moved that Bill , be read the second time and referred to a committee.
She said: Mr. Speaker, I am pleased to begin debate today on Bill C-37 to address a serious and pressing public health matter, to improve public safety, and to protect the health of Canadians.
I am eager to work with all the MPs to help advance this important bill, in particular with my new parliamentary secretary, the hon. member for .
This legislation is introduced in the context where Canada is facing a national public health crisis related to opioids, characterized by ever-increasing rates of harm, overdose, and death.
The opioid crisis raises many concerns, and the one we hear about perhaps most often is the rapid rise in the numbers of deaths from accidental overdose. Last year, in British Columbia alone, more than 900 people died from overdose. That is an 80% increase from 2015. The majority were linked to the swift spread of powerful drugs like fentanyl. Alas, the situation is getting worse. Last week it was reported that there were 20,000 overdoses in British Columbia alone. At a national level, deaths from overdoses are now more numerous than deaths caused by motor vehicle accidents.
Before I continue, I would like to extend my condolences to the families and friends who have lost a loved one. We share their grief. We are aware of the pressing need to turn the tide of this crisis as quickly as possible.
I would also comment at the outset that while the focus of the legislation is on immediate action to address the opioid crisis, we must bear in mind that lasting solutions require an understanding of the roots of the opioid crisis, which are messy, but not mysterious. It should be acknowledged, for example, that pain is a central theme at the heart of the drug crisis. Sometimes, problematic drug use begins with physical pain, but we must also admit that emotional pain is a factor in substance use. To fully resolve the opioid crisis we must address the multiple social drivers, including poverty, social isolation, childhood trauma, sexual abuse, and mental illness.
Addressing the roots of the crisis demands a whole of society response. It means calling out stigma and discrimination as barriers to accessing care. It means building a society where children receive tender attention and adults are not isolated and lonely. It means an international search for effective answers and being willing to discuss bold policy alternatives and the evidence associated with them. We must deal with this crisis comprehensively, collaboratively, and compassionately. We must assess what works and what does not work, and then we must do what works.
The crisis is moving eastward in Canada, with more drug seizures of fentanyl and carfentanil.
Canadians are increasingly aware that problematic substance abuse spares no one—people of all ages and from all socio-economic groups—and that it has devastating consequences on individuals, families, and communities.
In the past year, I have met with bereaved parents, people who use drugs, first responders, addiction specialists, mental health experts, indigenous leaders, health educators, and others to learn their perspective on the challenges we face. A complex, multi-dimensional social challenge of this nature demands timely, coordinated, and effective action.
Before I discuss the details of this proposed legislation, I would like to thank many members of this House who have been outspoken on the urgent need to respond together. I thank the member for for his support and advocacy on the issue, and especially for his calls to pass this legislation by unanimous consent.
I would also like to thank the Standing Committee on Health. Its members are actively working on this issue, and they made a series of recommendations that we reviewed carefully. We have acted on that. I look forward to responding formally to the committee report in due course.
There are many important components of this proposed legislation that would support communities and enhance public health and public safety when it comes to the use of drugs and substances. Bill would save lives. It needs to be passed without delay.
At this point, please permit me to outline some of the federal actions to date on the matter.
Early last year we made naloxone, the antidote to overdose, available without prescription. We arranged an expedited review of naloxone nasal spray and ensured an emergency supply for Canadians.
We granted an exemption to the Dr. Peter Centre in Vancouver to operate Canada's second supervised consumption site, along with an unprecedented four-year renewal of the exemption for Insite in Vancouver.
Last summer, we announced Health Canada's opioid action plan to improve education for the public and prescribers, to expand access to treatment, and to build the database.
In September, we overturned a ban on the use of prescription heroin, so that it is available to treat the most severe cases of addiction.
Our government has supported the good Samaritan overdose act to remove the fear of drug possession charges for individuals who call 911 when they witness an overdose.
We added regulations to schedule fentanyl precursors as controlled substances, making it harder for illicit substances to be manufactured in Canada.
In November, along with the Ontario Minister of Health, Eric Hoskins, I hosted a national conference and summit on opioids, which led to a joint statement of action to address the opioid crisis. That statement includes 128 separate commitments made by Health Canada, nine provincial or territorial health departments, and over 30 other organizations. In February we will provide Canadians with an update on the progress made so far regarding those commitments.
In work led by the , the RCMP now has an agreement with China to combat the flow of illicit fentanyl.
Because this is a national crisis, we activated additional supports. In collaboration with the provinces and territories, we have established a special advisory committee on illicit opioids that includes the Council of Chief Medical Officers of Health to advance information among jurisdictions related to the opioid crisis.
We have built a task force within the federal health portfolio to work with other federal departments in a comprehensive response to the crisis. We funded McMaster University to produce new evidence-based guidelines for prescribing opioids for chronic pain. They are now available for consultation.
We funded the Canadian research initiative in substance misuse to provide evidence-based guidelines for medication-assisted treatment; and with the support of the , we identified new federal funding of $5 billion over the next 10 years to address mental health and addictions. We know that untreated mental illness is a common cause of addiction, and early intervention is key.
We introduced the new Canadian drugs and substances strategy, to reinstate harm reduction as a pillar in Canadian drug policy and return the lead for drug policy to the .
In December, I introduced Bill , which proposes to amend the Controlled Drugs and Substances Act and other acts. This legislative framework is an important part of our comprehensive approach to drug policy. It aims to accomplish three important goals: one, to provide support for harm reduction, in particular the establishment of supervised consumption sites; two, to reduce the supply of illicit substances; and three, to reduce the risk of diversion of other legitimate controlled substances.
Evidence shows that, when properly established and maintained, supervised consumption sites in communities that want and need them will save lives and improve health without increasing drug use or crime rates.
Last year, I visited Insite in Vancouver to witness the important work it does to help vulnerable people and communities. I was moved by what I saw. Facilities like Insite promote health-seeking behaviour by introducing people who use drugs to the health system in a non-judgmental and non-stigmatizing manner. They have hygienic facilities and sterile equipment, and are supervised by qualified health professionals who provide advice on harm reduction and treatment options as well as prevention of overdose.
Under the Controlled Drugs and Substances Act, the has the ability to provide exemptions to allow supervised consumption sites, but the Respect for Communities Act from the previous government introduced unnecessarily onerous requirements that must be met by communities before the could even respond to the request for an exemption.
We have heard desperate cries for help from communities most affected by the opioid crisis. They have indicated that the current requirements are burdensome and hinder their ability to offer services needed to reduce harm and to save lives. Currently there are applications being reviewed by Health Canada from across the country from communities such as Vancouver, Toronto, and Montreal.
Proposed legislation would simplify and streamline the application process for communities that want and need to establish supervised consumption sites. It would replace the current 26 application criteria with the five factors outlined in the Supreme Court of Canada 2011 decision regarding Insite. In fact, the criteria in the proposed legislation are exactly those written in paragraph 153 of the Supreme Court decision.
A vital criterion that Bill retains is the requirement for community consultation. It would improve transparency by adding a requirement for decisions on applications to be made public, including reasons for denial.
To support these proposed changes, Health Canada would post new information online about what is required in applications, how to process works, and the status of applications.
To help keep opioids and other illicit substances off the street in Canada, we need to make sure that they are not easy to produce. To that end, the bill proposes to prohibit the unregistered importation of pill presses and encapsulators. This measure has been included in part because certain jurisdictions, such as British Columbia, have asked for it. While it is true that those devices do have legitimate uses, they can also be used to manufacture counterfeit drugs that contain dangerous substances, including fentanyl.
This legislation would also give Canada Border Services officers greater flexibility to inspect suspicious mail, no matter the size, that may contain goods that are prohibited, controlled, or regulated. Protecting the privacy of Canadians is of the utmost importance. The measure would only be for incoming international mail where the prevalence of illicit drugs is greater. In fact, just one standard size mail envelope can contain 30 grams of fentanyl, enough to cause 15,000 overdoses.
Lastly, the bill updates a number of provisions regarding compliance and enforcement of the Controlled Drugs and Substances Act in order to modernize that piece of legislation. These legislative measures allow over 600 licensed dealers to manufacture, purchase, sell, distribute, import, export, and transport controlled substances for legitimate purposes.
The proposed amendments will allow Health Canada inspectors to conduct inspections in a variety of situations, especially in any location where it is suspected that any activities involving controlled substances are taking place. These amendments will help prevent the diversion of controlled substances to the illegal market.
Bill supports our government's new Canadian drugs and substances strategy, which the and I announced on December 12. In the past, federal drug strategies aimed to balance public health and public safety objectives through key pillars of prevention, treatment, enforcement, and at times, harm reduction; but in 2006, under the national anti-drug strategy of the previous government, the harm reduction pillar was removed. Our government will pursue an evidence-based approach to drug policy. Accordingly, this new strategy would formally reinstate harm reduction as a key pillar, in addition to prevention, treatment, and enforcement.
It should be noted that the reintroduction of harm reduction does not diminish the importance of the other pillars. In particular, we must not let up on our efforts for prevention and treatment. I will continue to encourage the expansion of access to a broad range of treatment options, which are essential to reducing the number of overdose deaths. In reframing problematic substance use as the public health issue that it is, it returns the lead to the Minister of Health from the .
In conclusion, the opioid crisis has taken a toll on many communities across Canada. It requires swift action, as well as a more balanced approach to deal with problematic substance use. Our renewed evidence-based approach would allow the government to better protect Canadians, save lives, and address the root causes of this crisis. Canada needs this action now.
While our focus must be on the current crisis, we must also pursue a balanced approach over the long term to address the upstream causes of problematic substance use.
We will continue to work with our partners, including the provinces, territories, municipalities, and indigenous communities.
While we cannot end this crisis immediately, we can markedly reduce its impact and set ourselves on a path to health for all. Measures proposed in Bill aim to take swift action to address the opioid crisis. I call on hon. members of the House to support the passage of Bill C-37 without delay.
Madam Speaker, I am happy to finally get the opportunity to rise in the House to debate bill .
I think all members of the House and all Canadians would agree that the ongoing opioid crisis is absolutely tragic. I know that the Premier of British Columbia and a few of our colleagues from B.C. have asked the minister to issue a national public health emergency as the overdose numbers continue to rise in the province.
This is a very complex issue. There is not just one solution.
I was fortunate to have been part of the opioid study recently conducted at the health committee. It allowed me, and I think all my colleagues on the committee, to truly learn and empathize with struggling addicts, communities, first nation health professions, and families that have had to endure an opioid-related death.
We had the opportunity to hear many first-hand stories, something that I am so grateful to have had the opportunity to be part of. We heard from parents who lost their children. We heard from recovered drug addicts, government officials, and the first responders who are reviving these people hourly. We sometimes seem so focused on those battling drug addictions that we forget about the first responders who are working so hard to ensure that our streets and our citizens are safe.
I would like to personally thank everyone who appeared as a witness. I truly believe that their testimony has played a huge role in encouraging all levels of government and Canadians to work together, and of course, to take action.
With that, I would now like to get to the bill itself.
The bill aims to achieve five main things. First, it would grant increased powers to the Canada Border Services Agency. Second, it would regulate the importation of unregistered devices, such as pill presses. Third, it would increase prohibitions against certain actions related to controlled substances. Fourth, it would give the minister authority to temporarily schedule and control new dangerous substances. Fifth, it would streamline the application process for approving and opening supervised injection sites.
We know that there are many factors that have contributed to the opioid crisis. While one cause of the crisis results from illegal substances and organized crime, many are battling addiction because of the over-prescribing of painkillers.
This bill seeks to address one aspect of the crisis: illegal activities and organized crime. I look forward to seeing what measures will be taken to address prescription drugs and over-prescribing, as I think we must acknowledge that it is a key contributor as well.
We know that China has been a primary source of fentanyl, carfentanil, and other dangerous opioids. It has been reported over the last year, and by the CBSA itself, how easy it is to import illicit substances into Canada with the current regulations.
My Conservative colleagues have been pushing the government to finally acknowledge the flaws at our borders and grant officers the authority to search and seize suspicious packages weighing less than 30 grams. While border agents already intercept dozens of these packages, exporters have found a way to hide illegal substances in toys, silica packages, and products that ultimately could not be searched without permission. Removing the “30 grams or less” exemption from the Customs Act is a much-needed step in combatting the opioid crisis facing our country.
Another weakness that has been recognized by many of my colleagues, but most passionately by Senator Vern White, is the need to target devices, specifically pill presses. These devices are capable of turning out thousands of deadly pills per hour, and under the current law, anyone can import one legally. That is not okay.
Abbotsford Police Deputy Chief Mike Serr stated:
Right now, they are not regulated and the importation of them—there really is very little from an intelligence perspective the police can do.... To have these machines registered would be at least one step for us.... We could then have a better sense for ensuring they are for legitimate purposes.
Again, granting the Canada Border Services Agency the authority to detain unregistered pill presses is something that must be done. It is important that all information obtained at the border be available to law enforcement agencies across the country so that they can take the appropriate steps in ensuring the safety of all citizens. Ultimately, that is what we are trying to ensure here: that all Canadians are protected and that access to illicit, dangerous substances is avoided any way possible.
That is what I find quite contradictory. The government is so quick to encourage the approval of supervised injection sites. Injection sites are known to give access to illicit and dangerous drugs, yet the government appears to want more of them. This is where there are some major inconsistencies in the government's policies.
The minister's mandate letter states, “Canadians need to have faith in their government’s honesty and willingness to listen. I expect that our work will be informed by performance measurement, evidence, and feedback from Canadians”. Yet, the bill would severely weaken the Respect for Communities Act, which was put in place to ensure that feedback from Canadians was taken into consideration before a supervised injection site was approved.
Under the previous Conservative government, we took steps to ensure there was a robust consultation process which included residents, local law enforcement agencies, and elected officials to be on board with an injection site in their community. Bill proposes to significantly change those requirements. While the expression of community support for opposition is a requirement, the specific requirements have been removed to allow the Liberals to easily change them as they see fit. This is a way to completely avoid parliamentary oversight. The minister's attempt to avoid community approval will fail.
We heard from numerous witnesses in the health committee that an injection site could not be successful without the support of the entire community. I will use the city of Ottawa as an example.
The mayor, the chief of police, and the former chief of police all have openly stated that they are opposed to an injection site in their community. Yet, under this bill, there is no assurance their views would even be taken into consideration. The minister has given herself the power to approve a site, regardless. What the minister does not realize is that not all communities want injection sites. Usually there are a few advocacy groups that are in support of a site, and no other legitimate stakeholder.
The Prime Minister's own stated, “They have been doing it in Vancouver for some years and there have been issues that have arisen there. I don’t know of any place in Toronto where that couldn’t have a significant negative impact on the communities.”
The Liberals are using harm reduction strategies as temporary solutions, band-aid solutions, and are refusing to offer any long-term solutions such as treatment and prevention. This is concerning.
In the minister's mandate letter, the states, “When Canadians are in good physical and mental health, they are able to work better, be more productive, and contribute more fully to our economy while living healthier, happier lives”. I agree with this statement, which is why injection sites should not become the norm. These sites are not helping people become productive. They are not encouraging good physical and mental health; in fact, they are doing the complete opposite. All injection sites are doing is providing a safe place for addicts to get their fix and if they overdose, someone will revive them. This is not a life. Injection sites do not save lives. They revive people who, from what I have heard from meeting with many recovered addicts over the year, do not want to be alive if drugs, crime, and overdosing is all they have to look forward to.
The also said, “the ambiguous messaging that comes out from a society that says you can’t use these drugs, they’re against the law — but if you do, we’ll provide a place [for you] to do it in.” This is exactly the type of conflicting message Canadians do not want children to be raised with. Drugs are dangerous. They are illegal because they ruin lives.
The and the Liberal Party are simply building a co-dependent relationship with drug addicts. To elaborate on what I mean, a co-dependent relationship is a dysfunctional relationship in which one party enables and supports another's addiction such as drugs. That is what the Liberals want society to become: an enabler as opposed to a preventer.
The president of the Canadian Police Association, Tom Stamatakis, said, “We should be treating addiction as a health issue and if harm reduction is part of a holistic approach to dealing with this issue, there should be a treatment pillar that focuses ultimately on how we get people away from engaging in harmful activities.”
Injection sites simply provide a place for drug users to get high, but offer no treatment. I will use Insite as an example.
In 2015, 6,531 people visited the injection site and only 464 were referred to Insite, the site's apparent detox treatment centre. Only seven per cent were referred to or offered detox treatment at Insite. To elaborate on the statistics, when I went for a visit, I was basically told by an employee that it was not in the business of treating these people. The site was there to provide them with needles and ensure that they would wake up. These sites are not saving lives; they are enabling and giving up on people whose lives have taken a bad turn.
The government's desire to quickly approve these sites without community support, especially law enforcement, is absolutely outrageous.
We cannot support the government's attempt to improve these dangerous enabling sites without knowing and being assured that residents, law enforcement, and elected officials are 100% on board.
Once the minister approves the site, the responsibility to ensure the safety of all residents rests in the hands of local police. Crime rates do not drop as the government keeps stating. Addicts are still illegally obtaining these drugs through break-ins, robberies, prostitution, etc. As Toronto Police Association president Mike McCormack said, “They’re (VPD) seeing more of what we’d call street disorder—more people using drugs on the street, smoking drugs, congregating, minor thefts.”
I worry about my community of Oshawa. Oshawa is an up-and-coming area with many new businesses and new residential areas for families to settle into. Oshawa and Durham region continue to work to improve the crime rates, and we have seen a drastic decline in assault, robberies, and drug crimes since 2009. This is thanks to the community as a whole working together to make it a better and safer place to raise our families. I worry that the approval of an injection site in my riding would lead to people looking for somewhere else to live, which ultimately would negatively affect these thriving businesses. It would cause alarm if local residents, the mayor, and local police were not consulted prior to an approval. This is something my local community would not be in favour of, and that is why I cannot support this portion of the bill.
Another issue we heard quite a bit about throughout the opioid study was the fact that new dangerous and deadly substances were constantly being made. This causes serious concerns. As the current rules stand, new psychoactive substances that are designed to mimic illegal drugs are chemically different enough not to be considered illegal.
I was happy to see that that the bill proposed to grant the the authority to temporarily and quickly schedule and control a new and dangerous substance under the Controlled Drugs and Substances Act. This will allow the minister to take immediate action for the public good, while launching a thorough review of the new substance. This means action is being taken while a decision on whether to permanently schedule the substance is warranted.
I think all members agree that the opioid crisis must be addressed. I also think that all members are in agreement on the severity of the issue.
The right steps are being taken to address security concerns at the border. Acknowledging that an international source is massively contributing to the opioid crisis is the first beneficial step the Liberals have taken to combat the issue.
Ensuring that the Canada Border Services Agency can now open any suspicious package under 30 grams will stop the inflow of illegal substances dramatically.
Unregulated devices such as pill presses are another massive contributor to the opioid crisis, and that is acknowledged in the bill. These devices are allowing organized crime to produce mass amounts of deadly drugs. Giving the CBSA authority to share information with law enforcement agencies will allow police forces to do their jobs and shut down these illegal activities.
The bill also acknowledges the notion that new dangerous substances are constantly being manufactured. In order to control the quick turnaround of newly designed psychoactive substances, under new regulations, the minister would be able to temporarily and quickly schedule control of a dangerous substance.
These are public safety measures that look out for the best interests of all Canadians. These measures look to negatively affect organized crime and make it harder for organized crime to produce and sell dangerous drugs.
However, severely weakening the consultation process with Canadians before the approval of an injection site is the exact opposite of these other measures. Approving these sites all around the country will normalize substance abuse. Drug addicts will still be committing extreme numbers of crimes to obtain these drugs. They will still be contributing to organized crime, and they are all to use freely in a government-sanctioned facility.
I acknowledge that every province has different needs. What is happening in British Columbia is not the same as what is happening in Prince Edward Island. However, I cannot acknowledge that injection sites save lives. I heard the analogies from a medical addiction specialist who said that, “If I was a lifeguard and saw someone drowning, I would run in and pull them out of the water. Once they started breathing again, I would not throw them back into the water”. That is exactly what injection sites do.
Streamlining the application process for approving injection sites is irresponsible. It would put communities at risk and it would put individuals with severe drug dependencies at risk. Drug addiction should be seen as a treatable illness. Until I see the government take appropriate steps to help these people get off these dangerous and deadly drugs, I cannot, and will not, support this harm reduction band-aid solution.
Madam Speaker, Canada is currently in the grips of an unprecedented opioid overdose crisis. According to David Juurlink, one of Canada's leading drug safety experts:
This is the greatest drug safety crisis of our time, and it's not hyperbole to say that every one of you knows somebody with an opioid use disorder. Whether you realize it or not, you do, and it's quite possible that you know someone who's lost a loved one to these drugs.
He went on to say:
The scope of the problem in Canada is completely unknown. We know that in the U.S., the CDC estimates that over the last 20 years, about a quarter of a million people have died from opioids, more than half of them from prescription opioids.... We have no corresponding numbers in Canada. I speculate that somewhere in the order of 20,000 Canadians have died over the last 20 years from these drugs. The fact that no federal politician can tell you that number is a national embarrassment.
In my home province of British Columbia, illicit drug overdoses claimed the lives of at least 914 people last year, making it the deadliest on record for overdoses. This places it at the same level as Alabama, the worst state in the United States in terms of overdose rates.
Last year two Ontarians died every single day from drug overdoses, with one of every eight deaths of young adults due to opioids, and 338 Albertans died last year. Quebec overdose deaths have increased by 140% over the last 10 years.
Although Canada does not track overdose deaths at the national level, which again is an inexcusable deficiency in national health policy, it is estimated that in 2015 alone, 2,000 Canadians died from overdoses. That number is certainly much higher for 2016 due to the rapid proliferation of extremely potent illicit opioids throughout Canada.
It is patently clear that drug overdoses and deaths are increasing in every region of the country and will continue to do so without extraordinary and effective action. The significant increase in overdoses in 2016 prompted B.C.'s provincial health officer, Dr. Perry Kendall, to declare a public health emergency last April for the first time in the province's history. Notwithstanding this extraordinary step, the crisis has deepened.
December saw another record spike in deaths in B.C., with Vancouver alone now registering 15 overdose deaths per week. This is truly a crisis of epidemic proportions.
Fentanyl, an opioid 100 times more potent than heroin, has been called a game-changer for drug overdose deaths in Canada, and now we are seeing overdoses caused by carfentanil, an opioid so powerful that it poses overdose risks to those exposed to it simply through inhalation or contact with their skin. These drugs are so dangerous that a dose the size of a grain of salt can cause overdose or death.
I think we can all acknowledge that there are many aspects to this complex crisis. Fentanyl is strong, cheap, easy to transport, and small amounts can be made into thousands of doses. For $10,000 or $20,000, manufacturers can obtain a kilogram of fentanyl, an amount so compact it can fit in a shoebox, and turn it into $20 million in profit.
Many overdoses are being caused by inexperienced young people experimenting with non-opioid recreational drugs, unaware that they are contaminated with fentanyl. For example, this past fall in Vancouver, there were nine overdoses recorded within 20 minutes in people who were using cocaine that was unknowingly laced with fentanyl.
Opioids have been overused and over-prescribed by doctors for pain management, leading to many patients becoming dependent and addicted. Canada has among the highest per capita volume of opioids dispensed in the world, totalling 19.1 million prescriptions in Canada in 2015, up from 18.7 million the year before. That is about one opioid prescription written for every two Canadians.
Even though there are no credible peer-reviewed studies that demonstrate that opioids afford more benefit than harm for chronic pain, opioid use has been marketed beyond palliative and cancer patients for regular use for people experiencing back pain and other common ailments. Prescribers were incorrectly taught that addiction was a rare consequence of using prescription opioids long term, that less than 1% of patients would become addicted.
In reality, the addiction rate is estimated to be 10%, with 30% suffering from opioid use disorder. This misuse of opioids reveals the absence of broad and effective treatment for chronic pain in Canada. Critically, there is an alarming lack of public detox and treatment facilities available across Canada, caused by underinvestment for decades at both provincial and federal levels, and even fewer resources dedicated to education and prevention.
Bluntly, our health care system has an appalling lack of publicly covered treatment options for Canadians suffering from substance use disorder, a pox on both Liberal and Conservative governments over the last number of decades.
In indigenous communities, inconsistent federal support for community governed and culturally based treatment has made addressing the opioid crisis a particular challenge. Nurses employed by Health Canada do not possess the scope of practice to support indigenous people in addressing opioid addiction in their own communities beyond 30 days by federal edict.
As Dr. Claudette Chase, a family physician at the Sioux Lookout First Nations Health Authority recently told our health committee:
I tear up every time I think about this, because our workers are putting themselves on the line to hear the stories of incredible trauma. We have little funding to train them. These are community members who, because Health Canada has refused to step up, have stepped up themselves. They do this and they get traumatized daily, and I have little or no means to support them other than being their family doctor. It's not acceptable.
Addiction is a complex psychosocial disease with genetic, environmental, and social determinant influences of every type. Although this crisis has been garnering increased media attention in recent months, make no mistake that it has been allowed to escalate for years, recently under a Conservative government blinded by superficial ideology and now under a Liberal government paralyzed by timid expediency.
What both Conservative and Liberal governments have in common, however, is a refusal to act on evidence in a timely fashion, and decades of history of failure to make the investments necessary to provide Canadians with essential health options to treat substance use disorder.
Over the last 10 years, the previous Conservative government slashed Health Canada's addiction treatment budget, removed harm reduction as one of the four pillars of Canadian drug policy, and spent nearly a decade trying to discredit the clear and overwhelming evidence that supervised consumption sites save lives.
Indeed, this crisis has undeniably been exasperated by barriers erected by a Conservative government that prevented supervised consumption sites from opening across Canada. Despite an abundance of research that conclusively established that Vancouver's supervised consumption facility, Insite, significantly reduced overdose deaths, the Conservative government obstinately refused to accept that evidence.
In 2011, it took the Supreme Court of Canada to rule that Insite and other supervised consumption sites must be granted a section 56 exemption from the Controlled Drugs and Substances Act because they “decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety”.
In response, in 2015, the Conservative government introduced Bill , which sets out a lengthy and arduous list of criteria that supervised consumption site applicants must meet before the minister would grant them an exemption. In practice and by design, these criteria made it effectively impossible for organizations to open new supervised consumption sites in Canada.
For example, Montreal has had applications pending Health Canada approval since May 2015, almost two years, for three fixed services in three neighbourhoods and one mobile service. Indeed, not a single supervised consumption site has opened in Canada since Bill was passed. Of course, that was exactly the Conservatives' intention.
Only an hour after Bill was initially introduced, in a move so vile it would impress Donald Trump, Conservative campaign director Jenni Byrne issued a fundraising letter stating that the Liberals and NDP wanted addicts to shoot up in the backyards of communities all across the country. This went beyond a juvenile refusal to accept evidence that ran contrary to their moralizing ideology. It was a clear and utterly disgraceful attempt to campaign on the backs of the most vulnerable Canadians, sick Canadians.
For those Conservative MPs who now claim to have found religion on the issue, who have recently echoed the NDP's long-standing call to declare a national public health emergency, I must remind them that it was Conservatives who blocked my attempt to move this bill swiftly through the House in December, to save lives faster.
Though the Liberals claim to support the expansion of supervised consumption sites, their government has not approved a single new facility since coming to office. In fact, the initially and stubbornly argued that legislative changes to Bill were not even necessary, since she had directed Health Canada officials to facilitate the application process under the existing law. She refused to acknowledge that the problem was the act itself with its 26 separate requirements acting as effective barriers to any new sites, as had been consistently pointed out by stakeholders, the NDP, and even some of her own colleagues. This tepid response stood in stark contrast to the view espoused by the member for , the Liberal member for Vancouver Centre, when she was the Liberal health critic in opposition.
When Bill was introduced, the member for publicly stated that the bill was deliberately written in a way that would ensure no supervised consumption sites were approved in Canada. She also questioned the constitutionality of the bill. It has frequently been observed that Liberals campaign from the left and govern from the right, that they talk progressively in opposition, but act conservatively when in power. I am afraid their conduct on the opioid crisis is yet one more example of this unfortunate truism.
Unacceptably, it took a mounting death toll and universal pressure from medical experts, public health officials, provincial governments, municipal leaders, and the federal NDP before the finally relented and outlined legislative changes she was willing to make to Bill , on December 12, 2016. This came on the heels of an announcement from the B.C. government that it was no longer willing to wait for federal approval and would take the extraordinary measure of signing a ministerial order making the provincial operation of temporary overdose prevention sites legal. This was in turn a response to the unsanctioned, makeshift supervised consumption sites that were being established throughout B.C. by activists like Ann Livingston and Sarah Blyth, who founded the Overdose Prevention Society last September with crowdfunding, due to the severity of the crisis.
While the current government was waiting, while people were dying, people in British Columbia and on the street were acting. Thus, the bill is an overdue acknowledgement that this is, in fact, a crisis and contains some important steps to address it.
I do want to credit the government for taking some positive measures.
The Liberals hosted an opioid summit, where they committed to better informing Canadians about the risks of opioids, supporting better prescribing practices, and improving the evidence base. They made naloxone available in a non-prescription status. They reversed the federal prohibition on the use of pharmaceutical heroin for treatment. They scheduled fentanyl precursors. They reinstated harm reduction as one of the four pillars of drug policy. Now the government has introduced amendments to the Controlled Drugs and Substances Act and other acts, to streamline supervised consumption site applications.
These changes are all welcome, if overdue, and New Democrats are in agreement with all of them. However, they do not go nearly far enough, fast enough. There is much more that we can and must do. That is why I must take serious exception to comments made by the in a recent interview. The minister said:
I would argue with the fact as to whether or not there's been progress made. I know that the number of deaths are rising, but we have been extremely active on this file....
I do not know how the minister measures progress, but I do know one thing. When Canadians are dying at unprecedented rates, when month after month we see increased death tolls from opioid overdoses, there can be no legitimate talk of progress. We in the New Democratic Party will measure progress by one factor and one factor only: when the death toll of Canadians goes down, not up. However by that standard, the crisis is getting dramatically worse, not better. Annually since 2012, the number of fatal overdoses in B.C. has increased significantly: 273 deaths in 2012, 330 in 2013, 366 in 2014, 510 in 2015, and now 914 in 2016.
Last month alone, we recorded the highest number of overdose deaths in B.C.'s history, with 142 lives lost. That is more than double the monthly average of overdose deaths since 2015 and a sharp increase from the fall. There were 57 overdose deaths in B.C. in September, 67 in October, and 128 in November. That is not progress.
To understand the scale of this epidemic, I would remind the House that during the SARS crisis in 2003, 44 people died in an outbreak of the disease across all of Canada. We are losing that many people every week to opioid overdoses.
I would suggest to members of the House that if 40 to 50 Canadians were dying every week from SARS, Ebola, or any other infectious disease, the House would not rest until it saw a response from the federal government that matched the severity of the crisis. Every life lost to overdose is a heart-wrenching tragedy that leaves devastated loved ones in its wake. The lives cut short by overdose matter just as much as anyone's, and this epidemic deserves the same attention and urgency as any other disease.
Moreover, we must remember that the consequences of inaction are felt severely by those on the front lines of this crisis. As Chris Coleman, a firefighter who works on Vancouver's Downtown Eastside, told the health committee:
...it takes a toll on an individual's mental health to see such helplessness and suffering up close on a daily basis; to work extremely hard but to feel that you are having little or no impact on a problem that is growing exponentially, like a tidal wave, on the streets of your city. There is mental strain in watching a population repeatedly harming itself and in ultimately witnessing death and deceased persons who have succumbed to this human tragedy....
I must stress that our brothers and sisters who work in the Downtown Eastside are in trouble.... In conversations with these firefighters, I hear a lot of “It's driving me nuts” and “I can't take it”. I'm told stories of their being in an alley with 20 or 30 drug users. They're unprepared and untrained for that. Part of their hopelessness comes from having to deal with the same particular overdose patient who has a needle in their neck, who's rolling around in urine and feces, more than once on the same shift. They feel abandoned and they feel hopeless.
We must not condemn our courageous first responders to the fate of Sisyphus, rolling an immense boulder up a hill over and over again for eternity. They need the Government of Canada to have their backs.
Indeed, the federal government's failure of leadership on the opioid crisis has led to renewed pleas for help from public officials from all across Canada. These include the mayors of Calgary, Toronto, Ottawa, and Vancouver, B.C.'s health minister, and health professionals from every discipline.
I know that the has repeatedly stated in public that the federal government is doing everything it can. Of course, that is utter nonsense. There are literally dozens of measures and recommendations made by health experts and stakeholders across Canada that remain unimplemented by the government.
Recently, the City of Vancouver sent a list of nine recommendations to the federal government to help address this crisis, including calling for a central command structure, daily meetings with Health Canada, and improved treatment services. A coroner's jury in British Columbia recently issued a list of 21 recommendations for action, and the Standing Committee on Health in December issued a report detailing 38 recommendations for the government alone, most of which remain unimplemented.
To demonstrate this leadership and illustrate the federal government's understanding of the scope of this crisis, the New Democrats have been calling on the federal to declare a national public health emergency for months. We are now joined in this call by municipal, provincial, and federal politicians of all stripes, including, recently, the Conservatives.
A declaration of a national public welfare emergency under the Emergencies Act would empower Canada's top doctor with the authority to take extraordinary measures to coordinate a national response to the crisis. This could include an allocation of emergency funding on the scale required to actually address the mounting death toll, as well as sanctioning the operation of temporary supervised consumption sites on an emergency basis.
Inexplicably, the minister continues to claim that a national public welfare declaration is unnecessary and untimely. With respect, she is utterly and demonstrably wrong. For example, such a declaration would allow overdose prevention sites across the country to open and operate legally, something they cannot do now. Not only are such sites needed desperately in every major city in Canada, but they would start saving lives today.
New Democrats have worked in good faith with successive federal governments to address the crisis with the urgency it deserves. We led the fight against the Conservatives' Bill C-2 from the day it was introduced, and then pressed the Liberal government to repeal or amend it. Last fall, we moved a motion at the standing committee to conduct an emergency study on the crisis. We tried to expedite this bill through the House in December; and we were the first to call for a declaration of a national public health emergency to address the crisis.
The New Democratic Party will support this bill and work in committee to improve it. We will continue to press the government to take every action it can to address this national public health crisis.
Madam Speaker, I will be splitting my time with the hon. member for .
I am pleased to rise today to speak in support of Bill , an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts. My private member's bill, Bill , the good Samaritan drug overdose act, is currently in the other place. Just like Bill C-37, it is just one piece in the harm reduction tool kit that would help to save lives.
Protecting the health and safety of Canadians is a key priority for this government. That is why on December 12, 2016, the , with support from the , introduced Bill in the House of Commons.
This bill makes several amendments to the Controlled Drugs and Substances Act and the Customs Act in support of the government's efforts to respond to the current opioid crisis and problematic substance abuse in general.
This comprehensive bill aims to balance the important objectives of protecting public health and maintaining public safety. It is designed to better equip both health professionals and law enforcement with the tools they need to address the issue.
Over the last decade, the harms associated with problematic substances abuse in Canada have become more complex and have been changing at a rapid pace. The line between licit and illicit substances has blurred with the opioid crisis, prescription drug misuse, and the rise of new designer drugs.
The government has committed to helping Canadians affected by these problematic substances and their use. Legislative and regulatory controls are certainly an important part of this approach. However, as we know, drug use and dependency pose significant risks for individuals, families, and communities. Our approach to addressing problematic substances abuse must include preventing and treating addiction, supporting recovery, and reducing the negative health and social impacts of drug use on individuals and their communities through evidence-based harm reduction measures. This must also be a part of our approach to addressing problematic substances abuse.
Harm reduction is viewed by experts as a cost-effective element of a well-balanced approach to public health and safety. Harm reduction connects people to other services in the health and social systems related to treatment and recovery. It recognizes that individuals and whole communities benefit when people with substance misuse and addiction issues can obtain the support and services they need rather than being marginalized or stigmatized. The evidence regarding harm reduction is absolutely clear. Harm reduction measures are a critical piece of a comprehensive approach to drug control.
That is why the government is determined to take a balanced, evidence-based approach that supports rather than creates obstacles to harm reduction.
To that end, on December 12, 2016, in addition to introducing Bill in the House, the announced that a national anti-drug strategy would be replaced with a new, more balanced, and health-focused approach, called the Canadian drugs and substances strategy. The new strategy will strengthen Canada's approach to drug policy by providing a comprehensive, collaborative, compassionate, and evidence-based approach to the protection of public health and safety and the reduction of harm from misuse of licit and illicit substances. To reflect the new health-focused approach, the strategy will be led and coordinated by the Minister of Health, in close collaboration with her colleagues.
Canada has had successive drug strategies in place since 1987 that have aimed to balance public health and public safety. In 1992, the government launched Canada's drug strategy, which was intended to reduce the harms associated with alcohol and other drugs to individuals, families, and communities. In 1998, harm reduction was added as a pillar alongside prevention, treatment, and enforcement.
However, the balance between public health and public safety in Canada's approach to drug policy shifted in 2007, with the release of the national anti-drug strategy. This strategy reflected the previous government's priorities of public safety, crime reduction, and safe communities.
The national anti-drug strategy focused primarily on youth and illicit substance use and did not retain harm reduction as a pillar. This shift brought Canada out of step with other like-minded countries, most of which include harm reduction in addressing problematic substance abuse.
The new strategy will retain and build upon the aspects of the national anti-drug strategy that worked well and, specifically, the new strategy will maintain the existing and well-established areas of prevention, treatment, and enforcement. These pillars, respectively, aim to prevent problematic drug and substance use, support innovative approaches to treatment and rehabilitation, and address illicit drug production, supply, and distribution.
However, perhaps the most important aspect of the new strategy is that it will improve upon the national anti-drug strategy by formally restoring harm reduction as a pillar. This shift to a more health-focused approach has been welcomed by stakeholders, including the Centre for Addiction and Mental Health, and our provincial partners.
Our government is committed to ensuring that its policies under the new strategy will be informed by a strong foundation of evidence, including data related to harm reduction policies, programs, and interventions. This will enable the government to better identify trends, target interventions, monitor impacts, and support evidence-based decisions. It will help ensure that Canada has a comprehensive national picture of drug use and drug-related harms and can fully meet our international reporting requirements.
Even before the new strategy was announced, our government included harm reduction measures in our efforts to reduce the negative health and social impacts associated with problematic drug use, including the transmission of infectious diseases, overdose deaths, and stigma.
For example, under federal legislation, we have improved access to naloxone, an overdose reversal drug, by making it available without a prescription specifically for emergency use in cases of opioid overdose outside of hospital settings.
This important measure broadens access for emergency workers and will help address a growing number of opioid overdoses.
We have also demonstrated our support for the establishment of supervised consumption sites, a key harm reduction measure.
After a thorough and rigorous review, in January 2016, Health Canada granted an exemption from the Controlled Drugs and Substances Act for the Dr. Peter Centre to operate a supervised consumption site.
Not long after, on March 16, 2016, Health Canada granted Insite an unprecedented four-year exemption.
If passed, Bill would go further to support the implementation of evidence-based harm reduction measures. In particular, it would reduce the burden on communities that wish to apply for an exemption to operate a supervised consumption site.
The proposed amendments would streamline and simplify the application criteria, while ensuring that community consultation continues to be an integral part of the process. By streamlining the application and renewal process and adding a new transparency provision, applicants could be assured that the process would not cause unreasonable burden or delay.
In conclusion, our government's approach to drug policy strives to balance the important objectives of protecting public health and maintaining public safety.
The Canadian drugs and substances strategy will restore harm reduction as a pillar, alongside prevention, treatment, and enforcement, and will formalize our commitment to a comprehensive, collaborative, compassionate, and evidence-based approach to Canada's drug policy.
It would mean that harm reduction-focused policies, such as support for properly established and maintained supervised consumption sites and increased access to naloxone, would now officially be part of Canada's drug strategy.
Implementing measures proposed in Bill would be a key step in realizing the objectives of the Canadian drugs and substances strategy.
Madam Speaker, I am very pleased to rise today to speak in support of Bill , an act that would better equip both health and law enforcement officials to reduce the supply of illicit opioids and other drugs and to reduce the risk of diversion of controlled substances.
Bill confirms once again our government's continued commitment to ensuring that our legislative frameworks for public health and safety are modern and effective.
Protecting public health through efforts to prevent disease, prolong life, and promote health is a key priority for the government. The recently announced Canadian drugs and substances strategy and the proposed legislative changes to streamline the application process for supervised consumption sites are just two ways the Government of Canada is demonstrating this commitment to public health.
This new strategy is comprehensive, collaborative and compassionate. It is comprised of four key pillars: prevention, treatment, harm reduction and enforcement, which are built upon a strong foundation of evidence.
While the new strategy places an increased emphasis on public health, our government recognizes that effective drug policy must balance both public health and public safety.
Therefore, not only does Bill address harm reduction measures such as supervised injection sites, it also proposes new ways to deal with controlled substances that are obtained through illicit sources.
Bill would amend the Controlled Drugs and Substances Act, or the CDSA, Canada's drug control statute. The CDSA provides a framework to control substances that can alter mental processes and that may produce harm to health and to society when diverted or misused. It has the dual purpose of protecting public health and maintaining public safety.
We know that the use of illicit substances can increase the risk of harm to health. The CDSA maintains public safety by restricting the activities such as import, export and trafficking of controlled substances and precursors.
The Controlled Drugs and Substances Act has been in effect for two decades now and some of its regulations, enacted under previous legislation, have been in place much longer. While the CDSA serves us well in many areas, there has been a significant evolution in both the legitimate controlled substances and precursors industries as well as the illicit drug market.
As we all know, problematic substance use is a serious public health issue. Our government is very concerned about the increasing rates of opioid-related overdose deaths occurring across Canada right now, and the devastating impact this crisis is having on individuals, families and communities at large, including in my own riding of . Opioid-related overdoses in British Columbia and Alberta have reached a crisis point and urgent action is needed to protect public health and safety, and disrupt illegal production and trafficking. It is becoming increasingly critical to ensure that the CDSA is modernized in order to better protect Canadians, their families, and the communities in which they live.
The Government of Canada is taking concrete action that will help address the current crisis and keep deadly drugs such as fentanyl and carfentanil out of Canadian communities. If the proposed amendments in Bill were adopted, they would further strengthen and modernize the tools available to the government to combat the illegal production and distribution of drugs and reduce the risk of controlled substances being diverted to the illegal market.
One such action would prohibit the import of unregistered pill press and encapsulator devices.
Pill presses and encapsulators can be used legitimately to manufacture pharmaceuticals, food and consumer products as well. However, they may also be used to make illegal counterfeit drugs that look like legitimate pharmaceuticals. These counterfeit pills can contain dangerous substances such as fentanyl and W-18. Pill presses can produce thousands of illegal pills in a short period of time, which poses significant risks to the public health and safety of Canadians. Currently these devices can be legally imported into Canada without specific regulatory requirements.
Bill would require that every pill press and encapsulator imported into Canada be registered with Health Canada. This would serve as a tool to better equip law enforcement to reduce the supply of illicit opioids and other drugs in Canada. Proof of registration would have to be shown upon importation and unregistered devices could be detained by officials at the border. The devices captured under this provision are aligned with those for the import and sales that must be reported in the United States. A new schedule to the CDSA would be created, allowing additional devices to be controlled in the future to respond to changes in illicit drug production.
The proposed legislation would enable better information sharing about imports of pill presses and encapsulators with border officials and police forces during an investigation.
Bill would also make amendments to expand the offences and punishments for pre-production activities of any controlled substance. Pre-production includes buying and assembling the chemical ingredients and industrial equipment that are intended to be used to make illicit drugs, but are not specifically listed in the CDSA schedules. These activities are not currently controlled under the CDSA unless the intent is to produce methamphetamine.
Members of the House may recall that concerns about the growing popularity of methamphetamine prompted private member's bill, Bill , in 2011. The passage of this bill made it illegal to possess, produce, sell, or import chemicals with the knowledge that they would be used to produce or traffic methamphetamine.
Given the growing opioid crisis and the evidence of illegal production of other drugs in Canada, including fentanyl, we must go further. The amendments proposed in Bill would extend the provisions that were added in 2011 so that penalties would apply to the illegal production, distribution, import, export, and transport of anything used to produce or traffic any controlled substance.
The government recognizes the complex challenges faced by individuals who are involved in problematic substance use. We remain committed to working with our territorial and provincial partners to address the issues related to illegal drug use.
Bill is one part of our government's response to Canada's growing opioid crisis. The legislative changes proposed in the bill will make the CDSA a more robust act and increase law enforcement's ability to take early action against suspected drug production operations, and better equip enforcement to respond to the evolution of the illicit drug market.
I encourage all members of this House to support this bill.
Mr. Speaker, I will be sharing my time with the member for .
I am rising to speak to Bill , an act to amend the Controlled Drugs and Substances Act and to make related amendments to other acts.
As we all know, addiction issues have been a challenge throughout the history of mankind. As noted by the Canadian Centre on Substance Abuse, addiction touches everyone. As of 2013, one in five Canadians, or six million people, met the criteria for substance use disorder, causing harm and heartache among families and communities throughout the country. Today, however, we are facing an unprecedented crisis: the casual or addictive use of drugs now includes a much higher risk of death.
I would note there were some questions in the previous exchange where the government talked about how it worked very hard with the provinces in terms of moving forward, but what the Liberals did not say is that they worked hard with the opposition.
There are many pieces of the bill that are very supportable and should move forward in a rapid and timely way, but the Liberals know very well that there is one component that we have a few concerns with, and I will articulate the reasons a little later. If the Liberals are talking about being concerned about this crisis, they should have proposed something that would allow us to immediately move forward with all the things we know we can agree on, and take a little bit more time for the conversation over the one piece that is giving us a bit of a challenge. This is a big concern.
The other big concern which people who are listening and watching need to be aware of is that on April 14, 2016, B.C. declared a public health emergency in response to this rise in drug overdoses and deaths. Now it is months later, at a time when pill presses and encapsulators, and border issues have been identified, but what did the government first talk about in its call for debate yesterday? It was a bill on Statistics Canada. It is absolutely shameful. The government had the opportunity to move forward on some important issues, but Statistics Canada was more important on our first day back. They presented a bill that the Liberals knew there were some challenges with instead of presenting something that we could all immediately support and move forward in a timely way. I think the Liberals should look at how they have dealt with this issue.
An emergency was declared in April, and it was recognized. Maybe it has not hit some of the other provinces, but it is interesting that it was a Liberal member, the member for , who said that if this crisis was happening in Ontario or Quebec, action would have been taken much sooner. That was said by a Liberal member, a family physician, who called out her own party on how it responded to this particular crisis. That is absolutely shameful.
The recent epidemic is characterized by an increasing proportion of death related to fentanyl, which is an illicit opioid substance. Back in 2012, fentanyl was seen in about 5% of the illicit drugs, and in 2016 it was seen in 60%. Fentanyl is dramatically increasing in use. In British Columbia in 2016, there were 914 deaths, with 142 in December alone.
Many might have read the Facebook page of the grandmother who was grieving for her young granddaughter saying that she just needed some help. She felt that maybe she could have dealt with her granddaughter who died a couple of days before Christmas.
In Kamloops, a community I represent, there were 40 deaths over the year. It typically had 10 deaths, steady over years and years, but in 2016, 40 people died in Kamloops from a drug overdose. With SARS, there were 40 deaths across Canada, and H1N1 had 400 deaths across Canada. I was on the health committee when H1N1 was happening. I remember that we had daily briefings from the chief public health officer of Canada. It was Dr. Butler-Jones at the time. He kept parliamentarians up to date every day on what was happening. That was for 400 deaths across Canada. We are talking about 900 deaths in British Columbia alone.
We do have in Bill a partial response to this crisis. As I indicated earlier, there are measures in the bill that are very supportable, such as the prohibition of designated devices, encapsulators, and adding to the schedule of substances reasonable grounds to represent health risks. There are more powers proposed for Canada Border Services Agency. We knew a year ago those were some of the things that could have been done to avert this crisis. The addition to broaden the prohibition and penalties to now apply to the possession, sale, importation, or transport of anything intended to be used is an important measure.
However, if the government had been concerned, it could have dealt with this many months ago instead of debating a bill about Statistics Canada. This is about people who are dying in British Columbia, and soon across the country.
I want to talk about the areas in which I have what I think are reasonable concerns. That is the part we need to be debating as parliamentarians. There is one area where there is a bit of a difference of opinion and it has to do with the process that should be in place for what they call safe consumption sites, or what are more commonly known by the public as injection sites, to move forward. That is a reasonable discussion.
Our Conservative government brought in the Respect for Communities Act. Certainly, there are some people who felt it made it too difficult, but it is a valid place for us to talk about what that should look like. We originally had 26 criteria that were to be addressed when people applied for a safe injection site. This bill changes it from 26 criteria to five factors. That is a little vague.
When I talked to the minister at committee, I tried to go through the 26 criteria. I asked her what objection she had to them, but I really did not get an answer. None of them said they were really concerned about any one piece, “I don't think the RCMP should be able to have a say”, or “I don't think municipal council should have a say”. Those are the criteria that are in place. What is being proposed now is a few factors.
The other thing the government has done is there were six principles that should be part of the thinking around whether the minister would approve a site or not. These principles have been totally removed and there are no principles left. Those are principles that recognize the issue of crime profits or criminal activity that is supported with illicit substances. We have gone from 26 criteria to five and there are no other checks and balances.
Using Kamloops as an example, the mayor and council voted unanimously to support a safe injection site. They have talked to the RCMP. They are having a consultation process under former Bill , which is now the Respect for Communities Act. That process allows the mayor and council to have input. They supported the safe injection site. I am not sure how they would feel if they were told they would not even be talked to about it, that it was just going to happen. They can write a letter and say whether they like it or not. They endorsed it unanimously. Interior health will be looking at it. That is important. As we know, Ottawa has not endorsed it. Those are pieces of public consultation that the government is looking to replace with vague references to talking to the community, but it really does not matter because communities do not tend to like these things. Kamloops council voted 100% for it. Why does the government not trust the community process that is specific and methodical?
There are some good pieces in the bill. We should move forward on those important pieces immediately. We should have done it a year ago. We should have a reasoned and appropriate debate around the changes to the safe injection sites. However, there are some pieces that are missing when it comes to the government's response to the crisis.
My colleague from and I both have said to listen to British Columbia. Let us call a state of emergency to raise the elevation so that people know about what is happening, because it is happening in B.C. now, and it will be going across the country. Youth councils are saying that there should be a national education campaign. Moms and dads need to be having that conversation. They will not have the conversation if they do not know.
In conclusion, let us look at the pieces, move forward on those critical ones, then look at doing those additional recommendations.