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441-00562 (Health)

Paper petition

Original language of petition: English

PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLED

Whereas:

  • 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 Mental Health and Addictions and Associate Minister of Health

Signed by (Minister or Parliamentary Secretary): Élisabeth Brière

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. The Government recognizes that substance use is a health issue, and is committed to a public health approach to address the crisis. Tragically, the most recent national data indicates that 29 052 apparent opioid toxicity deaths occurred between January 2016 and December 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 2021 involving fentanyl.

The Government of Canada also recognizes that the 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 due to COVID-related health measures (such as social distancing requirements, isolation requirements, etc.) and staff shortages, such as life-saving harm reduction, pharmaceutical-grade supply 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.

With respect to the request to declare the overdose crisis a national public health emergency, the Emergencies Act is a federal law that can be used to respond to an urgent, temporary and critical national emergency that seriously endangers the lives, health or safety of Canadians, is of such proportions or nature that it exceeds the capacity or authority of a province to deal with it, and that cannot be dealt with effectively by any other law in Canada. The Emergencies Act is not an appropriate mechanism to address the ongoing overdose crisis, which requires a longer-term, sustained, and multi-jurisdictional effort to address the complex, interrelated health, social and economic factors driving opioid-related deaths and harms.

The Government of Canada remains fully committed to addressing the overdose crisis and working with partners across all provinces and territories to save lives. 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, safe supply 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 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, which are shown to effectively reduce overdoses deaths and harms. Provinces, territories and municipalities also have the power to declare a public health emergency in response to a significant increase in overdose-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 and territorial government to access and exercise extraordinary powers to address a crisis. The Emergencies Act is not an appropriate mechanism to address the ongoing overdose crisis, which requires a longer-term, sustained, and multi-jurisdictional effort to address the complex, interrelated health, social and economic factors driving opioid-related deaths and harms.

The Government recognizes that social determinants of health, such as poverty, discrimination, and trauma, can place individuals at an increased risk of substance use harms and that the approaches to reduce these harms require sustained efforts and supports from diverse systems. Canada’s approach to substance use issues is 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.

The Government of Canada remains fully committed to addressing the overdose crisis and working with partners to save lives. Since 2017, the federal government has taken significant actions and made commitments of over $800M to address the overdose crisis and substance use-related harms. Recent examples of key federal investments 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 direct services in a COVID-19 context and 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 39), 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 25 safer supply service delivery projects in British Columbia, Ontario, Quebec and New Brunswick, as well as a National Safer Supply Community of Practice, for a total investment of more than $73.5 million (note: the number of active projects is subject to change as sites open and close);
  • 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 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); and,
  • 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.

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 and 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 who use drugs. 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.

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 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 reduce stigma 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 law enforcement members with practical tools to support their interactions with people who use drugs.

The federal government is committed to using every tool at its disposal and examining all 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 to access supportive health and social services and build those truly important trusted relationships. 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.

Furthermore, Bill C-5, which was reintroduced in the House of Commons on December 7, 2021, proposes legislative amendments to the Criminal Code and to the Controlled Drugs and Substances Act (CDSA). Among other measures, the amendments would encourage the use of diversion measures for personal drug possession offences, such as referral to health and social services, rather than laying a criminal charge. These amendments also propose to repeal mandatory minimum penalties for six offences in the CDSA to reflect the Government’s health-focused approach to substance use.

On May 31, 2022, at the request of the province of B.C., the Federal Minister of Mental Health and Addictions and Associate Minister of Health announced the granting of a time-limited exemption under the CDSA so that adults 18 years of age and older in the province will not be subject to criminal charges for personal possession of small amounts of certain illegal drugs. More information on the exemption is available here. The exemption will be in effect from January 31, 2023 to January 31, 2026. Throughout the exemption period, the federal government will work with the province to rigorously monitor and evaluate implementation, analyze the data and evidence, and assess impact to ensure this exemption continues to be the right decision for the people of B.C.

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
Elizabeth May (Saanich—Gulf Islands)
June 13, 2022 (Petition No. 441-00562)
Government response tabled
September 20, 2022
Photo - Elizabeth May
Saanich—Gulf Islands
Green Party Caucus
British Columbia

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