2nd Session, 41st Parliament,
Volume 149, Issue 134
Wednesday, April 22, 2015
The Honourable Leo Housakos, Speaker pro tempore
Controlled Drugs and Substances Act
Bill to Amend—Second Reading—Debate Continued
On the Order:
Resuming debate on the motion of the Honourable Senator Dagenais, seconded by the Honourable Senator Maltais, for the second reading of Bill C-2, An Act to amend the Controlled Drugs and Substances Act.
Hon. Mobina S. B. Jaffer: Honourable senators, I rise to speak on Bill C-2, An Act to Amend the Controlled Drugs and Substances Act.
The summary of this act states:
This enactment amends the Controlled Drugs and Substances Act to, among other things,
(a) create a separate exemption regime for activities involving the use of a controlled substance . . . that is obtained in a manner not authorized under this Act;
(b) specify the purposes for which an exemption may be granted. . . and
(c) set out the information that must be submitted to the Minister of Health before the Minister may consider an application for an exemption in relation to a supervised consumption site.
Honourable senators, I would like to first of all thank Senator Campbell for his very articulate and passionate presentation yesterday. Senator Campbell is a very knowledgeable person on these issues, so when he was speaking, he came from a place of having first-hand experience.
My experience on this issue is from people who use it, and I would like to share that with you.
We live in a very rich country. I come from the very rich city of Vancouver, probably one of the most beautiful cities in the world; of course, I’m biased. I am very embarrassed today to stand here and say that I also come from a city where the homeless population is increasing. No Vancouverite can be happy about that. In fact, I’m very embarrassed about that.
On very cold nights, I walk on the streets with outreach workers to find out how we can find shelters, or help to find shelters, for homeless people. I see homeless people sleeping almost on the road, a dirty road, with very few belongings. Many suffer from addictions. When I have observed them using an injection to deal with their addictions, the one thing that I have seen outreach workers do is try to convince that person to go to a clean site, a clean place, so that at least the injection would not infect them.
Honourable senators, we live in one of the richest countries in the world, and if we cannot look after the most desperate people in our communities, then we all have a lot to answer for.
I work closely with Pivot Legal Society, whose tagline is equality lifts everyone. This is an organization that works very closely with the homeless, and they are a very respected organization in the city. They have set out what a safe injection site is about. They say that supervised injection services are specialized health care facilities where people who inject drugs can access harm-reduction services, get connected to other health care services, including detox, be supported by nurses who are trained to detect the symptoms of narcotic overdose and can treat it.
There are over 70 such health care facilities around the globe, but only one in Canada. At Vancouver’s Insite, there were 1,418 overdoses between 2004 and 2010 without a single death. Many of these overdoses could have been fatal had they occurred outside the facility.
Insite was established in response to a public health emergency. A decade’s worth of research during that time, as well as ample evidence from international facilities, have confirmed that supervised injection services are both effective and necessary.
By way of background, senators, Insite is a health care facility in the Downtown Eastside of Vancouver, where people who use IV drugs can access harm-reduction services, be connected with other health care services, including detox, and where nurses are trained to detect the symptoms of narcotic overdose and to treat them.
As I have already stated, there have been 1,418 overdoses at Insite between 2004 and 2010.
Honourable senators, Insite is a place where people can have a chance to live. The effect at Insite is to insulate clients, called “participants”, and staff from the functioning of the CDSA, which would otherwise expose them to criminal sanction for possession or possession for the purpose of trafficking of illicit drugs while they are inside the facility. The criminal prohibition of drugs continues to function normally outside the facility, as it does in the rest of Canada.
This section of the bill and the minister’s discretion to use exemptions under it were the subject of a 2011 Supreme Court of Canada case called Canada (Attorney General) v. PHS Community Services Society. The court ruled in the Insite case that the minister’s discretion was limited by section 7 — life, liberty and security of the person — Charter rights of IV drug users and that exemptions would be granted in all but exceptional circumstances. The court also set out some factors the minister could consider in the future.
Honourable senators, I am not going to comment on what this bill is about because we are going to be studying it. It would be better to comment once we have heard from people, but I will set out for you what Insite does. It saves lives.
Insite has been operating since 2003. The scientific evaluation of Insite has been carried out by researchers at the B.C. Centre for Excellence in HIV/AIDS and the Department of Medicine at the University of British Columbia. The results of the evaluation research have been published in more than 30 articles in the world’s leading peer-reviewed scientific and medical journals.
Insite decreases activities related to HIV transmission, it reduces overdose risk, it increases access to addiction treatment, it increases public order, it increases medical care for injection-related infections, it increases safety for women who use drugs, it does not increase drug use or related crime, it saves taxpayers money and it saves lives.
Honourable senators, if you were from my city, you would all appreciate the work that Insite does.
I gave a lot of thought as to what I could say about Insite. I am not a medical person, so I am turning to people who have medical knowledge, who have set out what Insite is doing.
Dr. Perry Kendall is provincial health officer of British Columbia. Dr. Patty Daly is chief medical health officer for Vancouver Coastal Health. Dr. John Carsley is a medical health officer for Vancouver Costal Health. This is what they had to say about Bill C-2 in an article entitled Supervision, not contempt:
If it becomes law, this legislation may cause the closing of Vancouver’s Insite and prevent other sites – we fear the worst for addicts and our cities . . .
Honourable senators, this is what they had to say on March 31, 2015:
On March 23, federal Bill C-2 — the “Act to Amend the Controlled Drugs and Substances Act” — passed in the House of Commons. Vancouver’s supervised consumption site, Insite, was recently granted a one-year extension under the existing legislation, but if Bill C-2 eventually becomes law, then it may well cause the eventual closure of Insite and make it almost impossible for new sites to open in other communities. The Conservative government has labelled this law the “Respect for Communities Act,” but “Contempt for the Health of Communities” would be more accurate.
The act lays out the requirements for an application to the federal Health Minister for an exemption to operate a supervised consumption site such as Insite or the injection room at The Dr. Peter Centre, both in Vancouver. It’s short, as legislation goes. Once you strip away the definitions and explanatory notes, you are left with more than 25 clauses listing the information an applicant must provide.
Based on our clinical experience of more than 10 years and the results of numerous peer-reviewed studies on Insite published in prestigious medical journals, we can say with absolute confidence that virtually all these requirements are unnecessary and excessively onerous. The requirements of the act are oriented toward building a case for denyingexemptions rather than approving them.
For example, if there is a demonstrated need for this public health service, it’s not clear whether opposition by a single group could prevent the granting of an exemption, or whether scientific evidence of clear benefit and lack of societal harm for such services carry greater weight than such opposition.
To give another example, for any staff working in the facility, the applicant must provide police records going back 10 years showing that the potential worker has not had a conviction for a drug offence, conspiracy, money laundering or terrorism. While most staff will be registered nurses who have already passed police checks just to work as nurses, others may well be recovered addicts who have succeeded in treatment. Scientific literature shows that such people are among the most successful peer educators — is it the intent of this bill to bar them from this work?
The act is also inconsistent with the Supreme Court of Canada’s 2011 ruling that the Health Minister’s failure to extend Insite’s Section 56 exemptions was not in accordance with the principles of fundamental justice, and violated Section 7 of the Charter of Rights and Freedoms. The court ruled that on future applications for such exemptions, the minister must exercise discretion within the constraints imposed by the Charter, and “aim to strike the appropriate balance between achieving public health and public safety goals.”
They go on to say:
Further, the minister should generally grant an exemption where “the evidence indicates that a supervised-injection site will decrease the risks of death or disease, and where there is little or no evidence of an impact on public safety.”
Our experience in Vancouver shows these sites do not increase crime, do not divert drugs and do not threaten the safety of their neighbourhoods. These are health services. They prevent overdose deaths, open a door to drug detox, keep HIV and hepatitis from spreading and used needles off the streets, treat wounds and infections, and decrease the use of police, ambulance and emergency medical services.
This law is a thinly veiled attempt to end supervised injection services. Period.
If any legislation at all is required, it needs very few elements: applications endorsed by local and provincial public authorities, the municipality, local police, provincial health and justice ministers. If these approvals are in hand, the federal minister should be granted an exemption. It’s that simple.
At present, a number of Canadian cities are considering seeking exemptions for supervised consumption sites. The passage of Bill C-2 would effectively curtail these needed services. We fear the worst for the health of our cities.
Last October, there was a brief but intense surge in injection overdoses in Vancouver when fentanyl, the powerful prescription narcotic, was sold as heroin. While deaths occurred in the community, all those who overdosed at Insite were successfully treated and survived. We can only imagine the death toll among some of our most vulnerable citizens if Insite were closed. Do we really want our alleys and hotel rooms to fill up with bodies again?
Honourable senators, these are not my words. These are words of people who work with people who suffer from addictions.
Honourable senators, Senator Campbell spoke of the plight of sexual workers. Let me share with you one experience I have had. Many times I walk on Fridays with sex worker outreach people. I have learned so much about my city when walking with these people. I have seen homeless sex workers walk into closed ATM machines, and when they walk in, they are dirty, they have very little makeup on, and you just are overwhelmed with how somebody like that could live in my city. I have observed in that small facility how they clean themselves up — I don’t know how they do it because there’s no water there — how they put on makeup, how they dress up and how they get ready to carry out their trade. Once they are ready, I have observed outreach workers go up to them and convince them to go to Insite to have safe injections before they carry out their work.
What this bill will do is stop the people who are most vulnerable in my city from getting the help they need to deal with their addiction.
May I have five minutes, please?
The Hon. the Speaker pro tempore: Will honourable senators grant Senator Jaffer five more minutes?
Hon. Senators: Agreed.
Senator Jaffer: Honourable senators, I want to remind you again. We are very lucky. We live in one of the richest countries in the world. We have a lot of resources in our country. We have the power to keep the most vulnerable in our society safe. Let us not forget those who need our help.
Thank you very much.
(On motion of Senator Hubley, debate adjourned.)