community and certainly the youth starting at school age.
We also have the drug abuse resistance program, which is well known as DARE. That also targets kids of school age, but more in grades 7 and 8, before they go to high school, where they are more likely to be exposed to, or get offered, different types of drugs. Again, it's about awareness and prevention.
We also have DEC, the drug endangered children program, an early intervention initiative that seeks to stop the cycle of child abuse caused by the exposure to drug activities. The program involves a resource guide, which has been translated into French, and training program service delivery personnel have access to that.
Those were very interesting presentations by everyone.
I know that what you are specifically dealing with as part of the team is the supply side, but from my knowledge as a physician and my understanding of these issues over the years, you can't only deal with supply side at any one point in time. You have to look at why the demand; the demand side is something you have to look at.
I would like to reiterate Mr. Hawn's request for short, crisp answers. I'll try to ask short, crisp questions.
Mr. Head, you said that 80% of offenders who came in were addicted in some way, or were taking medication of some kind, either prescription or illicit. I also note you said that after 20 years of doing this, this statistic has remained constant. Do you look at evidence-based...? I mean, if some statistic remains constant over 20 years, is there an opportunity to look at whether or not this is the right procedure?
:
Yes, I think that's important because now there's a huge set of studies that are showing that in fact for that tiny group, if they don't get diacetylmorphine or hydromorphone, which is Dilaudid, they will go onto street drugs again. So that's one way of stopping them getting back into that street drug system. I'm glad you think that evidence should work in some of these things.
I wanted to talk about the idea—and I don't know who should answer. Mr. Chair, you might want to direct that to whoever should answer it—you talked about the First Do No Harm program. Does that mean that you think that harm reduction is an important piece, if First Do No Harm is the obvious medical ethic? Who wants to answer that?
I noticed that no one had harm reduction as part of their comprehensive package of looking at substance abuse and at looking at decreasing the amount. Who wants to...?
Mr. Chair, who wants to take the First Do No Harm and tell me why there is no harm reduction in your programs?
:
I know the Canadian Centre on Substance Abuse has harm reduction as one of their pillars. So I just wondered why are we cherry picking some things and not others, especially when internationally it has been shown that harm reduction is of use. In Australia, in Europe, it is now completed accepted as a piece of that, because when you reduce harm and the person knows they're not going to die, their tendency to want to be treated becomes greater.
How much time do I have, Mr. Chair? A quick minute.
Ms. Davies talked about coordinating. I remember, in 2002, the report from the committee on this issue suggested that everyone integrate the work they do. Integrating the work that you do means working with the provinces, etc.
I know that in British Columbia there's a triplicate program for opiates. It means that when the doctor writes a prescription, there are three pieces to it. The doctor keeps one, the pharmacist gets one, and the colleges get one which they share with the police, and therefore you stop. It's been very effective in stopping double-doctoring.
Why wouldn't you, working with the provinces, think this is a good idea to promote as a national strategy? It's not just provinces. You're working with them. You all said that—that this integrated approach is working. So why wouldn't that happen, especially with people the federal government is responsible for, like Inuit, first nations, and the armed forces?
I thank the witnesses for being here today. Most of you are from the enforcement side, so it becomes somewhat tricky, shall we say, from time to time, when you're talking about treatment and prevention. Most of the dialogue that you people are dealing with is on the enforcement side.
Mr. Cormier, sir, I'll lean my first question to the RCMP. I'm a retired member, so I'll respect the rank. Back in 2009—I don't know if the RCMP stopped collecting—they used to publish an annual drug situation report.
Could you tell me if that still goes on? If it does, where can it be found, or is it internal?
Certainly, from my perspective anyway, there will always be a portion of society who is not concerned about treatment and prevention. Their job is to actually lure people into the problem.
This may be directed to the Department of Justice, but is there anything under the CDSA or FDA, or the Criminal Code, for that matter, that may relate to the context of prescription drug misuse or abuse? There's not a lot in there right now, aside from double-doctoring.
I know that we have the trafficking offence. Trafficking offences apply to pretty well all the scheduled drugs. If this particular drug, for instance, falls under one of these schedules, the trafficking in that drug would get caught, as well as possession for the purpose of trafficking, for instance.
I'm not familiar with that particular drug, so I don't know if it's actually listed in one of these schedules.
:
Thank you, Mr. Chair, and thanks to all the witnesses for being here today.
I have a couple of different things. First of all—and I'll come back to it—I did want to speak about youth and some of the issues that are associated with all types of drug abuse. I was a high school math and physics teacher for 34 years, and I've seen a lot of kids who have gone through the system. I've seen situations where we would have these fantastic grade 8 students coming in, and by the time they hit grade 12.... You would see people coming around to prey on them, and sadly four or five years later you would see them in that same cycle, so I think it's so important we find ways of breaking that.
Of course, this is simply one more added feature we have now as we have the prescription drugs. I'm sure parents would love to know exactly just what is happening in that regard because in a lot of cases the drugs are coming from the parents. I think this is one aspect of it.
I would like to go back to some of the testimony that was given earlier. Mr. Bhupsingh, you spoke about the 2011 national workshop that had taken place, this facilitation of a multi-sectoral discussion and different ways of analyzing misuse of pharmaceuticals.
In a lot of cases you also talked about seniors and issues from the kinds of drugs they are prescribed. I was curious as to whether or not they have gone to senior drop-in centres and that type of thing to make sure the message is getting through there as well.
:
I'll say a few words, and then I'll turn it to my colleague, Ms. Goguen.
Back in 2011 I think what we recognized—and some of my colleagues have spoken about this—is we have tried not to take just a supply side and a total law enforcement perspective on this. What we tried to do back in 2011 was really bring in other sectors. So we brought in pharmacists and doctors to really talk about what the issues were and develop what we think are novel ideas in terms of trying to attack this issue.
The complexity around it largely deals with the fact that we are starting from something that is a legal commodity, so it's quite different from the illicit marketplace. It requires us to change our thinking in terms of what we are doing.
Let me leave it there, and I'll let Ms. Goguen address a couple of the other points you inquired about.
Again, congratulations to our new chair.
Thank you very much for coming today and for your continued incredible service to our nation.
My colleague, MP Wilks, touched on a specific question: what drugs are actually being abused the most? There wasn't a concrete response to that. Do you have an appreciation, perhaps, of which prescription drugs children and youth seem to be abusing the most?
:
First, let me say how delightful it is to be coming to a committee meeting on a Monday afternoon, especially the health committee.
I have a number of questions, and one of them follows up on one my colleague asked about the RCMP's collection and publishing of an annual report that used to occur, called the drug situation reports. The last report was published in 2009, as you said. As we all know, data is very important when we're tracking how we're doing in the system, because you can't just go by gut and people's different impressions. Yet this data—that used to be collected by the RCMP, that would have led to informed policy, informed decision-making around the kind of prevention we want to have, but would also give us a realistic view of what was happening out there in this area—doesn't happen anymore. I want to know why. Was it the RCMP who said we don't want to do this anymore, we don't need it as a tool? I'm looking at why such a valuable service was stopped.
:
I would really appreciate that.
As a teacher and a long-term counsellor in both elementary and high school, one of the things I realize is that the drug situation is a serious situation. I don't think there is any disagreement on either side, or all three sides, or whichever way we want to look at it. But I think we also know that there are no simple solutions. We need a multi-pronged approach.
I want to pick up on a question that was asked by my colleague across the way, about prevention programs available for young people. I was very impressed with the answers you gave around all the training and everything that happens for the service provider end. But I also know that we could take up all our resources and not have anything left to spend on anything else unless we look at the causes and start addressing some of those and start with...education is the best antidote or the best medicine in this case.
Being a teacher from B.C., I've seen a lot of those resources disappear over the last number of years. When I left the education system—and that was a few years ago—by that time a lot of the prevention programs had already gone, not because people didn't want to do them, but because of funding. I have a lot of concern around that. I know you're here for the enforcement end, but I think it would be very naive to look at only the enforcement end without the context of what we're doing to address the whole area.
I have another comment I really want to make, and then I have a question. I come from the city of Surrey. I'm a member of Parliament for Newton—North Delta. Newton is the Surrey part. Today it almost devastated me when I read the news that we've had our 22nd murder of the year. When I read the report in the paper the comment was that the majority of the homicides, murders, have been drug or gang related. So I have a huge interest in this because I live in a community that simply rocks and is devastated every time another murder takes place, and we've broken a record this year. Most cities want to win records, but this is not the kind of record you want to have.
I suppose my question leading from that—and I have met with the police in my area—
:
I can answer this. My colleague wants to add something to it.
Certainly, we do have a strategy. When it comes to enforcement, we have enforcement strategies in place that include multi partners. We believe that addressing the problem involves not only the RCMP but is more a whole-of-government of Canada approach, all partners who would have enforcement or prevention or whatever their role in it may be.
As well, I believe in targeting the problem to address it, not only the symptom but the root cause of it. That is where we get involved into deeper investigation of criminal organizations that may be involved in this type of trafficking.
:
Congratulations, Mr. Chair. I came late, and I would like to take this opportunity to congratulate you on your position and to thank our witnesses for coming here this afternoon.
I have a very basic question that may allow us to understand the problem better.
On the enforcement side, you have this group of people who abuse prescription drugs, you have those who commit criminal offences—obtaining them and then distributing them—and of course, you take appropriate actions. But now we have a group of people who would fall under prescription drug abuse because they go to the doctor and they somehow get hooked on the drugs. Technically, they don't do anything illegal, because they obtain drugs by getting a prescription from the doctor, or maybe from a few doctors if they wish to, and then they take them. And sometimes, if they have children or have some young people visiting, maybe they can get hold of the medication as well.
Now, how do you address that issue? The way I see it, there's really no criminal activity here, but the problem is here. So how do you address this? Do you have any examples, especially the RCMP, working with law enforcement agencies in different countries? Are there ways to limit it? Are there ways of approaching the problem that other countries have, other law enforcement agencies, and the medical profession as well?
I know it's very general, but it's a part of the problem that's not necessarily a criminal activity.
Your question is very good. It deals with what was said previously, in that obviously if someone is prescribed drugs for medical purposes that prescription is personal information about them, and it's information that is regulated under privacy laws in place at the federal level and in the provinces. Some of them deal with the public sector; others deal with the private sector. Certainly in the health environment, information is being created and used by different actors. Some of them are private actors; some of them are state actors.
It does make for some difficulties in that the purpose of such legislation is not necessarily to prevent the sharing of that information but to regulate it for certain purposes. Even though the legislation across the country is to some extent similar and based on the same broad principles, it's not exactly the same everywhere, and each case tends to be treated on a case-by-case basis.
On the use of prescription drugs, there are many circumstances that are perhaps different from others. Obviously you have patients who are law-abiding, who are using the drugs as they were prescribed, and you have others who may not be doing that. In different circumstances the law will authorize the sharing of information, and in others, perhaps not. Obviously that can be remedied by passing more laws, if that is necessary.
:
Thank you very much, Mr. Chair.
A lot of questions are about how prescription drugs get abused. I think the most important thing to know about this is there's a process here. The doctor prescribes a drug. Opiates and opioids are very useful to deal with pain: post-operative, cancer, chemotherapy, all of that kind of thing. They are probably the best known painkillers going, either opioids or opiates.
But if you wanted to look at how you stop the chain, physicians, who are self-policing in every province, have... That's why I asked earlier on about sharing best practices. I know when I practised medicine a lot of people came to me, cross border, to try to get prescription drugs for opiates. They came across the provinces. They told me their doctor in Alberta, or their doctor in Winnipeg, etc....and I never did. I always said, “Give me the doctor's name, and I will call your doctor and just check up.”
What happens in B.C. that captures this is the college picks up what is known as a triplicate prescription. Whenever you write an opiate or opioid prescription, you have to write a triplicate prescription, and the college is able to look at the prescribing practice of doctor X, and why doctor X gives so many opioids or opiates, etc. And if they can share that with other provinces, you can stop that from happening. That's why that national program or pan-Canadian program of sharing that information among colleges would be a very important thing to do, to stop that.
But I wanted to go to something about the obligation of the patient to say, “Oh, my gosh, look at...”, too. These are very addictive drugs. When you get hooked you need to take the drug all the time, and so this becomes the problem. The patient has to.
Kids get it out of their parents' locker. A lot of the spread of prescription drugs on the street is because you can get, what?, $45 a tablet for OxyContin. So kids take it and they make money. People get it and they make money. They practise it. It becomes not necessarily organized crime in terms of large organized crime—there is some of that—but organized in terms of small communities of people trying to make money off it.
I think the important thing is to deal also with the addiction component. I need to get somebody to answer this question, which has never been answered, given that the most used opiate—we are number one in the world, surpassing the U.S.—is OxyContin. The U.S. has stopped making generic OxyContin which is easily usable on the street, and they have asked that this happen in Canada. The minister last year allowed for six generic pharmaceutical companies to make OxyContin.
Now, the United States Attorney General is asking for this to stop. How, as the supply-side policing part of it, do you allow this kind of thing to happen? Don't you talk to Health Canada and say, “This is going to go out on the street, people. Why are you allowing this to happen when across North America now it's not happening except in Canada?” This is a really important question to ask. If we are going to work together to deal with the problem, there has to be some sort of way of coordinating action that makes sense, common sense.
Can anybody answer that question for me? How does that make sense?
Okay. Thank you. I got my answer.
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I would like to know how much work you do, as you work with Health Canada and other groups, looking at the issue of actual demand.
Knowing that addiction is a chronic disease, a medical disease where we look at medical intervention.... Most people who are addicted are not addicted because they lack willpower; they are addicted because—we now know about—the neurotransmitters in the brain, etc., so everyone agrees with the idea of replacement therapy.
My question is this: What are we doing to deal, very clearly, with the demand side? Are you working together with Health Canada and the provinces in a reasonable way to deal with the issue of addiction per se and the medical problem, and how we can treat it and at the same time prevent harm? I simply want to know if you are involved in this. I know the police departments are. But in the RCMP, I'd like to know if you are looking at this from that perspective.