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431-00198 (Health)

Paper petition

Original language of petition: English



  • The overdose crisis in Canada is a public health emergency, as has already been declared by British Columbia's Provincial Health Officer and several municipalities across Canada;
  • More than 13,900 individuals have died of opioid-related deaths and there have been 17,050 opioid-related poisoning hospitalizations in Canada since 2016;
  • There is disproportionate representation of Indigenous people affected by the overdose crisis; and,
  • The Canadian Public Health Association, the Global Commission on Drug Policy, the World Health Organization, and the United Nations, have recommended drug decriminalization,

We, the undersigned citizens and residents of Canada call upon the House of Commons in Parliament assembled to:

  • Declare a public health emergency due to overdose deaths in Canada;
  • Reframe the overdose crisis in Canada as a health issue rather than a criminal issue;
  • Take a comprehensive, multi-faceted approach to the overdose crisis, by addressing issues of addiction, poverty, housing, health care, racial discrimination, and economic inequality and instability;
  • Listen to and act on recommendations made by social workers, front-line workers, nurses, doctors, drug users, and individuals directly involved in the drug-using community; and,
  • Decriminalize drugs in Canada.

Response by the Minister of Health

Signed by (Minister or Parliamentary Secretary): Darren Fisher

The Government of Canada is deeply concerned about problematic substance use in Canada, including the ongoing opioid overdose crisis and the devastating impact it is having on the well-being of individuals, families, and communities. Tragically, there were more than 14,700 apparent opioid-related deaths in Canada between January 2016 and September 2019.

The Government recognizes that the complexity of this crisis has only increased due to the ongoing COVID-19 pandemic. Public health guidance around physical distancing and self-isolation presents a unique challenge for people with substance use disorder. Health Canada and the Public Health Agency of Canada have been working with provinces and territories and other partners, including researchers, advocates and people with lived and living experience, to help make sure that people who use(d) substances can continue to access treatment, harm reduction and other substances during the pandemic.

Health Canada has asked provinces and territories and regulatory colleges to improve access to opioid agonist treatment medication and to allow for special accommodations during the pandemic response that reduce or remove requirements that may not align with public health direction during the pandemic. This could include take-home dosing, and the removal of the requirement for witnessed ingestion, doctors’ visits and urine screening.

Health Canada issued a class exemption to allow pharmacists to extend and renew prescriptions, to transfer prescriptions to other pharmacists, and to allow other individuals to deliver controlled substances to patients, and ensure continuity in access to pharmacotherapy for addiction treatment and management of other health conditions such as chronic pain. To allow patients with chronic medical needs to adhere to physical distancing and self-isolation guidance, Health Canada has allowed prescribers to issue verbal prescriptions for narcotics. Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs to physically distance and self-isolate and stay safe. The toolkit provides a summary of the exemptions now in place for health care professionals to facilitate flexible models of care during the pandemic. It includes prescribing and practice guidelines for health care professionals to increase the appropriate prescription of medications to address symptoms of withdrawal, including methadone, Suboxone, and to provide access to pharmaceutical grade medications like hydromorphone as a safer alternative to the toxic street supply. It will also assist people who use drugs, harm reduction advocacy groups and families who support people who use drugs to understand the changes and exemptions in order to secure medications and treatment supports, as well as educate on harm reduction measures.

Health Canada is working with community organizations funded through the Substance Use and Addictions Program (SUAP) to re-direct resources from funded activities to support the COVID-19 response. For example, the BC Ministry of Health will use a portion of its SUAP funding to provide personal protective equipment to pharmacists providing injectable opioid agonist treatment and the University of Victoria will use a portion of its funding to purchase basic needs and supplies (such as food) for clients at select front-line harm reduction sites.

The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy during this difficult time and over the long term.  The Strategy includes four pillars – prevention, treatment, harm reduction and enforcement – and is designed to be comprehensive, collaborative, compassionate and evidence-based.  The Government is placing particular focus on:

  • ensuring that life-saving harm reduction measures are available to Canadians who need it;
  • working with stakeholders to reduce stigma directed at people who use drugs, which acts as a barrier to accessing critical health and social services and often leads to social isolation;
  • working with provinces and territories to improve access to evidence-based treatment options; and
  • implementing additional surveillance and research activities that will further build the evidence base and allow us to pursue innovative solutions to this public health crisis. 

The Government of Canada recognizes that the overwhelming majority of deaths caused by the opioid overdose crisis are due to a street drug supply that is contaminated with highly toxic substances, such as fentanyl. The Government is taking a series of actions to address this issue, including:

  • funding the development of national guidelines for injectable opioid agonist treatment;
  • removing federal regulatory barriers to effective, evidence-based treatment options, including making it easier for health practitioners to prescribe diacetylmorphine and methadone to patients with opioid use disorder, and facilitating community delivery models for opioid agonist treatment;
  • allowing the importation of drugs approved in other countries (but not yet in Canada) to address urgent public health needs, including diacetylmorphine for the treatment of opioid use disorder;
  • approving the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder – the first approval of injectable hydromorphone for this purpose in the world;
  • supporting pilot projects to provide pharmaceutical hydromorphone to eligible patients with opioid use disorder in British Columbia; and,
  • working with provinces, territories, and stakeholder groups to address this issue and identify what additional steps can be taken.The Government of Canada has made substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing $76.2 million to take action to protect Canadians and prevent overdose deaths. This investment will be used to scale-up key lifesaving measures and increase access to a safer drug supply as an alternative to the contaminated supply. These measures build on the Budget 2019 investment of $30.5 million over five years, with $1 million ongoing, to expand access to safer alternatives to the illegal drug supply and support better access to opioid overdose response training and naloxone in underserved communities;
  • providing $1.7 million to the University of Saskatchewanto increase access to chronic pain services, and providing $1.2 millionsto implement and evaluate pathways to care for people living with pain and opioid use disorder, both funded through the Substance Use and Addictions Program.
  • providing $231.4 million over five years through Budget 2018 for additional measures to help address the opioid overdose crisis, including a one-time $150 million emergency treatment fund for provinces and territories to improve access to evidence-based treatment services;
  • providing emergency funding to British Columbia ($10 million) and Alberta ($6 million) to address the ongoing crisis in these two jurisdictions, plus $5 million in targeted health care funding for Manitoba to assist with priority needs, including their opioid response;
  • providing an additional $200 million, with $40 million per year ongoing, to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities; and,
  • allocating $13 million over five years to launch a new national, multi-year public education campaign to help reshape Canadians’ attitudes and perceptions about people who use drugs.

In order to prevent and reduce the harms of problematic substance use, including to enable access to evidence-based treatment and support recovery, the Government has undertaken a broad range of policy, legislative and regulatory actions, including:

  • Approving supervised consumption sites (with 39 currently in operation across Canada), and providing class exemptions to facilitate the establishment of overdose prevention sites;
  • supporting the passage of the Good Samaritan Drug Overdose Act, which encourages people to call for emergency help at the scene of an overdose by providing protection against simple drug possession charges;
  • establishing effective Federal, Provincial and Territorial public health emergency governance, including the Special Advisory Committee on the Epidemic of Opioid Overdoses and the Federal/Provincial/Territorial Assistant Deputy Minister Committee on Problematic Substance Use & Harms;
  • collaborating with provinces and territories to better understand the evolving crisis, and undertaking timely monitoring and reporting of opioid-related deaths and harms in Canada;
  • deploying public health officers from the Public Health Agency of Canada to support public health surveillance systems in provinces and territories; and,
  • supporting the development and dissemination of national clinical practice guidelines to treat opioid use disorder, which include a recommendation for medication-assisted treatment as a front-line option for patients, through the Canadian Research Initiative in Substance Misuse.

We are focusing on a safer supply and building the evidence base for this public health intervention. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. The federal government has taken steps towards increasing access to pharmaceutical-grade medications, including making prescription opioids used in the treatment of severe opioid disorder more easily accessible to healthcare practitioners, reducing regulatory barriers, and funding national clinical guidelines for the management of opioid use disorders.

Certain programs, sometimes referred to as “safer supply”, build on these established models in an attempt to reach a wider range of people at risk of overdose and create additional pathways to health and social services. The federal government is supporting pilot projects to increase access to pharmaceutical-grade medications as a safer alternative to the contaminated illegal drug supply. As part of its approach, the federal government is also supporting a comprehensive evaluation of the pilot projects to develop valuable evidence on effective service models and help develop best practices.

To protect the health and safety of all Canadians, any prescription-grade medications, including those that may be used in safer supply programs, may only be provided with the appropriate oversight of a qualified health care provider (e.g., a physician or a nurse practitioner), as per the parameters of the Controlled Drugs and Substances Act and its regulations, as well as applicable provincial, territorial, and professional regulatory requirements.

Some provinces, including British Columbia and Alberta, have declared a formal public health emergency or crisis to address the overdose crisis. Under their respective provincial legislation, these declarations can provide access to additional powers and authorities, such as new funding, and streamlined decision-making. At the federal level, legislation is not required to access similar additional powers. The comprehensive federal response has included reductions of legislative and regulatory barriers, new prescription guidelines, marketing restrictions, new tools for law enforcement, improvements to the knowledge base, and emergency funding to provinces and territories – all of which were put in place without a formal declaration of a public health emergency.

In Canada, our circumstances require that we undertake a comprehensive and collaborative approach across all provinces and territories.  No single organization or level of government alone can solve the opioid overdose crisis.  All levels of government, a wide range of stakeholders and all Canadians who are impacted by opioid use must work together to reduce opioid-related overdoses and deaths, and improve the health and well-being of Canadians who use drugs.

Through the Canadian Drugs and Substances Strategy, the Government of Canada remains firmly committed to addressing all forms of problematic substance use with a public health approach that is comprehensive, collaborative, compassionate, and evidence based.

Presented to the House of Commons
Elizabeth May (Saanich—Gulf Islands)
May 19, 2020 (Petition No. 431-00198)
Government response tabled
July 20, 2020
Photo - Elizabeth May
Saanich—Gulf Islands
Green Party Caucus
British Columbia

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