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37th PARLIAMENT, 1st SESSION

Special Committee on Non-Medical Use of Drugs

EVIDENCE

CONTENTS

Wednesday, April 17, 2002

0840

The Chair (Ms. Paddy Torsney (Burlington, Lib.))

0845

0850

Staff Sergeant Jim Skanes (“B” Division, Royal Canadian Mounted Police Coastal Watch Program)

0855

The Chair

Sergeant Michel Frenette (Drug Awareness Services Coordinator, Royal Canadian Mounted Police)

0900

0905

The Chair

Corporal Peter Keirstead (Drug Awareness Service, Royal Canadian Mounted Police, “H” Division, Halifax, Nova Scotia)

The Chair

Ms. Dianne Kelly (Chief Coroner, York County Court House, Province of New Brunswick)

The Chair

Ms. Dianne Kelly

0910

The Chair

Corporal Mike Gallagher (Supervisor, Drug Section, Miramichi Police Force)

The Chair

Cpl Mike Gallagher

0915

0920

The Chair

Sergeant Rosco Larder (Halifax Regional Police Drug Unit)

0925

0930

0935

The Chair

Mr. Randy White (Langley--Abbotsford, Canadian Alliance)

The Chair

S/Sgt Jim Skanes

The Chair

S/Sgt Jim Skanes

0940

Mr. Randy White

S/Sgt Jim Skanes

Mr. Randy White

Sgt Michel Frenette

0945

The Chair

Mr. Randy White

The Chair

Sgt Michel Frenette

The Chair

Mr. Réal Ménard (Hochelaga--Maisonneuve, BQ)

The Chair

Mr. Réal Ménard

Cpl Mike Gallagher

Cpl Keirstead

0950

The Chair

Cpl Mike Gallagher

The Chair

Sgt Rosco Larder

The Chair

Sgt Rosco Larder

The Chair

M. Réal Ménard

The Chair

Ms. Dianne Kelly

Mr. Réal Ménard

0955

Mr. Réal Ménard

Sgt Michel Frenette

Mr. Réal Ménard

Sgt Michel Frenette

Mr. Ménard

Sgt Michel Frenette

1000

The Chair

Sgt Michel Frenette

Ms. Libby Davies (Vancouver East, NDP)

Sgt Michel Frenette

1005

Ms. Libby Davies

Sgt Michel Frenette

Ms. Libby Davies

Ms. Dianne Kelly

1010

The Chair

Ms. Dianne Kelly

The Chair

Mr. Dominic LeBlanc (Beauséjour--Petitcodiac, Lib.)

The Chair

Mr. Dominic LeBlanc

The Chair

Mr. Dominic LeBlanc

The Chair

Sgt Michel Frenette

The Chair

Mr. Dominic LeBlanc

Cpl Mike Gallagher

Mr. Dominic LeBlanc

Sgt Rosco Larder

1015

Mr. Dominic LeBlanc

Sgt Rosco Larder

Mr. Dominic LeBlanc

Sgt Rosco Larder

The Chair

S/Sgt Jim Skanes

The Chair

Ms. Hedy Fry (Vancouver Centre, Lib.)

Sgt Rosco Larder

1020

Ms. Hedy Fry

Sgt Rosco Larder

The Chair

Ms. Dianne Kelly

Ms. Hedy Fry

Ms. Dianne Kelly

Cpl Keirstead

Cpl Mike Gallagher

1025

The Chair

Sgt Michel Frenette

The Chair

Ms. Dianne Kelly

The Chair

Mr. Kevin Sorenson (Crowfoot, Canadian Alliance)

1030

The Chair

Mr. Kevin Sorenson

The Chair

Cpl Keirstead

The Chair

Sgt Rosco Larder

Mr. Kevin Sorenson

Sgt Rosco Larder

Mr. Kevin Sorenson

1035

Sgt Rosco Larder

The Chair

S/Sgt Jim Skanes

The Chair

Sgt Michel Frenette

The Chair

Mr. Derek Lee (Scarborough--Rouge River, Lib.)

Sgt Rosco Larder

1040

Mr. Derek Lee

Sgt Rosco Larder

Mr. Derek Lee

Sgt Rosco Larder

Mr. Derek Lee

Sgt Rosco Larder

Mr. Derek Lee

Sgt Rosco Larder

Mr. Derek Lee

Sgt Rosco Larder

Mr. Derek Lee

The Chair

Ms. Dianne Kelly

The Chair

Cpl Mike Gallagher

The Chair

1045

Sgt Michel Frenette

The Chair

Sgt Michel Frenette

The Chair

S/Sgt Jim Skanes

Cpl Keirstead

1050

The Chair

Cpl Keirstead

The Chair

Sgt Rosco Larder

The Chair

1105

Mr. Howie Sullivan (Executive Director, SANE Sharp Advice Needle Exchange)

1110

1115

The Chair

Ms. Renée Masching (Executive Director, Healing Our Nations)

1120

The Chair

Ms. Renée Masching

1125

The Chair

Ms. Margaret Dykeman (President, AIDS New Brunswick)

1130

1135

The Chair

Dr. Christiane Poulin (Associate Professor, Department of Community Health and Epidemiology, Dalhousie University)

The Chair

Dr. Christiane Poulin

1140

The Chair

Dr. Christiane Poulin

1145

1150

1155

The Chair

Dr. Christiane Poulin

The Chair

Mr. Randy White

Mr. Howie Sullivan

Mr. Randy White

Mr. Howie Sullivan

Mr. Randy White

Mr. Howie Sullivan

Mr. Randy White

Mr. Howie Sullivan

1200

The Chair

Ms. Renée Masching

Mr. Randy White

Ms. Renée Masching

The Chair

Ms. Margaret Dykeman

Mr. Randy White

Ms. Margaret Dykeman

Mr. Randy White

1205

Dr. Christiane Poulin

Mr. Randy White

The Chair

Ms. Margaret Dykeman

Dr. Christiane Poulin

The Chair

Ms. Libby Davies

Ms. Davies

1210

The Chair

Dr. Christiane Poulin

Ms. Libby Davies

Dr. Christiane Poulin

Ms. Libby Davies

Dr. Christiane Poulin

Ms. Libby Davies

Dr. Christiane Poulin

Ms. Libby Davies

Mr. Howie Sullivan

1215

The Chair

Ms. Renée Masching

The Chair

Ms. Renée Masching

Ms. Margaret Dykeman

The Chair

Mr. Réal Ménard

1220

Dr. Christiane Poulin

Mr. Réal Ménard

Dr. Christiane Poulin

Mr. Réal Ménard

Dr. Christiane Poulin

1225

Mr. Réal Ménard

Dr. Christiane Poulin

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

Ms. Margaret Dykeman

1230

Mr. Réal Ménard

Ms. Margaret Dykeman

The Chair

Ms. Margaret Dykeman

The Chair

Mr. Howie Sullivan

1235

The Chair

Ms. Margaret Dykeman

Ms. Renée Masching

The Chair

Mr. Dominic LeBlanc

The Chair

1240

Ms. Margaret Dykeman

The Chair

Ms. Renée Masching

Mr. Dominic LeBlanc

Ms. Renée Masching

Mr. Dominic LeBlanc

The Chair

Mr. Derek Lee

1245

Mr. Howie Sullivan

Mr. Derek Lee

Mr. Howie Sullivan

The Chair

Ms. Renée Masching

Mr. Derek Lee

The Chair

1250

Dr. Christiane Poulin

The Chair

Dr. Christiane Poulin

The Chair

Mr. Kevin Sorenson

The Chair

Dr. Christiane Poulin

1255

Mr. Kevin Sorenson

Dr. Christiane Poulin

The Chair

Ms. Margaret Dykeman

The Chair

Dr. Christiane Poulin

The Chair

Ms. Margaret Dykeman

The Chair

Ms. Hedy Fry

1300

1305

Dr. Christiane Poulin

Ms. Hedy Fry

Dr. Christiane Poulin

The Chair

Mr. Kevin Sorenson

The Chair

Ms. Margaret Dykeman

The Chair

Ms. Renée Masching

1310

The Chair

CANADA

Special Committee on Non-Medical Use of Drugs

NUMBER 036

1st SESSION

37th PARLIAMENT

EVIDENCE

Wednesday, April 17, 2002

[Recorded by Electronic Apparatus]

¾ (0840)

[English]

The Chair (Ms. Paddy Torsney (Burlington, Lib.)): I bring this meeting to order.

Good morning. I'm Paddy Torsney, the member of Parliament for Burlington, Ontario, and chair of the Special Committee on the Non-Medical Use of Drugs. Before I introduce all our witnesses, let me introduce my colleagues around the table, and there are more who are coming.

The vice-chair of the committee is Randy White, and his colleague is Kevin Sorenson. Randy is from Abbotsford, B.C., and Kevin is from Crowfoot, which is not too far from Edmonton. Réal Ménard is a member of Parliament from the Bloc Québécois and is from the south part of Montreal, the Maisonneuve--Hochelaga riding. Libby Davies is from Vancouver East and represents the NDP. Dominic LeBlanc is from Beauséjour, New Brunswick, so some of you are probably some of his constituents. We have some other colleagues from Vancouver, the Toronto area, and from Montreal, who should be here. They're probably caught up with some other meetings.

We have Chantal Collin and Marilyn Pilon, who are our researchers, and Carol Chafe is our clerk. They're an amazing team that keeps everything running smoothly behind us. Interpretation is available in English and French. Should questions be posed in the alternate language and you need help, there's some interpretation here.

This committee is very pleased to be here in Halifax and to have representatives from New Brunswick with us today as well. It's our chance to hear what's happening in this part of the country. We have been to Vancouver, Montreal, Toronto, to Niagara Falls to see the border, and we will be heading to Edmonton and Saskatoon, and also into the U.S. just to see what's going on there.

Our witnesses today are, first, from the RCMP Coastal Watch Program, Jim Skanes. Welcome, Jim.

Also from the RCMP we have Michel Frenette, who is the drug awareness services coordinator. He's from New Brunswick. And with him is Corporal Peter Keirstead, who is with the Halifax detachment.

We also have, from the York County Court House, Dianne Kelly, who is the chief coroner. Welcome.

¾ (0845)

From the Miramichi Police Force, we have Corporal Mike Gallagher, a supervisor from the drug section, and from the Halifax Regional Police Drug Unit, Sergeant Rosco Larder.

Welcome.

I'll have you speak in the order you've been introduced. I'm not sure exactly how long people's presentations are. Why don't I give you the five-minute signal, and if you need more time, you can finish up. If you need way more time, we'll try to figure that out at the time.

Please don't say I gave you the finger, which some guy said yesterday. It wasn't one of our finer moments.

Then we'll have an opportunity for questions and answers from the people who are around the table and we can get some more of the issues.

I'll stop speaking and ask Staff Sergeant Skanes to present first.

¾ (0850)

Staff Sergeant Jim Skanes (“B” Division, Royal Canadian Mounted Police Coastal Watch Program): Thank you, Madam Chair, committee members.

I'll certainly be within the five minutes. It won't be a problem.

The coastal watch program, which includes another program called the air watch program, is a national RCMP project that has been in existence for quite a number of years, going back to the mid-1970s.

It was designed to increase public awareness and develop interest in assisting in the detection of persons, vessels, and aircraft using our extensive coastlines, runways, and the major airports to smuggle drugs into Canada.

In Newfoundland and Labrador alone, we have more than 17,000 kilometres of coastline, more than 100 remote air strips, several major regional airports, and two international airports. Needless to say, the police cannot monitor this territory all by itself. So we've attempted to enlist the eyes and ears of the general public to help out through this coast and air watch program.

We've long known that tonnes of illegal drugs are smuggled into Canada through the coast and the ports. Back in 1974, a local person near the community of Tors Cove observed some suspicious activity on the coast, did a little investigation himself, and reported it to the RCMP. The subsequent investigation turned up two and a half tonnes of marijuana. Needless to say, that seizure wouldn't have happened without the awareness and the public involvement of someone who took the initiative.

It was a very small step from that and a short time later that the coastal watch program was introduced. We could really see the validity and the usefulness of the program in enlisting the public's support.

Through coastal watch we endeavour to contact people who live or work near or around the water. We make them aware of some of the past investigations, the amount of drugs that we know or suspect have passed through our coastline. We provide them with some profiles, some information about things to look for--strange vessels, vessels operating after dark without running lights, those kinds of things.

I just ask that if they see something that's a little bit out of the ordinary, they pick up the phone and give us a call--no more to it than that.

We've partnered with a lot of groups in this effort--the Canadian Coast Guard Auxiliary, Canadian Rangers patrol groups, yacht clubs, fishermen, recreational boaters--the gambit.

We take the same approach in contacting people who live near airports and remote air strips. Basically we do the same thing. A lot of little strips in Newfoundland are not used on a regular, day-to-day basis, and we just ask people if they see aircraft coming or going, again, give us a phone call. It's very simple. We partner with groups like flying clubs, refuelling companies at the airports, and airport workers. Basically all we're asking of them is to make a phone call.

While initially the emphasis was on drug smuggling, we've broadened the scope of that program and today it pretty much includes all smuggling--alcohol, tobacco, other contraband, and illegal immigrants.

We encourage people to call the nearest RCMP detachment and report their observations in connection with the coastal or air watch. We'd like them to make that distinction, that they're calling on behalf of or because they attended a coastal watch program, and report the vessel or aircraft. Give us some kind of description--the markings, the colours, something about the person or persons--the usual type of information, and of course that information is held in confidence.

This is not a labour-intensive job, nor is it very costly in either financial or human resource terms. It's probably one of the few things the RCMP does that doesn't have a really big dollar value attached to it.

While some organized meetings are required, for the most part the contacts are informal. We're out and about on a day-to-day basis, so when we're talking to the fishermen on the local wharves we sell the program a little bit. If we're at the airports, we do the same thing, just through day-to-day contact. Occasionally, we'll sponsor a formal meeting. We invite groups like the coast rangers--the Canadian Rangers--or the Coast Guard Auxiliary to sit in and listen to the presentations.

That's the way we sell the program. As I say, our people are out on the street day to day anyway, so there's no big dollar value or cost attached to the program.

Most divisions have dedicated full-time resources during the coordination and monitoring of this initiative, but in Newfoundland and Labrador, the coastal air watch program falls under the drug awareness provisions already.

It falls to me on the drug awareness program to coordinate this. We did have a full-time coordinator for the last year or two. He's just moved on to greater glory, so that position is now defunct. Unfortunately, the program was being raised to a pretty good level--everything is flying along fairly well--but now that position is gone; it's sort of on the back burner for us.

To sum up, since 1974 we've had 20 major marine seizures of cannabis product across the Atlantic area. Approximately 40 tonnes of marijuana and 122 tonnes of hashish have been seized, with some relation to the coastal air watch program. So with very little cost, both financial and human, we do get some bang for the bucks.

That's it pretty much in a nutshell.

¾ (0855)

The Chair: Thank you so much, Staff Sergeant Skanes. I'm sure my colleagues will have some questions for you.

Michel Frenette.

[Translation]

Sergeant Michel Frenette (Drug Awareness Services Coordinator, Royal Canadian Mounted Police): Thank you. I would like to let committee members know that I will be making my presentation in French, en français, and I'll be switching back and forth between French and English. New Brunswick is the only officially bilingual province in Canada.

I will proceed in both languages.

First of all, allow me to introduce myself. I am Sergeant Michel Frenette and I work for the RCMP.

This morning, I have come here to represent the Drug Awareness Service for the entire Atlantic region, even if my colleague, Peter Keirstead, is here. We have agreed that I will be making the presentation for Atlantic Canada. However, should there be questions, they could be addressed to each division or each province.

The Drug Awareness Service in Atlantic Canada is the same as it is nationally. The main purpose of the Drug Awareness Service is to combat drug addiction through awareness and education. We are committed to sensitizing the public to the appropriate Canadian laws and to the harmful effects of drugs on users and their families and communities.

To this end, we have adopted various strategies over the years. Partnership and various education and awareness programs all play a role. I will now describe them to you, and there is a distinction to be made between our education programs and our awareness programs. We do make a difference between the two.

One of the main issues we are presently dealing with in the area of awareness is that of the partnerships to be put in place. We to some extent adapted the national model called Health, Education and Enforcement in Partnership, or HEP, which in French is called Santé, éducation et services de police en partenariat, SESPP.

In New Brunswick, as is the case throughout the entire Atlantic region, we have established regional groups comprised of interested persons and stakeholders in the areas of education, justice, police services, health, as well as several other community partners, who sit on these committees and thus participate when we launch education and awareness programs.

I will now talk about some of the programs targeting youth. Let me first mention the main program we have put in place in the Atlantic region, called DARE, which stands for Drug Abuse Resistance Education, and emphasizes resisting drugs and violence.

Last year, in 2001, the RCMP alone, without taking into account municipal police forces, made presentations to a total audience of more than 6,000 students. Prevent alcohol and risk-related trauma in youth.

¿ (0900)

We also have, in Nova Scotia and New Brunswick, a program called PARTY, Prevent Alcohol and Risk-Related Trauma in Youth. This program targets mainly ninth-graders. Once again, it is a community program that requires community participation. When we talk about mobilizing the community, it is this type of program we have in mind. In the future, we will continue to establish this type of program in particular with our different partners, namely public health services, hospitals, rehabilitation centres for victims, municipal police forces, the RCMP and others as well.

Another awareness program is in existence. It is called Drugs and Sport. Right now in New Brunswick, we are, in partnership with the University of New Brunswick Faculty of Kinesiology, conducting a study to determine the attitudes of students from grade six to grade twelve towards performance-enhancing drugs. We hope to involve 1,600 students from grade six to grade twelve. This pilot project has lead us to deep reflection about the attitudes students of both sexes today have, because close to 47% of both girls and boys--the percentage is the same for both sexes--say that they are tolerant towards the actions of those who take substances. However, only 12 to 14% of those surveyed admitted that they use performance-enhancing drugs. This is nevertheless quite a serious problem. We are pursuing our study and we will probably have data available in the fall of 2002.

Another awareness program we make good use of is called Two-Way Street: Parents, Kids and Drugs. This program is mainly delivered to parents, but we also offer it to young people. It is a program mainly geared towards communication. During the presentations we make under this program, parents generally ask us to identify the symptoms corresponding to various drugs, from alcohol to opiates and the rest, but especially those drugs which we call designer drugs. We are witnessing a major rise in drug use even here in New Brunswick and it is probably also the case in Halifax and elsewhere in the country. Through talking to parents we have also discovered that young people are using a a lot of substances they absorb through inhalation such as solvents. This is another very worrisome trend. It is perhaps a practice that is not as well known by the general population, but when we talk about this with young people, we see that the practice is quite common for them. But it is a relatively dangerous practice. We are trying to sensitize parents to the need to be on the look-out for any sign of this type of behaviour.

For adults, we have a program called The Winning Solution--Drugs in the Workplace. This is a national program. In the Atlantic region, we respond to the requests of businesses for information or for talks on drugs. We mostly emphasize the advantages of having workplace policies and we explain how they can tie these policies in with the employee assistance programs they already have in place. This program has been quite successful. We receive feedback from businesses who tell us how things have come along for them since receiving the information. As a matter of fact, there is a company in Mr. Leblanc's area that asked us for help not very long ago, some time last year. In that particular case, the union took it upon itself to establish workplace policies where there was drug abuse. This is a step in the right direction.

We also have the Aboriginal Shield Program. Here again this is a very interesting program because it is a mobilizing force in the community. It is not just policemen who deliver the program. The community itself gets involved in dealing with the problems caused by substance abuse.

Lastly, there is another more regional program this time, here in New Brunswick and in Ontario, and that is presently being used mostly in Nova Scotia, Newfoundland and Prince Edward Island. This program is called Racing Against Drugs. This program uses car racing in schools to mobilize communities and students. At one point we were told that in order to get the message across to young people, especially the youngest among them--and I am talking here about youngsters from grade three to grade six approximately--one has to put on quite a show. Simply showing up in schools with a little drug kit is not going to be enough to get the message across. But when we use this kind of presentation... The set-up is about 32 or 37 feet long by 10 feet wide, and there are eight little cars that go around the track. The youngsters must use the track. They must know how to control the gears and the speed. When we ask them if they would be able to operate these cars under the influence of drugs, they get the picture right away. They already know the answer. The board also has pit stops where people can give different messages about prevention, suicide or AIDS. Unfortunately, it is very difficult for us to set up this program in all of the communities given the costs, whether we are talking human resources or funding.

That is about all I can tell you in the eight minutes I have been given this morning.

Thank you very much.

¿ (0905)

[English]

The Chair: Thank you very much.

Did I get that straight, that Officer Keirstead is not going to present?

Corporal Peter Keirstead (Drug Awareness Service, Royal Canadian Mounted Police, “H” Division, Halifax, Nova Scotia): I won't. Michel's done a very good job and he's covered it, so there would be a lot of duplication.

The Chair: Okay.

From the York County Court House, Dr. Kelly, please.

Ms. Dianne Kelly (Chief Coroner, York County Court House, Province of New Brunswick) : I should clarify. We're no longer at the York County Court House, and I am not a medical doctor.

The Chair: There you go. Are you a PhD doctor?

Ms. Dianne Kelly: No, I'm not. I think they assumed...they attribute a medical degree to all coroners and chief medical examiners, but a number of us are not--

The Chair: But you're still the chief coroner for the Province of New Brunswick?

Ms. Dianne Kelly: I am indeed. I don't have a medical degree. I have a business background, actually. I also have a lot of experience in the justice system.

The Chair: Okay.

Ms. Dianne Kelly: Thank you for the opportunity to participate in this panel today. I really appreciate the opportunity, and I expect I'll learn a lot from listening to the other participants, as I already have.

My comments are really to explain the role of the coroner in identifying the incidence of drugs and alcohol in sudden death. I should say first of all that the coroner's model we've adopted is that we speak for the dead to protect the living. Our mandate is to investigate all sudden and unexpected deaths. The purpose of the coroner's investigation is to ensure that no death is overlooked or ignored, to ensure that every death is thoroughly investigated, and to learn from the circumstances of the death--that is, how to prevent such deaths in the future.

Our investigations address five basic questions, the usual who, what, where, when, and why. We investigate about 23% of the 6,000 deaths that occur in New Brunswick each year. We work in collaboration with police agencies during the course of that investigation, and we're a vital part of law enforcement in determining whether such deaths are due to natural causes, accidents, suicides, homicides, or undetermined causes.

We also work in partnership, as others have talked about, with the provincial Department of Health and Wellness, especially on suicide prevention initiatives. This year we've commenced a joint project to study all suicide deaths that occur in New Brunswick to better understand the risk factors, the protective factors, and any help-seeking strategies. Our interest is especially with suicide completers. The health department is also looking at suicide attempters, but of course the role of the coroner is only when there's been a death. As part of this research, we'll be conducting interviews with families and friends of the suicide victims to understand their difficulties and problems, including whether or not the person was an abuser of alcohol or drugs and if these were contributing factors in their death.

We also work in cooperation with many agencies to provide data on the factors in sudden and unexpected death in addition to health and wellness. There are a lot of agencies that use the data we generate as part of our death investigations. Just a few that would have an interest in drug or alcohol deaths are Statistics Canada, the Traffic Injury Research Foundation of Canada, and the RCMP. A number of these agencies use our data to conduct research and inform their policy decisions around alcohol and drugs.

We've recently identified that the number of deaths as a direct result of drug use is increasing in New Brunswick. We're not talking large numbers in our case. We're a small province anyway. I think I said earlier we have about 6,000 deaths a year. Of those, we investigate about 1,400. But we've recently found, in 2000-2001, there were 11 people in New Brunswick who died as a direct result of the misuse of drugs, and these drugs would include anti-psychotic drugs or opiates.

This is an emerging issue in New Brunswick, and we're just beginning to monitor this trend. We do have an inquest announced for later this year--it's actually going to be held in May--into the death of a young man who died as a result of the misuse of prescription drugs. This inquest will address the circumstances of his death, and a coroner's jury will have the opportunity to make recommendations on how such deaths could be prevented in the future.

In addition, we've looked at other statistics concerning the role of alcohol or drugs in sudden death in New Brunswick. We found they are a significant factor in many sudden and unexpected deaths, particularly accidental deaths and suicide deaths. Over a three-year period, we found alcohol was involved in 12% to 20% of accidental deaths and 15% to 20% of suicide deaths, depending on the year.

We also looked at motor vehicle accidents and the incidence of alcohol use in motor vehicle accidents in New Brunswick in a particular year. We chose the year 2000. We found 33% of drivers, who were deceased as a result of a motor vehicle accident, were impaired at the time of death. Moreover, the alcohol level was twice the legal limit.

I have tried to give you a little picture of our role and some of the information I think might be relevant to this issue.

In summary, I want to say our investigations do demonstrate that alcohol is involved in as many as 30% of sudden deaths. Drugs, as a direct cause of death, are rising in New Brunswick. I think Mike is probably going to talk more about it.

We do work with other officials in the justice system, like the police. We also work with Health in particular to try to identify the deaths when they occur and to develop prevention strategies as to how we can address the problem.

We hope to learn from the work of this committee. We look forward to the report you'll be tabling this fall.

¿ (0910)

The Chair: Thank you very much, Ms. Kelly.

Now, from the Miramichi Police Force, we have Corporal Gallagher.

Corporal Mike Gallagher (Supervisor, Drug Section, Miramichi Police Force): Good morning. Thank you.

I did plan to come here this morning with a quick Power Point presentation for everyone to have a look at. However, I don't have it with me this morning. I did give some notes, on the way in, for you to have a look at. Hopefully, you have them. In the notes, there are some photographs that I did want to speak about this morning.

I'm here today wearing two hats. I'm the corporal in charge of the drug section for the Miramichi Police Force. As well, I'm the president of the Miramichi committee on prescription drug abuse. I may be speaking from both points of view this morning.

The first thing I want to mention is that the statistics I speak about are all Miramichi statistics. They're the ones I know about, the ones I'm familiar with, and the ones I have accurate figures for.

The Chair: Colleagues, the information is here. There are pictures and some words, but they're all in English. We would have to get them translated. Would you like them in English, to be translated as soon as possible?

We will endeavour to make sure you have them as soon as possible to work with witnesses in the future.

Thank you, Corporal Gallagher.

Cpl Mike Gallagher: In Miramichi, we first saw a trend in prescription drug abuse in 1998. Prescription medication has been abused since it was created back in the 1930s. In 1998, we in Miramichi first started to see commercial sales of the prescription medications.

In 1998, we saw Percocet as being popular on the street. Of course, Percocet is an opiate. It is fairly mild compared to some of the more powerful opiates. It first started to surface in 1998. Since 1998 and the present day, the number one drug of choice is Dilaudid-hydromorphone, MS Contin, and the morphine-based opiates.

In the handout I have photos of some of the pills to show you how small the pills are and how difficult it would be for police to locate the pills on an individual if they happened to be searching them. As well, I have a photo of a shooting kit. Again, we're seeing a lot of spoons and syringes on the street with youngsters, teenagers, and adults.

There are a number of reasons why we see an increase in the abuse of prescription medications. One reason is the profit. I have some prices to give you a rough idea of what the pills are worth on the street. Dilaudid at eight milligrams is $40 and four milligrams is $20. The morphine 200s cost $40.

If you look at a person who has a legal prescription and decides to sell some or part or all of the prescription, it's a way to make huge amounts of money. The photograph there is of just one of the drug raids we have done, probably close to a year ago, with some Dilaudid number 4s. In one container there were roughly 200 Dilaudid 4s, so at $20 a pill resale, one pill container could be worth as much as $8,000.

We're seeing an increase in violence directly related to the abuse of prescription medications. Looking at Miramichi statistics, I can say that and back it up because I actually have access to the files. We've seen a large increase in the amount of violent crime: home invasions, armed robberies.

Typically, in Miramichi we didn't see those kinds of crimes. We've seen the normal crimes. We didn't see home invasions until probably three years ago, and we had maybe one or two armed robberies a year. This year we have had three already. Each one of these armed robberies is directly related to the abuse of prescription medications, Dilaudid and morphine, and I can say that because these people are picked up and interviewed, interrogated. They have track marks in their arms; they're all shooting it with needles. The thefts or the crimes are to get money for their habits.

Typically, a home invasion involves going in to ask for money. Last month, we had one when they went in and asked for prescription drugs. This was an elderly couple. The female was slow, mildly retarded. Both of them were beaten severely with the end of a pool cue while the robber looked for their prescription drugs. What had happened is they were followed from the pharmacy. This particular gentleman believed they had Dilaudid in their house, and that's why the crime took place.

We're also finding a lot more used syringes on the street, which is a big concern in terms of hepatitis C cases. In Miramichi alone, the public health department, on average, is seeing two new cases of hepatitis C a week. When you consider our community of Miramichi is roughly 20,000 people, that's quite a large amount. A lot of it is younger people. Local statistics with the Miramichi city police show that in 2000 the patrol officers received 11 calls of found syringes. These would just be from members of the public finding syringes on the ground and calling in for the police to pick them up. We had 11 in 2000; last year there were 29 calls. They're being found in mailboxes--when the mail deliverers pick up the mail, they're getting poked with these syringes--on walking trails, and in public washrooms of the restaurants in the city.

Where are the drugs coming from? The vast majority of these drugs are legal prescriptions that are being sold. Dealers will seek out--for lack of a better word I use the word “compassionate”--doctors. There's a lot of role-playing going on with the doctors. These patients are smart individuals. They know how to manipulate the system. They know the symptoms and signs to get these powerful medications, such as Dilaudid, what pain would make sense for them to display to the doctor to get these prescriptions. And then the prescriptions are being sold. We have at least two doctors in the province of New Brunswick who have asked to be removed from the list authorizing them to prescribe narcotics. In each case the doctors just didn't want to put up with the intimidation and the clientele they were seeing seeking narcotics.

We're seeing cases of double-doctoring in the province. In Miramichi we had one individual who was seeing eight doctors at the same time across the province of New Brunswick. Unfortunately, in New Brunswick, we have no central database linking the pharmacies together or the doctors together. We see that as a huge problem.

In another police investigation we did, we had one gentleman receiving 2,300 morphine tablets every 26 days. That would be 88 pills a day. In this investigation--and I'm not a medical doctor by any means--the amount of pills seemed high to me, and it seemed high to some of the doctors I've spoken with. But that's what's going on, and at present in the province of New Brunswick we have no way to police or know what's being prescribed out there by the doctors.

British Columbia has a system, PharmaNet, with a database where there are records kept of the amounts the doctors are prescribing and which patients have them. If a patient goes into a Shoppers Drug Mart in Newcastle and then goes to one in Chatham, it's going to come up on the computer that he's been to the other pharmacy and what they've been giving him for prescriptions. At present, we don't have that. It's basically wide open in the province of New Brunswick now, as far as medications go, where there's no record kept. The pharmacies of the same chains aren't even linked together.

¿ (0915)

Why the increase in popularity? Well, prescription drugs are very popular among the users because they're viewed as safe. For users buying cocaine, when police seize those substances, very, very often they find they're cut with other substances.

The number of overdoses in the Vancouver area from heroin is oftentimes caused by the purity not being consistent with the heroin the user has used before.

So the users see prescription medications as safe. They're controlled. They're produced in a controlled factory. They're monitored. They're safe. And when you get a round capsule or a tablet with an “8” stamped on it, you know it's a Dilaudid 8 and you're going to be safe with that.

It is very difficult for police and medical practitioners to see legitimate from illegitimate uses. When they're being prescribed, the doctors can't read minds. Of course, medical drugs and non-medical drugs can both lead to abuse, and sometimes we seem to forget that prescription medications are being widely abused.

At the high school level we're seeing a real problem, not just with the opiates but with just about everything: Pyranol, Valium, Ritalin, Tylenol IIIs. I think it comes down to the fact that there are profits to be made.

Medications are taken in three different ways: orally, intravenously, and snorted. We see at the high school level most commonly they're being snorted. At the street level they're most commonly being shot with syringes.

The statistics from Health Canada are that with intravenous drug users, 70% of them are hepatitis C positive. With the statistics in Miramichi, we can confirm that those figures are indeed accurate.

To sum up, as a committee in Miramichi we'd like to have the governments--both provincial and federal--look at three different avenues: regulation, education, and treatment. Again, we realize we can't regulate the drugs without having systems in place to help those who are already to the point at which they're using.

We'd like to see a central database to monitor controlled drugs.

I brought with me a copy of the Criminal Code of Canada. Of course, those are the federal laws governing the whole country. In the back of the Criminal Code is a section called the Controlled Drugs and Substances Act. All of these powerful prescription medications I spoke about are listed here as being controlled drugs, and right now--at least in the province of New Brunswick--there's really no control on those drugs.

We'd like to see a central database to monitor these controlled drugs. We'd like to see the doctors assisted with training when issuing prescriptions. Currently in the province of New Brunswick, doctors don't have post-graduate training in these medications. Prescription drug companies send salesmen to all the doctors to show them the new drugs that are popular now, that are being used now, and that's what is being issued.

I'd just add, on our committee in Miramichi we have doctors, pharmacists, social workers, and addiction service counsellors, so we have a wide range of expertise there to come up with these regulations.

Our education, of course, needs to educate health professionals, government, youth, etc., about the dangers of prescription medications. There is information out there about cocaine and heroin, but about prescription medications the education is few and far between.

Most important, probably, is to make sure we have current, accurate information when speaking to groups. Right now I have to stick with the Miramichi statistics because that's all there is out there that is accurate. We have to get together as a province, as a country, and get some more accurate statistics on this.

Finally, I would like to see treatments in place for those affected. Commit the resources. There is a methadone program in New Brunswick. I believe there are 18 or so doctors licensed to dispense methadone; however, there is only one I know of, in Moncton, who is actually doing so to the people with drug problems.

Thank you.

¿ (0920)

The Chair: Thank you, and thank you very much for giving us the local scene. It's really terrific.

Now from the Halifax Regional Police Drug Unit we have Sergeant Larder.

Sergeant Rosco Larder (Halifax Regional Police Drug Unit): Thank you, Madam Chairperson, committee personnel, and the other guest speakers here.

I'm Sergeant Rosco Larder with the Halifax Regional Police Drug Street Unit.

I've basically broken my speech into different categories, actually to make it simpler for me.

The first aspect I'm going to deal with is the geographic location of the province of Nova Scotia and the city of Halifax. I think most of us know that the province of Nova Scotia is very attractive to tourists. Unfortunately, it seems to also make it a target for drug dealers.

Our province has, like Newfoundland and New Brunswick, a considerable amount of coastline. This leads to importation dealing with offloads from large, what we call “mother ships” onto small pleasure craft, which are either dropped from isolated islands along our coastline or at some of our small inlets. They're then picked up by contacts on shore and in most cases shipped off to central Canada--Montreal, Toronto--where most of our organized crime is. Then it's shipped throughout Canada.

Also, as a port city, we have two container piers within our facilities, and certainly they facilitate the importation of drugs through containers from source countries abroad. I know--probably reading the news--that every couple of months we make fairly substantial seizures from our port through containers, here as well as in Montreal and B.C. It's certainly a degree of concern to us.

We also have Halifax International Airport in close proximity to our metro area, approximately 15 minutes away. However, we've found that since the security measures after September 11, there certainly has been an impact on domestic as well as international importation. Up until last September, it was fairly common for persons flying from here to Toronto and Montreal to suitcase the drugs and fly back here. Certainly, most domestic flights up until the last while wouldn't even have been X-rayed. So unless a dog detected someone bringing stuff from one airport to another.... And in Canada, it was a pretty good chance you'd have a safe flight. That obviously has changed somewhat.

At our international airport...a lot of our designer drugs such as Ecstasy are notoriously shipped in from Europe, obviously, since the scrutiny at the airports. Of course, the organized crime people in many cases are a step ahead of us, so they've probably set up their own labs now in central Canada, where a lot of the Ecstasy is produced, as well as in B.C., and it's shipped down through here. I know of a couple of cases where we've intervened with shipments coming through New Brunswick, and there have been a substantial number of seizures of Ecstasy headed for our city.

We also have links with the U.S. through the Yarmouth ferry and the various cruise ships that come to our port. Again, I think the disaster of September has impacted on this, but it is still there. I know the number of cruise ships visiting our port cities here and in New Brunswick has increased drastically. Each of those ships has several thousand people on board, so you can imagine the amount of drugs that they could import into our provinces probably without a lot of intervention.

Also, drugs can be brought to our city by bus, vehicle, and railway--certainly they all have links to central and western Canada. For those dealing in the drug trade, to pick up, let's say, cocaine from Montreal, it's a 12-hour drive. So if some of our local organized crime members are going to get drugs, it's just a 24-hour turnaround. They can drive up there and drive back, and unless they are unfortunate and are part of an investigation, it's a pretty safe bet they're going to return with their drugs unchecked.

Next, I'll just briefly touch on our organized crime elements. We have a chapter of the Hell's Angels here in Metro. Some of our local members are of high national profile. Certainly, as members of Hell's Angels they have international contacts throughout the world that will assist in any type of importation into our country and our port city.

Also, in the metro area we have well-organized and established groups involved in importation and the interprovincial drug trade. By this I mean they're organized such that they will pool their moneys, go to one of our central cities, make the drug deal, and return to our city.

¿ (0925)

The next aspect I'm going to deal with is what I consider the two most common drugs of use here within metro. Since I deal with a street-level force unit, we certainly see this firsthand. As is probably the case across Canada, certainly the number one drug of choice seems to be cannabis-marijuana. It's one drug that seems to be commonly used by both sexes and all age groups.

There has been a very noticeable increase around the schools, as some of the other speakers have spoken about. It's of grave concern to me as a member of the community, a parent, and someone in law enforcement.

In the last few years we've actually run our own UC operation at one of our local high schools. The results of that were sort of eye-opening at the time.

We've also found we're now dealing with a lot of sophisticated hydroponic grows dealing specifically with cannabis-marijuana. It is probably the most profitable drug of choice for those dealing in the illegal drug trade.

Many times we have found, through searches and dealing with sources, that regardless of what kind of money the drug dealers or growers put into the equipment, pretty well after one harvest the equipment, time, and money they put into it is recouped. When you consider that a grow takes between two and three months to harvest, you can see it's very profitable.

Certainly here in metro we've noticed an increase in the number of grows we've come across, and not just the elaborate types of grows. When I started as one of the NCOs in the drug unit five or seven years ago, most of them were what we call earthen types. The yield from that type of grow isn't that great, and obviously it's the same as growing outdoors. The elements affect it fairly substantially. However, with these new hydroponic grows, they almost control the growing elements, so they can get the best yield from the grow operation. Also, by having it indoors, most of it's sort of out of sight, out of mind.

The other day I was looking to buy a house in one area of metro. Right down from there they arrested two young teens breaking into the house. We were lucky enough that a concerned citizen stopped, and of course in the back they had a bunch of cannabis plants. When we went back to the house, we found they had a grow operation in the basement.

It seems to be the type of operation you can set up almost anywhere. It can even be a large industrial business. Without getting into too many particulars, we took a large one down in the last several years. It's still before the court so I can't get into it too much, but it was pretty well an entire business set up just for a grow operation. So we're running across a variety of set-ups, from the extremely large to ones set up in bedrooms.

They have it so down pat today. The trays we're coming across are 8x4, and they can buy them in a kit. It's about $500 for the kit, and the yield from that is fairly substantial. For these hydroponic grows, we find they're also stealing the hydro.

The next obvious choice of drug, which is probably our most problem drug out there, is crack cocaine. I think everyone around the table knows it's very addictive. We've found the highest usage in the adult male population. The problem with this is the violence associated with its consumption. From our in-house stats I ran off yesterday, just in the last 12 months there have been 326 reported robberies with violence. A lot of those are indirectly related to substance abuse, and a great majority of those in our community would be related to crack cocaine. It seems to be the drug of choice.

When they're out, they don't seem to care a lot about the consequences of their crimes. I think we all know it certainly affects their families, home lives, work, and financial lives.

¿ (0930)

As a drug unit, we try to attack this problem on two fronts. One is with the UC operations. I find this probably would be our best method to try to deal with this type of problem.

One of the big issues is identity. Whenever you have an undercover officer or agent in the field, identity doesn't seem to be the issue. We get many early pleas. The courts seem to give longer sentences for people who are charged with trafficking. They're affordable for us to run at the street level. There's not a large cost involved.

The biggest cost is probably when you start dealing with mid-level dealers and there's a security issue. Then you're starting to deal with the relocation program. That's one area of concern. I know that to assist me and drug enforcement personnel is certainly very costly to our department.

I'll briefly touch on some of the areas where we would like to have some assistance. For people like repeat offenders, many times I'd like to see a reverse onus on them. Many times the people we're dealing with today, when you check the record, we've dealt with two and three times.

The other thing is that when we make money seizures, it would be nice to see that money brought back to the police force involved. We could use the money to further fight organized crime and drugs.

¿ (0935)

The Chair: Thank you very much, Sergeant Larder.

I'll now turn to colleagues for some questions.

Mr. White.

Mr. Randy White (Langley--Abbotsford, Canadian Alliance): Thank you very much for your presentations. I found them very interesting.

Mike, I think you changed my mind. I was tending to lean away from the issue of prescription drugs, but you've changed my mind on that.

I have three questions that are going to take too long so I have to find a way around this. This committee is responsible for making a report to the House of Commons in November on a variety of issues about drugs, anywhere from legislation, to enforcement, to harm reduction, rehabilitation, education, funding, polling, goals, prisons, and prescription drugs. This morning at some point I'd like to get from each one of you the two priorities you would have, as individuals in your respective areas, for this committee. I don't ask you for more because it would take too long. But at some point this morning I would like to get that out of you.

There are two driving questions here that I have. Let's cut down on your workload here. Let's legalize marijuana. That way you don't have to go chasing two and a half tonnes. You don't have to spend the time on grow ops. I've been on lots of busts with police in grow ops. In my community you could hit a grow op every night and still not get them all, all year round. Why not do that? Let's just legalize it and get you guys concentrating on cocaine and heroin, and those other things.

The Chair: I'll start with Sergeant Skanes.

S/Sgt Jim Skanes: Personally, I have struggled with this question over the last little while. Legalization is not an option for me. That's Jim Skanes' viewpoint, and I think it's the RCMP's viewpoint at this point in time too.

Decriminalization might be a better approach. Again, I think that's an RCMP viewpoint. I think I can work pretty well within that framework, if that should occur.

The Chair: What does it mean to you then?

S/Sgt Jim Skanes: What does it mean to me?

Mr. Randy White: Decriminalization.

S/Sgt Jim Skanes: Basically, we're going to make it a summary conviction offence, a ticketing offence, if you like.

Mr. Randy White: For a small amount?

S/Sgt Jim Skanes: Yes, for a small amount. To a large extent that's happening today in any event.

Mr. Randy White: It's already occurring?

S/Sgt Jim Skanes: To a large extent. In a few instances, we're still seeing some prosecutions for a small amount. I think that's pretty much a rarity, as opposed to the general rule today. I can think back to the seventies when we were vacuuming carpets for seeds in order to be able to lay a charge. Today, at least in my experience, that doesn't happen any more.

I think if we're going to go the route of decriminalization, to espouse the RCMP viewpoint, some other things have to fall into place--the balanced approach that's been put forward. A big part of that balanced approach involves the things Michel has been talking about: the awareness programs, education, the treatment programs where they're required. It just can't be, “We're going to decriminalize.” We have to put some resources into other areas, whether it's health, or awareness and education, or treatment.

¿ (0940)

Mr. Randy White: “It's part of the big package” is what you're saying, really.

S/Sgt Jim Skanes: Yes, but it has to be a big package, for me, to make it a workable solution.

The Chair: Do you have something you want to move to?

Mr. Randy White: I do, but I just want to get something else in here first. Time is of the essence.

Drugs are on the rise; there's no question about that. Every one of you basically said that. I think, Mike, you expounded on that in prescription drugs, and so on.

There are many who might say you're not doing your job, then. Why give you more resources? You have perhaps 80% of all the federal resources into enforcement today, so why give you more? Why not look for other alternatives? Why not give you less? If you can't stop this system with what you have, how much would it take for you to stop the rise of drugs? It appears it's not going to be stopped. The more you work at it, the further the bad guys seem to get ahead of you, and the more there's trafficking, and the more drugs hit the system. What can you do if more money goes your way?

The Chair: Mr. Frenette.

[Translation]

Sgt Michel Frenette: First of all, talking about legalization as you are doing this morning is a good way of dealing with the issue.

My view with regard to what Jim was saying can be summarized as follows. It is true that we have a national policy that we must follow, but if we are talking, for example, about legalizing drugs, then there must be a reduction in the workload. Given the success we have had with drugs that are presently legal, alcohol, for example, I have serious questions as to what we will get out of it if we legalize another substance, given, especially, what Ms. Kelly told us this morning, more specifically that 33% of traffic accident deaths are attributable to alcohol consumption. It seems this would make the situation even worse. Also taking into account Mr. Gallagher's statement with regard to drugs that are already controlled and the results we are getting in our fight against drugs, it seems we are not very successful.

In the third part of your question, you ask what we would do if we received a big pile of money tomorrow morning, if we received a lot of resources for enforcement and all of the other prevention activities. There is one thing I would like to draw the committee's attention to. In this country, we have been very serious up until now with our education efforts. We are devoting our efforts to education in order for people to get beyond primary prevention. The role of those in charge of drug awareness is to do primary prevention.

In Canada, at the present time, the RCMP has 34 permanent positions. British Columbia has 17 or 22 of these. There are therefore 14 of them left for the rest of the country. If we were really serious about prevention, it is at that level that we could really make a difference.

I have 24 years' experience as an RCMP officer. I worked at street-level. I worked in general police work and I worked in major crime. With Canada's Drug Strategy, that goes back to 1987, there was a decrease up until 1994, according to the polls that were carried out in schools. But since 1994, Canada's Drug Strategy has not carried the weight it should have. We have made gains, but there has been a relaxation. Not long after the beginning of this relaxation, we noted results such as those we are seeing today.

In my view, if we were serious about prevention... We talk about a balanced approach. I believe that the balance is leaning a little bit more towards enforcement. If we are unable to reduce the demand as we should as a country, how are we going to succeed in controlling the supply of drugs?

We are seeing this now. We heard representations this morning about prescription drugs. I myself have some knowledge about this. Mr. Gallagher has statistics. I do not have any for the province of New Brunswick. But if we place more emphasis on prevention, I am truly convinced that within this balanced approach we would be able to make a difference. But we have to begin... I should not say begin, because we have already begun. Simply, there was some slackening off along the way. Today, we are placing more emphasis on prevention and treatment. When we talk of secondary prevention and even tertiary prevention... As to the tertiary level, there are perhaps a lot of people here today who will speak about this. We discussed it a little bit this morning, during the break. We talked, for example, about methadone programs, about needle exchange programs and other things like that to reduce harm.

I believe we have a lot of work to do. We must be successful with our work in primary prevention. The RCMP and other police forces are involved in this type of prevention with young people who are still at school. But these efforts must continue. We present the DARE program to fifth and sixth grade students. Some people will say that this is not working whereas others will say the contrary. But to have the program work is not sufficient. One cannot only stay in school until grade six and then be successful. There must be a continuum. This continuum could be realized if there was funding and if the funds were accompanied by proper direction.

I am thinking about leadership at the national level that would have a presence in the provinces and the regions. I am convinced we would be successful. I have been doing awareness work with people for seven years. I continue to fight because I have seen the people Mike, the coroner and others around the table have talked about. I have seen them when we have gone to the scene of an accident, when we have been called in to deal with a domestic situation, major crimes, murders, in the presence of the family of the victim and of the accused. When we see that the common denominator is substance abuse, this gives us the fire we need to go on. With funds and national direction, we could truly make a difference. Yes, we could succeed.

Thank you.

¿ (0945)

[English]

The Chair: Thank you. Merci beaucoup.

We're way over time.

Mr. Randy White: But you took all my time.

The Chair: You took all your time.

[Translation]

Sgt Michel Frenette: This is an issue I am passionate about.

[English]

The Chair: Our challenge this morning is really going to be how we manage. We'll go till about 10:40, but if I can get my colleagues around the table to be very succinct--one question, then we'll get answers--it will go a lot smoother.

Monsieur Ménard.

[Translation]

Mr. Réal Ménard (Hochelaga--Maisonneuve, BQ): You know me, Madam Chair. I will get straight to the heart of it. My first question has two parts to it.

I believe that one of the concrete recommendations this committee might make would be to follow the suggestion made by Mr. Gallagher and to talk about a database. I know that the police have access amongst themselves to a common pan-Canadian database. When I sat on the sub-committee dealing with organized crime, this was explained to us. What do you have in mind? What type of information would you like to see in this database and who should play the leadership role in order for this to come about?

That is my first question, and I have three others. I would be pleased to hear what you have to say about this.

[English]

The Chair: Are you asking everybody?

[Translation]

Mr. Réal Ménard: No. My question is for Mr. Gallagher, who made a recommendation with regard to databases.

[English]

Cpl Mike Gallagher: First, I think a provincial database for each province would be sufficient. I would like to see a federal position supervise or monitor the system. The information I would like to see in there would be the prescribing doctor's name, the medications prescribed and their amounts, and the pharmacy that fills the prescription.

Cpl Peter Keirstead: May I speak on that for a minute? I'm involved in the Prescription Monitoring Association of Nova Scotia. I'm a member. There are dentists, doctors, lawyers. It has had a database for a period of time, but there's a big problem. There's a catch-22. That information cannot be released to the police without doing it illegally. So how do you get a search warrant?

I, for one, like my rights. I don't know if I want the government keeping records on my health care. From that aspect, if the government proposed something like that, I think it would be very hard to get past the Canadian public. There has to be some way around it.

When this monitoring group meets, the surprising fact that comes up time and time again is the prescribing. It's a big problem. It's very few doctors who do most of the prescribing. It's usually one, two, or three doctors who are prescribing the large amounts. Maybe that's a way it could be looked at.

But I don't think it's simple. This is what we ran into in Nova Scotia. It's not as simple as saying we get a big database and put all the prescriptions that are written in there. To be truthful, I don't think the government should be keeping my medical records somewhere for that type of purpose.

¿ (0950)

The Chair: Just to clarify, I think you said, Mr. Gallagher, just the doctor and the pharmacy, and not the patients. Is that correct?

Cpl Mike Gallagher: The patient's name would be in there as well.

A voice: It has to be.

The Chair: Okay. Monsieur Ménard.

Sgt Rosco Larder: Madam Chair, could I add a comment as well?

The Chair: Yes.

Sgt Rosco Larder: I've been involved with the same committee in the past, and I know the committee was set up basically to monitor the prescription usage and the doctors as well. When I was there, my understanding is that part of the panel or committee was to hopefully deal with the doctors who showed they were abusing the situation or were not taking steps towards correcting it, if there was a noticeable problem there, through this program.

When I was there, and I was involved with it for a couple of years, I can honestly say I never heard that any doctor was spoken to or had letters directed towards him regarding his practice. That to me was always a sore point, because that's what it was set up for, and I wondered why they weren't doing it.

The Chair: Merci beaucoup. Monsieur Ménard.

[Translation]

M. Réal Ménard: I believe that our witness... I know that you will take his intervention into account in your allocation of time. It is your social-democratic side that endears you to us.

[English]

The Chair: I'm being tested, but yes.

Ms. Kelly.

Ms. Dianne Kelly: I was just going to say I think a database is certainly something worth considering, but it isn't the only solution. I think one of the challenges, particularly with prescription drug medications, that we're looking at now as a result of what we're doing is that sometimes there are legitimate needs. Doctors have the challenge of identifying the patients who have legitimate needs and those who are faking.

I think part of the solution there is education of the doctors, not only about the medications they are prescribing and the addictive properties in them, but also to help them understand the point at which they may want to reassess the treatment regimen with the patient.

We're just exploring this now, but there are guidelines available to doctors to help them identify that problem, and to identify when the patient may be going too far down the road.

So education is another avenue, I think, but also educating the patient about the potential, because lots of people may not start out with the intent of becoming addicted but don't realize the addictive properties of some of the prescription drugs they are taking.

I think there isn't a single solution. It has to be multi-faceted.

[Translation]

Mr. Réal Ménard: Very well. Might I ask my second question? It seems that there is something concrete here that the committee might suggest.

Mr. Gallagher, you mentioned that Dilaudid is a drug that is very popular here. I am not very aware of its characteristics, of its effects. Could you give us some explanation about this? Having gone to Toronto, Montreal and elsewhere in Canada, I have the distinct impression that this is specific to your region as far as prescription drug use is concerned. Is it because it is much more difficult to find other types of drugs? Have you done comparisons with the national average? I have the impression that this is really specific to your area of the Atlantic region. How does Dilaudid fit it with all of the other drugs that are available?

[English]

Cpl Mike Gallagher: To start off with, the abuse of prescription medications does seem to be more of a rural problem than an urban problem. Dilaudid is an opiate analgesic. It's for moderate to severe pain. We see it typically in the Atlantic region. I have information from the Calgary region, but it seems to be more popular in the rural areas where heroin isn't as prevalent. Heroin is diacetylmorphine. It has very similar characteristics to Dilaudid in potency. People often refer to it as synthetic heroin. That's not an accurate statement, but it is diacetylmorphine and has a very similar chemical make-up to heroin. As far as strength, we can compare it and some of the other morphine--the MS Contins--to heroin. The addictions we're seeing are similar to heroin addictions, and that is why we have an increase in violence.

¿ (0955)

[Translation]

Mr. Réal Ménard: One final question, if you will allow me, Madam Chair, small but nevertheless important.

Most of you are convinced that it would be a mistake to legalize access to drugs, beginning with marijuana, but eventually extending that to other drugs as well. Yesterday, there was a panel whose viewpoint was exactly the opposite of yours and whose main argument was the following: 12 of the 15 countries in the European community have decriminalized cannabis, but it is not in these countries that there has been an increase in use.

For example, as we were told yesterday, if we compare European countries and the United States, we see that there is a lot more drug use in the United States. How do you react to that type of argument?

Sgt Michel Frenette: We look at the different studies or more particularly the different polls for which we have statistics. When we look at drug use by young people, we see that the increase is mostly for those aged 14 to 18, rather than in the adult population, and these are facts that we have documentation on.

Mr. Réal Ménard: In Europe?

Sgt Michel Frenette: More and more, with young people; this is a fact. Now, if we are talking people, you have before you a group of policemen, and that is our territory. As for the process, when we see things in the street, and at all other levels... I believe that are very few people who have the privilege to see what happens as we do, in all areas. Some people see it at the medical level or at the social level, but as police officers, especially in the smaller provinces or in smaller communities, we see the incident in the person's home, then we see the process before the court and we even sometimes see the death and the autopsy.

When we talk about legalizing drugs and when we see that the drugs that are already legal are the greatest burden on the country... Take for example the study done by Mr. Eric Single and published in 1996: we are talking $18.4 billion; 51% of all socio-economic costs are related to tobacco use and 40% to alcohol. As a society, how can we say that if we legalize yet another substance, the effects of that will not fit in with the data we already have here? I have difficulty with that idea, because I believe that if we make certain drugs available or liberalize access to them, the effect will be mathematical. I am not inventing anything.

Mr. Réal Ménard: But you are forgetting one argument: one of you mentioned the auditor general's report. You must tell us what the effect of that would be on the black market. As a matter of fact, you are the people who at one point stated that when there was a national strategy, there was a drop in use. But there has not been a national strategy since 1994, but 90% of resources are put into the fight against drugs. Do you not believe that legalization would free up the resources that you would no longer have to devote to prevention work?

Sgt Michel Frenette: I believe that the only way to combat use recurrence is to first of all make people aware of the consequences of taking drugs. Earlier, I believe there was a question put to Mr. Gallagher with regard to national percentages. I have comparative national data.

For example, when you look at the national rate, you see that there has been a 300% increase in prescribed Dilaudid, nationally.

In New Brunswick--in Miramichi, St. Stephen, Bathurst--, as in Flin Flon, as in anywhere in Canada, there has been a 300% increase from 1996 to the year 2000. That comes directly...

Mr. Réal Ménard: Could you table this data with our researcher?

Sgt Michel Frenette: I do not have it here, but I will be able to get that for you. As for those prescriptions, those prescribed drugs, the company that produces the drug keeps an official tally. It is available. Perhaps it is more visible in certain regions. I could not compare the situation here with that of other provinces, because I do not work in other provinces, but this data is certainly available. Therefore, if we say that we are going to legalize another product that is presently illegal, might the numbers reach those same levels? With all of the math behind this, with all of the research data we have, the answer is yes.

À (1000)

The Chair: Very well. We will look for the statistics you have mentioned. Do you also have the study on marijuana use by young people?

Sgt Michel Frenette: Here, in New Brunswick?

The Chair: No. You stated that young people between the ages of 14 and 17...

Sgt Michel Frenette: Yes, I can get the data on that. I do not have that information here, but I can get it at the office.

The Chair: Fine. Thank you.

Libby Davies.

[English]

Ms. Libby Davies (Vancouver East, NDP): Thank you, first of all, for coming this morning. It has been a very interesting presentation.

We've had quite a few presentations from our law enforcement agencies. The level of frustration you experience in trying to carry out your work becomes very evident.

One of the concerns I have is it seems to me the reality we're facing is there has to be a recognition that in the strategies we've had in place, the traditional approaches have actually failed. We are seeing a deteriorating situation.

I have concerns right now about the idea that police officers are teaching parents to look for signs or symptoms, as you said, of drug abuse in children. It seems to me that if we understand this is a health issue, why would we have police officers doing that? I think sometimes the resources are misplaced. However, it's only an opinion. I know there is a lot of debate about it.

I wanted to focus on the question of enforcement and how much emphasis it should be given. It seems to me we've repeatedly heard that departments would like additional resources provided. A number of you mentioned it today.

Yet we can look to other models where there has been success. We are hopefully going to be visiting some European cities. It was actually the police departments in Frankfurt and Zurich that led the movement, or the call, for a different kind of approach. They realized the traditional criminalization enforcement approach was simply creating more and more of an open drug scene. They couldn't control it and took some very drastic measures. As a result, they saw crime decrease by something like 65%. They were able to then focus resources more properly on dealing with large trafficking issues.

It's really the question I have. I feel frustrated. In the RCMP, not so much individual officers, who have a very pragmatic approach, but as an overall operation, there's this box. You can't get out of the box. We continue the pattern, and the so-called war on drugs is a total loss.

Sergeant Frenette, particularly, is very vocal on the issue.

Have you actually examined what has happened in some of the European experiences from a police perspective? Have they actually had some very dramatic results?

Sgt Michel Frenette: First of all, I think you have three components in your statement. We talk about police officers going to talk to parents about symptoms, and also about communication between the parents and their children. The parents are normally the ones making the request to the police. We have to be prepared to answer the issues with the parents.

I think they're asking the police, as I explained previously this morning, because of the broad exposure we have on different social problems in communities and because we are also available in smaller communities and larger communities in different places.

When we look at the European cities, if we talk about Frankfurt, for instance, and some of the reading I've done on it, one of our drug awareness coordinators in B.C., Staff Sergeant Chuck Doucette--

À (1005)

Ms. Libby Davies: He doesn't support what they're doing.

Sgt Michel Frenette: Actually, what happened is, according to his visit to Frankfurt, their legislation is a little different from what we have in Canada. So of course there was a drastic diminution of some of the problems involving, for instance, the safe injection sites when they came on board in 1994 and all that.

But previous to that, with the legislation they had, the way I understand it--I haven't been there; I'm just doing this from the reading and the information that was transmitted to me--the police forces down there have some legislation where they could expel the people who were not local residents of Frankfurt, and they were not able to come back, maybe similar to the type of immigration laws we have in Canada, where if we do expel someone, they have to be at least one year outside the country.

As I said, there are some variables there that might not be similar to the ones we have in Canada. So that could be one of the things.

The thing about the “war on drugs” is that I think this is an American statement that was probably brought forward to Canada through the media, because to say we had a “war on drugs” in Canada...personally, I haven't seen it yet. If it's there, I haven't seen it, because the strategies we had in place were not, to my knowledge, strong enough to classify them as a war on drugs. I know the term is being used, but in actuality, I don't think I have seen a war on drugs in Canada as of yet.

Right now, we have a “war on terrorism”, and we've seen the actions that are being taken. But if we talk about the drug issue, I don't think we have a similar thing. I'm not seeing it. Maybe I'm missing the point, but I haven't seen it yet.

Ms. Libby Davies: Ms. Kelly, I'm interested in the fact that you have seen an increase in the number of deaths. I don't know whether it's from drug overdoses or.... I can't remember quite how you explained it. Is the coroner's office at all involved in any kind of education?

For example, I know in B.C. we ended up with a situation where the leading cause of death for men and women between 30 and 44 years of age was from drug overdose, which is quite astronomical.

The coroner's office was actually very instrumental in bringing forward recommendations and proposals to say that these deaths are preventable through various measures. I just wonder whether or not, as a result of your work, you've been able to examine that at all.

Ms. Dianne Kelly: I think I described our problem as an emerging one, and quite a contrast from B.C. There are different demographics there. If you look at their statistics, I think there is a lot longer history of problems of this sort than there is in New Brunswick.

We have recognized, though, that it is a problem, and the cases I was describing are prescription drug problems, by and large. It doesn't mean that would be exclusively prescription drugs. In some of the cases, they certainly were involved in illicit drugs as well.

But that's what we're identifying as a trend, which is surprising, the extent to which prescription drugs are causing death. We certainly would want to pursue the kinds of things British Columbia has done. We certainly work in collaboration with the coroners' offices across the country.

But at this stage, all we're really doing is recognizing the problem. We haven't really developed any strategy as to how to address it. I've made reference to the fact that the inquests we'll be holding later this year will be one avenue--the work that is being done in Miramichi and I believe in St. Stephen as well, on a comparable problem there. We'll work with the law enforcement community to identify the extent of the problem, what are the factors, what we can do about it. Definitely our interest is in preventing death.

But I have to defer to these people, who have far more experience than I do with the issue of whether or not drugs should be criminalized, decriminalized, legalized, or whatever, and the consequences for law enforcement.

But when you look at the problems I'm describing with prescription drugs, these are legitimate drugs that are being used in inappropriate ways. So sometimes whether or not the drug of choice is legal or not is really not the only problem. I think that's why you have to look at a more multi-faceted approach. I think my description about education and treatment also have to be factors.

Do I have more time?

À (1010)

The Chair: One minute to make a statement, I suppose.

Ms. Dianne Kelly: Okay, I'm sorry.

The Chair: We'll have to come back to you on another round.

Mr. LeBlanc.

Mr. Dominic LeBlanc (Beauséjour--Petitcodiac, Lib.): Thank you, Madam Chairman.

[Translation]

I have two rather precise questions. I will try to leave some time for my colleagues.

I would like to follow up on a comment made by Mr. Gallagher. Mr. Frenette, in our region, as we all know, there are a lot of small rural communities. I would like to know if your police force does prevention work in the schools and what types of programs are in place. I wish to congratulate you, because I believe that as a police force you are doing a lot of good. But in which way should we attack the problem in the smaller communities? Do you have the means of redefining the programs or the opportunity of seeing your resources increase? Is it true that your circumstances or your way of operating are different? Give me a little picture of the situation in the small rural communities compared with the larger cities of our region, such as Halifax, the largest city in the Atlantic. We understood through Mr. Gallagher that in the Miramichi, for example, circumstances are perhaps different, and it is perhaps the same for Caraquet or Cap-Pelé. Could you therefore explain to me how you will go about taking into account the various regional differences? It is obviously a matter of resources.

[English]

And another question for Mr. Larder.

Today is the 20th anniversary of the Charter of Rights, so it's kind of fun to have a panel of law enforcement officers talking about some of the challenges. I am curious, on the 20th anniversary of the Charter of Rights, how you would make a reverse onus work for repeat offenders.

Sgt Rosco Larder: That's why I bring it to you.

The Chair: First, I'll have Mr. Gallagher answer the question.

Mr. Dominic LeBlanc: Sure.

The Chair: Not the charter question, the other question.

[Translation]

Mr. Dominic LeBlanc: No, but it was also a question for Mr. Frenette.

[English]

The Chair: Okay, Monsieur Frenette, then Mr. Gallagher and Mr. Larder.

[Translation]

Sgt Michel Frenette: I will answer. It is a very good question. At the present time, as I stated in my introduction, when I made my presentation, we work in partnership. Be it in a small community or in a large one, I believe that the only way to improve prevention, which is my field, is to work with the communities. In that regard, I believe we have gained much ground. Recently, in other words since 1998, since the establishment of the National Crime Prevention Council, we have worked with our communities.

But my role with the RCMP, in New Brunswick... I am perhaps privileged, because it is not a large province. If we had a little bit more in the way of resources for prevention, this would allow us to strengthen these ties and to do follow-up work. Often, we set up wonderful things in the communities, but, whether we like it or not, the police is the catalyst for these small communities in the regions, and it cannot be present all the time. It is the same as in other areas: if we want to ensure long-term success, we must continue to reaffirm the ties and to develop them with different partners, be it in the area of health or of education, because each small community has its school. That is our basic link.

Therefore, within the RCMP, I work with our schools, with our clergy, with our social groups, with our Lyons Clubs, our Nights of Columbus in the regions. All of those people, all of those Canadians have a deep interest in the welfare of our children, who are our most important resource. This would not require that much more of an effort, but it is the follow-up that counts.

We must begin to sensitize youngsters at the primary level and maintain that action until they reach college and beyond. If we succeed in informing them in primary school, in grades 4, 5 and 6, and if we are able to convince them to not use illegal drugs or even to not use legal drugs in an abusive way, once they reach adulthood, they will be able to make these decisions by themselves. If such is the case, we will have accomplished our mission. But we still have some ground to cover before getting there. We are partly... [Editor's Note: Inaudible]... but I believe that this must be tightened to a much greater extent.

[English]

The Chair: Monsieur Gallagher.

Mr. Dominic LeBlanc: Did you want to add to that, Mike?

Cpl Mike Gallagher: No.

Mr. Dominic LeBlanc: Mr. Larder, your reverse onus.

Sgt Rosco Larder: Again, that's just my personal belief. I realize, you're right, it is the 20th anniversary. What I find today in our courts is that when you're dealing with people who have previous charges for subsection 5(2) of the Controlled Drugs and Substances Act, which is possession for the purpose of trafficking, those who are dealing with trafficking or those who are dealing with importation or cultivation, now it seems to be commonplace for the courts to say that if someone hasn't been before the courts and charged with a similar fact case in the last five years, then it doesn't really come into play.

I think when we're dealing with this type of organized crime individual, we should in many cases be going beyond the five years, because many times it's the RCMP who are running these investigations, and they have many years of resources put into these. It seems to be all too common that when you get to trial, if they haven't had a record for a number of years for the same type of offence, they seem to be going against it being used in court. But I'm a firm believer that if someone had been charged, especially with importation, in the past, then that should certainly weigh heavily on the sentencing today. Again, I only say reverse onus because I think there should be some onus on the individual as to why that shouldn't come into play.

À (1015)

Mr. Dominic LeBlanc: You're talking about that information being used in sentencing, not in actually convicting or reverse onus, for example.

Sgt Rosco Larder: No, you're right, in conviction.

Mr. Dominic LeBlanc: You're talking about sentencing?

Sgt Rosco Larder: Yes.

The Chair: Thank you. Did any one else have a comment? Mr. Skanes.

S/Sgt Jim Skanes: I've been listening to the conversation, especially concerning the resources going into the RCMP with respect to drug enforcement. I want to make the distinction that we're talking about two different things here, at least for our group.

You're right, significant resources go into enforcement and all aspects of drug work, and it's very costly, both financially and in terms of human resources. That doesn't necessarily mean that drug awareness has seen a whole lot of that money, as Mike suggested a minute ago. There are 14 of us across the country. I'm looking after all of Newfoundland and Labrador. It's a coordination system, and I do get some help from the detachment from the people at street level, but it's one person for all of Newfoundland and Labrador.

If we had the wherewithal, whether it was financial or human resources, we'd have a bigger impact. We're doing some, I like to think, wonderful work through the programs we have in existence right now. If we could drive this like the tobacco lobby is driving some of the anti-smoking things, we could have a much more significant impact on the whole drug issue.

So it's not so much that we need more money within the RCMP, although I'm sure that would be nice too, but I think we want to move some of the money from the enforcement sector to the awareness sector. That would be very useful from a preventative point of view and doing some things we would like to do.

The Chair: Dr. Fry.

Ms. Hedy Fry (Vancouver Centre, Lib.): I wanted to ask Mr. Larder specifically a question. In your recommendations you have suggested repeat offenders need to be held more accountable for their actions. What would you suggest one would do to make them more accountable? What are your suggestions for that?

Secondly, I don't know if Mike Gallagher, Peter Keirstead, or Dianne Kelly might be able to answer this, but I wanted to ask a question about the monitoring of the databases. I know that in some provinces, and I understand here, you have the triplicate prescription monitoring system. That was meant not only to pick up the physicians who were prescribing inappropriately, but it was also meant to pick up those who were double, triple, and quadruple doctoring--the patient who went to 12 doctors in a week and said, look at me, I have a terrible pain and you're my only doctor. That was meant to flag to the physician the particular person who was doing that so when the person came into their office they would know. This was also for the pharmacist, who would be able to say, here is Joe Blow or Mary Blow who is attending 12 physicians and getting 12 of the same prescriptions and obviously doing something wrong with them, and they would be able to stop them and not prescribe for them.

I would like to know why that isn't working. Has anyone monitored that, done an evaluation to find out why? It was meant to work on paper, and obviously it's not working in reality, so I'd like to know why.

Whoever wants to answer that one may, but the first question is obviously for Mr. Larder.

Sgt Rosco Larder: Dr. Fry, when I say they should be more accountable, even if it's for the public in the way they perceive it, if someone's being charged with importing or possession for the purpose, I think the sentence should show it.

I know, in many cases, it appears the benchmark is around two years for many offences. I think a repeat offender's benchmark should go up. I know at sentencing, in many cases, it does. I think they should be held more accountable. The fine should possibly be higher than it is today.

À (1020)

Ms. Hedy Fry: Did I misunderstand? When you say “repeat offender”, do you mean the user, the person who has simple possession, or the trafficker?

Sgt Rosco Larder: No. We don't deal with simple possession. It's not a part of our mandate at all.

Ms. Hedy Fry: You were talking about the trafficker.

Sgt. Rosco Larder: Certainly, the traffickers are what I'm looking at. It's not part of our mandate to go out and deal with people who have simple possession. We deal with people who are dealing with trafficking and who are growing it to sell it.

Ms. Hedy Fry: Thanks. I think I misunderstood.

Sgt Rosco Larder: I apologize.

The Chair: Ms. Kelly.

Ms. Dianne Kelly: Actually, at this time, I can't say with certainty why the process you're describing doesn't work. I think it doesn't consistently work.

From what we've explored so far, in terms of looking at the deaths that occurred in New Brunswick, it's too cumbersome.

There have already been a number of suggestions that the solution is for all pharmacies to be tied together. There should be a way for at least the doctor to recognize when other doctors may have prescribed drugs. The information should be shared with the people who are treating the person.

Ms. Hedy Fry: Isn't it done on the system? The system is meant to be computer-controlled with central databases.

Ms. Dianne Kelly: We have no such system in New Brunswick. I think a lot of provinces are in that position. Maybe Mike knows more about this than I do at this stage.

I think B.C. is the only province that has actually implemented it.

The Chair: Mr. Keirstead, then Mr. Gallagher.

Cpl Peter Keirstead: The Nova Scotia system has had a computer-based system for a number of years. They track it all. The system isn't being used because they can't legally give the information to the Halifax police to get a search warrant.

The other problem is they know the doctors who are writing the prescriptions, but there are very small penalties or no one is approaching them on the problem. There has been some success in the last while. They found a couple of doctors, who are addicted themselves, who were doing a lot of prescribing. They received help and it has cleared up part of the problem.

Looking at this issue, I don't know how closely you deal with the other group meeting on the health problem of the aging population. There are going to be some built-in problems here.

One issue came up in the Prescription Monitoring Association of Nova Scotia. As we grow older, a lot of us get cancer. We're going to need very strong drugs to control the pain or whatever.

Controlling it is very hard. You have rural areas where you have to write a prescription for 80 or 100 pills. The person may die in the meantime and only 20 pills were used. There are problems that are going to be coming as we get older and more prone to disease.

The Chair: Mike, would you like to comment?

Cpl Mike Gallagher: The statements you made, Doctor, are completely accurate. The system we wanted was to assist the doctors to make sure no one was double-doctoring. It was one thing.

Of course, according to the Criminal Code, a person has to disclose to a doctor any prescriptions they received in the previous three days from another doctor. It is not taking place. There are actually doctors in the province of New Brunswick who weren't aware of it. Again, the onus is on the patient, and it's not happening.

To my knowledge, through information I received from the pharmacists in my community of Miramichi who were speaking with pharmacists in Nova Scotia, the problem with the system in Nova Scotia was that it was a paper system. It was not in real time. If I went to a pharmacy at 11 in Halifax and went to another one at 11:30, the documentation would not be there. It's a paper system. It may be a six- or seven-week lapse in time when that gets sent and put on the database, or filed away somewhere. So the pharmacists in our province and our community have said it's not real time.

The doctors have said they want to know. If they're being taken advantage of by certain patients, they don't want to be part of the problem. The pharmacists don't want to be part of the problem. We all want to get together and solve the problem. The database isn't the only answer, but it's a step in the right direction. We see it in the province of New Brunswick--myself, as a police officer, here in Miramichi, and as president of the committee. It's one possible option that allows educational and treatment programs.

À (1025)

The Chair: Thank you, Officer Gallagher.

Sergeant Frenette.

Sgt Michel Frenette: Thank you, Chair.

In 1997, Dr. Fry, I started to work on prescription drug misuse. I opened a file on it, and I started to do research with the registrar of the pharmaceutical society of New Brunswick. I started to work with the largest pharmacy network we have in New Brunswick.

There are a couple of things blocking this from happening. One of these is a piece of legislation, la loi, that prevents these people from disclosing the information they have.

Now, I had a meeting not too long ago with Mr. Bill Veniot, who is the registrar for the pharmaceutical society of New Brunswick, and as he said, even if we had all the systems in place, as long as they don't have legislation that permits them to release or disclose that information.... You can have all the systems in the world, but at this point in time they don't have the legality to release it for our purposes.

Now, there's a matter of perhaps changing legislation or putting legislation in place that would give them the power, but that's beyond my expertise.

There was a situation in 1997 around the non-insured health benefits program. I'm not sure if you're aware of that. Here in Halifax, for the Atlantic region, they started a process of flagging all the misuse of the prescription system they had in place. As a result, they sent 2,400 letters to all doctors and pharmacies across Atlantic Canada in that system. Within the first three months, there was a diminishing of prescription drug abuse of about 23%. Again, these data do exist somewhere. However, because of the legislation in place, they were not able to continue it because it was infringing on the rights of the people who were part of that system.

Again, we go back to the legislation. It's nice to invent all these procedures and the process, but we have to have the tools included so we can use it--from the police or from someone else. It doesn't have to be the police. It could be a main inspector from a provincial level--nothing to do with the police. They could control it from within.

I think the goal is not only to do repression, but to do prevention. And that type of prevention doesn't have to come from the police. It could come from within the medical and the pharmacy system, with their own inspectors. They could control themselves, do self-policing. They don't need us to do this; they have the expertise.

So that would be my point on it.

[Translation]

The Chair: Thank you very much.

[English]

Ms. Dianne Kelly: I agree. I think the focus isn't just on whether or not the information should be made available to the police, because some people would have a concern with that. But there is an opportunity, if systems like this are in place, for better policing--self-policing--within the professions, whether it's the pharmacists or the physicians. But they need the tools to work with as well.

The Chair: Thank you very much, Ms. Kelly.

Thank you, Dr. Fry.

Mr. Sorenson.

Mr. Kevin Sorenson (Crowfoot, Canadian Alliance): Yes, thank you, Madam Chairman.

And thank you for coming. It's been an excellent session so far.

I have a couple of quick questions, and I want to get back to what Mr. White asked each one about recommendations.

One of the questions that is posed to Parliament during debate and in committees is about the port police. We've seen the port police disappear over time, and I realize that the RCMP now has broadened their scope of responsibilities because some of the ports police have disappeared.

We hear many times about how enforcement and prevention have been hindered because of the disappearance of port police, and we have extra expectations of the RCMP and those enforcing. But do you think there have been adequate resources made available, in light of the fact that port police have disappeared?

Also, we were talking about the percentage of containers that come into the port here in Halifax. I'm not sure who mentioned that. I think perhaps it was Mr. Larder.

What percentage of containers are searched? We visited the port in Montreal and saw that they had dogs, ion scanners, X-rays. There was a real question in Montreal as to the infiltration of organized crime with the longshoremen and the unions and those working on the dock. Whether there are similar problems here in Halifax is a question. I believe Mr. Gallagher and some of the others didn't have an opportunity to respond about the two recommendations you would have as we build legislation, as we build a drug strategy--things that should be included.

À (1030)

The Chair: Let's concentrate just on the question about the ports, and then I'll do a round on the priorities. I think actually Mr. Gallagher and Mr. Larder did outline their two priorities. It's the others who didn't.

Mr. Kevin Sorenson: I think Mr. Skanes and Mr. Larder did.

The Chair: All right, we'll sort it out.

Mr. Keirstead.

Cpl Peter Keirstead: Concerning the issue on the ports, I've been in the drug awareness section for about two years. Previous to that, I was on the Halifax drug section as JFO with the Halifax city police, and a large part of my job was working with Ports Canada Police, Canada Customs, and the Halifax city police. There's a major problem with containers. There is some inherent risk. It's not a simple problem; some people like to think it is. A large volume of containers come in and out of there. The full ones are a problem, but then again, empty boxes being taken off all the time are a problem as well, because they could contain any type of contraband. I always looked at it as more than a problem with drugs coming in. It's an easy way to transport nuclear waste. If I were a crooked person, the first thing I'd do is ship nuclear waste to Canada, because a box can come in and sit there for months. Nobody has to sign for it before it comes to anybody's notice, and that's usually because the company that owns the container--they call them boxes--wants its boxes back.

Every month, two or three boxes were found with drugs--cocaine, hash, grass, or whatever--on a continuous basis. It is a problem. Some people in the country like to say there's no organized crime. I differ on that. It was a big problem to do any type of surveillance down there or try to organize--they have a strong union--checks and balances to be put in place.

To address it, I'd say first of all we need some sort of legislation or some mechanism in place when a container comes to Canada. Maybe it can't be done just because of the big volume, but somebody has to be responsible for that container.

The Chair: Thank you.

Sergeant Larder, and then I'll go to Skanes and Frenette.

Sgt Rosco Larder: Peter worked down there. I have three of my investigators assigned to the metro drug JFO; they work down there. I guess the answer to your question about the percentage of containers checked is that I honestly don't know. I could probably get that figure for you and supply it to the panel.

Mr. Kevin Sorenson: But is it a minimal number? There are hundreds and hundreds of thousands--

Sgt Rosco Larder: I don't know exactly what method they use to check them. I do know, though, that since we have our presence there ourselves, working along with our IS police brothers down there...I know from my level--street-level enforcement--I get more feedback from that area now than I ever have in probably the past ten years, because of the enforcement down there now. Whether it's because it's a branch of our own that's down there or not--that very well could be the reason why--in the last few years the number of containers they've picked off with importation appears to me to be increasing.

I certainly know it is an extremely hard place to make inroads in policing, as far as what's going on there is concerned. I know we're talking about drugs, but it's not just drugs that are a problem down there. It's the associated theft from the containers themselves. I know it's been an ongoing problem, and I know they've taken some steps to check it. I don't even believe we have the capability of X-raying the containers here in Halifax, as I think they have at some of the other large centres, like probably British Columbia or Montreal.

If you're looking for a ticket item to assist investigations down there, probably something like that would be useful. I do many residential searches in homes. We're in there for several hours just doing a residential search, so I could only imagine how time-consuming it is when you take out one of those containers the size of an 18-wheeler that is packed from end to end.

Mr. Kevin Sorenson: But in Halifax, I think it was last fall, we had a terrible stretch there, about four days, where we had people being smuggled in containers.

À (1035)

Sgt Rosco Larder: Yes, exactly. It is a concern. We actually have one of our staff sergeants who works right on-site there, and he has officers assigned to him. There's coverage there around the clock. But again, you're dealing with aspects of organized crime, and they've been at the job down there a lot longer than we've been at it ourselves. It's certainly a problem area.

The Chair: Thank you.

Officer Skanes.

S/Sgt Jim Skanes: Sergeant--not to put a fine point on it.

You're quite right that in Newfoundland the number of containers that are checked are minimal, and for the most part they're customs checks, not police checks. We don't usually get involved at the ports unless we have an active investigation or perhaps some information that would bring us down there. Of course, since there has been a decline in Ports Canada and Ports Canada Police, it's an area that we're getting more and more involved in. It's another one of those areas that we're getting tasked with more and more, and with no extra resources coming with it--quite the contrary.

Over the last 10 years--and you folks all know it's right across the government, whether it's armed forces, police, coast guard, public service, or anybody else--we've all seen significant cuts. So we've lost people over the years, and now we're picking up all this additional work, whether it's at ports or the airports, which are another high-profile area in which we've lost people in the last five or ten years. Now we're assuming all this work, again with no additional resources.

We know there are problems with all the ports, whether it's illegal immigrants, drugs, or all the other types of contraband. As I say, we simply don't have the resources to check every container, or even contact all the companies that are bringing containers in on a regular basis. So there's very little being done in that whole area.

I'm speaking now of St. John's, Newfoundland, in particular. I suspect the same thing is true in Halifax and most of the rest of the country.

The Chair: Corporal Frenette and then Corporal Gallagher.

Sgt Michel Frenette: One of the points that the Commissioner of the RCMP made in his last statement, and it's also supported by the Atlantic regional director here, is that we have to become more intelligence-focused.

When you look at the sheer amount of cargo that goes into the ports across Canada, I mean it's a huge amount. I think the strategy of getting better, of integrated policing amongst ourselves on the national and international levels--I think we could go a long way by working in that area. It's much easier to enforce something when we have the knowledge that it's taking place from the departure to the receiving than just trying to catch up in between the two.

I think the Commissioner of the RCMP made it very clear that one of our strategies, one of the pilots that we're going to be working on, is intelligence gathering. I think that would be a step in the right direction. That will probably help the situation that was just described here.

The Chair: Mr. Gallagher, do you have comments on ports issues?

Cpl Mike Gallagher: No, I don't.

The Chair: Okay.

That actually concludes the 10-minute round, Mr. Sorenson. I will go to Mr. Lee, and then I'll get the priorities from the rest of the gang.

Mr. Lee.

Mr. Derek Lee (Scarborough--Rouge River, Lib.): Thank you.

I was interested in a brief comment by Mr. Larder earlier. It had to do with possession of small amounts of drugs. It might have been marijuana, I don't recall exactly, but your reply was something like, “That's not part of our mandate; we go after the traffickers.” Could you elaborate on that?

Sgt Rosco Larder: Yes, but I didn't say that. My unit is drug enforcement. We deal with all charges dealing with drugs, whether it's simple possession, or trafficking, or possession for the purpose of trafficking. As an enforcement, we have so many files, and basically I assign my investigators, obviously, to deal with those--they come up with targets--people who are dealing with trafficking or people who are selling.

We definitely do deal with specific possession--don't get me wrong here--but I don't send my guys out to try to stop people or observe people out there. You know, they're smoking and they acquire.... If we come across them, we will, but my mandate for my officers is certainly to enforce all aspects of the CDSA. It's certainly more geared toward...if I have a drug shop, we're geared up to do search warrants. As you'll see in my stats, we do a lot of drug searches.

The other avenue in my particular interest is running undercover operations where we can definitely target those who are trafficking.

À (1040)

Mr. Derek Lee: I do understand. Your comment had more to do with the allocation of your available resources to maximize the outputs.

Sgt Rosco Larder: Yes. I had sent investigators to cover the whole metro area from the street level.

Mr. Derek Lee: Is it generally the case, in your experience, that there's a trend away from enforcement of some of the drug laws in favour of the more complex or trafficking offences primarily because of a shortage of resources?

Sgt Rosco Larder: To me, it would be my mandate to get those who are selling the product and making a living off it. That is a personal pet peeve per se. That's where I see our biggest job.

Mr. Derek Lee: But those who possess the drug are still breaking the law.

Sgt Rosco Larder: They certainly are, and we deal with them accordingly, yes.

Mr. Derek Lee: It's just as crystal clear in the law that the person who possesses a drug illegally is as anti-social in terms of behaviour under the law as someone who is trafficking. The sentencing regime may be stricter for the latter.

I guess what I'm trying to focus on is that de facto, on the street, we have a change in the way our laws are being enforced simply because we don't have enough resources to chase everybody who has a marijuana seed in their pocket.

Sgt Rosco Larder: You're certainly right.

Mr. Derek Lee: Does that make your job more difficult or less difficult, in terms of figuring out where you are in the spectrum of things?

Sgt Rosco Larder: I look at my job as using my resources where I can get the best use out of them, as you indicated before, and to me, the best use is to target those who are selling the drugs.

Mr. Derek Lee: One citizen might say to you, “Good job for maximizing your resources. You're rationalizing it. Thank you very much; you're doing a great job.” The other citizen may say, “You're not doing your job. You're letting us down. We have the law and your job is to enforce it, and you're not doing it. Use it or lose it. Maybe we should change the law. If we're not enforcing it, why don't we change it?”

You don't have to answer that.

Sgt Rosco Larder: I'm anti-drug in any amount.

Mr. Derek Lee: Okay. Thank you.

The Chair: Thank you.

I'll now go to the White/Sorenson question. I'll start with Ms. Kelly. Do you have two priorities for what this committee should recommend to the government in November 2002?

Ms. Dianne Kelly: I think I want to be rather modest in my suggestions there. You people have had the opportunity to travel all across this country and hear all kinds of testimony. I have only heard about this committee in the last couple of weeks. I did read your terms of reference. I've read a lot of the material that's been produced. You have a challenging mandate. I think it would be presumptuous of me to suggest that I could give you two priorities with what knowledge I have compared to what you have.

However--

The Chair: We're going to make you.

Ms. Dianne Kelly: I guess if I were to have to say what I think you should focus on, it would be to try to find the best balance you can between the regulation, the education, and the treatment of problems as a result of misuse of drugs.

To go back to our mandate, our focus is on prevention. I think resources need to be dedicated to prevention, not just dealing with the problems after the fact.

The Chair: Thank you.

Mr. Gallagher, I thought you outlined three things in yours, but did you have two top lines for Mr. Sorenson?

Cpl Mike Gallagher: I'd just like to make one additional comment. First of all, I think the federal government is doing a good job overall. We have a few small bumps along the way, but overall the system is working on the street.

The other comment I want to make is that the RCMP does a great job with enforcement. I would, however, like to see municipal police forces across the country have access to some federal financing that we currently don't have. We have our own drug sections, as well as the RCMP. Our funding is solely coming from our municipalities. Lots of times we do with less because the finances just aren't there, and we're expected to have the same results, if not better.

That's just something for consideration. Maybe give the municipal police forces some access to some federal moneys for investigations. Thank you.

The Chair: Thank you.

Mr. Frenette.

À (1045)

[Translation]

Sgt Michel Frenette: Those are the two main points as far as we are concerned. The first thing would be to have strong leadership on the part of the federal government in support of Canada's Drug Strategy, which has already been put in place and has made some headway. And if ever the federal government were able, within its framework, to allocate additional funds and resources, it would perhaps be a good idea

[English]

to allocate those resources in the most strategic way possible in all sectors, not only police, but all sectors, all levels of government.

[Translation]

Those are my two most important requests.

[English]

The Chair: I wonder if it's a question of reorganizing our resources.

[Translation]

Sgt Michel Frenette: Reorganizing our resources, is that what you are saying?

The Chair: Yes.

Sgt Michel Frenette: How I would like to see that?

The Chair: If that were the only choice.

Sgt Michel Frenette: If we reorganize our resources, it must be done strategically, in other words, they must go where they will have the greatest impact in the areas of prevention and enforcement. That is for the police side of things. For all of the different sectors, for example health, etc., we can always take into account prevention and treatment issues.

[English]

The Chair: Merci beaucoup.

Sergeant Skanes.

S/Sgt Jim Skanes: For the most part, I'd simply like to echo Mike's comments on his two recommendations. If there are no new resources forthcoming from the federal government, I'd like to see reorganization.

In the RCMP we always talk about a balanced approach, but I don't see that balance. It's pretty much enforcement, and awareness education is left holding the smaller share. If it's to be balanced, then let's make it a balanced approach. Let's put more resources, not necessarily new resources, but more effort and resource funding, into our end of the drug enforcement area.

The Chair: Officer Keirstead.

Cpl Peter Keirstead: I would echo Michel's comments. The message should come from the government at the national level about the inherent risk and problems of drug use and abuse, and we should work on prevention education. There has to be a balanced approach and some enforcement.

We always keep going back to this legalization problem, and we have to somehow look back. We use a lot of best practices in our force now. Sometimes we have to look back at what we have done well and what we've done poorly.

I've worked with native communities up north and I've bought drugs in downtown Vancouver. I've worked in a number of detachments in Nova Scotia. There's one thing I've used in a lot of my lectures that you could think about. Alcohol has been a big problem and always has been. We're not going to try to make that illegal to possess.

Look at me. I'm relatively young and I've lived through prohibition. I was in a native community where it was prohibited to have booze. I'll tell you right now it didn't work. It made criminals out of a lot of people who shouldn't have been criminals. It caused deaths where there shouldn't have been deaths. Maybe we could look at that as a best practice.

I can also say that 23 or 24 years ago I was stationed in a place called Glace Bay, Nova Scotia. You could leave the office and pick up four or five impaired drivers within a five-mile radius. When I say impaired, I mean you'd open the door and they'd fall out on the road.

Many years later we still have a problem with impaired driving, but it's not like it was and it's not to the same degree. That's because we've used a balanced approach. We've used enforcement, but we've also educated people; we've educated children. One of the biggest things you hear about right now is parents who don't want to go to the Christmas party and come home after drinking because their children find it unacceptable. So we need to educate the people and make them aware--and I use that word “awareness” a lot--of the inherent problems.

I may drink alcohol or smoke marijuana every week and I may not have a problem. Other people might try it once and be severely addicted, and it's going to ruin their family, their chances for a job. I could go on and on. I won't.

À (1050)

The Chair: That was a hypothetical “may”.

Cpl Peter Keirstead: Yes, hypothetical. As far as the resources are concerned--and I don't want to sound critical of government or of our hierarchy--a lot of times statements are made and those funds never really appear. We've heard over and over again about so many millions of dollars, so many positions. Whether working in enforcement of drugs or in drug awareness, you can sit around later, have meetings in Ottawa with people across the country, and none of the sections have ever seen a dime more and have never seen any new positions.

Again, we can make somebody accountable. If the RCMP is saying they're doing a drug awareness program across Canada, show us what you're doing. Since I've been in this job I've learned a lot about addictions and so on. We have to have assessments and surveys in place. You can't use a program year after year and never look at whether it's having any success or any benefit to anybody. They just keep repeating themselves. After a while, they need to be changed.

So, yes, we need more resources, but somebody needs to be accountable that they actually get there on the street for the Canadian population. And we need some good surveys and assessments on the programs to make sure they're doing what they say they're doing. Thank you.

The Chair: Thank you.

Sergeant Larder, you had four items. You mentioned two.

Sgt Rosco Larder: If you don't mind, I'll say what I feel are my two most prominent ones. I think we've all touched on it here. It's certainly public awareness. That has to be key throughout any type of thing. Again, it has to come from a panel such as yourselves--through Parliament. We have to make sure that it starts in the schools. To me, I think that's where some of the other programs seem to have the grassroots. If you continue through the programs--TV or otherwise--that's where its impact is. Certainly this was the case with our drinking and driving in the past. I think with the drugs, we have to make a stand there as well, just to cover all age groups.

The second one, yes, is funds. Again, I'm only talking as a municipal police force. As regards the mandate I have to work with for funds, I know that when I fight organized crime or those involved in trafficking, it's not a whole lot. Certainly funding would help the way we do our business.

The Chair: Thank you very much.

This panel has gone a little later than we anticipated, but you have provided us with lots of great information and we really do appreciate that. This committee is going to hear witnesses and receive testimony through till probably the end of June. If you have specific information or ideas or additional colleagues who want to participate or something relevant that you see in international information and want to send that to us, if you direct it to the clerk, she'll make sure it's distributed to all the members, even the ones who aren't here in the room, in both official languages.

On behalf of all my colleagues, we really appreciate the time you've taken to come here, to prepare your presentations, and to talk to us about the issues you know so well. We also appreciate the work you do each and every day in our communities, and we wish you lots of good luck with the things you're doing. So thank you very much.

Colleagues, I'll suspend for five minutes so we can get the new panel up and ready. Just so you know, we've pushed back departure a bit, and I'll talk to you about that. Thank you.

We're suspended for five minutes.

À (1051)

Á (1101)

The Chair: I bring this meeting back to order.

We're very pleased to have with us, for our panel on harm reduction, from SANE, the Sharp Advice Needle Exchange, Howie Sullivan, the executive director; from Healing Our Nation, René Masching, the executive director; from AIDS New Brunswick, the president, Margaret Dykeman; and from Dalhousie University, somebody who was actually spoken about in several presentations, Dr. Christiane Poulin, an associate professor in the department of community health and epidemiology. Welcome to all of you.

Just to introduce our colleagues around the table who are here, we have two representatives from the Canadian Alliance; Réal Ménard from Montreal, who is Bloc Québécois; Libby Davies from Vancouver East, who is with the NDP; Derek Lee, who is from one of the Toronto ridings; and Dominic LeBlanc, who is from New Brunswick.

We are very pleased to have all of you come to talk to us. We'll have an opportunity for questions and answers. This session can go as late as one o'clock, if that's okay with our witnesses. I will give you a signal when you are at about eight minutes--I'll just shake the little clock--and you should try to wrap up. At ten minutes, I'll really start shaking the clock, and then we'll really have to wrap up. If I'm going like this, it's because I'm stressed out.

Kevin Sorenson is the other person I should have introduced earlier, from an Alberta riding.

Mr. Sullivan, good morning. You're up.

Á (1105)

Mr. Howie Sullivan (Executive Director, SANE Sharp Advice Needle Exchange): Thank you.

I've decided to talk a little bit about the rural setting and how that applies to the harm reduction philosophy, particularly in Cape Breton. There we have basically one industrial area--Sydney, Glace Bay, and a couple of other communities--that houses about 65,000 to 70,000 people. In the remainder of Cape Breton Island, another 100,000 people are spread out over a much broader geographic area, with many more isolated communities, such as Ingonish, Chéticamp, and so on.

The idea of harm reduction, as I'm sure we're all aware, is to minimize the impact of illicit drug use or non-medicinal drug use. On the Sharp Advice Needle Exchange program, in 1996 the province responded to an outbreak of hepatitis B in the north Sydney area, which is one of those communities I mentioned earlier that's in the industrial area of Cape Breton. It was realized at the time that the transmission of blood-borne pathogens in the needle-using community was reaching epidemic proportions.

One of the outcomes of that study was that 47% of the people who participated in the study tested positive for hepatitis C, which is much more insidious than the hepatitis B virus and can contribute to much more serious long-term health impacts.

That basically was the birth of the needle exchange program in Cape Breton. What we had found initially was that a storefront operation just wasn't going to work. We had tried bringing the client, or the drug user--the service user, per se--into the establishment, and it wasn't being met with very great success. Over the first six to eight months the contact with the drug-using community was minimal at best. We were only reaching a small portion of that community.

What we realized was that in order to maximize the impact and deliver services to the community as a whole and target the community we needed to focus on, we had to involve that community and the population of people who were abusing drugs. Hence, there was a Natural Helper Network born at that time. The Natural Helper Program basically takes people who are extremely knowledgeable of the drug-using community in various parts of Cape Breton. Either they're currently drug users themselves or they are former drug users or they have a very sincere care for their community and want to help in whatever way they can.

Basically we, as a fixed site, provide the syringes and supplies, the printed material, and any other resources we can make available. We provide those to a series of outreach sites located throughout Cape Breton Island. The people who house these sites, so to speak, have been given the capacity to deliver the information from our staff. They participate in annual and semi-annual training: ongoing training with reference to the current state of affairs involving treatment and other options related to the transmission of HIV, hepatitis C, hepatitis B, vein care--things of this nature.

One of the things the harm reduction philosophy has allowed us to do is look at it on a continuum, from complete involvement in using, of whatever kind it may be, to abstinence. Abstinence is not necessarily a realistic goal of harm reduction. It's certainly a desired goal, but not necessarily a realistic goal; it's not always going to happen. We've come to realize that if we provide the services in a non-judgmental, non-coercive manner, the drug user, the person seeking services, will oftentimes, once a level of trust has been established through one of our outreach sites, contact the office--because they want to make a visit to their physician, because they have an abscess, because they've been injecting incorrectly.

That's a small step towards good health, and to us it's a huge success. That person may at some point, and oftentimes does, say “I've really had enough of this, I don't want to be this way, I don't want to use this any more”, and may want to try a detox program. That could happen twenty times. In fact, I know many people who have gone through the doors of different rehab centres over and over and over again, but the idea is they are moving towards the other end of that continuum. We try to support whatever decisions the community makes.

Á (1110)

It's all about allowing the individual to have the right to self-determination. They make decisions based on what they believe their best interests are. If they have questions, concerns, or need support of any kind, we do what we can to make it available.

The Natural Helper Network, again, is a big part of it. It has done a great deal to raise awareness of the issue in the community, but the shame dynamic implicit in injection drug use and drug use in general makes it very difficult. Even with something as successful as the Natural Helper Network in a rural community, the shame dynamic makes it very difficult for someone to speak out about current reality, health and well-being, and needs, as they may be expressed to us.

We, on the other hand, will advocate on their behalf. The messages, I think, come more passionately from the community members themselves. Often, for obvious reasons, they can't. As I said, with the shame dynamic implicit in needle use, they often fear being arrested, have a general fear of institutions, and won't speak on their own behalf.

The Natural Helper Network over time has allowed us to provide education and support. More recently, we've been able to advocate on behalf of the community. Ultimately, our goal is to empower the community to speak on their own behalf. We feel we're moving in that direction through dialogue happening at different levels of government.

For instance, the former Minister of Health, Mr. Rock, made a statement that drug use is, first and foremost, fundamentally a health issue and not a criminal issue. It was met with great regard in the drug-using community. Indeed, from our perspective, it certainly is a health issue and should be addressed as such.

The shift in that direction is slow, of course. The former panel that was here earlier talked about the balance between education and enforcement. You folks have a difficult job on your hands.

From our perspective, it is indeed a health issue. In the prevention of one case of hepatitis C or HIV, the real savings in tax dollars to the Canadian public are tremendous. If you took it and spread it across the national landscape, it would indeed be significant.

I think the focus of the criminalization of drug use really should be re-evaluated. It really should be looked at as a health issue. They are people who are sick, not people who are bad. They are people who don't choose to live that kind of lifestyle. They live that kind of lifestyle for a number of social reasons.

We, as a community, need to respond to some of the things. I think the establishment of needle exchange programs across the country is definitely a step in that direction.

I'll stop there. I saw the clock.

Á (1115)

The Chair: Thank you. It worked. Thank you, Mr. Sullivan.

I'll now turn to Ms. Masching.

Ms. Renée Masching (Executive Director, Healing Our Nations): Thank you. I'll have to beg your patience. I'm afraid I haven't brought any materials in French. I apologize. It's not something we're often able to do in our office.

I'll start with good morning to Madam Chair, honourable members, and fellow panelists.

I'm afraid I'm reading a little of this. We were in meetings in Montreal for the last three days. I managed to prepare something, but not to memorize it.

A voice: It's a beautiful place.

Ms. Renée Masching: It is a beautiful place. It was 26 degrees yesterday.

My name is Renée Masching. I'm the executive director of Healing Our Nations, the Atlantic First Nations AIDS Network. I'm originally from the Six Nations first nation in southern Ontario. In addition to my regional position, I'm also the chair of the first nations caucus of the National Aboriginal Council on HIV/AIDS. On behalf of the Mi'kmaq and Maliseet nations, I'd like to welcome you to this territory and, in the spirit of healing, thank you for this opportunity to speak to you.

Healing our Nations is an aboriginal community-based AIDS organization. Our organization began as a provincial project in 1991 and grew to a regional program in 1993. From that time, Healing Our Nations has maintained a mandate to address HIV/AIDS and related issues in the context of prevention and empowerment. We provide training, education sessions, policy analysis, and advocacy representation for 31 first nation communities in Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland. We make the distinction that we're not in Labrador, where there's a unique cultural group. We work in partnership there, but not as representatives.

We operate out of Dartmouth, Nova Scotia, which is our head office, with a suboffice in Fredericton, New Brunswick. In recent years, we've begun to explore opportunities to work with the broader aboriginal community, regardless of residence, within the Atlantic region. As a community-based organization, we receive the majority of our funding from Health Canada and we access several streams of funding under the Canadian Strategy on HIV/AIDS, including the AIDS community action program, the urban and rural non-reserve program, and First Nations and Inuit Health Branch funds. Of particular interest and importance is the unique relationship we maintain with the first nations leadership in this region.

Á (1120)

The Chair: Can I just ask you to go a little more slowly?

Ms. Renée Masching: I apologize.

The Chair: I have the same problem on a regular basis.

Ms. Renée Masching: We'll work on that. When I get nervous, I talk quickly.

From 1993, all the AIDS-targeted funding for the first nations communities in this region has been pooled together to establish and maintain our office. The Atlantic is the only region in Canada where our leadership has demonstrated this commitment to and investment in developing and sustaining a response to HIV at the community level.

In terms of our member base, we're comprised primarily of members who are living with HIV who are Mi'kmaq or Maliseet. At this time, we have fewer than ten members, who range in age from childhood to their fifties. IV drug use is a common mode of infection for many of our members--for the majority, in fact--both those who are with us today and those who have passed on. Given the current trend of high levels of infection within the aboriginal community across Canada and injection drug use as the primary mode of infection, the issues related to harm reduction are of grave concern to us.

Specifically regarding harm reduction, in the fall of 2000 and spring of 2001, Healing Our Nations undertook a short project to explore the meaning of harm reduction in Mi'kmaq-Maliseet territory. We recognized that there were many definitions of what harm reduction is, and we thought we'd better try to clarify it for our communities: when I speak about it, this is where I'm going. I have left the resulting brief on the table for you.

We began from a place of understanding the important role of harm reduction and the place that's taken within the AIDS movement internationally. We stopped to find a place where the concept might fit for those we work with and for. As an aboriginal organization, we approach all of our initiatives with the goal of finding balance between our traditional world view and the context of the modern world where we reside. The project was entitled “Harm Reduction: Defining Our Approach”. The term “harm reduction” is translated in Mi'kmaq and Maliseet roughly as “to do or cause no harm”. Our journey with this project is fully documented in a short report that I hope you'll have some time to review.

In brief, what we found is that harm reduction philosophies have a place and in fact already exist in our community. For many of those we've met with at this time, formal harm reduction programs, such as a needle exchange, are considered a surrender to substance abuse and at least enable the addict to continue using. That's an area where we, as an AIDS organization, are working with our communities and a place where we heard very strongly from our communities that there is a concern.

Concern for children arose in all of our discussions. This concern relates to practical issues. What if a child finds a dirty needle and gets stuck? What message does a child receive when the band or community centre gives out clean needles? Within a broader context of aboriginal people, we're taught to understand our place in time as being somewhere between those who have gone before us and our children's children. We must always consider the impact of our actions on seven generations to come.

Harm reduction is considered an approach, with abstinence and eventual sobriety as the goal. As community consultations began we realized that framing harm reduction within the medicine wheel was most appropriate for presenting the concept and initiating discussions.

In the east, we begin with a person who is using, feels isolated and ashamed. In the south, the concept of harm reduction begins to find its place, building relationships, reaching out to the person using to increase the possibility of recovery and to build trust. In the west, the user has made a choice to begin the journey to sobriety and begins to abstain from substance use and abuse. In the north, the person is sober, has made peace with their addiction, and knows it is behind them.

Throughout the wheel it is understood that this process is not linear and that movement back and forth and around again occurs. There's patience and support for the person who is involved in substance use and abuse, with a consistent goal to rebuild healthy, strong communities.

Certainly the issue of injection drug use is highly stigmatized in our communities. People using will most often leave their home community and travel to a nearby city where drug access is better and their families not right up the road.

At present, community health and addiction staff both on and off reserve are exploring and speaking about their concerns related to injection drug use within our territory. This has been as recently as the last four to six months that the issue of injection drug use in our communities has become something people will speak about.

This is very much an underground community of people when they are using. Some respondents felt that people using keep to themselves due to the illegal nature of the drugs they're injecting, such as heroin and cocaine. This is in contrast to the more familiar addictions that might involve alcohol or prescription drugs.

Overall, harm reduction strategies or alternatives to abstinence would serve as a bridge to the individual choosing to commit to a better life, which in the aboriginal context would be seen as recovery from their addiction and sobriety. Within a continuum of resources available to our people, the tools of harm reduction have assisted and will continue to assist us in our response to addictions within our communities and ultimately to HIV-AIDS prevention.

In closing, I'd like to leave you with these powerful words from the introduction of our position paper:

“What has been consistently expressed is that the potential well-being of the individual, family, community, and nation is valued above all else. This is the vision of healing and wholeness that gives hope to those working in the field of First Nations health. This is the vision that sustains First Nations people in the struggle to survive while their culture is under attack. This is the vision in which harm reduction has to find its place.”

Thank you. Merci.

Á (1125)

The Chair: Thank you very much.

Now I'll go to Ms. Dykeman.

Ms. Margaret Dykeman (President, AIDS New Brunswick): First I'd like to thank everybody for having me.

As Renée said, I was one of those people in Montreal, so if I'm not understandable, you'll just have to ask.

I think that some of my language is couched definitely in health. Most people here probably need to know that I'm a nurse practitioner, having worked with the addicted in the HIV-positive populations in the States. So some of my language may come across as much more health-driven than some of the other discussions will.

I'm here representing not only AIDS New Brunswick but AIDS Saint John, AIDS Moncton, and the New Brunswick Hepatitis C Society. We all, as Renée's first nations group, sort of form a partnership within the province--sometimes loosely, sometimes more closely--around hepatitis C, HIV, and AIDS problems that we're facing. And of course in this day and age that definitely includes injection drug use--I guess from a health point of view, injection drug use and all drug use, because usually one leads to the other as time goes on.

I missed some of the information this morning because I didn't have earphones and I couldn't understand the French, but in the talking around marijuana, one of the things that I think from a health perspective we need to look at and think about is we had a big discussion about whether we should legalize, medicalize, all these kinds of things. But one of the things from a health perspective is that marijuana today is not marijuana in the 1960s. In the 1960s, if you got a good joint, you got about 4% drug. In 2000, if you get a good joint, you get over 30% drug.

What we're seeing in the drug scene is that some of the kids are actually having some of the same kinds of reactions as they used to do with LSD in the 1960s, because it causes some of those breakdowns in brain chemistry and so on, even though they're not as long-lasting. But I'm not totally sold either that it's as innocuous as we would like it to be. That's just a comment to bring the panel up to date on some of the new research that's being done around that.

The problem in New Brunswick, as we see it, and some of the police from our part of the country talked about that this morning, is that injection drug use is on the rise, and exponentially so. We're seeing, for example, on the Miramichi, two hepatitis C cases monthly--that sort of thing.

In regions where, even when I came home from the States four years ago, they would have said we have a drug problem, but not an injection drug problem, there used to be an invisible line across for use somewhere in that area, where above it was thought to be more of a snorting, injecting, that kind of thing, but below that line was injection drug use. That's no longer so, and I think our hepatitis C cases in the north of the province are pretty much proof of that. We probably don't need a whole lot of research to back that one up.

We are having minimal success with harm reduction--I would say very minimal success. For the last four years, we've been working on needle exchange in the province. We did this when we started looking at the danger around the HIV infections and so on. In the four years since we've been working toward doing harm reduction, we now have two viable needle exchange programs in Fredericton and Saint John. We've tried our very best to get one going in Moncton and we've worked some on the Miramichi. We have had funding to set one up in Moncton, but we have been unable to find someone who would actually house it for us. There are multiple reasons why people don't want this in their backyards. So those kinds of issues need to be addressed when you start working on these kinds of programs.

Going back just one step, I would like to address addiction more as a social health problem than a criminal problem and how we talked about that to a certain degree. We're not going to find easy answers. They're going to have to be very complex. It's a very complex problem. There's no one problem driving it. There's no one reason why people get in this condition or have this problem. From a social aspect, we really need to be doing more work around why we are having this problem and why it is getting worse in some of our more rural areas. It's usually not an end in itself; it's usually some symptom of a huge or greater social issue.

The other piece that didn't come out at all in this morning's discussion, and probably has in some of your other discussions, is we like to sit around tables and say that as individuals we have choices. If you have used a drug and you have become addicted, you no longer have a choice. You either need that drug or in some instances you die. And I have seen patients who have died, because they have not been able to get their drug.

Look at all of our strong push to stay alive in this world no matter what our situations are or how difficult our lives are. Some of my patients have been addicts for twenty years and have never lived in a house for that twenty years, but would still come into my clinic with a smile on their face and say “How are you, Margaret? What's going on? What's your life like?” That means to me that these people are very strong people who have a real need to be helped and given some kind of a standing in our society. I just want to leave that perspective with the panel. They are essentially hidden people, because a lot of them are illegal or they have done illegal things or they need to do illegal things to stay alive. So they also need other people to speak for them.

In New Brunswick I believe we're looking at a problem around.... And I suspect from seeing some of the things that have come out through my e-mail in the last week or two that everybody doesn't agree that methadone is a great program. But I'm not sure anybody on this panel will say that harm reduction is the end of the world. I think it is a step in the direction to where we want people to become health, and it may be the bridge we need to get them there.

Á (1130)

If you can get them in to speak to them and you can hang on to them, then you have a chance of making some change for them or helping them make some change for themselves. But if you don't put those kinds of programs in place, then they are the hidden population. They're not connecting with anybody anywhere except the illegal side of things to keep themselves alive, and you don't have a chance to intercede or make things better or move it to another step.

On the other hand, I have to play the devil's advocate and say that not everybody is going to be able to come off methadone. If you're a hardcore heroin addict, some of you may come off, some of you may not. But a good majority of my patients who were steady on our methadone program in Chicago could go to work every morning, go to school every day, actually get a masters degree. So there are some benefits to being able to incrementally take the steps that are needed to get back into a role in society where you can look after yourself.

In New Brunswick we are getting very little support around either one of these programs. So we have been having some problems around the methadone program in getting it any kind of funding to get it going. We haven't received any amount of funding except through the HIV division for our needle exchange program, and they're very heavy on counselling, so they're very time-consuming.

We had seven new cases in New Brunswick last year of HIV-DU, HIV new cases for whom the risk factor was IVDU. In a province that had two cases altogether in 1999, that tells me something. It probably tells you all something too.

One anecdotal piece I'll say before I give this up is that we know from fact that six of these people are sharing needles still in the region in which they live at least once a month. So if that doesn't raise the hair on everybody's neck here, it should.

I'll stop there. Thank you.

Á (1135)

The Chair: Thank you.

I will hear from Dr. Poulin. I think Dr. Poulin has some slides for us.

Dr. Christiane Poulin (Associate Professor, Department of Community Health and Epidemiology, Dalhousie University): Yes.

Actually, if I talk loudly, will it work?

The Chair: No, it won't work because we have a challenge with interpretation. So Lise will be our Vanna. She will make the slides change for you if you just say “slide” every time you want a slide changed.

Dr. Christiane Poulin: Great.

I'm delighted to be here today. I'm a full-time researcher at Dalhousie University and my research portfolio is entirely in addictions. Most of my work pertains to teenagers, so I'm going to be talking about harm reduction as it might pertain to teenagers.

I understand this committee has as its mandate the non-medical use of drugs. It can be understood in different ways. One of them, for example, would be the abuse of prescription drugs that have a potential for abuse. In teenagers, that would pertain primarily to a class of drugs called stimulants, including amphetamines and Ritalin. Ritalin is an analogue of amphetamines. I'm not going to concentrate on that this morning. I'm just bringing that to your attention because harm reduction with teenagers and amphetamines and Ritalin is a special case that needs some work on its own. Certainly Dr. Fry mentioned one of the possible ways to look at that, which is through a monitoring program.

In any case, I'm going to focus on harm reduction in teenagers one might consider mainstream teenagers, teenagers not on the street--that is, teenagers generally in school. For the longest time we've had drug prevention that is school-based, and that is what is at issue in my discussion.

I've been thinking about harm reduction for many years. I was a family doctor for quite a few years in a rural area of Nova Scotia. Looking back in this past month because somebody asked me how I actually got into this issue of harm reduction, I can very easily pinpoint the moment. It was one night when I was called to the emergency room. A young lad had been brought in. I was called up in the wee hours of the morning because the lad was drunk. I got to the hospital, and the lad was way beyond drunk. The lad had what we call “acute alcohol poisoning”.

The nurses and I worked all night long. We had the IWK poison control on a telephone line and got advice. We worked all night long and helped the lad recover. He was 18 years old. He was barely responsive to me when he first came in. We worked all night, and we saved a life. I patted myself on the back that night because I'd saved a life. I also had one other thought: that it had not needed to be that way.

Over the years, I've thought many times about that one instance, and I've learned many lessons through education and through research and practice. Here are three lessons that I'm going to share.

The first lesson is that I did not save a life that night. The nurses did not save a life that night. The IWK poison control centre did not save a life that night. A life was saved that night, but it wasn't because of the medical system. A life was saved because a teenager brought in the lad from a party. The teenager had realized that the lad was going down, so he brought him in for help. The teenager saved a life that night.

The second lesson I learned is that it was no accident. When we talk about accidents, we generally talk about events that seem to be random--for example, motor vehicle accidents. But if the motor vehicle accidents always happen on a particular part of the road, then we start seeing that this is not a random event. We don't know “who”, we don't know “when”, but we know “where”, and it's no longer random.

In the first slide, here is the situation in Nova Scotia in terms of the proportion of teenagers who have used substances over the course of the year.

Á (1140)

The Chair: Could you move it a little bit? I can't see it. Is it 1991, 1996, 1998?

Dr. Christiane Poulin: This is over a seven-year span, from 1991-1998. Our survey is going to be taking place this year, so we'll have new follow-up statistics on this. We can see that the proportion of teenagers who use alcohol, tobacco, cannabis, and most other drugs has increased over the seven-year period.

I was talking about this in reference to it being no accident. If we know that drug use happens, what's not accidental here is that drug use happens. None of these numbers are zero. So for teenagers, we don't know the “who”, the “when”, or the “where”, but we know the “why” and the “how”. So the events that have come out of substance use are not entirely random. It suggests that we can work with teenagers to do something about it.

The third lesson that I've learned from this particular event in my life is that it need not have happened that way. The event, which was a near catastrophic event or a near death, need not have taken place.

The graph I'm showing you now is called a risk continuum. This risk continuum is based actually on the statistics from Nova Scotia. This is for alcohol. It shows us that about 50% of teenagers use alcohol, and 50% don't. Among the teenagers who do, we see that some use alcohol without having major problems, or no problems at all, and we see that a small percentage--in red--about 5% to 10%, have experienced problems to the extent that some of them might need some assistance and some help and treatment with their drug use.

So among all teenagers in school we have teens who don't use, teens who do use, and teens who use to the extent that it's way beyond experimentation.

Concerning the event I was talking to you about, the 18-year-old lad who was brought into the emergency room, there's one more fact that you need to take into account: that it was a “safe graduation night”. So here we have a teenager and a whole area, a whole school, where there's a safe graduation night, but this teenager somehow falls through the cracks.

What it amounts to is that where that teenager was, it was even more unsafe than it need have been, not only because, as I've told you, there was obviously alcohol being served at the party he was attending, but that party was one where other teenagers, almost all of them, were high-risk teenagers. They were not attending a safe graduation night.

We know that every year there are parties. A safe graduation night is a very good idea, but the bottom line is that a few kilometres down the road, or a couple of days before or after, there's another party, and that party is not safe. We know that. It's a pattern.

So we should be able to address that, rather than ignoring it and considering moving everybody into an area of abstinence, which isn't going to happen. That's our aim with safe graduation: to try to move everybody from the red into the green--abstinence. But we know it's not going to happen that way. We know teenagers are going to be using, so we need to approach that.

There was one event that was not accidental that night. Has anybody spotted the event? It was one event that was purely out of the blue, sheer good luck. At that party there was a teenager who knew first aid, who knew how to recognize a decreasing level of consciousness in another teenager. That teenager had learned first aid years and years ago as a boy scout, and he recognized this even though he was at that party. That was an accidental event.

The fact is, it need not be an accidental event, because teenagers can learn first aid. Teenagers can learn what to do if things go awry with substance use, if only we tell them what can go awry and how to deal with problems that come out of substance use; in other words, acknowledge that use happens and then deal with the possible consequences of that use. Teenagers themselves, being the major role players because they are the ones who use, are the ones who must get themselves out of the problems that arise from use, or prevent the problems that arise from use.

There is a lot to learn from very simple graphs, isn't there? In this next slide there is a third graph. This one tells us that whenever we talk about drug education in schools, we talk about alcohol, tobacco, and cannabis, and we talk about it as if they were happening exclusively and uniquely by themselves. The fact, though, is that teenagers who smoke use cannabis and alcohol, and about 25% of those teenagers use all three. Therefore, we cannot continue to do drug education one drug at a time, when this is the picture: that teenagers have a constellation of high-risk activities.

You can add sex to that as well. Sex during drug use is one of the unplanned, unwanted consequences of substance use--for example, unplanned sexual activity. We talk about AIDS, we talk about pregnancy, but there are also the very subtle psychological and emotional hurts that a person can experience, especially teenagers, as a result of finding themselves in a situation where they've had sex without ever having meant to, at the time when they were drunk or under the influence of a drug.

I said at the beginning that my focus was going to be on teenagers in the mainstream or in school. The fact is that for the past one hundred years there has been a movement for drug prevention that attempts to prevent all and any substance use, including experimentation, and that movement is very strong in the United States. We've also adopted that to an extent. Clearly, with the statistics I showed you before, this increased prevalence in substance use in the past decade that we've seen not only in the four Atlantic provinces but also in other Canadian provinces, the U.S., and the United Kingdom certainly suggests that primary prevention is not the most effective kind of approach.

The alternative, then, is to look at harm reduction. The problem is there is very little out there in the way of concrete, useable information about what harm reduction is, what it means, how it should be done for teenagers when we're talking about teenagers in school as opposed to street teenagers, where the issues are entirely different. There are only a handful of studies in the international literature. The best comes from Australia and the U.K. A little bit comes from the United States, where the policy framework is so different that the information is not necessarily very transferable to this country.

The bottom line is there's no proof. Harm reduction seems like the intuitively correct way to go, but there is no evidence. At this stage in Canada we have adopted an evidence-based method or approach to health care services, to policy development and all that. We want to know that it's going to work, how it works, why it works, and where it doesn't work before we embark on something holus-bolus.

The situation for teenagers in school is quite complex. First of all, they're teenagers. They're not autonomous. The activities they're engaging in are clearly illegal--not necessarily illegal activities, but the substances are illegal. For teenagers under 19 in this province, alcohol and tobacco cannot be acquired legally. Cannabis, of course, is illegal for all of us to possess.

Á (1145)

Behaviours happen in the community. Most drug use does not happen in schools, but schools have been given the portfolio because kids are a captive audience, so to speak. We know that kids are not a captive audience, so behaviour happens in the community.

The school has been given the problem, but the budget resides in health. Of course, the community doesn't have any budget. It becomes very complicated to know how to frame this. Schools are not exactly conducive to allowing autonomy among students. The schools have a public mandate for public good. They must provide public education. So the way schools are set up doesn't necessarily allow a harm reduction approach. The final thing is that we really don't know that harm reduction does in fact work.

I'm almost finished, Madam Chair.

Here's what we need to know. We need to know in which direction school-based drug education should go, and whether we should adopt a harm reduction approach.

By the way, we've adopted the British term, “harm minimization”. The real question is, what is this beast called harm minimization or harm reduction for teenagers, especially mainstream teenagers?

At this point I'm going to bring to your attention the definition that is from Patricia Erickson, who is a criminologist. It was published in the Canadian Medical Association Journal. She breaks it down into a few components of what we think we might mean when we're talking about harm minimization for teenagers in schools. It is education about rather than against drugs--the facts. It's also the facts about the benefits, not just the risks. It is credible, accurate information--no propaganda. It acknowledges the appeal of drugs, why teenagers use them, but also acknowledges the flip side--the risks and the consequences. And finally, it takes into account where a teenager is in his or her development. There's a world of difference between a 12- or 13-year-old and an 18- or 19-year-old in terms of the decisions they can make. An 18-year-old can vote for our prime minister.

I've brought you back to the risk continuum at this point because it's the most concrete way we've unearthed here in Nova Scotia by which to consider harm reduction at this point. What we're talking about is that there's a population of teenagers. There are some who don't use, some who use, and some who use to the extent of experiencing problems. We need to take care of all teenagers from where they are. The idea is to bring teenagers back from the high end of the continuum, the red area, toward the green. Some teenagers will never be abstainers, but they do not need to face such dire consequences as some of them might be currently facing.

This diagram has policy implications, for example, in terms of resource allocation. We need to allocate resources for all components of the risk continuum. Currently, we certainly allocate resources for treatment at the high end of the continuum and we certainly allocate resources toward primary prevention. It is the middle group that has been ignored for a long, long time.

Here I bring you to the end. Here is what we need to know about harm minimization before making a lot of decisions about it.

It seems like a good idea, like a natural and intuitive way to approach teenagers' substance use, but the bottom line is that we need actual evidence about these things--what harm minimization is; how it should be done, precisely or generally; whether or not it actually works. All of this is an approach to school-based drug prevention or drug education. And, I would add, we need to know about that in Canada. It is one thing to look at Australia, the United States, and the United Kingdom, but their policy-setting is so vastly different from Canada's that it is simply not good enough evidence for us to be able to endorse harm minimization right now, as things currently stand.

Á (1150)

Let me give you an example. Australia also has a national drug strategy, as Canada has a national drug strategy. Their harm minimization or harm reduction strategy was adopted, not only federally, but also adopted by all the states and territories independently, such that all the school systems within the states were able to adopt harm minimization or work towards that, for example, by implementing it in school curricula. That is vastly different from Canada, where harm minimization has been adopted at the federal level but not necessarily endorsed or ratified at the provincial level, and certainly doesn't have any impact necessarily on the education system, where we are attempting to conduct most of our education for teenagers pertaining to substances. Those differences are not trivial. The differences with the U.S. are even bigger than that, and that is why I say we need the evidence in Canada.

Thank you very much.

Á (1155)

The Chair: Thank you very much, Dr. Poulin.

Dr. Christiane Poulin: How many minutes was that?

The Chair: I'm not telling. But I gathered even your fellow panelists were quite fascinated by the presentation. I do apologize to them for the time difference.

We'll now go into questions, and I will be strict. The first questioner is Mr. White. If Mr. White directs the question to you, and another panelist is interested, if you could just indicate, I will keep track.

Mr. White.

Mr. Randy White: I want to thank you all for coming.

Christiane, I'll make your day, because I think that's the best presentation from a researcher I have heard in years. I want to congratulate you on that.

Some of you expressed yourselves in a philosophy very similar to my own, so I'm going to come back to that part.

Howie, you said a couple of things that I really can't figure out here. You made a statement about allowing the individual to determine their own direction. I presume you were talking about an addicted individual. Could you explain what you meant by that?

Mr. Howie Sullivan: Yes, exactly, I meant the service user--somebody who would access services at the needle exchange program. We're there to provide nothing more than, fundamentally, needles and the equipment that is needed to inject clean. If that's all a person wants, that's fine. Over time we have realized that the more contact an individual who is injecting drugs has with us, the more likely they are to engage in dialogue about other issues that move away from the actual injecting or using and that go into the realm of their own health and well-being.

Mr. Randy White: But are you suggesting that individuals who are addicted to the point where they are shooting up--every day, all day--selling themselves, breaking and entering, doing home invasions, are able to determine their own direction?

Mr. Howie Sullivan: I believe they have a right to determine their own direction. Whether they're able to move in what you or I may see as being in the best interest of themselves or others is not necessarily how it may be. But at the end of the day, I believe they have the right to make their own decisions, yes.

Mr. Randy White: Do they have the right to stay addicted and participate in home invasions to get money to supply their drugs?

Mr. Howie Sullivan: They certainly have a right to continue using. If the criminal aspect of drug use, as opposed to drug distribution--we're talking about drug use--was removed, then perhaps they wouldn't have to break into somebody's home in order to feed their habit.

Mr. Randy White: Where I'm coming from, much to the dislike of my colleague shaking her head here, is what about the concept of individuals, and I've seen lots of records, with more than a hundred convictions? What about the concept of an individual who's an addict and is mandated to go to a facility for a year or two years for the purpose of getting them away from drugs? Do you agree with that?

Mr. Howie Sullivan: Are you talking about incarceration or rehabilitation?

Mr. Randy White: I mean a person in a residential drug facility.

Mr. Howie Sullivan: Are you asking me if I'm in agreement with a mandatory treatment program?

Mr. Randy White: Yes.

Mr. Howie Sullivan: Yes.

Â (1200)

The Chair: Ms. Masching wants to comment.

Ms. Renée Masching: I just want to speak briefly on mandatory programs. You can lead a horse to water, but you can't force it to drink. Mandatory programs traditionally don't work unless a person says “I have a problem and I need help.” That's Howie's point.

The first time you come into the needle exchange, the twentieth time you come into the needle exchange, all you need is the works and maybe a place to stay warm and dry for a couple of hours or a couple of minutes. As time progresses and trust builds, you start to have the option of talking about what else is available. I don't have the statistics or the research, but I know it's out there.

Mr. Randy White: I appreciate that. However, a majority of individuals who are addicted will not go to those facilities, so what do we do?

We see 60 people in a methadone clinic here in town, but there are one heck of a lot more than 60 people addicted to drugs in Halifax. They're breaking the law and doing everything they can to get their drug habit fulfilled. What do we do?

Ms. Renée Masching: That's where additional steps in harm reduction become important: the determinants of how that has become the new model--or the old and new model--Health Canada is working from.

Maybe the solution is to ask whether they have adequate housing and food. Let's reduce the reasons why you need to break and enter. Let's reduce the reasons why your money is going in one direction and not the other.

We've certainly seen it in one of the communities I work with in New Brunswick. When people were able to access methadone, there was a radical decrease in the number of break-and-enters and crime in that specific community of 400 people.

So we need to offer alternatives that aren't necessarily to the extreme of mandatory treatment. But you're right, we need to intervene. It's not acceptable for society to be menaced, but there are steps in between the two extremes. I would offer that as a beginning.

The Chair: Ms. Dykeman.

Ms. Margaret Dykeman: I would add that some of the mandatory treatment sessions and not even mandatory treatment.... Let's say you put somebody in jail for doing one of these things, and it happens to be one of the few jails in the country they can't get their drugs into, if there is such a jail. When they come out of that situation and should have been clean for six months, if they haven't taken any drugs, all the angst should be gone. But we've historically sent them right back to where they came from. We haven't supplied them with any kind of support, services, counselling or anything on the outside that might help them.

I can tell you from my experience in working in the community that three days later they're out on the street again sitting around the same barrel of hot coals and sharing the same needles. You can ask them why, and they'll look you in the eye and say “What else is there for me to do?” So I think we have to look at those programs too.

Mr. Randy White: I'm asking a question, not making a statement. I did not say to put them in prison. I'm personally wrestling with what we should do with the people who don't go to the--

Ms. Margaret Dykeman: I'm not saying you said to put them in prison; I'm just using that as an example. We don't need to talk about mandatory treatment programs, we can just talk about our people who are incarcerated who don't.... And there are a few places where you can't get drugs in jail. We still don't have any kinds of services on the other end for them, and a lot of times that whole piece is lost because we haven't followed it up with continuing treatment.

Mr. Randy White: Do any of you agree that harm reduction includes the legalization of any drugs? Do any of you agree with that statement?

Â (1205)

Dr. Christiane Poulin: May I speak?

Alcohol is currently legal; tobacco is currently legal. From that perspective we certainly have adopted, as a society, a tolerance to some substances, within parameters. I think the major issue for cannabis involving teenagers--because teenagers and young folks are certainly the predominant users of that substance--would be more decriminalization than legalization. There is still a lot of room to work within the system as it exists, but looking at a decriminalization of certain aspects of the law would be another way of dealing with it.

Mr. Randy White: I've got thirty seconds.

Margaret, you indicated that marijuana, of course, is a lot stronger today and is basically not a safe substance, and I would agree with that. Also, if we're spending hundreds of millions of dollars trying to tell people not to smoke, I don't know why on earth anybody would be thinking about making smoking marijuana a legal issue.

The issue of decriminalization of marijuana seems to me a red herring. That is, fining somebody for a small joint or two doesn't seem to me to resolve anything, because today we're not making criminals out of people who are smoking a joint or two anyway. They don't go to the courts today that I'm aware of. So isn't it just a bit of a red herring?

The Chair: Ms. Dykeman, and then Dr. Poulin.

Ms. Margaret Dykeman: Well, are we talking about legalizing something we're already doing?

Maybe the rest of the panel can answer better than I can, but I suspect--I would say at a clinical level, because of my nursing background--we've already done it but haven't done the paperwork to follow it. I'm not sure whether there's more to it than that, but that's what it sounds like.

Dr. Christiane Poulin: There is huge variability across the country, and even within provinces, about how the issue of marijuana is addressed from the legal perspective. It does have some consequence whether we're talking about legalization or decriminalization.

When I say there is room yet to think about decriminalization, I'm thinking about certain implications of policy--for example, in schools and school boards where possession of a small amount, any amount, really, can be dealt with by a school in various ways. We can have a very heavy-handed approach of expulsion, detention, and that kind of thing for an infraction that outside the school might not receive the same treatment. There is a lot to look at in terms of that kind of policy framing of the issues.

The Chair: Thank you.

I'll now turn to Ms. Davies, in an agreement between Ms. Davies and Mr. Ménard.

Ms. Libby Davies: Thank you, and thank you to my colleague.

A couple of us have to leave. I'm afraid I won't be here for the whole panel, but thank you very much for showing up today.

There's been so much misunderstanding, confusion, and misinformation about “harm reduction” or harm minimization that I think you've helped present a real picture of what's going on. Thank you for doing that.

I have to say I really disagree with any suggestion that somehow the majority of users are refusing treatment. In our situation in Vancouver, people are crying out to get into detox and into treatment. Or sometimes treatment is available but not accessible because the barriers are so high. They are based totally on abstinence, and you've got to be practically clean before you can even get in the door. All of those realities are there.

I wanted to focus on the question of education, because probably if there's one thing we all agree with totally, it's the idea that there has to be education. But it seems to me that then the question is what kind of education. You've really pinpointed that today.

We've heard lots from RCMP about the DARE programs, which from what I know and have seen of them are based more on a message against drugs--“Just say no”--than on your suggestion, which is education, informed decisions, and health and well-being. I strongly support that.

I think one of the arguments that gets thrown out all the time is harm minimization education or reality-based education really are enabling it. We're enabling kids to get into the lifestyle or whatever. How do you respond? Have you seen any programs in effect? You say intuitively you have a sense that the programs would be good. Are you aware of any models operating in Canada we could look at?

Â (1210)

The Chair: Dr. Poulin.

Dr. Christiane Poulin: There are two questions. First, there is a claim that giving any message other than “don't use” condones substance use. I think it's the key thing for a risk continuing. As I've shown, a more correct message would be if you use, this is what might happen and this is what you should do.

There is no way we should ever drop the message of not using drugs. It is part of a risk continuum. For some teenagers, not using drugs is the way they will remain safe. We should not throw out the baby with the bath water. It is a good approach.

The fact is it doesn't really meet the needs of a large percentage of teenagers. We need to look at their perspective and work with them from where they are. We should never abandon the notion that abstention or non-use is part of the way that we, as a society, address substance use in teenagers.

Are there any models in Canada? Nova Scotia is currently testing this idea in the field. We are almost at the end of a research project of several years and will be reporting.

Ms. Libby Davies: You will be reporting in schools?

Dr. Christiane Poulin: We will be reporting in schools. We will be reporting on it at the end of 2002 or at the beginning of next year. It will provide us with some evidence on it.

There has also been a project in Manitoba involving some 22 schools. Again, it is a different take on harm reduction.

There are a few projects. I've named two. There aren't very many, are there?

Ms. Libby Davies: Are you familiar at all with Marsha Rosenbaum's work?

Dr. Christiane Poulin: Yes, of course, I know her work from the Lindesmith Center.

Ms. Libby Davies: They're doing similar work.

Dr. Christiane Poulin: Yes, except it is under the guise of a federal policy that does not allow them to really investigate the idea of harmonization.

When I say there's little evidence about harmonization in schools from the United States, there is exactly one good study done in one school. It's only 50 students who participated in a private school. It's looking under every rock.

The reason for it is, with the federal policy, public schools really cannot embark easily on research projects that seem to go against the mainstream message of “do not use”.

We're not going to get the best evidence from the United States. It's going to be from Canada.

Ms. Libby Davies: Okay. I have a quick follow-up.

Obviously, a needle exchange is one example of harm reduction. It would be great if we did have a strong federal policy. It would be a beginning.

I think, Howie, you raised the whole implementation issue. Right?

You can have great policies around having needle exchanges or whatever, but when you meet resistance in a local community, the NIMBY syndrome, “not in my backyard”, can be pretty difficult to deal with.

I wanted to ask you, Margaret, or Renée, if you have any suggestions, as we're formulating recommendations, about what could be done.

Australia is a good example where you said it went federal, state, and local.

How can we provide the continuum here so we don't only have a great policy, but we're actually helping to get it implemented and aren't having municipalities or local communities fighting against a needle exchange, a heath clinic for drug users, or whatever it might be?

Mr. Howie Sullivan: I think the whole notion of harm reduction and the impact of reducing the harm caused by needle use and drug use via IV is something that has to be transferred. At the federal level, it has been adopted in theory as a great approach. But to take that information and transfer it to the provincial level, and then from the provincial to the municipal, is the missing link.

You're right, people say “Not in my backyard.” Well, of course. I mean, at our fixed site in downtown Sydney, there are no residents around. But the outreach components are in the middle of several residential communities throughout Cape Breton.

How to do that is by involving the community, involving the drug users. They are the experts. They will tell you how to do it. Believe me, they know how to live. They know how their needs need to be met. Bring them to the table. Bring people who are injecting today to the table and ask them what their needs are. Ask them how you can help them. And believe me, they'll tell you. They tell me every day.

Â (1215)

The Chair: Thank you very much.

Ms. Masching.

Ms. Renée Masching: Thank you.

I completely agree with Howie. But you start at all levels. Have the people who are using, who will use the service, and who are the active addicts in the community help to explain what their needs are. That's where it has to come from.

At the same time, as a community-based organization we sit and identify where the power rests. In some communities it may rest with a church. In some communities it may be city hall. And in some communities it may be both. Or it might be in the local fire department, where everybody gets together on Saturday night. So identify those places, educate there, and allow those people to be part of the process too.

In my work it's going to our leadership and expressing the need for harm reduction, that the notion of harm reduction is imperative, and these are the reasons. Often I find that we end up in a fight in a community because we're starting.... Maybe it's just without even following a protocol. You're actually not able to introduce something in the community because it's “not in my backyard”, and because the people you should have spoken to, whose noses are now out of joint, aren't going to help you.

Sometimes it seems so simple, yet we don't get as far ahead as we could. But I think that's really.... And be very broad in understanding who makes the decisions in the community. If it's the women--the women's auxiliary...get to know the community. Get to know the people. And identify needs at a variety of levels.

The Chair: Mr. White was heard to mutter “It's always the women.”

Ms. Dykeman.

Ms. Renée Masching: The majority of the panel today, too.

Ms. Margaret Dykeman: I was just going to add to that.

I think you have to approach it from a multi-point basis, too. It's not just an individual drug addict problem. It's a community problem. It's a public health problem, because our children step on these needles. I mean, we find them in the pool where the kids go to play. It's a violence problem, from the criminal side. So I think we need that very broad-based direction in order to get all the players we need.

In the two communities in New Brunswick where we have good programs, the police were the people who came to the public and said “We need to do something because the public's at risk.” And that has worked much better than when we go into an RCMP police community and say “We need your help.”

So there are some of those instances out there. I think we need to draw on other people's experience too.

The Chair: Thank you.

Thank you, Ms. Davies. Bon voyage.

Monsieur Ménard.

Mr. Réal Ménard: Thank you.

[Translation]

I will begin with Mrs. Poulin.

During the two days we have spent here, we heard a lot about a very worrisome trend, an increase in the use of injectable drugs in the Atlantic region. I would be interested to know what the triggering factors are. I am quite a supporter of the harm reduction model. I am the member of Parliament for Hochelaga-Maisonneuve. It is a model that has been experimented since the early 1990s by Dr. Morissette, whom you may know since you have linkages or networks in Montreal.

The figures you gave in your presentation are captivating: a survey among students shows that 50% used alcohol, and 50% abstained. Among those 50% of users, 5 to 10% have a drinking problem.

Do you have an explanation as to what is the trigger for this drinking problem in teenagers? Is it related, for example, to factors such as social class?

In this regard, one of your colleagues who is a psychologist here in this province has established a link between these problems and the lack of recreational facilities. I asked him if this situation would improve if Nova Scotia had a recreations and sports policy. He said yes. Although I know one should not oversimplify, I believe we need to better understand what triggers the problem. So I would like to ask three questions and I will start with this one.

Â (1220)

Dr. Christiane Poulin: What are the triggering events? In terms of the increase, what we call the upper trend, we really do not know why things turned out this way in those specific places, but this seems to be a worldwide trend or at least one that happens in many countries. But at this stage we only have theories to explain or try to understand the causes. One of these theories blames economic changes that occurred, while another one points to societal change that makes people more tolerant, or less intolerant, towards drug use. Others focus on the fact that the parents of today's teenagers came of age during the 60s and 70s, a time where drug use was very widespread, a fact that could explain that these parents show more tolerance. However, these are only theories.

In the United States, the argument is made that funding for primary prevention has been cut, which means that less resources are devoted to promoting abstinence and that this had lead to problematic behaviour among teenagers. These are only theories and I am aware of no study that would provide definitive answers to this question.

Mr. Réal Ménard: Do you know the study to which I made reference? What was the name of the psychologist who was sitting yesterday in Mrs. Masching's chair? McKim.

Dr. Christiane Poulin: Bill McKim, from Newfoundland? I know him.

Why do these things happen? Why does a child start experimenting and get into all the resulting problems. You could ask the question at the level of the individual, and this is the field of psychology, but you can also ask it at the level of the teenage population. At the level of the individual, there are all sorts of theories, including that you mentioned. However, I myself am more interested in what happens at the level of the teenage population.

Let us take, for example, social or economic factors such as poverty, licence and culture as can be observed in various population groups or sub-groups. Even there we do not have a good grasp of why teenagers are getting into this problem. We are just starting research in order to understand the problems in this population segment. There are differences within population groups in Canada. In Ontario, for example, a smaller percentage of people have drinking problems than in the rest of Canada, but no one really knows why.

Mr. Réal Ménard: Facetiously, one might wonder if Mike Harris might have something to do with it, but that is not my question. As a clinical practitioner, could you discuss the relationship between self-esteem and suicide. My views have changed since we embarked on this work, specifically since we went to Burlington, the riding of our chair. In Hochelaga-Maisonneuve, the neighbourhood I represent, there are some very negative trends, there are many positive things in that area but also a high prevalence of criminal activity, single parents and school drop-outs. It is understandable that people in such circumstances would turn to drugs as a means of escaping reality.

In your clinical practice, have you encountered cases of talented young people having a good life, who are grade A students from well-to-do families who abuse drugs?

Dr. Christiane Poulin: There are all sorts of circumstances and responses are very diverse. You can look at individuals or at populations. There are neighbourhoods, such as Hochelaga-Maisonneuve, where you have lots of poverty and unemployment, etc. These are macro-influences that impact individuals. But there are also emotional and health aspects that can either increase or decrease the impact on a specific individual.

For example, we talk about resilience. We know that some children live under absolutely terrible circumstances but who, one way or the other, are able to overcome the impact of their environment. We also know young people who are living in positive circumstances and who fall into drug abuse without there being any reason related to their environment.

Â (1225)

Mr. Réal Ménard: I have a last question before going to Mr. Sullivan. All considered, your presentation today seemed to say that at the school level... Earlier, we had a rather optimistic presentation from the RCMP. They say they reach some 6,000 teenagers a year in the school system. On the other hand, you seem to say that in terms of available material in schools, you do not really have the tools you need for positive action.

I am not convinced that this needs to be done at the federal government level but what are you giving us to understand regarding the tools you have available in the school system?

Dr. Christiane Poulin: First of all, we need to take the time to find out. We have been doing things a certain way for the last 20 or 30 years. It does not seem to work very well. Why would it take only a year to come up with new ways of doing things? It will take a lot of time to check the effectiveness of new methods.

[English]

Secondly, a policy is simply an enabling tool. In the case of federal policy, it can allow for a range of activity, a range of approaches. In the case of our federal policy on harm reduction, it does that. That is not the only part of how we want to move forward with harm minimization. If I can look at Australia again, I will point out, for example, they have adopted harm minimization in schools while not having the proof that they should be doing it.

So in a sense policy is a two-edged sword. It is permissive, but it can also be an imposition. It can introduce change, but the change may not necessarily be in the right direction. So I'm rather pleased about Canada's stance in the sense that there's enough movement to be able to cautiously, carefully, taking the time it takes, look at a different approach.

[Translation]

Mr. Réal Ménard: Do I have time for a last question, Madam Chair?

The Chair: Yes, a short one. Did you have a question for Mr. Sullivan?

Mr. Réal Ménard: No, but I will ask one. In fact, it is a question for both of them.

You seem to say that there has been funding for setting up a needle exchange program in a city--I did not understand if it was Moncton of Fredericton--but that prejudices were such that no one wanted to house the site. Did I understand correctly and does either one of you have a profile of the user? We visited four needle exchanges since we started on this study and I would be interested to know what is the profile of the typical user here, in the Atlantic provinces.

[English]

Ms. Margaret Dykeman: I can answer both of those questions from my perspective.

The community group in Moncton received funding to do a needs assessment in Moncton, looking at what kind of program would probably work there through one of the special funding project moneys from I don't know whether it was Population Health Canada or ACAP, but one of those groups. They did that. They put together a report. They had the program all designed, but they cannot find a place within the area where it's handy to the people who need it to set it up. They're still working at it, but it's taking time.

The profile for the users at our needle exchange is that they are getting much younger. Up until the last quarter to six months, we were seeing the majority of our people being 25 to 45. In the last six months 41% of our people are 17 to 20 years old--both males and females. You get people who are regular users of a needle exchange program. You get people who are users for other people besides themselves. We'll have people who come in with whole bags of needles and go away with the equal number of needles to distribute to their cohorts. They believe in what they can do and the good of them, but there are people still too afraid to actually show up at the site.

You get some of that kind of stuff going on. You get people who for the first two or three or even maybe four to five visits come in, grab their needles, and run away. But then they begin to see that there is some benefit to sitting and getting counselling and maybe picking up whatever food is available that day. I am pleased to say that in the two years that we've actually had a fair number of people coming through the door, we've had several successes. Those people are no longer needing needles. We meet them on the street and they say hi, I'm good, I'm fine.

So even in our small program and project, we are seeing some successes. They're not the only ones I call successes, I'm afraid. I also say that the ones who can get off the needle for two or three months but then fall back into the routine again have had a success for them. If you look at the time some of these people have used--not these ones maybe, because they're not 20 yet, but some of the long-terms have used for 20 years, have never been clean for three days, and even five days in that kind of a regimen is a positive step in the right direction.

I don't know if that answers your question about profile, but that's pretty much what we're seeing these days.

Â (1230)

[Translation]

Mr. Réal Ménard: Yes, but was it for physical reasons that the site was not set up? It was not because people in the community did not want it, but because you did not find a proper place. It was not the same situation as in the 80s where there were situations I remember where people sometimes did not want to have shelters for people with AIDS in their community. We have had such cases in Montreal and elsewhere. But in your case, it is due to physical reasons and not prejudice, or is it?

[English]

Ms. Margaret Dykeman: No, it's prejudice in this case, because the landlords for the AIDS Moncton building, where they're sited at the present time, has told them they will cancel their rent if they open up an exchange within that organization. They have also had insurers say that if there is going to be a needle exchange in the building, they will not insure them. It's those kinds of issues. Hence, they haven't been able to find somebody who will rent them space and who will insure the project.

The Chair: In terms of the profile, can you also tell me what people are injecting?

Ms. Margaret Dykeman: The main drug of choice in Fredericton and surrounding area is dilaudid. No drug user is a straight drug user ever, but that's the majority.

The Chair: Okay. Mr. Sullivan and then Ms. Masching.

Mr. Howie Sullivan: With regard to the profile of an IV drug user in Cape Breton, we've never actually done a profile per se. We have seen a big shift in terms of age, as Margaret spoke to. We are seeing more and more young people turn to IV drug use, and there are a number of reasons that we believe are behind that.

We're also seeing a tremendous number of steroid users coming through the doors of our needle exchange program. They're accessing services through the local gyms in the area and they're also coming on site. What's interesting is that they're coming in to be trained on how to inject into the muscle without causing problems.

We're also seeing more and more women and more and more young women come through the doors and access services through the outreach sites. That's some strong tip-off language.

In terms of what drug is the predominant drug of choice, it's prescription opiates, predominantly OxyContin at this time throughout Cape Breton.

Â (1235)

The Chair: Just before I turn to you, Ms. Masching, Ms. Dykeman wanted to add something.

Ms. Margaret Dykeman: I wanted to add that we actually have started a database around all of this in many of our needle exchange programs in Fredericton, so there will be hard data in another year or so about the whole profile of what's going on.

The Chair: Ms. Masching.

Ms. Renée Masching: I wanted to add to some of the discussion about the needle exchange in Moncton. Certainly housing is a barrier, and insurance is a huge barrier, that actually relates to some of the questions around needle exchanges being federally mandated and federal law versus provincial mandates and provincial law and how the two do or do not mesh.

But what is the really fundamental problem? Nobody will fund the program. There's no money. If they were offered the money to start the program, I have no doubt they are creative enough, that my colleagues in Moncton have the dedication and the passion to find a location or to create a mobile program or look at options. There's no money. Everywhere they've turned they've been turned down. The location is certainly a barrier, as Margaret has spoken to, but there's a much more significant factor. You can reach around the rent, but you must have the money to pay it somehow.

I would also add that in Fredericton dilaudid is seemingly still a concern, but in the Miramichi and other parts of New Brunswick we're hearing more about heroin and cocaine use, which is a stunning and rather intriguing and confusing reality right now. I don't know where it's coming from or how, but that's a trend that's been identified recently.

The Chair: Thank you, Ms. Masching.

I'll now turn to Mr. LeBlanc and Mr. Lee.

Mr. Dominic LeBlanc: Thank you, Madam Chairman.

I was going to ask Margaret the question that Réal had asked. I wasn't aware of the particular circumstances in Moncton and I was curious to hear your reaction.

I had a question for Margaret and one for Renée.

Margaret, I understood that HIV cases were on the rise in rural New Brunswick and rural communities. You alluded to the fact in your statistics. Whether it ties into intravenous drug use or not is obviously the issue. Am I correct in understanding that reported HIV cases in rural communities in New Brunswick are rising? If so, why do you think that is?

The question for Renée, if I may, Madam Chairman, is based on her allusion to the federal-provincial dynamic in the delivery of health care services, and perhaps in some people's opinions the need to have the federal government mandate needle exchanges or deliver directly needle exchanges. But Mr. Ménard and his colleagues would, perhaps correctly, become quite exercised about the federal government delivering directly health care services in provinces. So that is the constant barrier, the federal-provincial dynamic.

However, the one place where the federal government has direct responsibility for delivery of health care services is with first nations. You often hear that the Government of Canada is in fact the 14th jurisdiction to deliver health care services--ten provinces, three territories, and the feds with respect to first nations. If that's accurate and that part of it is accurate, from your experience with aboriginal communities--and I've spent a fair bit of time at Big Cove and others in my constituency, but particularly Big Cove, because it's a big first nation--is it your sense that the federal government, with responsibility for first nations health in Health Canada, differs in their harm reduction strategy or approach or willingness to look at harm reduction from that of other provincial governments with whom you deal in the four Atlantic provinces?

How is the approach of Health Canada with respect to first nations different in harm reduction from that of the government of New Brunswick, if you went to a regular hospital in Moncton or in Ste-Anne near Big Cove?

The Chair: Ms. Dykeman.

Â (1240)

Ms. Margaret Dykeman: We have regional testing centres. I can't really answer your question as to whether they came out of the rural community because most of the testing is done within either the anonymous or the confidential testing sites.

I do know that seven of last year's injection-drug-using community are using the services of AIDS Saint John for their service base. We have at least one, and maybe two, in Fredericton that I know are rural because they're coming out of communities that I'm aware of.

We hardly have enough urban in New Brunswick to say one or the other. I don't really think it makes a whole lot of difference. The drugs are in both. If I go to urban high schools, they're there. If I go to community high schools, they're there. I don't think there's any great difference.

Mr. Dominic LeBlanc: Thank you.

The Chair: Ms. Masching.

Ms. Renée Masching: I haven't heard the 14th jurisdiction before. I like that.

What's happening primarily around health in the Atlantic is the transfer process. There has been a lot of devolution from headquarters at First Nations and Inuit Health Branch down the road out to the communities. In particular, communities like Big Cove have transferred early and have taken full control of their health care programming. The administration of the non-insured health benefits program still rests with headquarters.

I think what happens to that inherently is greater flexibility. And, as I think you said regarding policy, it has its pros and cons. In communities such as Big Cove that have taken an approach to whole health and wellness and have a large community, a large amount of funding, and a well-educated staff who are committed to healing, the programming they are able to develop is incredible. They are role models across the country.

For small communities that have a population of a hundred people your health program may be able to afford a community health representative three days a week. The dedication may be there, and the capacity may be there, but the funding and the time aren't.

We work quite closely with Health Canada and with First Nations and Inuit Health Branch here in the region. They have been very much open to supporting and working with the communities however we can. In fact, because of some of the concerns around injection drug use just recently we had a meeting with several of the key program people at First Nations and Inuit Health Branch to discuss how we are moving forward, how we are informing leadership, what plans we are going to start to put in place to assist communities to respond.

I don't know If that answers your question, but I would say the defining difference is flexibility.

Mr. Dominic LeBlanc: So you think it's a fair statement to say that Health Canada with respect to first nations health is more flexible than would be a provincial health department for somebody who was not an aboriginal person?

Ms. Renée Masching: I think that's fair.

Mr. Dominic LeBlanc: Thank you.

The Chair: Thank you, Mr. LeBlanc.

Mr. Lee.

Mr. Derek Lee: Thank you.

I want to follow up on a couple of comments that were made earlier. Mr. Sullivan, maybe back in the saddle, made a comment about reasons, which he didn't get around to stating, for an apparent increase in intravenous drug use. Perhaps we should get this on the record.

Then Ms. Masching made reference to an apparent increase in the amount of heroin and cocaine use in the areas she works in, geographic or other. I was curious. Could she speculate as to why there are those increases? Where are they coming from? Who is generating the market? I am asking, why the increase? Where's the supply coming from? Who is doing it?

Lastly, I don't think anyone has asked yet how many drug-dependent persons there are in Halifax. Maybe we have asked and I've missed it. Dr. Poulin may know. There may be an estimate out there. How many people in the Halifax area have to serve their brains--what is it, the meso-limbicdopamine system of their brain? In other words, how many people are drug-dependent, have to have the drug, and are dedicated to doing that and doing all things necessary to do that, in the Halifax area?

We visited the methadone maintenance program yesterday, at least one of them. It's handled 60 with a bit of a waiting list, but we're not sure how many people out there are drug-dependent and potentially serviceable by that kind of a facility.

In any event, there are three questions there.

Mr. Sullivan, you had mentioned that there were reasons lying behind an apparent increase in intravenous drug-taking and you didn't get around to saying what those reasons were. I'd be interested in hearing those.

Â (1245)

Mr. Howie Sullivan: It's affordability, number one. It's also the means of ingestion: needle use is a quicker high. In the case of prescription opiates or opiates in general, it tends to last longer in the initial stages. In the early stages of injection, before tolerance is built up to the drug or the medication, whatever it may be, the high lasts longer for the individual. Of course, that changes over time as the person develops resistance, but that's not an issue to a young person who has $20 or $25 or $50 and wants to get high for the weekend. They can buy some prescription pills, break them down, and use them. They're not thinking about the fact that they're going to have to do that six times a day a year down the road.

Furthermore, in the industrial area of Cape Breton at least, predominantly two or three years ago, cocaine was the primary drug of choice throughout the community. That has shifted because with cocaine the high lasts only a short period of time in comparison to a prescription-based opiate, whether it's snorted, rolled up and smoked, or smoked in the form of crack cocaine. It's very short-lived and the paranoia that results afterwards is not the most pleasant experience for the addict.

Opiate-based addiction is different, in that those effects aren't seen immediately. Somebody who is new to the drug-using culture and new to the drug-using community or who is entertaining the notion of using just as a recreation doesn't see those things when they're talking about opiates. As a result of that, they choose to inject as the primary means of ingestion.

Mr. Derek Lee: So these are new entrants into this wonderful new field you're talking about when you're talking about increasing intravenous drug use. These are not switchers from other, long-time forms of ingestion. These are new users.

Mr. Howie Sullivan: Right. It's people who are just coming on the scene, more often than not. I think the evidence would support that other drugs like alcohol, marijuana, and so on have often been referred to as gateway drugs. There's a lot of truth to that, I suppose, but if somebody is looking for a way to escape whatever their reality is, they're going to do what they have to do to get there. To me, that links back to the fact that drug use is just a symptom of a greater social breakdown.

The Chair: Ms. Masching.

Ms. Renée Masching: This is where I say for the record that this is purely speculation.

When I was in one of the communities and asking what were the drugs of choice, I heard “heroin”. My first question was “Are the Hell's Angels around?”, and the response was that somebody had recently been in jail and had come home and talked about connecting with the Angels.

A month or so ago there was a big bust in Moncton. That's the only connection I could make to where heroin is coming from, in my experience and the work I've done with my colleagues in the region about where drugs are coming from within the region. I don't know if this recent bust has had any particular impact on that, but that's my primary speculation about who's bringing in the drugs.

There are bootleggers on the reserve, in the communities. You can bring it in, and if you make it an interesting drug people will migrate to what's considered the best of the best. Heroin and cocaine are considered classier drugs. They may get chosen over others just from a perception point of view.

Mr. Derek Lee: Do you know the number of addicts?

The Chair: Does anybody know how many addicts there are in Halifax, or in Nova Scotia?

Â (1250)

Dr. Christiane Poulin: We don't know, and nobody knows. Any number is suspect, so I don't believe any of them.

It's not for a lack of trying, because you can certainly call on the Canadian Centre on Substance Abuse or CCENDU, the Canadian Community Epidemiology Network on Drug Use, for that information. But in all the information regarding the numbers of addicts in the ten cities across the country that are part of this surveillance system, all the numbers are anecdotal. There are no white pages or yellow pages or registration for this behaviour.

The Chair: “Go online and find your name. Register with us.”

I notice that you're packing up, Dr. Poulin. What time do you have to quit?

Dr. Christiane Poulin: About a half hour ago, but it's so interesting.

The Chair: I know. I actually have questions for you, too, so if we can keep you until one o'clock....

Mr. Sorenson.

Mr. Kevin Sorenson: Thank you.

I was actually going to pass on the questions, because you have covered everything fairly in depth, and we appreciate your attendance here.

One of the concerns that I think you addressed, Dr. Poulin, was the 50% not involved in drugs. We discussed this yesterday as we travelled around the province a bit. Ultimately the goal, through education and through everything else.... The people who “just say no” are the people who are not costing the system to the degree that anyone else is really costing and feeding our concerns.

We have some who are opposed to the DARE program by the RCMP because they say the “just say no” message doesn't work. But a huge number of people, young people in high school, do just say no to drugs.

One thing I did appreciate--and I'm not sure if it was Margaret who said it--is that we do want to move individuals somehow to the point where abstinence is acceptable amongst youth.

As far as education goes, I've heard a number of parents who have gone to education programs dealing with the sex education in schools and who have come out saying that to a certain degree people who give the lessons go in with almost a defeatist attitude, saying there are very few of you who aren't going to do this. All of a sudden they're being stereotyped as an individual who is out of touch with reality. Even though they've made those choices, we recognize that people are in the minority. But I think that's one thing in our education system: how do you prevent an education system from becoming a how-to education?

We've attended needle exchanges and methadone facilities...or not even methadone facilities. Actually I'm thinking of a needle exchange where we saw a video on the harm reduction of needles, which was all good, but it could be viewed by some as being a how-to on injection. So as far as the education system is concerned, how do you do it?

There was one other thing here.

The Chair: In the interest of time, if I could get Dr. Poulin to answer that, that would be helpful.

Dr. Christiane Poulin: All 17 questions?

The Chair: Yes.

Dr. Christiane Poulin: In two minutes.

First, I want to provide you with the statistics that you mentioned.

About 30% of students in Nova Scotia don't use anything. In the U.K., about 5% of students don't use anything. So this province and the other provinces in the Atlantic, and actually Ontario, the other provinces that have student drug use surveys, fare quite well on the issue of not using anything at all. That's good news.

You've mentioned abstinence, and that for some students abstinence is an option. What we are trying to convey with this idea of exploring harm minimization is that abstinence is a viable option, but it is only one of a range of options that young people could use with regard to substance use. It is not to say that opening up the field of options then condones substance use.

Let me give an example. One message is “Don't use cannabis”. Another message that is just as important for teenagers to hear is if you use cannabis, don't get behind the wheel of a car. And if you use cannabis, don't get in a car where the driver is using cannabis, because you're just as much at risk if the driver is under the influence. If you use cannabis or plan to use cannabis, or are going to a party where cannabis is being used, make sure you have a way of getting home; plan it before you go. We do that as adults. We call it “designated driver”. Okay?

Drugs are a part of our society. Another part of our society and our societal values is the freedom to choose in many regards. So we have to come to terms with that.

You mentioned drug education or sex education as possibly having a defeatist attitude. I don't exactly know what you meant by that.

Â (1255)

Mr. Kevin Sorenson: Drugs or sex or any of it. I think a lot of individuals walk in with a defeatist attitude, saying we can't stop you from doing this and we aren't going to try. I'm not saying that some of this is wrong. I'm saying that they come across almost in a defeatist attitude. We want to portray very clearly that when you have sex as a young person, as a high schooler, as a junior high schooler, if or when you do, make sure that you--

Dr. Christiane Poulin: Protect yourself.

Mr. Kevin Sorenson: --have safe sex in a way that young people can understand it, so that you don't get AIDS, you don't get some type of transmitted disease.

Dr. Christiane Poulin: I love your analogy with sex education, but sex education isn't only about not getting pregnant or not getting AIDS and other sexually transmitted diseases. It's about a young person developing sexually in a way that fosters feeling good about oneself and about one's own sexuality and sexual orientation. Twenty years ago, if a teenager got pregnant in a high school, the teenager was expelled or somehow disappeared. We don't do that any more. We have probably a much more rational approach towards teenager sexual development than we used to have, and we talk about it in schools.

The same thing can occur with substance use. It is one thing to not talk about it and it is another thing to talk about it in a way that is strictly negative. What I think we're talking about here in our harm minimization is opening the possibilities for kids to talk about substances and allowing the discourse to happen, so that they can find where they stand, find what are the options that make sense for them, and then make some informed decisions about that, opening up a whole range of options that fit in with their own development and where they are as teenagers.

That again is part of our societal values. We value growth, we value freedoms in our society. So this is quite consistent with it.

The Chair: We have Ms. Dykeman, and then we have more questions.

Ms. Margaret Dykeman: I was just going to say on the sex issue that we've just completed a full study on sex and parents, sex and teachers, and sex and students. Now we've done all three phases. Sandy Byers has been in the news for the last couple of weeks. What the students are actually telling us in New Brunswick is that what they're getting in sex ed is not what they need. I think it's not just education of the student, but it's also education of the teacher, what we're teaching people, and education of the parents and the PTAs--or whatever the groups are called now, since my children all have children--to allow that. We still cannot, as an AIDS organization, go into our local high school with condoms. We have to start doing dialogue around those issues and move it along. I don't know what they'd say if we went in talking about needles. I have an idea. But we're not there or anywhere near there.

The Chair: Thank you.

Dr. Fry, we have a bit of a problem. I think the question I would like to ask Dr. Poulin is probably similar to what you're going to ask. It's a bit of what we were trying to pursue in P.E.I. I was so glad that you had “risk” up there, because it seems to me that in some ways all of the stuff is about minimizing risk and about giving people really good options.

Maybe we would do better by telling people, children particularly, some of the things you mentioned, Dr. Poulin, so that they don't just say no because everyone told them to say no; they say no because they want to say no. They may say no, not at this time, or say no to drugs and say they don't want to drink either.

Frankly, if we parse it out as tobacco education, alcohol education, and drug education, we're not getting the same kinds of messages, because almost everybody has somebody in the family who at least drinks on occasion. We could wrap it all into one education process about saying yes to certain things. “Here's what you need to know if you're going to use steroids: you'd better make sure you don't get AIDS while you're using them.” Frankly, I don't think you should say yes to steroids; it would be better if you didn't want to do that. But if you were giving people a risk-based approach and minimizing the harm or the risk not just of the use but also of all the corollary stuff, recognizing that it can be very expensive to develop this kind of drug habit, and planning for the future--“If you are going to start using dilaudid on the weekend, are you really ready for the $180 every single day?”--are we getting anywhere? Are we going to have such a program? Would it work? I'll let you answer.

Dr. Christiane Poulin: I think part of the key underpinnings of harm minimization is the word “risk”, and its context. It is one thing to walk across a street; we do it all the time. It is another thing to walk across the street after having taken three tranquilizers. The context matters a great deal. Part of how we conceptualize harm minimization for drug education purposes is to emphasize that notion of risk. It's one thing to go sky diving. One way to protect oneself from dying as a sky diver is not to sky dive; that's one way. Another way is to wear an extra chute; another way is to take lessons; another way is to go in a credible plane--all of these things. You leave the options open to not engage in the behaviour, because that's an important aspect of it. Not all teenagers will use substances.

The Chair: If you use a crosswalk when you cross the street, for example, your example is even more apropos, because everyone has to do so at some point. It's not just about using the crosswalk, either; you'd better look to make sure there isn't a car running a red light. If we could get people to focus on some of these things and make more active decisions, it would be helpful.

Lastly, I'm not sure why in New Brunswick you don't have the public health department--the regional health services or whatever it is--being the needle exchanges. In Ontario it was actually mandated by the province that every health department had to have a needle exchange. We're not sure exactly what the genesis of this was, whether it was Harris or Rae, but somehow it slipped into all our communities.

Réal talked about going to Burlington, my community. I didn't even know we had a needle exchange until just before we were headed there.

They have taken all the heat out of it. I'm sure there's one in Brantford and other communities. It's stopping disease prevention and making sure there's intervention. They were talking about a lot of the young people who are going to use it for the first time. They'd rather they be safe and think about the risks--and maybe rewards; I'm not sure. I was also going to ask you about what the rewards were.

Ms. Dykeman, and then Dr. Fry.

Ms. Margaret Dykeman: Public health is a partner in the needle exchange grouping and programming in the province, but they have turned it over to the community and made it a community responsibility. They provide most of the condoms and all of the needles and works and that sort of thing. They feel that's their piece of the puzzle.

The Chair: Maybe we can get you the e-mail address for ours, and maybe that will give you some ideas.

Quickly, Dr. Fry.

Ms. Hedy Fry: Christiane, you've talked about evidence base, etc. I just wanted to clarify a couple of things, because I don't think you meant to imply that harm reduction doesn't work. In other words, you just mentioned a lot of pieces of harm reduction that we do. If you drink, don't get into a car. If you are going to do rollerblading down the street at an angle, or you're going to do a whole lot of things, wear a helmet--if you're going to do it--and so on. We even know that the whole concept of harm reduction has been there in medicine and in public health for a long time. We know it does work.

For instance, as a physician you don't eventually get everybody in, take a needle, and give them their vaccines--if you have a kid in--with the same needle. We know you can't use the same needle more than once. The concept of suggesting to somebody who is using a needle on a daily basis that everybody shouldn't use the same needle is just simply an extrapolation of what we already know and what we already do.

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What I wanted to suggest to you is that I would like you to clarify.... What you're talking about is the concept of harm reduction, harm minimization in terms of youngsters, adolescents, in school. What are the best ways to do it to achieve your best results?

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Dr. Christiane Poulin: To clarify, my talk was about harm minimization for mainstream kids, kids in school, as an alternative to an approach that is strictly abstinence-based or that incorporates abstention as part of the message, restricting the options to only saying no, for example.

We don't have the evidence that is needed for us to be able to adopt harm reduction in schools, with school boards, and at the provincial level as the standard fare. We don't have that kind of evidence, and nowhere in Canada is that kind of evidence available.

Ms. Hedy Fry: You weren't thinking about needle exchange programs.

Dr. Christiane Poulin: No. We have very good evidence about needle exchange programs. We have evidence from quite a few European countries, from Canadian cities, from Australia, and from some sites in the United States. Those needle exchange programs were by and large founded and set up to serve the needs of street folks, some of whom were adolescents but many of whom were adults.

When we talk about teenagers in school, by and large we're talking about alcohol, tobacco, and marijuana. We are not talking about cocaine and heroin. That is exceptional. In fact, by and large, if a teenager were using those substances, he would probably not be in school. It's that much of a high-risk behaviour.

The Chair: Mr. Sorenson has a question for you.

Mr. Kevin Sorenson: It's not really a question, it's a comment.

When we're talking about some of these “just say no” programs, you have to realize it is part of a balanced approach. For others who have opposed the DARE program, the police who have come forward with the DARE program are giving out a “just say no” not as the be-all and end-all, but they recognize that somebody else is going to come in and give the other part of the equation, that being harm reduction when you do it. But the message has to get out. So I just wanted to come back to anybody who would suggest that the DARE program and “just say no” programs are somehow failing our school system. I don't believe they are.

The Chair: With respect, I don't think everyone said that. Most people said it's not enough.

The kids in my community said specifically that telling them they're supposed to say they're allergic is a bit stupid. If I'm in grade 11, do you think my friends are going to believe me when I say that I'm allergic? They said that it didn't give them the tools they needed to make good decisions. In fact, in some cases they've seen a rise in drug use where kids have only had DARE programs.

Ms. Dykeman.

Ms. Margaret Dykeman: I just have one thought, and it just adds to this conversation. I don't think it's enough that we give them education; we also have to give them the skill base. They have all kinds of information out there. All kinds of studies say that telling people, knowledge, is not the change factor here. It doesn't matter what age group it is. Whatever that educational program is, it has to have a skill base to it. I don't know about the DARE one, whether they're actually teaching skills or whether they're just teaching knowledge. That might be why some of the people are having a bit of a problem with it.

The Chair: A very subtle distinction.

Ms. Masching, quickly.

Ms. Renée Masching: I'm thinking of the story Dr. Poulin started her discussion with.

I had a very humbling moment at the end of November in our focus group with youth, elders, and other people in our community around providing sexual health education for young people. This young guy walked in, and I thought he was going to be full of attitude and not contribute anything. He looked at us and said, “Stop targeting me; start targeting youth. I can't talk to my parents because nobody teaches them. I can't get condoms because the band council won't put them in the school. I can't get access to health care because I can't drive and nobody is going to take me to the pharmacy.”

I sat there and I thought, well, I've been put in my place. You're important; you're our future. I just think it's very important.... Certainly in every consultation I've done, in all my work and according to my personal beliefs, youth are huge--they're our future.

I'm not that much past being a youth myself, but I just found it a very obvious and profound statement from a young person, in saying the policy-makers aren't changing policies. You can educate me and tell me to just say no, or go ahead and fill my boots, but it doesn't change how I access services, or what services are available. This is a very important additional layer that was pointed out to me in November.

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The Chair: Thank you for that. The voice of youth...and just beyond.

Thank you all very much, on behalf of everybody who's here and those who will have to read the testimony of this committee. We really appreciate the time you've taken to come here--some of you have made quite a journey--to share with us your ideas, and the efforts you've put into your presentations. On behalf of all the committee, let me thank you for all of the work you do so passionately in each of your areas of expertise. We wish you good luck. We really do appreciate it.

We will be hearing testimony until probably around the end of June. If you have additional things to say to us, please get them to Carol. If there are information studies or you see something fascinating in Australia or anywhere else, get them to us.

Before I adjourn the meeting, I would like to ask Dr. Poulin to e-mail us her slides so we can distribute them. Is that a problem? We'll talk to you.

The meeting is adjourned.