43rd Parliament223Government response tabledJune 15, 2021432-00960432-00960 (Health)HeatherMcPhersonEdmonton StrathconaNDPABMay 13, 2021June 15, 2021March 9, 2021Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Jennifer O'ConnellThe 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 19,355 apparent opioid-related deaths between January 2016 and September 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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.
Building on the $66 million invested in the 2020 Fall Economic Statement, Budget 2021 proposes to provide an additional $116 million over two years for the Substance Use and Addictions Program to support a range of innovative approaches to harm reduction, treatment, and prevention at the community level.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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. No single organization or level of government alone can solve the opioid overdose crisis. All levels of government, a wide range of stakeholders, especially people with lived and living experience, 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledMay 10, 2021432-00733432-00733 (Health)JennyKwanVancouver EastNDPBCMarch 25, 2021May 10, 2021February 3, 2021Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Jennifer O'ConnellThe 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 19,355 apparent opioid-related deaths between January 2016 and September 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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.
Building on the $66 million invested in the 2020 Fall Economic Statement, Budget 2021 proposes to provide an additional $116 million over two years for the Substance Use and Addictions Program to support a range of innovative approaches to harm reduction, treatment, and prevention at the community level.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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. No single organization or level of government alone can solve the opioid overdose crisis. All levels of government, a wide range of stakeholders, especially people with lived and living experience, 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledMay 10, 2021432-00732432-00732 (Health)CharlieAngusTimmins—James BayNDPONMarch 25, 2021May 10, 2021February 26, 2021Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Jennifer O'ConnellThe 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 19,355 apparent opioid-related deaths between January 2016 and September 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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.
Building on the $66 million invested in the 2020 Fall Economic Statement, Budget 2021 proposes to provide an additional $116 million over two years for the Substance Use and Addictions Program to support a range of innovative approaches to harm reduction, treatment, and prevention at the community level.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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. No single organization or level of government alone can solve the opioid overdose crisis. All levels of government, a wide range of stakeholders, especially people with lived and living experience, 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 12, 2021432-00558432-00558 (Health)MatthewGreenHamilton CentreNDPONFebruary 25, 2021April 12, 2021November 24, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 12, 2021432-00520432-00520 (Health)Hon.Kerry-LynneFindlaySouth Surrey—White RockConservativeBCFebruary 17, 2021April 12, 2021November 24, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 12, 2021432-00519432-00519 (Health)Hon.Kerry-LynneFindlaySouth Surrey—White RockConservativeBCFebruary 17, 2021April 12, 2021February 3, 2021Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 12, 2021432-00505432-00505 (Health)TracyGrayKelowna—Lake CountryConservativeBCFebruary 16, 2021April 12, 2021February 4, 2021Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledMarch 22, 2021432-00486432-00486 (Health)Marie-FranceLalondeOrléansLiberalONFebruary 4, 2021March 22, 2021November 24, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledMarch 22, 2021432-00476432-00476 (Health)MichaelBarrettLeeds—Grenville—Thousand Islands and Rideau LakesConservativeONFebruary 4, 2021March 22, 2021November 16, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledMarch 22, 2021432-00447432-00447 (Health)FrancisScarpaleggiaLac-Saint-LouisLiberalQCJanuary 28, 2021March 22, 2021December 18, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): The Honourable Patty HajduThe 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 17,602 apparent opioid-related deaths between January 2016 and June 2020.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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic.Since taking office, our government has taken strong action to address the opioid crisis. The comprehensive federal response has included legislative and regulatory enabling measures, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories. We will continue this important work to help save lives and keep Canadians safe.The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 toxic illegal drug supply that is contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses illegal drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs due to the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists and eased restrictions on the transportation of controlled substances to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing $44.2 million for projects providing a safer supply of pharmaceutical medications for people with substance use disorder in British Columbia, Ontario, Quebec and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to bolster further these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here. Furthermore, the Canadian Agency for Drugs and Technologies in Health published a Rapid Review of clinical and cost-effectiveness of injectable opioid agonist treatment for patients with opioid dependence. The report can be found here.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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, such as:
  • 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, as well as the injectable opioid agonist treatment clinical and operational guidelines through the Canadian Research Initiative in Substance Misuse. The guidelines can be found here.
The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports for people who use drugs. For example, on August 18, 2020, the Public Prosecution Service of Canada issued guidance to prosecutors stating that alternatives to prosecution should be considered for simple possession offences, except when there are serious aggravating circumstances. In addition, Health Canada is currently funding a three-year project in Peterborough, Ontario, to develop a multi-sector response to direct people who use drugs away from the justice system and into care. In addition, on February 18, 2021, the Department of Justice introduced Bill C-22 in Parliament to help address systemic racism and the overrepresentation of Indigenous peoples as well as Black and marginalized Canadians in Canada’s criminal justice system. Among other measures, this Bill would repeal mandatory minimum penalties for drug related-offences, and would also require police and prosecutors to consider other responses to laying charges for simple possession of drugs, such as diversion to treatment programs.It is recognized that there are a growing number of calls for drug decriminalization, in acknowledgement that criminalizing personal drug possession results in stigma and discrimination, creates barriers to accessing health and social services, and increases the risks of overdose and other harms. The City of Vancouver and the Province of British Columbia have written to the Minister of Health requesting exemptions to decriminalize simple possession of small amounts of controlled substances for personal use in their jurisdictions. We will continue working with them on options to address the overdose crisis that respond to their local and regional needs.We will also continue to take a comprehensive and collaborative approach, working with all partners. 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.
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021432-00305432-00305 (Health)GordJohnsCourtenay—AlberniNDPBCNovember 27, 2020January 25, 2021November 26, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs, in order for them 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021432-00290432-00290 (Health)HeatherMcPhersonEdmonton StrathconaNDPABNovember 25, 2020January 25, 2021November 24, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths between January 2016 and March 2020. 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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic. Concerning the declaration of a national public health emergency, at the federal level, such a declaration is not required to access important responses to the opioid overdose crisis. The comprehensive federal response has included  legislative and regulatory enabling measures,  new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories; these were  put in place without a formal declaration of a public health emergency. The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 situation is now such that anyone who uses drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs from the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical-grade alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists, and eased restrictions on the transportation of controlled substances, to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing funding to support 11 projects in providing a safer supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical-grade medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to further bolster these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) has recently developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here: https://crism.ca/projects/covid/. These measures help to ensure continued access to medications and ongoing management of health conditions such as chronic pain. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here: https://www.canada.ca/en/health-canada/services/substance-use/toolkit-substance-use-covid-19.html.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include: 
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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 37 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.
 As outlined above, the Government of Canada takes a public health focussed approach to addressing substance use, working with civil society organizations, first line responders, academics, people with lived and living experience and other key stakeholders  to assess options that could better support the needs of people who use drugs during this difficult time. In terms of decriminalization, early evidence suggests that in places that have decriminalized drug use, there has been a concurrent investment in robust treatment services, and this has been shown to be instrumental in helping people to address substance use issues. Since early 2016, the Government of Canada has taken urgent action to address the opioid overdose crisis through significant federal investments, legislation, and regulatory action. The Government is working with provinces and territories to improve access to harm reduction services, raise awareness of the risks of opioids, and remove barriers to treatment such as addressing stigma. The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports. For example, Health Canada has recently provided three-year  funding for a project in Peterborough, ON, to develop a multi-sector response, with a team dedicated to caring for people at risk of experiencing overdoses, in order to direct people away from the justice system and into care. In addition, on August 18, the Public Prosecution Service of Canada issued guidance to prosecutors directing that alternatives to prosecution should be considered for simple possession offences, except when there are serious mitigating circumstances. This policy is available at: https://www.ppsc-sppc.gc.ca/eng/pub/fpsd-sfpg/fps-sfp/tpd/p5/ch13.html 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. 
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021432-00287432-00287 (Health)JennyKwanVancouver EastNDPBCNovember 25, 2020January 25, 2021November 24, 2020Petition to the Government of CanadaWhereas opioid crisis is one of the most deadly public health emergencies of our lifetime, with a death taking place on average about every two hours and a death toll of almost 15,400 in the past four years alone (January 2016 to December 2019);Whereas 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.
  • Ensure this emergency is taken seriously with adequately funded programming and supports.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths between January 2016 and March 2020. 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 who use drugs. 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 drugs can continue to access treatment, harm reduction and other services during the pandemic. Concerning the declaration of a national public health emergency, at the federal level, such a declaration is not required to access important responses to the opioid overdose crisis. The comprehensive federal response has included  legislative and regulatory enabling measures,  new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories; these were  put in place without a formal declaration of a public health emergency. The Government of Canada remains committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy. 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 situation is now such that anyone who uses drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs from the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical-grade alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists, and eased restrictions on the transportation of controlled substances, to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program (SUAP), the Government of Canada is providing funding to support 11 projects in providing a safer supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical-grade medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to further bolster these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) has recently developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here: https://crism.ca/projects/covid/. These measures help to ensure continued access to medications and ongoing management of health conditions such as chronic pain. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here: https://www.canada.ca/en/health-canada/services/substance-use/toolkit-substance-use-covid-19.html.The Government of Canada continues to make substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include: 
  • investing an additional $66 million over two years to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context;
  • 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 Saskatchewan to increase access to chronic pain services, and providing Alberta Health Services $1.2 million to 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 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 37 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.
 As outlined above, the Government of Canada takes a public health focussed approach to addressing substance use, working with civil society organizations, first line responders, academics, people with lived and living experience and other key stakeholders  to assess options that could better support the needs of people who use drugs during this difficult time. In terms of decriminalization, early evidence suggests that in places that have decriminalized drug use, there has been a concurrent investment in robust treatment services, and this has been shown to be instrumental in helping people to address substance use issues. Since early 2016, the Government of Canada has taken urgent action to address the opioid overdose crisis through significant federal investments, legislation, and regulatory action. The Government is working with provinces and territories to improve access to harm reduction services, raise awareness of the risks of opioids, and remove barriers to treatment such as addressing stigma. The Government of Canada continues to encourage the use of diversion programs that create pathways away from the criminal justice system toward appropriate health services and social supports. For example, Health Canada has recently provided three-year  funding for a project in Peterborough, ON, to develop a multi-sector response, with a team dedicated to caring for people at risk of experiencing overdoses, in order to direct people away from the justice system and into care. In addition, on August 18, the Public Prosecution Service of Canada issued guidance to prosecutors directing that alternatives to prosecution should be considered for simple possession offences, except when there are serious mitigating circumstances. This policy is available at: https://www.ppsc-sppc.gc.ca/eng/pub/fpsd-sfpg/fps-sfp/tpd/p5/ch13.html 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. 
Drug use and abuseHealth emergenciesOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021432-00248432-00248 (Health)GordJohnsCourtenay—AlberniNDPBCNovember 19, 2020January 25, 2021October 30, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs, in order for them 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021432-00213432-00213 (Health)GordJohnsCourtenay—AlberniNDPBCNovember 4, 2020January 25, 2021February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs, in order for them 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJanuary 25, 2021e-2783e-2783 (Health)JoanneHallPaulManlyNanaimo—LadysmithGreen PartyBCAugust 11, 2020, at 1:59 p.m. (EDT)October 10, 2020, at 1:59 p.m. (EDT)November 2, 2020January 25, 2021October 15, 2020Petition to the <Addressee type="3" affiliationId="" mp-riding-display="1">Government of Canada</Addressee>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;In the first five months of 2020, 554 residents have died from opioid overdoses in British Columbia;Most overdoses in Canada are drug poisonings due to the street drugs being tainted with fentanyl and carfentanil;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 Government of Canada to:1. Declare a public health emergency due to overdose deaths in Canada;2. Reframe the overdose crisis in Canada as a health issue rather than a criminal issue;3. 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;4. 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;5. End the wasteful and ineffective war on drugs; and6. Decriminalize personal possession of all drugs in Canada and guarantee a safe supply of drugs in Canada.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe Government of Canada is deeply concerned with the ongoing opioid crisis.  Tragically, between January 2016 and March 2020, 16,364 Canadians lost their lives to apparent opioid-related overdoses. Many jurisdictions are now reporting record-breaking levels of opioid-related deaths and harms since the onset of the COVID-19 pandemic.Concerning the declaration of a national public health emergency, at the federal level, legislation is not required to provide important responses to the opioid overdose crisis. The comprehensive federal response has included reductions of legislative and regulatory barriers, new prescription guidelines, marketing restrictions, awareness campaigns, improvements to the knowledge base, and emergency funding to provinces and territories, which were put in place without a formal declaration of a public health emergency.The Government of Canada’s approach to substance use issues has been comprehensive and collaborative, guided by our federal drug strategy – the Canadian Drugs and Substances Strategy (CDSS), which was first introduced in late 2016. 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. The Government has placed a 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, as stigma 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;
  • 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; and 
  • working and communicating directly with front-line workers including health practitioners, public health advocates, people who use drugs, and people with lived and living experience.
The Government of Canada recognizes that the overwhelming majority of deaths caused by the opioid crisis are due to a street drug supply contaminated with highly toxic substances, such as fentanyl. The situation is now such that anyone who uses drugs for any reason in Canada is at risk of a potentially fatal opioid-related overdose every time they use drugs from the contaminated illegal supply.The Government of Canada has taken actions to reduce barriers to providing people who use drugs with a safer, pharmaceutical-grade alternative to the toxic illegal drug supply. For example, Health Canada has issued class exemptions to pharmacists, and eased restrictions on the transportation of controlled substances, to make it easier for people to access the medications they need during the COVID-19 pandemic while following public health advice, such as physical distancing. In addition, through Health Canada’s Substance Use and Addictions Program, the Government of Canada is providing funding to support 11 projects in providing a flexible safer supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. These investments will help provide pathways to care and treatment. Examples of funded projects include:
  • The Vancouver Island Health Authority was provided approximately $2 million over 48 months for an innovative project that will provide pharmaceutical-grade medication as an alternative to the toxic illegal drug supply for people in Cowichan Valley who have not responded to other forms of treatment for opioid use disorder.
 
  • The London InterCommunity Health Centre (London, Ontario) was provided more than $6.5 million over 50 months to deliver a safer supply program that will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder during the pandemic and beyond.
Findings from these initiatives will contribute to the evidence base to support the scaling up of effective models. In addition, to further bolster these efforts, on August 24, 2020, the Minister of Health sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges to encourage them to provide people who use drugs with a full spectrum of care options, including access to a safer supply of drugs.The Government of Canada has also taken a number of steps to provide options for those seeking treatment for severe substance use disorder. On April 25, 2019, the Minister of Health added diacetylmorphine to the List of Drugs for an Urgent Public Health Need. This makes it possible for provinces and territories to import this drug for the treatment of opioid use disorder. Amendments to federal regulations have also allowed health care practitioners to provide diacetylmorphine-assisted treatment outside of a hospital setting, if permitted by their province or territory. In addition, on May 1, 2019, Health Canada approved the use of injectable hydromorphone by qualified healthcare professionals as a treatment for adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.The Government of Canada is also providing guidance and leadership on the prescribing, dispensing, and delivery of opioids and other narcotics during the pandemic. For instance, through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) has recently developed a series of national guidance documents related to substance use in the context of COVID-19. The guidance documents can be found here: https://crism.ca/projects/covid/. These measures help to ensure continued access to medications and ongoing management of health conditions such as chronic pain. Health Canada has also assembled a toolkit to provide clarity on prescribing for the treatment of substance use disorder and/or to provide a safer supply. The toolkit can be found here: https://www.canada.ca/en/health-canada/services/substance-use/toolkit-substance-use-covid-19.html The Government of Canada has also made substantial investments to address the crisis in several areas. Recent examples of key federal investments in this area include:
  • The investment of nearly $600 million committed by our Government in response to the opioid crisis has focused efforts on prevention, treatment, enforcement and harm reduction. This includes $150 million provided directly to provinces and territories through the Emergency Treatment Fund.
  • As part of Budget 2019 and additional funding commitments, our Government committed to investing $106.7million to scale up key life-saving measures, help circumvent the toxic illegal drug supply, and identify and address emerging drug threats.
  • In response to the COVID-19 pandemic, the Government of Canada committed an additional $500 million to address immediate needs and gaps in the support and protection of people experiencing challenges related to mental health, substance use, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times
The Government of Canada has also undertaken a broad range of policy, legislative and regulatory actions, such as:
  • approving supervised consumption sites (with 38 currently in operation across Canada), and providing class exemptions to facilitate the establishment of overdose prevention site;
  • consulting Canadians (from August 15, 2020 to October 14, 2020) on a proposal to develop proposed new regulations for supervised consumption sites and services;
  • passing 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;
  • collaborating with provinces and territories to better understand the evolving crisis, undertake timely surveillance and reporting of opioid-related deaths in Canada, and to encourage action at all levels to better provide care to people who use drugs with a full spectrum of options for receiving care;
  • deploying 11 public health officers from the Public Health Agency of Canada to support surveillance systems in 11 provinces and territories;
  • 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; and
  • supporting a pilot project to provide pharmaceutical hydromorphone to eligible patients with opioid use disorder in British Columbia.
Further, in recognition of the importance of addressing pain prevention and management more broadly as efforts to address the opioid crisis must take people who live in pain into account, the Government of Canada released, in October 2020, the second report of the Canadian Pain Task Force, “Working Together to Better Understand, Prevent, and Manage Chronic Pain: What We Heard”. The report reflects the evidence, ideas, experiences, and practices that the Task Force heard throughout its extensive series of in-person, written, and online consultations about the gaps and challenges, best and promising practices, and elements of an improved approach to preventing and managing chronic pain The Government of Canada is not currently considering the decriminalization or legalization of illegal drugs at this time. We will continue to work with civil society organizations, first line responders, academics, people with lived and living experience and other key stakeholders to assess options that could better support the needs of people who use drugs during this difficult time. The Government of Canada continues to encourage the formation of partnerships between law enforcement and health and social services to help divert people who use drugs away from criminal sanctions and towards appropriate health and social services.  For example:
  • Funding a three-year project in Peterborough, ON, to develop a multi-sector response, with a team dedicated to caring for people at risk of experiencing overdoses, in order to direct people away from the justice system and into care.
  • Issuing guidance to public prosecutors to pursue suitable alternative measures and diversion from the criminal justice system for simple possession cases, except when there are serious mitigating circumstances. This policy is available at: https://www.ppsc-sppc.gc.ca/eng/pub/fpsd-sfpg/fps-sfp/tpd/p5/ch13.html.
The opioid crisis has had a devastating effect on Canadians from every walk of life and impacts communities in every region of the country. There is a need to look “upstream” at the root causes of the problem in order to better prevent substance use at the outset, and to consider substance use in the context of broader socioeconomic issues such as housing, poverty, discrimination and trauma. To this end, we will continue open communication with those most affected by the opioid crisis in order to determine what more we can do, and will work closely with community leaders, people with lived and living experience, as well as our provincial, territorial, and municipal partners, to advance innovative solutions to address this devastating public health crisis.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledNovember 16, 2020432-00054432-00054 (Health)GordJohnsCourtenay—AlberniNDPBCOctober 2, 2020November 16, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs, in order for them 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledNovember 16, 2020432-00022432-00022 (Health)GordJohnsCourtenay—AlberniNDPBCSeptember 28, 2020November 16, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledNovember 16, 2020432-00006432-00006 (Health)GordJohnsCourtenay—AlberniNDPBCSeptember 24, 2020November 16, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020.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 services and other necessary medications during the pandemic.For example, the Minister of Health has asked provinces and territories and regulatory colleges to improve access to prescribed medications and to allow for flexibility 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 also issued a temporary 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. This exemption was extended to September 30, 2021, given the ongoing nature of the COVID-19 pandemic.Additionally, Health Canada has developed and disseminated a toolkit to service providers to better support people who use drugs, in order for them 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’s Substance Use and Addictions Program (SUAP) is providing $21.9 million in funding over four years to support 11 projects that provide a supply of pharmaceutical grade medications for people with opioid use disorder in British Columbia, Ontario and New Brunswick. This includes $16.1M for five multi–year pilot projects and $5.8M for six shorter-term initiatives funded in response to the risk posed by the worsening toxic illegal drug supply as a result of the COVID-19 outbreak. Health Canada is also working with community organizations funded through SUAP to re-direct resources from funded activities to support the COVID-19 response. For example, the British Columbia 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 is committed to a holistic, public health approach to addressing problematic substance use that is focused on reducing harms and saving lives, through the Canadian Drugs and Substances Strategy. 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. 
While our government is not considering the decriminalization or legalization of illegal drugs at this time, we will continue to work with civil society organizations to assess options that could better support the needs of people who use drugs, during this difficult time.The Government of Canada also 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-grade alternatives to the contaminated illegal supply to eligible clients at risk of overdose; 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 Saskatchewan to increase access to chronic pain services, and providing $1.2 million to 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.
The Government of Canada is further supporting those who are most vulnerable during the COVID-19 pandemic by investing $500 million towards health care, including support for Canadians experiencing challenges with substance use, mental health, or homelessness. This investment is part of the more than $19 billion invested through the Safe Restart Agreement to help provinces and territories safely restart their economies and ensure Canadians have the support they need in these challenging times.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 37 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 supporting a range of care models for people at risk of overdose and building the evidence base for innovative public health interventions. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJuly 20, 2020431-00229431-00229 (Health)GordJohnsCourtenay—AlberniNDPBCJune 3, 2020July 20, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJuly 20, 2020431-00198431-00198 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCMay 19, 2020July 20, 2020January 31, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • 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 HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledJuly 20, 2020431-00170431-00170 (Health)GordJohnsCourtenay—AlberniNDPBCMay 5, 2020July 20, 2020January 31, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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. 
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledMay 25, 2020431-00142431-00142 (Health)PaulManlyNanaimo—LadysmithGreen PartyBCMarch 10, 2020May 25, 2020February 28, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • 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 HealthSigned by (Minister or Parliamentary Secretary): Mr. Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledMay 25, 2020431-00130431-00130 (Health)GordJohnsCourtenay—AlberniNDPBCMarch 9, 2020May 25, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Mr. Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledMay 25, 2020431-00127431-00127 (Health)PaulManlyNanaimo—LadysmithGreen PartyBCMarch 9, 2020May 25, 2020February 28, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • 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 HealthSigned by (Minister or Parliamentary Secretary): Mr. Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 20, 2020431-00125431-00125 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCFebruary 28, 2020April 20, 2020February 10, 2020Petition to the Government of CanadaTHEREFORE, YOUR PETITIONERS call upon the Government of Canada to cease incarceration of those who suffer from drug abuse, and to begin rehabilitation of said victims back into society through treatment programs, as does Portugal.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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.
Drug use and abuseImprisonment and prisoners
43rd Parliament223Government response tabledApril 11, 2020431-00046431-00046 (Health)GordJohnsCourtenay—AlberniNDPBCJanuary 30, 2020April 11, 2020December 6, 2019PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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. 
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 11, 2020431-00081431-00081 (Health)AlistairMacGregorCowichan—Malahat—LangfordNDPBCFebruary 18, 2020April 11, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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. 
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 11, 2020431-00090431-00090 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCFebruary 19, 2020April 11, 2020February 5, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • 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 HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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. 
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledApril 11, 2020431-00100431-00100 (Health)GordJohnsCourtenay—AlberniNDPBCFebruary 21, 2020April 11, 2020February 3, 2020PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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. 
DecriminalizationDrug use and abuseOpiates and opioidsPublic health
43rd Parliament223Government response tabledMarch 12, 2020431-00041431-00041 (Health)GordJohnsCourtenay—AlberniNDPBCJanuary 28, 2020March 12, 2020December 6, 2019PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWe, the undersigned residents of Canada, draw the attention of the House of Commons in Parliament Assembled to the following:Whereas over 4000 Canadians died in 2017 and over 2,800 in 2016 due to preventable opioid overdose resulting from fentanyl-poisoned sources. The number of preventable deaths has surpassed the total number of deaths of all other Public Health Emergencies in the last 20 years including SARS, H1N1, and Ebola. Those who have died as a result of a preventable opioid overdose from fentanyl-poisoned sources were valued citizens of this country; our children, siblings, spouses, parents, family members, clients, friends. And whereas Substance use is a normal part of human experience; documented across centuries and all over the world. The current war on drugs has been costly and grossly ineffective and resulted in widespread stigma towards addiction and against those who use illicit drugs. Criminalization of particular substances has resulted in the establishment of a drug trade that now traffics dangerous and lethal products, such as fentanyl. Regulating to ensure safe sources, with proper measures and bylaws, will reduce the criminal element associated with street drugs. Problematic substance use is a health issue and is not resolved through criminalizing personal possession and consumption. Decriminalization of personal possession is associated with dramatically reducing overdose deaths in the countries that have modernized their drug policy.Therefore, We, the undersigned, Citizens of Canada call upon the Government of Canada to:
  1. Declare the current opioid overdose and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act in order to manage and resource it with the aim to reduce and eliminate preventable deaths.
  2. Reform current drug policy to decriminalize personal possession.
  3. Create with urgency and immediacy a system to provide safe unadulterated access to substances so that people who use substances, experimentally, recreationally or chronically, are not at imminent risk of overdose due to a contaminated source.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Darren FisherThe 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 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  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;
  • 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 $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 40 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 healthcare 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.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.
DecriminalizationDrug use and abuseOpiates and opioidsPublic health