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441-00382 (Health)

Paper petition

Original language of petition: English

Petition to the Government of Canada

Whereas:

The opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average every two hours and a death toll of 22,828 in the past five and one quarter years (January 2016 to March 2021); and

The overdose crisis rages.

We, the undersigned, call upon the Government of Canada to declare the overdose crisis a national public health emergency and:

Take steps to end overdose deaths and overdose injuries Immediately collaborate with provinces and territories to develop a comprehensive, pan-Canadian overdose action plan Ensure that any plan considers reforms that other countries have used, such as legal regulation of drugs to ensure safe supply, decriminalization for personal use, and changes to flawed drug policy and policing; and

Ensure this emergency is taken seriously with adequately funded programming and supports.

Response by the Minister of Mental Health and Addictions and Associate Minister of Health

Signed by (Minister or Parliamentary Secretary): Élisabeth Brière

The Government of Canada recognizes that the overdose crisis is one of the most serious and unprecedented public health threats in Canada’s recent history, which is having devastating impacts on individuals, friends and families, and communities across the country. Tragically, the most recent national data indicates that 26,690 apparent opioid toxicity deaths occurred between January 2016 and September 2021. Fentanyl and its analogues continue to be major drivers of the crisis with as many as 86% of accidental apparent opioid toxicity deaths in the first nine months of 2021 (January to September) involving fentanyl.

The Government of Canada also recognizes that the complexity of this crisis has only become more complex due to the ongoing COVID-19 pandemic. This had led to a more uncertain and toxic illegal drug supply, resulting in tragic increases in overdose-related deaths across the country, as well as reduced access to health and social services, such as life-saving harm reduction and treatment services. Health Canada and the Public Health Agency of Canada have been working with provinces, territories, municipalities, Indigenous communities and other partners, including researchers, advocates and people with lived and living experience, to ensure that people who use drugs can continue to access the treatment, harm reduction and other services they need during the pandemic.

With respect to the request to declare the overdose crisis a national public health emergency, the Government of Canada remains fully committed to addressing the overdose crisis and working with partners across all provinces and territories to save lives. Such a declaration is not required at the federal level to access important responses to the overdose crisis. In addition, the Government believes that the crisis requires a longer term, sustained, and coordinated effort, which the Emergency Act is not designed to provide. At the federal level, we have taken action by reducing legislative and regulatory barriers, developing new prescription guidelines and marketing restrictions, launching a public awareness campaign, improving the knowledge base, supporting treatment and harm reduction initiatives across Canada, and providing emergency funding to provinces and territories.

Provinces and territories have a range of tools and authorities to address the ongoing opioid overdose crisis in their respective jurisdictions. For example, provinces and territories fund and deliver the majority of direct social and health interventions, such as naloxone distribution, and safer consumption sites, that are shown to effectively reduce opioid overdose deaths and harms. Provinces, territories and municipalities also have the power to declare a public health emergency in response to a significant increase in opioid-related deaths, as was the case for British Columbia in April 2016 and Alberta declaring a public health crisis in May 2017. More recently, Yukon declared a substance use health emergency in January 2022. The declaration of a provincial and territorial public health emergency allows a provincial or territorial government to access and exercise extraordinary powers to address a crisis.

Canada’s approach to substance use issues aims to be comprehensive, collaborative, and compassionate, guided by our federal drug strategy – the Canadian Drugs and Substances Strategy (CDSS). The CDSS takes a public health-focused approach, and lays out our framework for evidence-based actions to reduce the harms associated with substance use in Canada. It includes four key pillars – prevention, treatment, harm reduction, and enforcement. In the context of the worsening overdose crisis, and taking steps to reduce harms and deaths related to substance use, the Government is placing particular focus on:

  • ensuring that harm reduction services are available to Canadians who need them;
  • 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 and further risk of harms;
  • continuing to work with provinces and territories to improve access to evidence-based treatment options;
  • continuing to address illegal production and trafficking, with a focus on organized drug crime; 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.

Since 2017, the Government of Canada has taken urgent action to address the overdose crisis through significant commitments of over $800 million. Recent examples in this area include:

  • over $282 million to the Substance Use and Addictions Program (SUAP) through the 2020 Fall Economic Statement, Budget 2021, and Budget 2022, in support of community-based organizations responding to substance use issues, including investments to help them provide frontline services in a COVID-19 context, to scale-up key lifesaving measures and increase access to a safer drug supply as an alternative to the contaminated supply;
  • $150 million through the one-time Emergency Treatment Fund to provinces and territories, which, when cost-matched with the provinces and territories, will result in an investment over $300 million to improve access to evidence-based treatment services;
  • $200 million, with $40 million per year ongoing, to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities;
  • more than $20 million for Naloxone distribution, education and training; and,
  • $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 addition to these investments, in order to prevent and reduce substance-related harms, the Government of Canada has undertaken a broad range of policy, legislative and regulatory actions, such as:

  • approving exemptions to establish supervised consumption sites (since January 1, 2016, the number of supervised consumption sites operating in Canada has increased from 1 to 38), and providing provincial and territorial class exemptions to facilitate the establishment of Urgent Public Health Need Sites (commonly known as overdose prevention sites);
  • reducing barriers to providing people who use drugs with safer, pharmaceutical-grade alternatives to the toxic illegal drug supply and supporting 17 safer supply projects across 29 sites in British Columbia, Ontario, Quebec, and New Brunswick, and one national community of practice, for a total investment of over $63 million;
  • providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic;
  • creating new regulatory pathways under the Food and Drugs Act and its regulations used to authorize medication used to treat addiction not otherwise available (e.g., approving diacetylmorphine hydrochloride as a supervised injectable opioid agonist therapy for adult patients with severe opioid use disorder and amending federal regulations to allow healthcare practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory);
  • supporting the passage of the Good Samaritan Drug Overdose Act, which encourages people to seek emergency help at the scene of an overdose by providing some legal protection against simple drug possession charges; and,
  • introducing Bill C-5, which proposes amendments to the Criminal Code and to the Controlled Drugs and Substances Act which, among other measures, would repeal mandatory minimum penalties for drug related-offences, and would require prosecutors to consider alternative measures to laying charges or prosecuting individuals for simple possession of drugs, including diversion to treatment programs.

The Mandate Letter of the Minister of Mental Health and Addictions and Associate Minister of Health calls on the Minister to, “Advance a comprehensive strategy to address problematic substance use in Canada, supporting efforts to improve public education to reduce stigma, and supporting provinces and territories and working with Indigenous communities to provide access to a full range of evidence-based treatment and harm reduction, as well as to create standards for substance use treatment programs.” The Government of Canada is continuing to work with provincial, territorial, Indigenous and municipal officials on options to address their regional needs. We have established federal, provincial and territorial governance tables, including the Special Advisory Committee on the Epidemic of Opioid Overdoses and the Federal/Provincial/Territorial Committee on Problematic Substance Use & Harms to facilitate ongoing collaboration and consultation with provincial and territorial partners. We are also 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. Public health officers from the Public Health Agency of Canada have been deployed to support public health surveillance systems in provinces and territories.

In addition, engagement with civil society organizations, direct care service providers, academics, people with lived and living experience, and other key stakeholders continues to inform federal actions to reduce opioid-related overdoses and deaths and improve the health and wellbeing of Canadians. For example, we continue to engage with stakeholders to inform them about safer supply and encourage them to look and work within their sphere of influence to remove barriers to this practice. Safer supply services provide a pharmaceutical alternative to the toxic illegal drug supply as a way to help prevent overdoses, improve the health of people who use drugs, and help connect people to trusted and supportive relationships in health and social services. Health Canada is supporting a number of safer supply projects through the Substance Use and Additions Program (SUAP). We have also taken action to increase access to safer supply services by:

  • helping to build the evidence base for safer supply by supporting the evaluation of pilot projects and seeking expert advice, including from health professionals and people who use drugs; 
  • making it easier to access needed medications, including issuing exemptions from the Controlled Drugs and Substances Act; and,
  • sharing resources and guidance on treating substance use disorder for the use of healthcare practitioners.

The Government of Canada is also taking action to ensure that our enforcement response is focused on organized drug crime and the cross-border movement of illegal substances and the precursor chemicals that are used to make many of them. As Canada’s national police, the Royal Canadian Mounted Police (RCMP) detects, investigates, and disrupts the most serious and complex criminal threats to the safety and security of Canadians and Canadian interests, including transnational and serious organized crime (TSOC) and the illegal drug market. At our borders, the Canada Border Services Agency (CBSA) is working to reduce the flow of illegal opioids and related substances, precursor chemicals, and other controlled substances. Efforts to disrupt the involvement of organized crime groups in the production, trafficking, and sale of what are now increasingly toxic substances remain critical, including in support of public health measures to prevent, treat, and reduce the harms associated with the use of those substances. Recent and/or ongoing federal activities include:

  • acquisition of new infrastructure and tools required to assist in the safe examination and sampling of suspected highly toxic substances in addition to increasing intelligence, targeting, and training support;
  • investigating TSOC networks that traffic multiple commodities, within Canada and internationally, as well as online vendors and manufacturers;
  • providing an integrated policing response to drug trafficking and organized crime networks by working closely with local law enforcement agencies, as well as private industry partners, including chemical producers, retailers and distributors, to limit the chemicals used for legitimate purposes from being diverted for the illegal production of controlled substances; and,
  • maintaining strong relationships with international partners, including the United States of America, to support joint operations and investigations involving cross-border drug activity, as well as to facilitate productive policy dialogue and information exchange.

Some stakeholders have reported that the criminalization of illegal drugs for personal use can perpetuate stigma, increase risks of overdose and other harms, and increase barriers to care. Canada recognizes that drug use stigma can prevent people who use substances from accessing the health and social services that they need and contributes to negative health outcomes. To help ensure that stigma is not present in police interactions with people who use drugs and to avoid causing more harm, Public Safety Canada launched an online training module specifically designed for law enforcement members in September 2020. The training raises awareness of the harms associated with substance use stigma and provides frontline law enforcement members with practical tools to support their interactions with people who use drugs.

The federal government is committed to examining all options and evidence to respond to the tragic increase in overdoses and to help save lives, while also ensuring the safety of communities across the country. The Government is working to divert people who use drugs away from criminal justice systems and towards supportive and trusted relationships in health and social services. In addition to the passage of the Good Samaritan Drug Overdose Act in May 2017, the Public Prosecution Service of Canada issued guidance to prosecutors directing that alternatives to prosecution should be considered for personal possession offences, except when there are serious aggravating circumstances.

Moving forward, under the mandate of the new Minister of Mental Health and Addictions and Associate Minister of Health, Health Canada will continue working with its partners and stakeholders to advance a comprehensive federal strategy to address substance use in Canada, including the overdose crisis. Canada will continue to support provinces, territories and Indigenous communities to improve access to a full range of evidence-based treatment and harm reduction services, in addition to leading efforts to reduce stigma and create national standards for substance use treatment programs. The Government of Canada believes that substance use is a health issue, and is committed to examining all options and evidence to respond to the tragic increase in overdoses and to help save lives, while also ensuring the safety of communities across the country.

Presented to the House of Commons
Heather McPherson (Edmonton Strathcona)
April 7, 2022 (Petition No. 441-00382)
Government response tabled
May 30, 2022
Photo - Heather McPherson
Edmonton Strathcona
New Democratic Party Caucus
Alberta

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