Speech in Opposition to in opposition to Bill C-2, An Act to amend the Controlled Drugs and Substances Act
November 8th, 2013 - 3:38pm
Mr. Speaker, I rise today in opposition to Bill C-2, An Act to amend the Controlled Drugs and Substances Act.
I am deeply saddened that the Conservative government has seen fit to introduce such a retrograde bill, and, as I will discuss, a bill that flies in the face of the unanimous 2011 Supreme Court decision on InSite. It seems obvious to many lawyers that this bill will also be struck down by the Supreme Court, costing Canadians hundreds of thousands of dollars. How many lives will be lost or wasted until that occurs?
I would first like to salute the remarkable work done by my colleague from Vancouver East, the health critic for the official opposition. Her compassionate leadership on this issue has been truly inspirational. It saddens me greatly that the Conservative government is only appearing to implement the Supreme Court of Canada judgment. In reality, this bill does nothing more than throw hurdle after hurdle in the way of those other communities across Canada that might wish to establish a safe consumption site to assist those who are suffering from the scourge of addiction.
At the outset, let us be clear, the federal government lost in the Supreme Court of Canada. The Court agreed unanimously that Vancouver's InSite clinic should be allowed to stay open and required the government to determine the conditions that would allow it and other facilities to do so. This bill is supposed to be the result of that Supreme Court judgment.
Before turning to Bill C-2, let me begin by describing the judgment of the Supreme Court. Then I want to examine the contents of the bill before turning to its importance to communities such as Victoria, which I have the honour to represent.
The court's unanimous judgment is extremely eloquent. I can do no better than to read certain portions of the judgment into the record today. It goes like this:
In the early 1990s, injection drug use reached crisis levels in Vancouver’s downtown eastside [...]. Epidemics of HIV/AIDS and hepatitis C soon followed, and a public health emergency was declared [...] in September 1997. Health authorities recognized that creative solutions would be required to address the needs of the population of the [downtown eastside], a marginalized population with complex mental, physical, and emotional health issues. After years of research, planning, and intergovernmental cooperation, the authorities proposed a scheme of care for drug users that would assist them at all points in the treatment of their disease, not simply when they quit drugs for good. The proposed plan included supervised drug consumption facilities which, though controversial in North America, have been used with success to address health issues associated with injection drug use in Europe and Australia.
Operating a supervised injection site required an exemption from the prohibitions of possession and trafficking of controlled substances under s. 56 of the [Controlled Drugs and Substances Act], which provides for exemption at the discretion of the Minister of Health, for medical and scientific purposes. Insite received a conditional exemption in September 2003, and opened its doors days later. North America’s first government-sanctioned safe injection facility, it has operated constantly since then. It is a strictly regulated health facility, and its personnel are guided by strict policies and procedures. It does not provide drugs to its clients, who must check in, sign a waiver, and are closely monitored during and after injection. Its clients are provided with health care information, counselling, and referrals to various service providers or an on-site, on demand detox centre. The experiment has proven successful. Insite has saved lives and improved health without increasing the incidence of drug use and crime in the surrounding area. It is supported by the Vancouver police, the city and provincial governments.
In 2008, a formal application for a new exemption was made. Again, I say, the Supreme Court held in favour of InSite. The court stated:
The Minister [of Health's] failure to grant a s. 56 exemption to Insite engaged the claimants’ s. 7 [charter] rights and contravened the principles of fundamental justice.
The minister's decision not to grant an exemption is not in in accordance with the principles of fundamental justice. It is arbitrary because it is undermines the very purpose of the Controlled Drugs and Substances Act, the protection of health and public safety. The court continued:
It is also grossly disproportionate: during its eight years of operation, Insite has been proven to save lives with no discernable negative impact on the public safety and health objectives of Canada.
It further stated:
The effect of denying the services of Insite to the population it serves and the correlative increase in the risk of death and disease to injection drug users is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.
The court went on to order the minister to grant that exemption to InSite, and here is the key point. It said this:
On future applications, the Minister must exercise that discretion within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between achieving public health and public safety. In accordance with the Charter, the Minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.
What does Bill C-2 do in the face of that judgment? It sets out a daunting list of criteria that supervised injection sites would have to meet before the minister would grant them an exemption under the Controlled Drugs and Substances Act. Experts agree; these criteria would make it much harder for organizations to open safe injection sites in Canada.
Do not take my word for it. Let us hear what the experts have said. Pivot Legal Society, the Canadian HIV/AIDS Legal Network, and the Canadian Drug Policy Coalition issued this statement on BillC-2 when it was first introduced as Bill C-65. They stated the following:
The bill is an irresponsible initiative that ignores both the extensive evidence that such health services are needed and effective, and the human rights of Canadians with addictions.
It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption [sites]....
The Canadian Medical Association and the Canadian Nurses Association have also criticized the bill. This is what the CMA stated:
Supervised injection programs are an important harm reduction strategy. Harm reduction is a central pillar in a comprehensive public health approach to disease prevention and health promotion.
The Canadian Nurses Association stated:
Evidence demonstrates that supervised injection sites and other harm reduction programs bring critical health and social services to vulnerable populations....
The NDP's position is clear. New Democrats believe that decisions about programs that may benefit public health must be based on facts and evidence, not ideology or appeals to the base of a particular political party. InSite users were found to have charter rights to access services and that similar services should also be allowed to operate with the appropriate exemption.
Over 30 peer-reviewed studies published in famous journals, like the New England Journal of Medicine, The Lancet and the British Medical Journal, have all described the beneficial nature of InSite in Vancouver. There has been study after study. There were 70 safe injection sites studied in Europe and Australia. They have all shown the same thing; it is a public health achievement. Canadians should be proud of what was forged in the Downtown Eastside of Vancouver.
Other communities that are seeking to address the scourge of addiction want similar tools to do so, and then the government passes Bill C-2. It is shocking. It is shocking that the Conservative Party's “Keep heroine out of our backyards” fundraising drive started mere hours after it introduced this bill. However, here is the irony. Bill C-2, after setting these virtually unattainable hurdles in the face of safe injection sites, is going to put heroine back in our neighbourhoods. Shame on the government.
We believe in harm reduction programs, including safe injection sites, and we believe that these exemptions should be based on the evidence, not ideology. The bill puts far too much emphasis on communities having to prove the benefits of these sites. No one, for a moment, has suggested that there should not be ample consultation with communities. Of course, there should. However, the number of hurdles in the bill are absolutely daunting.
That brings us back to what the Supreme Court said. It said there cannot be arbitrary decisions by the minister. The NDP believes that any legislation brought forward should respect that ruling imbalance between public health and safety. Bill C-2 does not do that. Therefore, we think the bill is retrograde. We think people in various communities will throw their hands up and not even bother applying, given the hurdles that I will describe. If that is the intent of the bill, which many believe it to be, then the government will have succeeded, at the cost of millions of people around the world who have had similar processes addressed through safe consumption sites, and at the loss of people struggling with addictions in various neighbourhoods in Canada.
If the bill is passed, new applicants in various communities are going to have to include unprecedented amounts of information, such as supporting letters and, ironically, scientific evidence as well. We think that the process will be slowed down. For example, there are no parameters for how long Health Canada is going to have to take to process an application. How long the minister would take to make a decision is wide open and unaddressed. It could be months; it could be years.
In addition, the bill outlines certain principles that the minister must adhere to before approving an application. They are outlined in section 5 of the bill. These principles include a number of things, some of which are entirely appropriate, but when added cumulatively show the government's real objective, which is to thwart the ability to ever have such a facility opened. Therefore, the bill may well achieve its objective, not giving communities the opportunity for a supervised safe injection facility.
What is going on at the ground level? InSite remains the only operational supervised injection facility in our country. Since it opened, what has happened in Vancouver? There has been a 35% decrease in overdose deaths. Furthermore, InSite has been shown to decrease crime, communicable disease infection rates and relapse rates for drug users. It was part of a public health plan. This statistic is absolutely shocking. Between 1987 and 1993, there was a 12-fold increase in overdose deaths in Vancouver. As the Supreme Court said, there was a public health crisis. That is why the community came together with the police, provinces, health authority and community groups to create this remarkable achievement. Now, of course, it seems like it is going to be for naught.
After the Supreme Court made its decision other public health officials, in Toronto, Montreal and Ottawa, started to consider opening supervised injection sites. So far, there has not been one such a request made to open a site.
I am indebted to my colleague, the member for Esquimalt—Juan de Fuca, for his research on the implications of Bill C-2 in our community, the lower Vancouver Island. In his earlier speech, he described the crisis in overdose deaths in Victoria and surrounding area.
The B.C. coroner reported last year that there were 44 deaths from illicit drug use on Vancouver Island in 2011, and 16 of those deaths occurred in greater Victoria. He noted that Vancouver Island is the region with the highest rate of deaths related to illicit drug use in British Columbia.
The Centre for Addictions Research at the University of Victoria concluded that Victoria's per capita death rate is almost 30% higher than in the Lower Mainland. That is right, so just a few kilometres away, a ferry ride away from our community, in the Vancouver community where InSite exists, 30% fewer people die from overdoses per capita than on Vancouver Island, where we do not have a safe injection site. All that Bill C-2 would do is make it virtually impossible for us to realize the public health benefits that have been achieved on the mainland.
The Health Officers Council of British Columbia has resolved that “supervised injection services have been studied enough as research projects, and that it is time to move them into the mainstream of health service provision.” The College of Registered Nurses and the Canadian Nurses Association have interpreted their professional standards for nurses and nurse practitioners to encompass and support the supervision of drug consumption by clients.
In September 2010, the City of Victoria presented a resolution to the Union of B.C. Municipalities to lobby the province to “legislate that base levels of harm reduction services, including needle exchange and access to safe substance use equipment”, and detox and treatment beds, “be made available in every [local government]”.
In April 2008, University of Victoria addictions researcher, Dr. Benedikt Fischer, and B.C.'s provincial health officer, Dr. Perry Kendall, called on relevant authorities to implement a supervised consumption site trial for high-risk street drug users in Victoria. Their argument would be the basis for an editorial published in the BC Medical Journal on April 1, 2008, which said:
Victoria provides a perfect platform to implement a distinct and scientifically evaluated supervised consumption site program that is uniquely tailored to reflect the local characteristics of street drug use and associated public health needs....
I could go on, but I would like to talk about the recent response to the bill by Katrina Jensen, AIDS Vancouver Island executive director, who said there is a need for such a site in Victoria. In June she said:
“We have had eight overdose deaths in the last six months and those are deaths that could have been prevented if we had a supervised consumption site,” she said.
“I think there’s overwhelming evidence that a site in Victoria would save lives and be beneficial to the community.”
Debra McPherson, head of the BC Nurses' Union, asks:
“How does this respect the Supreme Court of Canada decision that recognized these facilities save lives?”...
She said the legislation is a smokescreen for the government’s real agenda of “pandering to prejudice and misplaced morality over health care, evidence and a coherent strategy on addictions and mental health.”
The bill does not achieve the goals that the Supreme Court of Canada set out. The Supreme Court of Canada suggested a road map for granting exemptions by the Minister of Health to allow supervised safe injection sites, consumption sites, to be established in communities.
The bill would set up all the red tape imaginable in communities that want to do something about this scourge, this public health and safety issue. These communities are only going to be frustrated by the bill. That is essentially why I oppose the bill. I think it is wrong-headed and contrary to public health and safety.