Proceedings of the Special Committee on
Illegal Drugs

Issue 10 - Evidence for November 7, 2001 (morning session)

The Special Senate Committee on Illegal Drugs met this day at 9 a.m. to reassess Canada's anti-drug legislation and policies.

Senator Pierre Claude Nolin (Chairman) presiding.

[Translation]

The Chairman: This meeting of the Special Senate Committee on Illegal Drugs will now come to order.

[English]

The Chairman: We were originally scheduled to be in Vancouver on September 12. Our committee held hearings in Toronto on September 10, and September 11 was supposed to be a travel day for us. Obviously, we had to cancel our Vancouver hearing. We are pleased to be here today.

Our first witness today is Mayor Owen, and I should like to relate some history with respect to Mayor Owen.

In 1999, I visited Vancouver, during the occasion of a meeting of the big city mayors' conference. Mayor Owen chaired that meeting, at which a motion was adopted to support the creation of this very committee. Hence, Mayor Owen, you are part of the making of our committee, and we thank you for that.

I would ask you to begin your presentation, after which the committee will have questions for you.

Mr. Philip Owen, Mayor, City of Vancouver: It is an honour to be invited to speak to you about the development of Vancouver's drug policy, "A Framework for Action: A Four-Pillar Approach to Drug Problems in Vancouver."

I was in Ottawa, in February, to meet with several people in the federal government about this policy document, which was in draft form at that time. The draft was well received. In June, when I was back in Ottawa to discuss the revised version, I met with Ministers McLellan and Macauley. I also spent a lot of time with Minister Rock, who has shown a lot of support. Therefore, I wish to extend my thanks to the federal government for being open to this whole subject. We have been very well received on both our trips to Ottawa. I have corresponded with Minister Rock several times since.

We are so pleased that your committee has come to Vancouver, to hear what we have to say. Over the past four years, the city of Vancouver and its citizens have come to realize that we cannot ignore the illegal drug problem and associated property crime in our community. We cannot incarcerate our way out of this problem; nor can we liberalize our way out of the problem. The problem exists in urban centres right across the country, indeed, in urban centres all over the world. It just cannot be ignored.

We just cannot turn a blind eye to the problem. Hence, Donald MacPherson - who is with me here today and who is the drug policy coordinator for the City of Vancouver - and I began to do some groundwork. We spent some time in the United States, where it is clear the war on drugs does not work. Hence, we need to manage the problem through a comprehensive system of care that leads to safe and healthy communities throughout our city.

During the 1990s in Vancouver, we experienced a serious problem with the sale and use of illegal drugs, most notably heroin and cocaine. Hundreds of individuals died of drug overdose during this period. As a result of injection drug use, many others became infected with HIV, Hepatitis C and other diseases.

The growth in the drug trade in Vancouver had a serious impact on the city. Hence, we developed what we believe to be a comprehensive approach to looking at issues of addiction and the drug trade in this city.

In 1997, we established Vancouver's Coalition for Crime Prevention and Drug Treatment. At the time of its formation, the coalition included the City of Vancouver, the Chief of the Police, and 20 community partners. We began to communicate with community interest groups and business groups, and today the coalition has 63 partners, including a broad spectrum of business, health, education, and social service sector people. Coalition partners have made a number of important contributions toward improving crime prevention and drug treatment, both in Downtown Eastside as well as city-wide. Crime prevention seminars, drug forums, youth drug prevention and education and many other coalition initiatives are contributing to improve crime prevention and drug treatment city-wide. There have been close to 100, I would guess, such forums in the last three years in Vancouver.

In November 2000, after four years of research and extensive community involvement in the Downtown Eastside and city-wide, the City of Vancouver released a draft discussion paper - the one I held up just a moment ago. This paper was built on the four pillars of prevention, treatment, enforcement and harm reduction.

For a period of six months, Donald MacPherson and I, along with many others, met with groups around the city to seek their input. We met with small and large groups, from 10 people to 250 people. We attended dozens of meetings. In the end, the document was well received. Public support was in the range of 80 to 90 per cent.

The document was sent back to Mr. MacPherson, who is its author. He did some editing, incorporated some good suggestions from citizens and emphasized certain parts of it. The final document was unanimously passed by city council on May 15, 2001.

In March 2000, the City of Vancouver, the Province of British Columbia and the Government of Canada signed what is known as the Vancouver Agreement. The Vancouver Agreement is an excellent new model for intergovernmental relations that commits the governments of Vancouver, British Columbia and Canada - it was signed by myself, Hedy Fry, on behalf of the federal government, and Jenny Kwan, on behalf of the provincial government. It agreement commits the three levels of government to work together in an urban development agreement to promote and support sustainable economic development, social development and community development in Vancouver.

Through the Vancouver Agreement, the three levels of government in the community will coordinate a comprehensive approach to substance misuse in Vancouver. In the context of developing an effective urban drug strategy, many actions related to drug issues cut across the three jurisdictions.

A key component of the Vancouver Agreement is the development of a secretariat to provide the implementation for "A Framework For Action." The secretariat will provide an opportunity for government and the community to work together to coordinate implementation and - the important word - evaluation.

Where are we now in relation to implementation progress on the drug policy? Since May 15, city staff have been working with the community and the other levels of government and significant progress has been made with respect to the drug policy.

Earlier I talked about the four pillars. The first is prevention. Under the prevention pillar, a Vancouver coalition working group and The Vancouver Sun are producing a five-day series entitled, "Power Choices - Drug Awareness and Prevention For Youth." This series will run in the newspaper for five days. The series will be distributed in approximately 2,000 Vancouver classrooms, coinciding with National Addictions Awareness Week.

The Alcohol-Drug Education Service, a coalition partner, is preparing to expand its "Making Decisions" prevention education curriculum. The program has been around for many years, but through the coalition the program will be expanded to grades 7, 8 and 9 over the next year. A program is already in place for almost 1,100 students in grades 6 and 7 throughout the province.

I have young grandchildren. As such, I would like to see the program extended to grade 1, and the prevention people say that they are moving in that direction.

Under the treatment pillar, four healthcare sites are underway as part of the Vancouver Agreement first focus initiatives in the Downtown Eastside. The sites include the following: a health contact centre, a life skills centre, a community health clinic and the Pender Health Clinic. Funding of $2.1 million is in place and the Vancouver/Richmond Health Board sites are scheduled to open in mid-December 2001, with the exception of the life skills centre, which is not scheduled to open until next April. The Vancouver/Richmond Health Board is continuing its plans for the decentralization of core addiction services throughout the city and the region. Core services including needle exchange, alcohol and drug counselling, home detox support and methadone availability will be located in local community health centres throughout the city.

Not all services are centralized in Downtown Eastside; services are spread throughout the city. The regional mayors are assisting us in their various municipalities; In particular, Richmond, Burnaby and the North Shore are very advanced in this area.

The Canadian Institute for Health Research has approved and partially funded the North American Opiate Medications initiative proposal to conduct clinical trials of heroin-assisted treatment in Montreal, Toronto and Vancouver. This project will enrol a small number, perhaps 240 nationally, long-term heroin users, in order to investigate the efficacy of using heroin in the drug-treatment process.

Under the enforcement pillar, which complements the health initiative, the redesign of the Main and Hastings corner in the Downtown Eastside will be underway in January 2002. After we have the provincial health board facilities in, we will make physical changes at Main and Hastings. The City of Vancouver has pledged $550,000 for that work. Focused on improving public safety, this program allows greater enforcement on the corner and reduces the level of drug activity.

The purpose of the pillars is to separate the user from the pusher. At the moment, we cannot do that. The initiative is wildly supported. The provincial government and Justice Canada have been working on the development of an infrastructure and program for the Drug Treatment Court, and that is moving ahead on Pender Street in Vancouver. It is expected that it will take a client approximately 10 months to complete the program at the Drug Treatment Court.

Under the harm reduction pillar, a federal-provincial-territorial report entitled "Reducing the Harm Associated with Injection Drug Use in Canada" was released by the provincial ministers of health in September 2001.

Six weeks ago, at a meeting in the Maritimes, the provincial medical health officers met with the provincial ministers of health, and they have come up with a very interesting report on harm reduction. The report calls for a task force to consider the feasibility of supervised consumption sites across Canada and will meet in late November. Also, research on overdose deaths is underway that is supported by the Vancouver Agreement and the chief coroner's office.

Other related progress includes work being done by the Vancouver/Richmond Health Board to address addictions in the region. Progress includes a detox access line that has dramatically decreased waiting times and has increased occupancy rates for detox beds throughout Vancouver, an ambulatory detox program to allow for outpatient care, a review of methadone in the region and a supported housing program that provides a combination of affordable housing and addiction program services designed to support individuals recovering from addiction with an abstinence-based environment.

We are pleased with this progress, but there is much more to be done. There is a lot of work to do to secure funding and implementation of all the actions in the drug policy. In order to improve the health and safety of our communities and individuals, we must continue to work vigorously with all levels of government and involve the community - and this is very important - in implementing, in a timely manner, the actions across all four pillars.

Minister Rock, with whom I correspond and talk to regularly, is aware of all of this and is very supportive, from the Health Canada point of view and the acknowledgement that the users are sick. We have a national healthcare system, and that is where those people belong.

This drug policy and the actions contained within it are a crucial part of addressing the illegal drug trade and its negative impacts on the health and safety of our communities. As the world becomes increasingly smaller, the regional, national and international implications of a comprehensive system of care to address substance misuse and crime is of key importance. The linkages between the illegal drug trade and terrorism, especially now, is just one example of the broader relevance of local drug policies.

The Prime Minister of Great Britain, Tony Blair, the other day said that an estimated 70 per cent of the heroin in England comes from Afghanistan. Hence, dollars are being vacuumed out of communities and ending up with terrorist organizations. There is a direct link to the havoc in the world.

I would like to thank you very much for being here. The public is definitely ready for action; that is what they are telling us in Vancouver. We have had extensive dialogue and massive public support. We have all begun to change our attitude about this subject. How do I know that? I know because you are here. You are here and we are talking about it, and this is very, very encouraging.

The Chairman: Mr. MacPherson, do you have a statement to make before we go into the question period?

Mr. Donald MacPherson, Drug Policy Coordinator, City of Vancouver: I have a brief statement to make.

First, I wish to thank you for taking the time to visit our city to hear about the people who are struggling with this intractable problem of substance misuse and how our community can respond to the sale and use of illegal drugs in Vancouver.

As you are aware, we have been through a very difficult time here in Vancouver in recent years. During the last decade, we have witnessed a great deal of pain, suffering and loss of health among many of the citizens of the city and have watched as the death toll of drug overdose, communicable diseases and related criminal activity has risen to alarming proportions.

We hope that at the conclusion of your committee's work your deliberations will result in recommendations that help Canada move forward in tackling issues related to illegal drugs in a way that clearly articulates an approach that is comprehensive, evidence-based and, most important, aimed to minimize drug-related harm to individuals and to our communities.

Much of the situation in Vancouver over the past decade is outlined in the paper that we have forwarded to you, "A Framework For Action: A Four-Pillar Approach to Drug Problems in Vancouver." This paper focuses primarily on illegal drugs other than cannabis. We have done this intentionally to bring focus to issues of addiction, the illicit drug trade and the negative impact of heroin and cocaine on our community. "A Framework For Action" is the result of several years of work by many in the community, non-governmental organizations and government agencies. This paper draws from several others that were written during the past decade from experiences in other jurisdictions and the many voices in all parts of this city that are working towards making our community a healthier and safer place to live and work.

As Mayor Owen has already mentioned said, in 1997 he created Vancouver's Coalition for Crime Prevention and Drug Treatment in recognition that the broader community needs to be involved in developing a response to drugs that fits the context in Vancouver.

In 1998, this coalition sponsored an international conference on crime prevention and drug treatment that brought experts from Europe, the U.S. and Canada together to talk to us about their experience with this issue. We needed to learn at that time.

In April 2000, Vancouver city council created the position of drug policy coordinator to the City of Vancouver in an effort to raise the municipal voice on drug-related issues. While much of the responsibility to respond to the sale and use of illicit drugs falls outside of the mandate of the municipalities, the negative impacts of the use and sale of illicit drugs on our citizens and our communities remains very much at the local level.

In November 2000, Vancouver city council unanimously passed "A Framework For Action" as the city's drug policy document. That document calls for leadership from all levels of government of dealing with illegal drugs in our community. It clearly states that addiction is an issue that must be dealt with through a comprehensive health approach that brings addicts into contact with health services and ends the marginalization of those addicted to heroin and cocaine. It states that criminal activity must be punished and that the safety of our communities is paramount. It also calls for accountability through coordination of efforts and a rigorous evaluation of any initiatives to ensure that drug-related harm is minimized.

"A Framework For Action" acknowledges that the use of illegal drugs is an international issue and that proposed solutions must take into account the regional, national and international context. It calls for strong leadership in those areas that are within the federal jurisdiction and notes that federal legislation must be reviewed in terms of possible increases and sanctions against criminals and organized crime and to review how our laws may actually create barriers to new and innovative approaches that have been developed in other countries.

We live in a society where drug use is common. Legal drugs are everywhere. They are readily available to help us through the day if we need them, to kill the pain, keep us awake, help us sleep, and so on. As with licit drugs, illicit drugs are also here to stay. It is an issue that we will have to come to grips with and, as the mayor said earlier, learn to manage in a way whereby harm to individuals and communities as a result of substance misuse is reduced. Acknowledging the problem is the first step to problem solving, and I believe that in Vancouver we have done that.

Another important element in any strategy is that whatever we do to make things better for people should be based on sound evidence that show us that interventions we might devise actually help the situation and lead to reduced harm to individuals and society. We must look at the research, talk to people affected by our interventions and figure out what approaches work for different situations. We must find out what works in the field rather than continue to have ideological debates that often ensure that little action is taken to address these serious problems. Where we do not have evidence, we must develop a network of experimentation and of trying new and innovative approaches in order to see what we can learn.

I believe the work of your committee will make a valuable contribution toward developing a clear, pragmatic approach to illicit drugs in our society. National leadership on this issue is important to assist municipalities across the country to develop new approaches and address issues within their particular context. "A Framework For Action" calls for that leadership, and we look forward to working with those at the national level and playing our role at the local level to support the development of a new drug policy for Canada.

The Chairman: Thank you, Mr. MacPherson.

I will open the questioning. You spoke, Mayor Owen, about the four pillars, which are the same four pillars that formed part of our national policy or strategy since 1987. Of course, it is much more detailed in your material than it was in the national drug strategy.

Let's start with prevention and education, your first pillar. Are you familiar with the D.A.R.E. program in the U.S.? Will you import that program, or will you build from scratch your own program?

Mayor Owen: Yes, we are familiar with D.A.R.E. The RCMP is incorporating parts of that program in the region. It is one form of education.

Alcohol-Drug Education Service, which is headed by Art Steinmann, has been around for a number of years. Mr. Steinmann he has a different approach. He has engaged the school boards. The Vancouver School Board, which three years ago was rather resistant, has now embraced his service. He now has access to the schools. The chairman of the Vancouver School Board and the school board itself have endorsed this program. The Minister of Education is aware of it.

People ask, "What is prevention?" Prevention is education. It is my hope that we bring this education even to grade 1 students. People say to me: "How can you do that? They will get upset."

I like to use the example of my grandchildren. I have six of them. My two youngest are six years old. Last year, when I put my young grandson in the front seat of my car, he said to me: "I cannot sit here. There is an airbag up here. I have to sit in the back." So he sat in the back. Then he asked me, "Have you got your seatbelt done up Pop?"

Try smoking around these children. You would not dare. These kids know everything.

We have to prepare these kids about substance misuse and abuse, about narcotics. They know everything else. We have to get at them early.

Mr. MacPherson and I visited a school in eastside Vancouver earlier this year. During that visit, two parents got up and told us about a pusher in the schoolyard. Apparently, a pusher was paying some grade 11 and 12 students - who no longer considered it cool to take drugs - $500 a week to find customers for the illegal products in the lower grades. We know there is drug activity in the lower grades, among the 11, 12, and 13 year olds.

I want my six-year-old grandchildren to know about bullying and about peer pressure. They know about smoking and alcohol. Prevention is about giving them the tools and the information to deal with these things at an early age, when they are first faced with it. The school board has endorsed that.

The Alcohol-Drug Education Service is slightly different than D.A.R.E. The RCMP are using aspects of the D.A.R.E. program. We are not associated with D.A.R.E., but it is reasonably active in British Columbia.

Senator Kenny: In terms of public health issues in Vancouver, where do illegal drugs rank in comparison to cigarettes and alcohol? Are they of comparable concern to you? Is one causing greater damage than the other? Can you rank them?

Mayor Owen: Alcohol deaths are a major problem. In terms of cigarettes, Vancouver was the first Canadian city to pass bylaws for a smoke-free environment. We were highly criticized for that by a people in the hospitality, hotel, entertainment, restaurant, and pub business. We had a rough ride for a long time, but we knew we were right and we were committed to it.

I will ask Mr. MacPherson to talk about the drug issue.

Mr. MacPherson: I do not have the data, but I think it is true across the country that alcohol and tobacco are clearly more damaging to more individuals in society than heroin and cocaine. What you are seeing with "A Framework For Action" is a plan to develop ways of dealing with illegal drugs. Obviously, we are moving forward and trying to minimize the harm of legal drugs. However, drugs are drugs; they all cause harm.

Given the steep rise in overdose deaths and the high incidence of HIV among injection drug users and the sort of damage caused by illicit drugs, we realized we did not have a sufficient response to the issue of heroin and cocaine in the city.

Mayor Owen: From the mid-1990s to the late 1990s, Vancouver was experiencing about 147 overdose deaths annually. This year, we are at about 70 or 71. We are beginning to experience some positive results.

Senator Kenny: You spoke about evaluation, which is impressive and important. The Atlanta Center for Disease Control talks about setting aside 10 per cent for evaluation. They suggest appointing an evaluator at the beginning of the program, having publicly stated objectives, setting benchmarks and then publishing the results and the evaluation.

Is this part of "A Framework For Action"?

Mayor Owen: Yes, very much so.

Senator Kenny: Ten per cent set aside?

Mr. MacPherson: The Vancouver Agreement is helping us there, in terms of the three levels of government working together to focus and set aside resources for evaluation.

One of the premises of the paper is that the addiction field in general has not been comprehensively or coherently evaluated. There are all sorts of programs out there that have not been evaluated and that are based more on ideology. Evaluation is a huge issue, a very complex one, and of course it costs money.

We are bringing resources to the table and encourage the provincial and federal governments to also bring resources. A significant portion of those resources will be for evaluation. The public, along with city council, is very much expecting an evaluation process.

Senator Kenny: You talked about D.A.R.E. and you also talked about what seems to be a very extensive classroom program. The delivery of this information to young people is from authority figures. We all know that part of being an adolescent is rebelling against authority figures and rejecting their advice.

Do you have youth-generated programs, to complement the programs that are coming from police and from teachers?

Mr. MacPherson: In our public consultation, that issue was raised. I think there are a couple of points to make here. One is that there is evidence in the research around prevention that some programs work better than others and that we need to look at that evidence.

Prevention has been the domain of authority figures, such as doctors, police officers, teachers, et cetera. We heard from youth that the most effective messages come from youth. Those types of programs are not widely available, very few exist, some struggle, but they need to be supported.

Your comments were certainly borne out in our consultation with the public.

Senator Carney: The Downtown Eastside is part of Vancouver Centre, which I represented as an MP for most of the 1980s. Hence, I am more aware than your average parliamentarian of some of the problems there

Mayor Owen, is there any direct link between terrorism and drug use in Vancouver?

Mayor Owen: Not that I know of, no. I was quoting the Prime Minister of Great Britain and other national figures. I heard American senators talking about the link also.

Senator Carney: We hear a lot about the side effects of drug use - increased car thefts, B&Es, health problems, devastation - but I did not know whether we had a specific terrorism link.

Mayor Owen: No. I was quoting Prime Minister Blair.

Senator Carney: Mr. MacPherson, you know the Carnegie Community Centre. You have obviously brought a lot of thought to the drug policy. Do you separate out the use of marijuana from other drugs, from the harder or injection drugs?

Mr. MacPherson: In the policy, we did not go extensively into the issue of cannabis. We acknowledge there is an array of illicit drugs out there - ecstasy, club drugs, cannabis. However, the focus in the drug policy is very much on heroin and cocaine. The question of separating out cannabis in some way from heroin and cocaine is raised in the paper, but we do not go extensively into recommendations on that.

Mayor Owen: In 1994, Vince Cain reported on substance misuse in British Columbia. One of the recommendations in that report was a public dialogue about cannabis, separate from other illegal drugs, particularly heroin and cocaine.

I was encouraged by the federal government talking about it being available for medicinal purposes on a very limited and controlled basis. I think the public is ready for that debate. There is a public mood and appetite to have a serious discussion and to come to a conclusion on the separation of cannabis particularly from heroin and cocaine.

Senator Carney: This afternoon one of my neighbours on Saturn Island, one of the Gulf Islands, will present a letter from a 19-year-old high school graduate on polling her high school colleagues on the use of private use of marijuana. I just want to alert you that we are going to be looking at a non-urban use of it.

B.C is a big producer of marijuana - as I understand it, it is B.C.'s leading export. There is a lot of private use, as well. Mr. MacPherson, based on your experience in the Downtown Eastside and at the Carnegie Centre, did you come to any personal views on that debate?

It is a matter of interest to the committee about whether we should be debating that issue. There is a serious debate among our group about that. How would you suggest that this committee deal with that issue?

Mr. MacPherson: Based on my experience and my personal views, the overwhelming substance abuse program in the Downtown Eastside up until 1990, I would say, was alcohol. At the end of the 1980s, there was a shift in the drug trade in Vancouver - and only the drug business knows about it. Cocaine began coming into town in much larger quantities, and cheaper. The same can be said of heroin.

Hence, experience tells me that alcohol, cocaine and heroine are the misused substances in our inner city. Of course, I could throw tobacco into the mix, also. Many poor people smoke.

There are certain cannabis markets in the Downtown Eastside - and this in itself was the subject of some discussion in our consultation. There are certain cannabis markets that are right beside heroin and cocaine dealers. Cannabis purchasers should not have to stand beside a heroin or cocaine dealer. We did hear those arguments in our consultation.

Senator Carney: Mayor Owen, in your opinion, what would be the most important contribution the federal government could make to combat the drug problem?

If we were going to recommend one or two things out of an array of possible instruments, what would you ask us to promote?

Mayor Owen: It goes to the issue of public health, public order. The public is now beginning to recognize that a teenage cocaine and/or heroin user is sick, not a criminal. Our people have trouble getting their minds around it, but that is now beginning to be a given.

These people need assistance through the national health care system to change their lifestyle, to substitute methadone for heroin and cocaine and eventually move toward abstinence. Yes, they will fall on and off for a time, but we need the facilities to walk them through that journey.

We cannot put them all in jail. The United States has tried that, and we all know the statistics there, that the situation is just abysmal.

All three levels of government must work on a coordinated basis.

The Vancouver Agreement runs from March 2000 to March 2005; it is a five-year partnership. We have $1 million a year for five years from the National Crime Prevention Centre. There will be a policy group, with a representative from each level of government, and a management group, made up of staff people. The staff from all levels will be able to work together because they know they are supported by the political arm. The Vancouver Agreement model is a very good instrument, one that I think will help a lot.

The fact that your committee is hearing evidence across the country, the fact that we are talking about the problem, these things are good. However, my first recommendation would be to make this a health issue, one focussed on treatment.

Enforcement has to be part of it, but the police are just one part of one of the four pillars. Five years ago, the general response to the problem was to call the police and to throw the users and pushers in jail. That went nowhere, thank goodness.

We now have a pragmatic, comprehensive, continue-with-care approach that has some legs to it, some sustainability, where three levels of government are involved in funding, implementing, and evaluating. The secretariat that was talked about is being funded by the three levels of government, provincial, federal and municipal. Each put up a third of the money for two years, $1 million, and work together.

Senator Carney: Given the effort and the money that has been directed at the problem, when do you expect to see some rewards or benefits, some significant improvement. When will you know whether your approach works?

Mayor Owen: We have been making a lot of changes in focusing on the Downtown Eastside. We do have the decentralization of services, needle exchanges and methadone availability.

Early in the new year, the Vancouver/Richmond Health Board will have its four facilities opened. The police will be able to take, say, a teenager who is wired and asking for help to a facility that will have full-time provincial registered nurses. There will be sobering facilities in another building, detox treatment, and then the life skills people will walk them through this journey of recovery.

Those facilities will begin to open, I would hope, at the end of this month, certainly the end of December, three of them, and then the final one in April. Once they are open, we will see some results. The user and the pusher will be separated. I think we will get a good reading in the first six months.

Senator Carney: There has to be a lifetime commitment, a long-term commitment.

Mayor Owen: Absolutely. A long-term commitment is absolutely essential, and it has got to be done. If this model works, Minister Rock is interested in putting in place some national strategies, some national pilot projects, perhaps making it available in several of the largest cities to see if some of these issues work.

Senator Kenny: Did we read in the papers, Mayor Owen, about the opening of a cannabis cafe here last week? If so, would you care to comment on it?

Mayor Owen: Yes. It is the Marijuana Teahouse.

Mr. MacPherson: The details I have are that the city issued a special-event permit to have an opening, but it was just for the one day. It involves a group coming forward to the city with development-permit applications to renovate an existing building in the downtown area for a facility for those people licensed by Health Canada to use medical cannabis.

Mayor Owen: They do not have an occupancy or business licence. They had the special-event permit, and they have to come back now with an application. Our permits and licence people will process it, and it may end up with council, but at the moment they do not have a business licence. They are not operating legally if in fact they are open today.

Senator Lawson: Mayor Owen, I know you bring a lot of passion to this subject and show a lot of leadership on council about this issue and about your program.

Mr. MacPherson says that we can learn from our youth, and you say to listen to our grandchildren. Sometimes we learn things we do not want to hear. For example, my five-year-old grandson climbs on my knee and he says, "Grandpa, can you talk like a frog?" I respond to him, "No. Why do you ask?" He answers, "When you croak, we are going to Disneyland." So sometimes we hear things we do not want to hear.

I do not know if you had a chance to read the National Post series a few months ago about this very issue. One of the headlines was "How Pot's Unofficial Decriminalization Has Created a Multi-Billion-Dollar Black Market." Although British Columbia exports hothouse tomatoes, peppers, and all kind of things, the record for export seems to be marijuana. It is a cash crop, and it is a billion dollar industry here in British Columbia.

The police are making a lot of busts on these grow operations, but according to the police the courts are not handing out severe penalties. There is almost a kind of acceptance about this unofficial decriminalization. As Senator Carney said, today the House of Commons will vote on a private member's bill dealing with marijuana.

The thrust of the newspaper was that we have lost the war on drugs and that we are wasting our time, spinning our wheels, spending billions and billions of dollars and getting nowhere, and that we should seriously consider not only legalizing marijuana but legalizing drugs.

In your presentation you talk about a heroin-assisted treatment program. I am not familiar with that program, but I assume it involves treat addicts with legal heroin in some form.

Do you accept that we have lost the war on drugs, that we are spending billions and billions of dollars but are no further ahead now than we were a decade ago, and that it is time for Parliament to decriminalize marijuana, as suggested by the many submissions we are receiving?

Mayor Owen: First of all, I do not think we have lost the whole war.

The public is ready to have an open debate about this issue. Pot and hard drugs are two different issues. The legalization of heroin and cocaine has not been done anywhere in the world that I know of. The issue around cannabis, pot, marijuana is different, and several states in the United States are moving in that direction - Ohio, California, in particular. Switzerland, Germany, and Holland are all looking at that separate discussion about the cannabis/marijuana discussion. I think that is important.

With respect to the courts and marijuana, the police only get 17 per cent of the grow ops they bust to court, and there is little or no sentencing whatsoever, generally a small fine, and that is all. I think that is where you probably want to have this separate discussion about this issue.

As I said earlier, we cannot incarcerate our way out of the heroin and cocaine and hard-drug use; neither can we liberalize our way out of it, but we cannot ignore it. I think we have a pragmatic approach to it that works.

My mind is separate when it comes to hard drugs and soft drugs. I think a separate discussion on grow busters and marijuana has got to take place. I think the public is ready for it.

Senator Lawson: Let's deal with the latter one, the marijuana situation. You and I both know, you as Chairman of the Police Commission and me in my involvement with the police foundation, that a lot of resources are being wasted on this, resources that could be better directed to the type of programs that you were talking about this morning.

Mayor Owen: Absolutely. There is no doubt about it. Marijuana is illegal. Our police officers, who are required by their oath of office to uphold the laws of Canada, cannot just ignore a citizen's complaint about marijuana being grown in the basement next door. They have to go after them. Council has to put another $750,000 into it.

Think of the lack of revenue, the effort, the disruption in society because of this. It is incredible. The numbers are staggering. We are not collecting any GST or PST on all these cash transactions. The public wants this to stop.

It is healthy for us to be able to sit here in Vancouver and talk to the honourable senators about this issue. I am very encouraged by the fact you are here, Senator Lawson, questioning our participation in this.

Senator Jaffer: I was struck by your passion, by your trying to separate the pusher from the user, by trying to get help for the user as opposed to the user going through the court system. However, from what I understand at the moment, for the three pillars, treatment, prevention, harm reduction, less money is spent on that than on enforcement. I understand a major part of the money is still spent on enforcement; is that correct? Is the majority of the money still spent on enforcement?

Mayor Owen: Not the money that has come to us under the National Crime Prevention envelope.

In Vancouver, the police budget is $120 million. It represents a little over 20 per cent of our total budget. Their effort and energy in this area comes under that budget. Hence, the funds are not coming from programs that we are involved in with the province and the federal government.

Senator Jaffer: Can you then tell me approximately how much is being spent in the budget you have between the other three pillars, the treatment, prevention and harm reduction?

Mayor Owen: If you include social housing, which the City of Vancouver is very much involved in, it would be somewhere in excessive of $10 million. We have an extensive social housing program, $6 million to $7 million a year. We just approved $550,000 in physical changes to be made at Main and Hastings.

I would have to go to different sources and add it up, but our budget is $545 million in the City of Vancouver, and we are putting at least $10 million of taxpayers' money into this. We get our money from property taxes.

Mr. MacPherson: Could I just draw your attention to a 1997 provincial health officer report that indicated that in British Columbia the cost of enforcement was about 4.5 times higher than the cost of treatment. I think many police will bear this out. They will say, yes, they have been out there doing enforcement but they need the other three pillars to be resourced. We have heard over and again that the police have been very much alone on the street trying to deal with what is really a huge social health issue. Certainly the Europeans that came over here made it very clear that we needed to invest and invest heavily in services for people with addictions, and that in turn would save us dollars down the line.

The Chairman: I wish to thank you both for attending here. I have other questions, so what I will do is write to you, and we will include in our proceedings both the questions and the answers.

On that final question on cost, at least on the federal side, the Auditor General will report by December a full examination of the various programs at the federal level on the drug situation. It will probably help you to understand how the money is spent.

Mayor Owen: Thank you very much. We are very encouraged by your presence in Vancouver this morning.

The Chairman: Our next witness is Dr. Mark Tyndall. Dr. Tyndall will inform us about the NAOMI Project, which Mayor Owen alluded to in his presentation.

Please proceed, Dr. Tyndall.

Dr. Mark Tyndall, B.C. Centre for Excellence in HIV/AIDS: Thank you very much for asking me to come and speak to this special committee this morning. I consider this to be an extremely important issue and congratulate the committee members for taking it on.

November 7 is also an important day, because it is bring-your-Grade-9-student-to-work-with-you day, so my daughter now confirms that what I do with my time is give my opinions to high-ranking political officials.

I was selected to speak here this morning as a researcher involved with a large group of injection drug users in the Downtown Eastside of Vancouver. As a physician who treats HIV infections amongst marginalized groups, I am actually here this morning as a concerned citizen with a sincere conviction that something has gone terribly wrong with our approach to illicit drugs and with the people who use them. As a physician, I am confronted daily with the severe health consequences of drug use, from the heroin junky in withdrawal to the emaciated crackhead coming off a 72-hour binge, to the battered teenage girl that just had a bad date. There is something terribly wrong; it cannot just be the drugs. There is something about our response to drug use that makes a bad situation much worse.

For the past two years, I have been the director of the Vancouver Injection Drug User's Study, which follows over 1,400 injection drug users who live in Vancouver. In addition to HIV and hepatitis C testing, we collect detailed information regarding sexual behaviours, types of drug use, incarceration, housing and the utilization of health services. The study was started in 1996 during an explosive outbreak of HIV and hepatitis in Vancouver's Downtown Eastside.

Currently 35 per cent of the study is HIV positive and over 90 per cent are infected with hepatitis C. These alarming statistics may well be an underestimation of the actual infection rates in the rest of the community. The vast majority of the participants continue to use injection drugs, despite the obvious physical and social costs. In fact, most have very long histories of substance abuse and invariably use drugs to dull the pain of family breakdown, physical abuse, sexual abuse or mental illness. Tragically, over 10 per cent of the total cohort has already died with half due to drug overdose.

As the study site is in the Downtown Eastside, over 80 per cent of the study participants reside there. It is estimated that in this small area there are over 5,000 active injection drug users. Few are employed and most are supported through welfare or disability insurance, with a fixed-housing allowance that essentially locks them in to Downtown Eastside living. Over half live in dilapidated single-room hotels, most rely on food banks and other handouts, and the majority are deeply entrenched in the street and drug culture. Over 70 per cent have been jailed for drug-related activities, and many of the women participants rely on prostitution to support their drug habits. Clearly, this community represents society's discarded people, the dispossessed, the marginalized, and in many cases those without hope. These people are the victims of society, drugs and neglect.

It should be stated clearly that the HIV epidemic in Vancouver is driven by injection cocaine use. Although polydrug use, including heroin, crack cocaine, marijuana, alcohol and a range of other drugs, is widespread, it is the pattern of injectable cocaine use that poses the highest risk of HIV and hepatitis transmission.

Cocaine is also associated with a high incidence of injection-related infections such as abscesses, bone infections and heart-valve infections. Injection cocaine users will often go on intense binges or drug runs that may involve 20 or more consecutive injections in a short period of time. With each hit, the risk of unsafe injection practices of inadvertent needle sharing is amplified. In our study, individuals who are intensive cocaine users are seven times more likely to become HIV infected than those who do not use cocaine.

It has been alleged that harm-reduction strategies will only encourage current drug users to continue their use and entice others to start using. There is absolutely no evidence to support this from the VIDUS study or in other cities that have adopted a harm-reduction approach. In fact, the Le Dain commission cited the Downtown Eastside as the drug capital of Canada in 1972, long before harm reduction was promoted.

From our survey, the two major reasons for addicts living in the Downtown Eastside are cheap housing and available drugs. In our most recent survey, there were no participants who said that the needle exchange attracted them to the Downtown Eastside, and less than 5 per cent mentioned any other services that brought them down there.

Although the Downtown Eastside is an obvious and a critical target for intervention, the use of injection drugs is rapidly expanding to other parts of the province. In many larger cities and towns, many versions of the Downtown Eastside are being formed. These are particularly concerning, because many lack even the most basic social and health services to deal with the problem. First Nations communities may be especially vulnerable to the introduction and spread of cocaine and heroin along with HIV and hepatitis infections.

Vancouver has been the site of a horrible natural study in drug use and more recently of HIV and hepatitis transmission. At international meetings, Vancouver is consistently held up as the place where an explosive HIV epidemic was not prevented. If we continue to be stalled with providing even the most modest services and interventions, we will be known as the city that did nothing when the epidemic occurred.

As outlined previously by Mayor Owen, in the last year there has been substantial movement to address this problem, and I think we are all very encouraged by that. It is ironic that we expend most of our efforts and nearly all of our resources on combating crime, reducing public drug use, restricting prostitution and treating drug-related illnesses as we allow underlying causes of this problem to go largely neglected.

Vancouver and other Canadian cities are not alone in the struggle to reduce harm associated with illicit drug use. We can look to several European cities that have shown tremendous success in dealing with their drug misuse problems through comprehensive harm-reduction strategies. Frankfurt in Germany is perhaps the most high-profile example of a city that transformed a large open drug scene into a well-managed, controlled and relatively safe drug-using environment.

It should be noted, however, that they did not eliminate the use of illicit drugs. Although both the addicted and the non-addicted universally recognize that drug use, as seen in the Downtown Eastside, is both unsustainable and in many cases deadly, abstinence can only be realized through a long-term service provision implemented in a comprehensive fashion.

Throughout this debate, one thing is clear to all - that is, something needs to change. It is in everybody's best interest to move on, especially the addicted. Contrary to popular belief, the vast majority of drug users would rather be doing something else. These people are not ambassadors for more drug use. Too often, drug users are portrayed as self-indulgent, morally corrupt and generally responsible for the social and economic problems we face in urban centres. Such scapegoating is entirely counterproductive and clouds the real issues - specifically, drug use is primarily a public health issue and should be approached through prevention and treatment.

From the merchant who wants to run a business, to the senior's group who wants a safe street, to the Provincial Government trying to balance their health budgets, to political activists who demand social justice, to the police who want to reduce crime, to street-involved persons who just witnessed a friend's overdose death, the status quo is not an option. Within eight blocks of this hotel we have Canada's most impoverished neighbourhood, perhaps the densest concentration of injection drug addicts in the world and HIV rates that are comparable to South Africa. Do people really need more convincing that something needs to be done?

There are a number of specific steps that are required. Most can be found in reports and recommendations that have been previously written and repeatedly articulated. These include increased public education and prevention programs, expansion of detox and treatment facilities, alternatives to jail sentence, establishment of safe injection rooms, enhanced needle distribution, more choice in substance substitution, such as the NAOMI project, improved methadone services, innovative programs for cocaine addiction, the delivery of HIV and hepatitis C treatment and improved housing. The list could be expanded beyond those.

Whether motivated by vested self-interest, by genuine compassion or something in between, we must move forward on these issues. Lives are being ruined, HIV is spreading, cities are deteriorating and young people are dying as this tiresome debate rages on. Canadians have an excellent opportunity to show global leadership through a balanced, humane and enlightened approach to drug use that will ultimately improve the health and well-being of our society.

Municipal, provincial and federal governments must understand that the social and economic consequences of doing nothing about illicit drugs cannot be imagined.

The Chairman: Thank you, Dr. Tyndall.

I think you are the appropriate witness to explain to us the North American Opiate Maintenance Initiative. We heard about it earlier this week when we heard the testimony of Dr. Ethan Nadelmann from the Lindesmith Center - Drug Policy Foundation. I believe it tries to replicate European experience. Senator Lawson referred to it in his discussion with Mayor Owen.

Could you elaborate on and explain that initiative to my colleagues.

Dr. Tyndall: I am only peripherally involved in the project. Martin Schecter is the principal investigator. Before my arrival in Vancouver, this was already simmering, but I can certainly fill you in on some of the details.

It is taken from a project in Switzerland, so the project has really been done where they offered certain very entrenched heroin or opium addicts.

The Chairman: I think it would be important to first talk about the similarity of the environment in Switzerland and here, to make sure that everybody understands that we are comparing apples and apples.

Dr. Tyndall: That is one of the difficulties. It is not exactly the same environment - however, it is probably the same environment as most Canadian cities. Vancouver is still fairly meek in the ghettoization of the drug problem in the Downtown Eastside. As I mentioned, things are expanding far beyond that, but this is really the focus, and in North America the Downtown Eastside remains very unique.

It is not the same as the Switzerland environment, but I think we can take some lessons from it. Some people are so entrenched in their habits and a failed treatment over and over again. They cannot hold on to a job. Crime enables them to have access to their drugs. To be a heroin addict on welfare is a very difficult life; it is an expensive habit and it has to be supported somehow. The health consequences and the crime consequences of the addiction come largely because people cannot get their drugs.

If that obstacle were to be taken away, we could engage people with a much clearer mind and, one hopes, lead them out of their addiction. As long as we allow people to be entrenched in this - that is, they cannot get their drugs and are desperate all the time - we are inviting a recipe for self-destruction and a destruction of our cities.

Hence, by allowing certain individuals access to free drugs, we feel that you eliminate a lot of those risk factors, both to society and to their own health, and that has been shown. In the Swiss study, such things as employment opportunities improved, certainly health statistics improved, transmission of blood-born infections was reduced. There are good examples from Switzerland that this has really worked, but I think that we still in the North American context need to see if this is appropriate.

The Chairman: So what NAOMI is trying to replicate in North America was tested or implemented in Switzerland over eight or nine years; correct?

Dr. Tyndall: They have been following that. The study is over, but it was implemented eight or nine years ago.

The Chairman: In plain words, it involved clinics administered by doctors and nurses and other social workers. Hence, an individual who has a prescription, let's call it that, can go there and receive free heroin or injectable drugs, right?

Dr. Tyndall: Yes, exactly, and in a controlled environment. There is a further NAOMI project to go through all the ethical reviews. There had to be nursing supervision there. Following the injection, people are supposed to stay for half an hour to ensure that there are no ill effects of the drug. They are expected to come back during the day for other injections. It is a fairly controlled environment, and would not be for everybody. Those people who are much more chaotic certainly would not submit themselves to that kind of regimen of their drug use.

The other thing about Vancouver I try to stress is the cocaine epidemic. Hence, for people who are using cocaine, heroin substitution is not the answer. In some cases, as we have seen in methadone substitution, people who are polydrug users certainly get more stabilized on methadone, even though they continue to use the cocaine, in some cases continue to use heroin. In that controlled environment, many of the risks people put themselves in could be reduced, but again, we would not expect that people on this heroin project would stop using other drugs or everybody would fall into line.

I think it needs to be stressed too that this is one element of a comprehensive program. Hence, if today you started a NAOMI project and opened it to all drug users in Vancouver, you would not be able to show a major impact, because it is not for everybody and there are so many elements involved in this problem. I see it as one part of many parts to address the issue.

The Chairman: It is important to acknowledge that the substances that would be provided in those clinics would be controlled. Everyone, the users included, would know what substance he or she was getting. There would be no mix or unknown content; correct?

Dr. Tyndall: Exactly. One of the major risks for people who are constantly buying their drugs on the street is that they really do not know what they are getting. A lot of overdoses are a result of drugs that have come on the street that are pure beyond what people are used to and people take too much and thus overdose. It is a very risky business to be a drug user on the street, buying day by day and scrounging around. The user really does not know what he or she is getting in many cases.

If we took that risk away, the number of overdoses would certainly be reduced. In cities where it has been implemented, there have been no overdoses in these sites.

Senator Jaffer: I wish to pursue the difference between Switzerland and here. To give me a fuller understanding, when you say it is not the same, are you talking about diversity or are you saying that we are not using enough resources?

Dr. Tyndall: I have never visited the Swiss site, so I am perhaps not the best expert to talk about it.

I think the ghettoization of the situation in Vancouver is quite unique. There are so many users in a very confined area. Things were very much more spread out in Switzerland, as in other North American cities.

Also, there were many more services offered to people simultaneously. Hence, if this program were implemented on its own, I do not think there would be an impact. It has to be part of a major comprehensive approach, as Mayor Owen outlined in his four-pillars approach. For that segment of the population that is basically unreachable, has not responded to treatment, it would offer them another avenue to engage in the system. I see it as a real tool to do that, but we really need to get all these other things in place at the same time.

Senator Jaffer: Are there any special programs for women here in Vancouver?

Dr. Tyndall: Yes. There are many community organizations in Vancouver. Some specialize in pregnant women; other programs are for women working the streets; others are for women in distress.

One of the interesting things about the Vancouver situation is the numbers of interested people in community organization. In fact, I have heard that there are more than 200 working in the Downtown Eastside. Those services needs to be coordinated.

The highest or new infections are more likely to occur in women in Vancouver than men. Women are highly vulnerable, both through sexual transmission and their needle-use activity.

The Chairman: This committee will hear at length experts from Switzerland who will explain to us the various aspects of that experience. They are up to 33 locations in Switzerland now, as at the latest count. We will hear from them in January in terms of exactly how the program works and what it costs, and about the evaluation of course.

Senator Lawson: With respect to the heroin-assisted program, when giving this legal heroin, is the object of the exercise simply to take care of the addict's needs, at the same level that he is using, or is it an attempt to get him off heroin?

Dr. Tyndall: The Swiss trials found that a large portion of the people stopped using. I would see it as a way to engage people who are right now unengageable.

It would not be our expectation that someone in the program would visit the same site two or three times a day for an injection over a ten-year period. That would not be our expectation. The purpose would be to try to engage people and offer them other options.

The career of a drug user spans many years. Drug use is a disease or an affliction characterized by relapse, and we really have to look at this in the long term. To understand that, a person who is injecting in the alley in puddle water and cannot get his or her drug is at extreme risk from a public health perspective. The ultimate goal of a program like NAOMI is to offer that person something different, a more controlled environment, an opportunity to engage in treatment and other opportunities to make changes.

Senator Lawson: There is a large school of thought - and I may belong to that school of thought - that we have lost the war on drugs. When you tell us as you did this morning that what is happening in the east end is now showing up in smaller communities throughout the province, it is easy to believe we have lost the war on drugs.

Would it make sense to have a joint federal and provincial program aimed at going to these outlying communities in an effort to cut it off at the pass? It is beyond my comprehension that users are willing to take what a stranger puts in their hands, something that may very well lead to brain damage or kill them. I understand that, but maybe that is because I am from the old school.

However, would it not make sense to find the resources to go to these communities to try to educate the users and, yes, to give them free drugs?

If we have lost the war on drugs, should we not talk about legalizing this? The experiment in Switzerland is working; it is working here in the east end on a controlled basis. Why not go to all the communities where drug use is just starting up and at least eliminate the overdoses, the deaths, of which there are so many?

We are talking about educating these people. What about raves? Now we have ecstasy. Again, we are not talking about children who do not understand, we are not talking about long-term drug addicts who so desperately need it that they do not care. We are talking about young adults - two who died, aged 18 and 25, I believe - who are willing to take from a stranger and bet their life that they will have a nice time at the rave. How do we deal with that? There has to be a different way or a better way than what we are doing.

Would it make sense to pool those resources and confront that situation, go to those areas and suggest a different way of doing it?

Dr. Tyndall: Yes. You articulated it better than I did. It is quite clear to many of us in the field that most of the damage from a health perspective and an HIV perspective comes from our response to drug use, not the drug use itself. Hence, by turning it into an underworld problem and letting those people make the calls, we have lost it as far as that goes, I think.

The phrase "the war on drugs" is an uncomfortable one. By concentrating only on the criminal aspects of drug use, we have allowed it to flourish. We have not approached it in a public health way. We have allowed thousands in the province to die grizzly deaths because we have not had any way to engage them. We have let the criminal elements drive the agenda.

In the Downtown Eastside community, targeting users versus pushers is very difficult. In the Downtown Eastside, with crack cocaine, for instance, an individual will purchase 12 rocks of cocaine for $100, sell 10, at $10 each, and keep two. I do not know whether the person is a pusher or not. The person is selling the drug to support his own drug habit; he is just as victimized as the people he is selling to.

It is very difficult to get at who is driving the agenda. On the streets, it is very difficult to differentiate between who is selling and who is buying and who is using. Most people down there are victims.

We do not have a good track record of interceding at a high level. A good example is the major opiate drug busts that occurred in B.C. last September. We tracked the price of drugs on the street in our study and the drug busts had no impact on price at all. The price stayed exactly the same.

We are missing a lot of the drugs that are coming into this country. Unless we come up with better ways to interject at that point, it is a lost cause. It is very difficult to separate who is dealing from who is using. Again, I really think all the people are victims to a certain extent and all need to be engaged.

Senator Lawson: From what you are saying, it is obvious that we must be wasting millions and millions of dollars in the health care field, with not very good results. If we could take the profit motive away from the dealers or those people who are making huge amounts of money and all the things that flow from that, we would have a lot more resources to direct toward health care and new programs?

Dr. Tyndall: Yes, that is the perfect agenda.

I did not go into my experience at St. Paul's Hospital, where I work as an infectious disease person and on the AIDS ward. The AIDS ward in the early 1990s was set up mostly for gay men in Vancouver. That population has switched totally over. Of those 18 beds, today 16 will be for injection drug users, most of whom will have injection-related problems. It is not that they will all be HIV diseased. They will have abscesses and endocarditis, things that are totally preventable, and we have to keep them in hospital for six to eight weeks at a time. It costs a lot of money.

We refer to people who are in and out of hospital all the time as frequent flyers. When somebody calls me about an individual, I ask the name now, because often I will know the person because I will have seen them within the last year or so. There is a huge revolving door. It is entirely preventable, and it is costing the health system millions and millions of dollars.

Senator Lawson: One final comment. To have you tell us this is so important, because some of us are on the Senate committees that is studying the state of health care in Canada. In not one of those presentations, that I am aware of, did a witness tell us what you are telling us about the number of beds that are being used for the situation with AIDS victims and drug users.

Dr. Tyndall: Allow me to digress, if I can. The irony to me is how much we spend to treat someone in the hospital - for something like endocarditis or a heart-valve infection, say, which sometimes requires surgery. They are often in the hospital for six weeks. We do multiple investigations, probably spend $1 million, and then we actually employ social workers to make sure that they get back to their hotel room, where the whole problem started, so that they do not lose their hotel room in the Downtown Eastside. Of course, as is so predictable, within three months they will be right back doing it again. Our whole mentality of how we deal with this as a health perspective is fairly warped, I think so.

The Chairman: A few questions on cannabis. In your clinical trials, do you encounter users of cannabis?

Dr. Tyndall: I would say close to 100 per cent.

The Chairman: Close to 100 per cent? Hence, we are not talking about cannabis only; correct?

Dr. Tyndall: It is a polydrug-using population, and we consider people who have started using cannabis to be at much less risk than the rest of the population. An individual who is spending his days chilling out in his room smoking four or five joints a day, not on the street, from a health perspective, is much better off.

It is a given that cannabis is part of the polydrug-using population, and people use it to cool down. An person who feels afraid coming up to welfare day, they will have all this money, they do not want to spend it on cocaine, one response is just to buy some marijuana and sit in front of the TV for the day. It is much safer there. I think marijuana is almost used as harm reduction in Vancouver.

The Chairman: I am sure you have heard about the regulations that have been in force since August 1, the marijuana medical access regulations. Have you read it? Do you have any recommendation to make to us about that?

Dr. Tyndall: I am familiar with patients who come to me in the clinics and want me to fill out forms so that they can qualify for free marijuana. It is a cost-saving issue for them. It is also readily available. It can be expensive, so if you can get it free, why not? However, for a lot of people it is not even worth going through all the paperwork. There is not much of an access problem in Vancouver.

The Chairman: In asking you to comment on the regulations, I am asking you if any illness should be added to the list, whether any should be removed, and to comment on the process, for example, whether it is bogged down in paperwork. As a doctor, there is a lot on your shoulder when you read those regulations. That was the extent of my comment.

Dr. Tyndall: The process is onerous. There is too much paperwork. The medical indications are that it should be used as an anti-nausea medication - say for people who are HIV positive. Some of the literature suggests that it is very effective.

However, for those people who just want to cool down a bit from their drug use, it would not be considered a medical indication.

The Chairman: You are not saying that we should extend the regulation to that, are you?

Dr. Tyndall: Sure.

The Chairman: I think you should say yes.

Dr. Tyndall: Yes. Everybody who comes into the clinic would like some free marijuana. What is required of me is to fill out their paperwork and come up with reasons. The easiest thing to say is that they are HIV positive and are not tolerating their anti-virus medication.

I think it should be expanded, however. As I say, in some of the questionnaires that we administer, we do not even ask about marijuana, because it is like asking about smoking. Certainly there are health consequences, but in light of the population that I am dealing with, hardened cocaine and heroin addicts, it is really a non-issue.

Senator Carney: Your discussion of cannabis as being almost a tranquillizer for anxiety-stricken patients reminds me that for a long time in this country heroin was used for medical purposes. It was administered during childbirth. At the time, it was considered to be the best drug to give a woman during labour, because it did not have the side effects of morphine.

Do you have any views on the use of heroin for medical purposes?

Dr. Tyndall: In a medical context, we have alternatives. Morphine, which we give out readily in a hospital, is basically the same drug with a different name. We are careful about how we hand it out, because of its addictive properties. Hence, I think in certain situations heroin would be just as adequate as morphine. However, we have alternative pain relievers in hospital.

Senator Carney: There is no great argument for it?

Dr. Tyndall: I do not think so, no. I do not think it is really necessary.

Methadone is another example of something that could be used in hospital. I did not discuss this with you, but it is the most highly regulated drug in the province for sure, and for good reason for the most part. I can order any drug on the hospital formula except methadone, unless I have a specific licence for methadone.

Hence, there is a fear of methadone, heroin. We do not want to create addictions out there.

Senator Carney: As a medical person, do you have any views, based on your clinical experience, on the effects of decriminalizing marijuana? I will not load the question. We are interested in whether the debate should be separated, as Mayor Owen suggested?

Dr. Tyndall: Yes, I definitely think the debate should be separated. In the context of the population that I am dealing with, I think marijuana is really a non-issue for those people. It is not creating noticeable health problems outside of the overwhelming health consequences of their cocaine and heroin use. For the larger population, that is really another question that you have to deal with. However, for the population I am talking about, it is really a non-issue.

The Chairman: Dr. Tyndall, what about those who are addicted to prescription drugs? For example, a lot of people are addicted to Prozac. Is that an area of concern for you?

Dr. Tyndall: I have heard people far more eloquent that I am talk about this issue. However, for me, it is a fairly arbitrary decision of what is legal and what is non-legal.

As you said earlier, alcohol causes far more health consequences than illicit drugs, and alcohol is a totally sanctioned drug. The decisions about what is legal and what is illegal seem fairly arbitrary. As I say, much of what drives the devastating problem with cocaine and heroin comes from how we have handled it.

In our effort to engage people back into society, if our only response is to throw them in jail and give them a criminal record, it is pretty unlikely that they are going to be very successful down the road. We have labelled people very early on in their injection career as basically being morally corrupt citizens who are not really worth our time and really have no future. We back them very quickly into a corner. An individual who has an extensive criminal record and who has been living downtown for three or four years in a hotel has little chance of getting a job or getting things going again without a lot of intensive community support. By criminalizing drug use, we have cornered people and have limited their opportunities for the future.

Senator Lawson: Would it make sense simply to add another type of product to the government liquor store, say, an area where one could purchase heroin or cocaine, and to charge the appropriate taxes, on the clear undertaking that the taxes would be directed to rehabilitation, healthcare and other drug-related problems? Would that make sense?

Dr. Tyndall: You are really pushing me now.

Senator Lawson: I have to ask these kinds of questions. Some people are suggesting this type of thing. I think we have to talk about it openly.

Dr. Tyndall: It would be a very interesting experiment. If we were to make the product available at the liquor store, there may be a few more people who may wish to try it. However, if public education were part of the experiment, and if people knew what they were getting into, I think it would make for an interesting experiment. I certainly do not think we would notice a major deterioration in the health of the population if we did that.

The other important aspect is how and why people decide to inject drugs. Again, that activity is driven by the criminality and the cost of these drugs. In New York, for instance, there is a very steep decline in the number of people injecting heroin. Instead, they are smoking heroin, and from a public health point of view that is much a safer activity. Because users are most often poor, they want the biggest bang for their buck, and that comes with injection. If we were able to shift the route of administration, it would have positive benefits from a public health point of view. By making it more available and legal, people would start doing that.

Senator Lawson: I put you on the spot by asking that question, but I agree with you; I would be willing to give it a try.

The Chairman: Dr. Tyndall, thank you for accepting our invitation to attend here this morning. We will keep in touch. If our researchers have more questions for you, we will send them in writing. We trust it would not be too much trouble for you to respond in writing.

Our next witness is Hilary Black, who is the person behind the Compassion Club of Vancouver, which has probably influenced the establishment of similar institutions in Vancouver, Toronto and Montreal.

We would ask you to proceed with your presentation, Ms Black, following which we will have some questions for you.

Ms Hilary Black, B.C. Compassion Club Society. I am the founder and co-director of the B.C. Compassion Club Society, as well as being a user of medicinal cannabis and a registered member of the society. I am honoured to be here today to present to you, and to be representing the Compassion Club Society members, staff and board and the greater cannabis community.

I will be addressing three main points in my presentation. First, I will provide an overview of the Compassion Club Society as a model of a community-based cannabis distribution centre that is both an alternative and a solution to prohibition. Second, I will address the importance and necessity of autonomy within health care and how it is compromised by prohibition. Third, I will describe how prohibition creates social destruction and can be used as a tool to advance political and corporate agendas rather than addressing real and health social concerns.

The Compassion Club Society is a registered non-profit society. We have been distributing cannabis for medical use for four years. We have created a zone where prohibition does not exist in order to allow medicinal cannabis users to access cannabis without the fear and stigma of prohibition. We are a consensus-based organization that employs 28 staff and serves a membership of 1,600 people.

Our members have a huge range of symptoms and conditions such as HIV and AIDS, cancer, multiple sclerosis, arthritis, chronic pain, fybromyalgia, seizure disorders, glaucoma, hepatitis C, anxiety, depression, insomnia, eating disorders and many others. To register a member, we require a confirmation of diagnosis and a recommendation for cannabis from a physician, naturopathic doctor or a psychiatrist. If a doctor will not sign a recommendation solely because she or he is uncomfortable with the legal status of cannabis or has concerns about professional retribution, we may register that patient without a doctor's recommendation, depending on the severity of the diagnosis. Our services are available six days a week.

Our daily menu usually has seven to ten varieties of cannabis, one or two varieties of hashish, cannabis tincture and baked goods. It is important that medicinal users have access to a variety of strains, as the effect of cannabis varies depending on which strain is being used and the method of ingestion. Our members are made aware of the differences and can then select the best strain of cannabis to most effectively treat their symptoms.

Indica and sativa are the two main varieties of the cannabis plant used as medicine. Many strains are crosses of those two varieties. Within each of those varieties and crosses there are a huge number of individual strains, each with a different cannabinoid profile and effect.

According to the anecdotal evidence, the indica strains are a relaxant, effective for anxiety, pain, nausea, appetite stimulation, sleep, muscle spasms and tremors, among other symptoms. The sativa strains are more of a stimulant, effective in appetite stimulation, relieving depression, migraines, pain and nausea. We are now aware of specific strains that are effective for specific conditions and symptoms. Members keep track of their use in order to find the most effective strain for themselves. We also keep close records monitoring members' purchases in order to assist members to track their own consumption and for us to prevent reselling and to encourage responsible use.

We have a smoking lounge where our members can smoke in a safe space, leaving the fear and stigma of being lawbreakers at the door. Members from a range of economic classes with different medical conditions provide incredible support for one another there.

The Compassion Club Society provides access to practitioners in our wellness centre. We have two clinical herbalists, two clinical counsellors, a nutritional counsellor, a doctor of traditional Chinese medicine, a reiki practitioner, an acupressure massage therapist and a yoga program. These services are subsidized by the distribution of the cannabis. Members are charged on a sliding scale of $3 to $30 for wellness centre services. Those who have more pay more, those who have less pay less.

Through our wellness centre we encourage the holistic use of cannabis, one of many medicinal herbs. We recognize that cannabis is not a cure, but a tool. It is a preventative medicine that provides symptom relief and improves the quality of life.

The Compassion Club Society is dedicated to improving the quality of our community. For four years we have been a successful, functioning model of a community-based cannabis distribution centre with no government involvement. We have solid relationships with our neighbours, and any concerns that they have had are not because of the services we provide, but because we are breaking the law.

Regardless of the fact that we are engaged in civil disobedience daily, we have many positive interactions with the medical and social services sectors. The medical community sends us referrals every day, and we are consistently asked to present to a wide variety of organizations and institutions who want information regarding medical marijuana, such as: Multiple Sclerosis Society, HIV/AIDS societies, B.C. Coalition of People with Disabilities, Riverview Psychiatric Hospital, St. James Hospice, University of British Columbia, Capilano College and the Justice Institute.

The local law enforcement community has generally been wonderfully supportive of us. It reports to the media that there are bigger fish to fry and that we are a low priority. In the Vancouver area, the police are usually respectful of those carrying membership cards and will not confiscate their medicine. They recognize that we exist in a grey area between the letter of the law and the way in which the law is applied.

We contribute to the economy by providing income and benefits to 28 staff, as well as income to a group of cannabis growers and their families. The provision of alternative health care through our wellness centre to our members and staff prevents many doctor and emergency room visits, saving the healthcare system precious dollars. Also making valuable contributions to the medicinal cannabis community are botanists, chemists, nurses, doctors, lawyers, cultivation experts and healthcare administrators.

Many of the experts who have presented to this committee have portrayed anecdotal data as insubstantial, but much of medical practice is built upon such case histories. We must also remember that humans have been using cannabis since the beginning of recorded history, and there are no recorded deaths from its use. As you have already heard from other witnesses, there is little evidence of biological damage even among relatively heavy users.

The opposition to decriminalizing cannabis has no toxicological foundation. Day in and day out at the Compassion Club Society we witness the proof of the safety and efficacy of cannabis. Gregg Cooper, who is here today, is a young man who was diagnosed with the rapid onset of multiple sclerosis only four years ago. Today, he cannot bathe himself, dress himself or feed himself without cannabis to ease his muscle tremors and pain.

Vicky Nicholson has multiple sclerosis, fibromyalgia, a serious joint and muscle disorder, and is restricted to a wheelchair. Instead of living a life debilitated by these conditions, Vicky is a national marathon athlete who wins medals each time she races. She attributes her amazing physical success to cannabis.

Michelle David is in her 60s, suffering from serious arthritis, among other conditions. She is able to resist pressure to move into a nursing home and pressure to use morphine and lives an independent, drug-free life through her use of cannabis.

Many of our members cannot walk, eat, sleep, or work without cannabis. It is also an effective tool in harm reduction. With access to cannabis, alternative healthcare and support of the community at the Compassion Club Society, we have assisted people who are addicted to heroin, cocaine, crack, methadone, morphine, codeine and alcohol to overcome their addictions.

While it is unnecessary to spend valuable resources to find out whether or not cannabis is truly effective, there is much to learn about how it provides relief for such a wide variety of symptoms. The Compassion Club Society is positioned to execute research to gather valuable information, such as the relationship between the cannabinoid profiles of a number of strains and the symptoms and conditions that they affect. Many of our members are eager to participate on such a project. Placebos are not necessary or ethical in such studies, nor is animal testing.

We created a research proposal with a team of research scientists from Vancouver. However, we were turned down because we refuse to facilitate a study using a placebo or low-quality, low-potency cannabis imported from the US National Institute on Drug Abuse. Any study attempting to prove the efficacy of cannabis as a medicine using such a low-potency herb, or unknown strains such as those currently being grown in Canada by Plant Prairie Systems, is destined to fail. There is no need to import cannabis for research, considering the high quality and huge quantity of cannabis being produced in Canada. The information we could gather is being requested by doctors, patients, pharmaceutical companies, Plant Prairie Systems and Health Canada, yet we are not financially empowered to facilitate this research.

Health Canada's stated priority is to fund research that will result in the creation of patentable, marketable pharmaceutical products. These legal products can be used to fortify the oppression of access to unprocessed cannabis. Those who need medicinal cannabis must have the option to use manufactured products or whole plant medicine, as they wish, not as determined by a political agenda.

One of our core values is to assist all people to be empowered in decisions regarding their healthcare. We believe people absolutely have the right to choose to use cannabis in its herbal form to relieve their symptoms and to improve the quality of their lives.

We believe that one does not have to be suffering with a chronic or debilitating illness to legitimately use cannabis. Recreational cannabis use is using cannabis as a relaxant, a stimulant or for its euphoric effects, instead of over-the-counter drugs, coffee, alcohol or other legal and illegal recreational drugs. Cannabis is used in this manner in many other cultures. For many recreational cannabis users, their use is self-prescribed preventive medicine. Stress opens the door to illness, and cannabis helps to keep that door shut.

Prohibition has created an artificial market for cannabis, and it is far more expensive than it should be. Many of our members are in a Catch-22. They are too sick to eat so they spend their food money on cannabis because they would rather have herb to relieve their symptoms than food that they are unable to eat. An end to prohibition would make it more affordable to buy both cannabis and food.

Financial considerations are one of the reasons why patients must always have the right to grow their own medicine, wherever and with whomever they choose. It is also one of the reasons that a monopoly on the growing and distribution of medicinal cannabis cannot be allowed. Unfortunately, prohibition is now a tool that can be used to empower corporations - instead of people - by banning the use of the whole plant in natural form so that patients are forced to use manufactured products. We hope to see the evolving legal environment create room for community-based distribution centres.

The pharmacy model will not work for everyone. People need access to the support and the services provided by distribution centres such as ours, and the healthcare system needs relief. Canadians must always have the right to choose whole plant medicine over pharmaceutical derivatives and must have access to cannabis as an herbal medicine that is not controlled by pharmaceutical companies.

As medicinal cannabis becomes a new legal industry in Canada, it will become either a government or corporately controlled monopoly or it will become a sustainable, efficient, fair cottage industry. As it stands now, Plant Prairie Systems is positioned to be the sole legal producer of medicinal cannabis. Economically and ethically, this monopoly is unacceptable.

Prohibition is even causing problems for Plant Prairie Systems in accessing seeds. Instead of working with legitimate and respected Canadian seed companies, a scheme has been concocted whereby seeds that have been confiscated by the police are being handed over and grown by Plant Prairie Systems. In an attempt to keep bureaucratic hands clean, the breeding work of the cannabis community is being stolen, while we continue to be persecuted and oppressed. This kind of hypocrisy is prolific.

The new dangerous viral storage facility in Winnipeg has a level 4 security classification, while the mine in Flin Flon where they are growing the stolen seeds has a level 7 security classification. This is not to protect the children in the neighbourhood; this is to protect the fear of cannabis, which generates support for prohibition. The highly charged political environment caused by prohibition has created a situation where the political agenda has been prioritized over real healthcare concerns. Prohibition has muddied the waters for those creating the regulations for access to medical cannabis and the regulations pander to prohibition rather than creating an effective, rational program.

Placing the doctors in a position of gatekeeper is solely to ensure that medicinal access does not look like decriminalization. Doctors do not want to control access to cannabis. Many doctors recognize cannabis as a natural health product, which is not their area of expertise. Meanwhile, the bureaucrats in Ottawa are overriding doctors' orders to grant access. It is a charade. Doctors should not be the gatekeepers, unless their involvement is for the purpose of establishing that the medical system will cover the costs.

A bill has been recently passed in Holland that allows for medical users to have the cost of their cannabis covered by the government. As in Holland, people should also be able to access cannabis outside of the medical system, if they choose not to pursue subsidy. Unlike in Holland, the new exemption regulations from Health Canada require the creation and maintenance of an expensive, unnecessary bureaucracy. These regulations are far more extensive, invasive, difficult to administer and enforce than regulations for any other prescription drug or natural medicine. The new regulations are akin to shooting a fly with a cannon.

Patients are not allowed to choose cannabis as their first treatment choice. They must consider, or try, all of the allopathic techniques first. Some epileptics would have to at least consider undergoing a lobotomy in order to apply for an exemption. The government is behaving like a two-headed beast.

Police who have come to the Compassion Club Society have told me what great work we are doing, and have, on one occasion, protected a safe full of cannabis on our behalf. However, I have had a police gun held to my head for being at a growing facility. While I met with the federal health minister, Alan Rock, to give recommendations and information Health Canada had requested from us, the RCMP raided a greenhouse that was growing low cost, organic cannabis for the Compassion Club Society. While I am here before you, sharing our information as experts in the distribution of medicinal cannabis, my colleagues risk arrest, imprisonment, their ability to travel, to be employed, and their freedom to distribute cannabis to those in need. Prohibition is not protecting Canadians from the evils of cannabis; prohibition is destroying Canadians' lives.

Stigma, shame and a criminal record can ruin one's ability to succeed in life. Families are torn apart by children being seized, or a parent may be taken away. Many good people are caged in jails although they are people we need in our society. The laws, not the plant, cause what violence there may be around cannabis.

Now prohibition is empowering corporations to have exclusive control over an area of medicine that they know very little about, while those with experience continue to be persecuted. There is no valid justification for the government to spend such a massive quantity of resources to control a non-harmful herb.

I use cannabis regularly. It keeps me healthy. I sell cannabis because it helps others to have health. I am tired of being judged as a criminal, while being called upon as a resource by you, by the federal government, the medical system, the universities and those in desperate need. I am tired of watching lives being destroyed, tired of knowing that sick and healthy folks are being harassed and abused by police and I am tired of watching my community live in fear.

When you hear the words "war on drugs," have no doubt, it is a war. It may not be a foreign war fought with bombs or one which makes the news each night, but it is a war nonetheless. It is a dirty domestic war that is waged against Canadians every day. We will not stop resisting until it is over. I implore you to do everything in your power to end this unjust and destructive war on our community. We simply want to be left in peace.

The Chairman: Thank you, Ms Black. You will not be accused of being a criminal by us or by a lot of people that I know. However, excuse us for trying draw from your experience. We need that experience in our job to understand better why you have created the club and how it operates.

We are glad to see that you have some of your members with you, and if my colleagues agree and if they have a question for one of your members, I do not have a problem with that. If there is some question, hopefully, we will hear your answers.

Thank you very much for accepting our invitation. We will, of course, read and consider your material.

Senator Carney: I have a couple of questions. Your brief was very well presented. It is interesting to have some of your members here because that puts a human face on the issue for us.

You mentioned that you take cannabis for a medical reason. For the record, can you tell us for what medical reason you are taking it?

Ms Black: As a little bit of a preface, my dad is in the room and I do not know if he knows this, which is kind of interesting. As a fairly young girl, when I was first discovering my sexuality, I contracted genital herpes and I used cannabis to control my stress. I do not have any outbreaks. I have not had an outbreak in three or four years. That is because I use cannabis to control my stress. A doctor has written a recommendation for me to continue to do that.

Senator Carney: I have questions about your distribution.

I have a concern, in reading your brief, about the concept of self-medication because I think that self-medication normally has some constraints on it.

However, I would like to know where you get your cannabis. As I understand it, you give it out free of charge, do not you? Who supports your 28 staff members and where do you get your cannabis?

Ms Black: Unfortunately, we are not able to give it out for free. Because of prohibition, growing cannabis is still expensive. There is much equipment that people have to buy to disguise the place where it is being grown, which is part of the artificial market that I was addressing. We have a number of growers that are in contract with us, and we are able to go to the place where the cannabis is being produced to examine cleanliness and standards of production. We also buy a small amount of our cannabis on the black market. We are dedicated to having it as high in quality and as clean as we possibly can. Unfortunately, it is not possible to have access to a laboratory at all times to actually test the cleanliness of the cannabis. However, we have a number of people on our staff with chemical allergies who, unfortunately, get used as our testers quite often.

Senator Carney: Who pays the 28 staff?

Ms Black: We distribute the cannabis for a price to our membership. Our members buy it. They are not getting it for free. We are unable to give it to them for free because of the cost of producing it.

Senator Carney: Can you give us a concept of the business? Can you give us any idea what your payroll costs are? Is this a business? Can you give us an idea?

Ms Black: Absolutely. Somebody in the crowd can actually answer this a lot better than me. I can tell you that the 28 staff are not all full time. Probably about half of the staff is full time and half is part time. We all work for a flat pay rate - as we are a consensus-based organization - which is only $13.50 an hour. We work for a very small amount of money. What we get to take home is the satisfaction of knowing that we are providing access to free healthcare to our membership.

Senator Carney: Your costs are covered by the price that you charge. I assume you are a non-profit association and the profit goes back to the organization.

Ms Black: Absolutely. We are a registered non-profit organization.

Senator Carney: Okay. On self-medication, how do you deal with the quality issue? Most of us on medication have assurance that our medication meets certain clinical standards. You, of course, cannot do that because of the nature of the grey zone in which you work. How would you like the issue of standards to be addressed so that people do not just rely on experimenting with different kinds to determine what helps them? Most of us cannot really assess our medical progress without some sort of clinical support.

Ms Black: This is a matter of people using a small amount of a few different strains of cannabis and seeing what the effects are like. One strain grown differently in three different environments is going to end up with very different effects. You can give one plant, within which the cannabis is fairly consistent, to ten different people who have the same condition and the same symptom and you may find a range and how much it is effective and how much people prefer to choose that strain over another. It really is a matter of personal preference when you are considering the whole plant.

Senator Carney: Do you feel that there is any need for having medical standards or prescription standards or quality standards? Have you ever had a bad experience, even with glucosamine sulphate or something like that?

Ms Black: It is absolutely crucial in the developments on which we are working - and that we would like to continue - to have strict guidelines in terms of moulds and mildews, pesticides, fungicides, heavy metals and the kinds of things - which can be very dangerous - that you find in non-organic cannabis. Even in organic cannabis, some of those elements of microbiology can be very harmful to people, especially for people with depleted immune systems. We can only develop such standards when the medical marijuana community has access to laboratories. I think that there are all kinds of standards that can be developed in terms of safety and cleanliness in growing and distribution.

Senator Carney: Where do you get your drugs and who should set those standards? Should it be done within the health system? You have a lot of criticism about the pharmaceutical aspect, but who sets the standards?

Ms Black: I think that it should be a collaborative effort of people who are in the trenches working with medical marijuana right now, people who have been growing and involved with cannabis for 30 or 40 years and health experts who have understanding and experience with what safe levels are for these different items that we are talking about within the plant.

Senator Carney: Okay. Other senators may wish to follow up on that.

What do you charge your patients, if that is the word?

Ms Black: They are charged a $15 yearly registration fee, which gives them access to our wellness centre. For the wellness centre they are charged on a sliding scale or they can access for free if they are not able to pay a donation. Cannabis ranges anywhere from $3 to $10 for one gram, which is generally about three or four joints.

Senator Carney: Is that not out of range for your patients?

Ms Black: For some of them it is. We have a donation program where each of our members is entitled to two one-gram donations a week and we try our best to have enough for donation in stock. However, poverty is the most random issue within our membership.

Senator Carney: Thank you very much. We are visiting your centre tomorrow, are we not?

The Chairman: Yes.

Senator Lawson: You have made an excellent presentation. Certainly, we are here to try to learn and be educated about what is happening. This is a wonderful contribution, in my case, to knowledge and understanding of what you are all about.

Two questions come very quickly to mind. You spoke about your suppliers. I assume that you have to have a constant supply. Do you have to change your suppliers from time to time? I ask that because you said when you were doing something or other the RCMP raided a greenhouse that was growing low-cost organic cannabis for the Compassion Club Society. I presume they closed it down, did they?

Ms Black: They did indeed close the facility down. We had not yet started to receive cannabis from that growing facility. It was the first crop that was being grown. We just continued to work with the people with whom we had been working. We have a group of producers that is consistent for us. There are a few people who change from time to time. It also depends on who is growing the best, cleanest, highest quality and most affordable cannabis. If the quality of a regular supplier goes down or there is a mould outbreak or something happens so that the crop is no longer acceptable to us, we will search elsewhere for cannabis that is usable.

Senator Lawson: From time to time you say you have consistent suppliers. Are they ever raided? How do they escape being raided?

Ms Black: That is by being good criminals essentially.

Senator Lawson: All right. I had not thought of that.

Ms Black: We have had a few people who ended up in the court system, not because of their relationship with the Compassion Club Society, but because of other things that happened. One instance involved a person who behaved as a middleman for the purchase of our cannabis from other growers. He was willing to do site inspections and to do some of the transportation for us. We went to court with him and he ended up with a discharge, I believe. The judge had some wonderful things to say about the kind of work that we were doing, once we laid it all out. Though we have had some arrests, the judicial system has come to understand what we are doing, and people are not punished as criminals in court.

Senator Lawson: I take it you use local suppliers?

Ms Black: Yes.

Senator Lawson: Is that part of a "Buy B.C." program?

Ms Black: Absolutely.

Senator Lawson: I understand, from what I am told, that it is very high quality.

I have another question. You talked about baked goods being among the things you sell. Can I ask if they are cannabis flavoured baked goods?

Ms Black: Yes. The baked goods are not just for the flavour. When you ingest cannabis through your liver - eat it rather than smoke it - it is a very different delivery system. The main active ingredient, THC, when absorbed through your liver, is broken down into something called 11 hydroxide cannabinoid, I believe, and it is up to 11 times stronger than when active ingredients are absorbed - by smoking, through the mucous membrane - into your lungs and directly into your blood stream. The effects when you eat it are up to two to three times as long and can be much more intense. The dosage can be more difficult to control because you do not feel the effects right away. It takes about two hours to feel the effects.

We keep a range of baked goods available, of different potency and different kinds of products and we educate our members as much as we possibly can before they take any of them home. That is the product where people may become over-intoxicated.

Senator Lawson: In this range of baked goods, do you still have the brownies that you used to have in the old days?

Ms Black: Yes. We have great brownies.

The Chairman: Ms Black, we are going to visit the Compassion Club Society tomorrow and we can address that. There are many questions that are, let us say, more sensible. I have one.

Senator Carney: What do you mean by "more sensible?"

The Chairman: By "sensible" I mean having material information.

Senator Carney: Are you objecting to Senator Lawson's brownies?

The Chairman: Not at all. I am sure Ms Black understands exactly what I mean by "sensible questions."

You are offering, in your daily menu, a variety of cannabis and marijuana and hashish. Are you informed about what Prairie Plant Systems, PPS, can deliver? Is it only one variety? Will it offer a draw menu of marijuana?

Ms Black: From what I understand, its long-term plan is to offer a range of strains. I believe the first crop, which they are working on now, is one strain and the next crop will be three strains. This is from media reports; it is not direct information that I have.

The Chairman: I have one last question on the quality control you have put in place to make sure that what you are receiving and what you are selling to your members is exactly what you are presenting in your menu. What is the system you have in place to control that?

Ms Black: We are able to go to the location where it is being grown. We are able to do inspections in the summertime of some of the outdoor places that are harvested in the fall and also some of the produce of local people who are growing in our town inside houses. We can actually go there to determine if there is mould on the plants, or if there is any kind of fungus, what chemicals are potentially hiding in a cupboard somewhere and inspect as thoroughly as we possibly can.

Once we receive the material, we have hired staff at the Compassion Club Society who are as close to cannabis experts as we can get without having graduated from cannabis college. There are signs and symptoms of mould or fungus or chemical use that can be identified with a sensitive nose, sensitive palate and especially upon actually having a smoke. If something has a little bit of mould or mildew or chemicals on it, you can get a reaction on your lips and feel it in your throat. From time to time we have had access to a laboratory where somebody is willing to engage in civil disobedience and give us actual lab results on the product that we have. Unfortunately, it is not a consistent service that we can continue to access because that person is not licensed to do that work for us. Having laboratory facilities would be the ideal situation.

The Chairman: Thank you very much. We will see each other tomorrow, and we will ask all the questions and get all the answers.

Our next witness is Dean Wilson, the executive director of the Vancouver Area Network of Drug Users.

Mr. Dean Wilson, Executive Director, Vancouver Area Network of Drug Users (VANDU): I would like to thank you for inviting me to speak to you on the subject of illegal drugs. I live in the Downtown Eastside of Vancouver. The issue of illicit drug use has had a profound affect on my community and, subsequently, the rest of Canada. Contrary to popular belief, the Downtown Eastside is a community filled with compassionate and caring people who believe that their neighbourhood, although the poorest in Canada, has many qualities that are the envy of cities throughout the world.

As to the issue of drug use, I feel that the problems we face in the Downtown Eastside could be used to find solutions that will benefit the rest of Canada. In the next couple of minutes I will talk about these problems, what these problems are and the solutions that this community has arrived at that will hopefully alleviate the stress that is associated with a large open drug scene.

For the last eight to ten years a large open drug scene has developed in the Main and Hastings area. The reasons for this scene are many and varied. Besides being a geographical transshipment point - so that there are a lot of drugs that are very inexpensive - we have a large population of poor people. We have had cutbacks in mental health dollars and homelessness. The war on drugs response by the Vancouver Police Department and the RCMP are just a few of the developments that have contributed to the situation.

What is depressing to me is that many excellent reports, such as the Provincial Health Officer, John Millar's "HIV, Hepatitis and Injection Drug Use In British Columbia - Pay Now or Pay Later?" and the HIV/AIDS Legal Network's "Injection Drug Use and HIV/AIDS," and more recently the City of Vancouver's framework for action and community directions and "An Alcohol and Drug Action Plan For the Downtown Eastside/Strathcona," which have all identified the major problems and have all proffered excellent solutions to these issues, yet no action has been taken.

What is even more depressing is that while this annually continues, my brothers and sisters in the Downtown Eastside continue to die in intolerable numbers. The Downtown Eastside has the highest level of HIV/AIDS in the developed world, and we also have the highest rate of drug overdose resulting in death in North America. What is particularly disturbing is that this is preventable. We have identified the contributing factors and through community consultation and research have come up with a comprehensive solution, but the powers that be still have not acted. Why? It is because a few - supposedly morally superior people - groups have vested interests in keeping the status quo, and due to Canada's willingness to allow the Drug Enforcement Agency, DEA, and the Central Intelligence Agency, CIA, to set our public health and illicit drug agendas. These small but moneyed and powerful concerns dictate outcomes under the guise of concern for the public good, but they actually cause more harm than the use of the drugs themselves.

Time has shown that the criminal justice approach to drug issues has not worked. Our justice system and prisons are filled with people - and drugs incidentally - who would not have had any contact with the system had we treated the issue as a social problem. We must remember that drugs do not cause social ills. They are a coping mechanism used by some to deal with those ills.

Although some of the solutions proposed may sound controversial, one must remember that, not too long ago, methadone maintenance therapy and needle exchange programs were also deemed controversial. Comprehensive solutions must include the decriminalization of personal amounts of all drugs, safe injection facilities, heroin stimulant maintenance programs and low threshold methadone programming. These programs, along with existing treatment protocols such as prevention, detox, sobering centres and abstinence-based treatment will allow the healthcare provider to function with a full tool kit, as opposed to the shackles they now carry when treating human beings with substance abuse problems.

The term for this comprehensive approach is called harm reduction. While this term seems to be much abused, the tenets that harm reduction adheres to not only relieve harm to the addict, but also to the community where the addict resides. Other determinates that must be addressed are Health Canada's 16 social determinates of health. These include stable housing, which the World Health Organization has recognized as the best way to prevent the proliferation of HIV/AIDS and hepatitis C and sound nutritional programming, which, when mixed with a little dignity and kindness, will go a long way to reducing the stress of illicit drug use in any community.

Instead, we waste millions of dollars flogging the same dead horse. Hiring more police officers is only a behaviour modification tool and has proven a dismal failure. If this method were effective, surely the $26 billion that the United States spent last year alone on drug enforcement should have solved the problem. Police departments seem to want to protect their budgets and subvert common people's civil liberties rather than really tackle the problem. I also feel that the medical fraternity has become entrenched in programming that offers very low rates of success. Addicts have become low-maintenance profit centres and are viewed as nothing but drug-seeking scum. These beliefs must be exposed and challenged before anything concrete will be achieved.

Lately this tandem of judicial medical mal-practice has come up with a new program called "drug courts." It is just another way of forcing treatment on addicts and it has little chance of success. These courts have been in existence in the United States since 1989, and in my opinion have just wasted scarce programming dollars. One only has to look at Portland, Oregon, the apparent success story, to determine that, while some criminal recidivism has been curtailed, HIV/AIDS rates have soared and overdoses causing death have almost tripled since the court's inception. These statistics alone should scare off anyone considering these so-called progressive courts.

No doubt by now you have heard testimony describing the European approach to drug addiction. I visited Frankfurt, Germany last fall and was astounded by the coordinated approach there. All stakeholders view the problem as a social problem and all four pillars - enforcement, treatment, prevention and harm reduction - work together so that a real continuum can be applied to the problem. This approach has been well documented and has saved many people and their families from the grief associated with drug addiction.

The group I represent is based on the European approach. It gives users of illicit drugs a real voice and allows users dignity and helps them to determine the outcome associated with their addiction. I am living proof that it works. I am a heroin addict but have been given dignity and I have allowed myself self-determination in my recovery from addiction. Who is better to ask than those involved about how to address the problems they face? I am not saying that addicts can do it alone. We surely need help and support. However, since I have taken an active approach to my own problems, I have started to tackle the issues that caused me to want to self-medicate in the first place.

In closing, I want to list what I feel will truly make a difference to all addicts, and subsequently, to their communities. Allow addicts self-determination, yet demand responsibility of them; support all four pillars equally; allow flexibility in programming; change with the times; let Canadians decide the way they want to deal with the problem without pressure from the United States Drug Enforcement Agency; allow local initiatives to deal with their community problems - not every city needs a safe injection site - and demand accountability from all the stakeholders. If the job cannot be done, then support and fund the groups who will.

If that list were followed, we would be much closer to dealing with what the real issues are and we would see a marked difference in our communities that have to face the drug scene on a daily basis.

In the words of Nancy Reagan, "Just say no" to the war on drugs.

The Chairman: Thank you, Mr. Wilson.

What amount of funding does your organization have and what are the sources of that funding?

Mr. Wilson: We are funded by the Vancouver/Richmond Health Board as a health advocacy group. We get about $185,000 a year. We have almost 1,000 members who are either former or current hard drug users - heroin and cocaine. However, we advocate through peer-to-peer counselling and outreach.

Our group, with this small budget, has done more to stop the proliferation of HIV/AIDS in our communities than any other group and all groups combined. We do alley patrols very late at night and make sure that people have safe injection gear or even just give a word of kindness. The streets are mean down there and we must advocate on our own behalf so that they will be safe. We have literally been sentenced to death by the way the programs are being run lately.

The Chairman: You referred to the new framework in Vancouver. Have you noticed a positive revolution within your membership since that framework was voiced by the Mayor?

Mr. Wilson: We had a great dealt of input in the design of that document. The McIntyre report suggested that upwards of 86 per cent of the population of the City of Vancouver supports it. What is particularly disturbing is that we are not acting on it.

We have had some small successes. The one access number for detox is now getting people into detox very quickly. I am happy about that, but we have to start implementing them all; we cannot cherry pick. The whole deal is the whole deal. We have lots of enforcement. We need prevention, we need treatment, we need harm-reduction programming and together, as a comprehensive program, we can tamper. We can remove two people from the scene. Two here, two there and the next thing you know, we will take all 4,000 people out.

In Germany I saw a park that was literally filled with 5,000 people daily. If you walk through there now you will see families there. Everybody goes there. That has been done through the contacts. The action that we must take is consultation with everybody involved in our city. It is time to act. My brothers and sisters are literally being sentenced to death. We do drugs, but it is time to change. Dead people do not detox.

Senator Carney: When you say that you are one of the groups funded by the Vancouver/Richmond Health Unit, are you the only group in the Downtown Eastside representing drug users? Are you the prime force for what you are doing, or are there others?

Mr. Wilson: There are a couple of others. The Consumer Board is another HIV/AIDS group, which is a smaller group. There is another one called Dudes that is being run by Downtown Eastside Youth Activities Society, DAYAS, which is the downtown needle exchange.

We are 1,000 strong. In fact, we are the number one user group in Canada. We have had a lot of input in not only the Mayor's "A Framework for Action: A Four Pillar Approach to Drug Problems in Vancouver," but also the community directions action plan. I recommend that you read the one about the Downtown Eastside/Strathcona, because that was a coalition of 58 community groups that got together over a long period of time and after a lot of blood letting.

We have come to the conclusion that we will not get everything that my group wants and the other side will not get all it wants. However, if we worked together to identify what is important, how are we going to stop this, how we will get that person out, we could make this thing work. We should act on the two programs, the community directions and the Mayor's framework, and act on it all and not just say "Let's get another 30 cops." We should say at the same time, "Gee, let's look at opening up a safe injection facility to stop the spread of HIV/AIDS." Our numbers down there are astounding. We have 5,000 injection drug users, 40 per cent are positive with HIV, 98 per cent have hepatitis C, which is a 20- to 30-year disease. What will happen in another 10 or 15 years, when you have 5,000 people knocking on your door looking for liver transplants? On the cost of the healthcare, John Millar said that you pay now or you pay later.

A study is being done in the Northwest Territories on what is the number one reason for the spread of HIV/AIDS among aboriginal groups in the Northwest Territories, which was that somebody had been to the Downtown Eastside in the last six months. We have health epidemics across this country because addicts are transient. We go to other inner city locales. Native brothers and sisters go back to their reservations. The next thing we have HIV, hepatitis C, tuberculosis and all the other diseases that are associated - the six diseases that are now a public health emergency.We are the vectors, and we have to somehow stop that.

Senator Carney: Can I just ask further on that? You are obviously highly motivated to do this work. What separates you from your colleagues in the Downtown Eastside who do not do this? In terms of what motivates you and your 1,000 members, how do you evaluate whether you are succeeding? What makes you feel better about the work you are doing? Is it the size of your membership or the results of your night patrols? This is a horrendous problem and it has been a growing problem for several years. What makes you think this is working? What motivates you and your members to do this?

Mr. Wilson: I think it is the fact that we are all essentially dying of something. I have been hepatitis C positive for the last 20-plus years. Forty per cent of our group is HIV positive. I think that we want to give back. A lot of our community is very marginalized. They are very ill. They may be illiterate. They may be this or they may be whatever, so we have to advocate on behalf of ourselves.

Ann Livingston, the program coordinator, has given us a voice. We finally realized that we have a voice and that we can make a difference. If you consider the number of overdose deaths in the last couple of years, the reduction is directly attributed to Ann going to the alleys and saying, "Be safe, do not shoot alone, use a condom," and all these things and also, by doing that with a little bit of kindness. We are literally treated like shit down there. Living in an alley is not glamorous drug use. This is not a party. The reality is huddling in some door in an alley downtown at 3 a.m. with nobody caring about you. We have burned so many bridges with our families and others by being addicts that there is not a place to turn, so we have to turn to ourselves. As I said, Ann gave us our voice and we are using it.

My getting through this motivates me. So far, I have hepatitis C, but I think it is about time to give something back to my community because I love the Downtown Eastside. It is the best.

Senator Carney: You have been a very powerful voice for your community and we are very glad that you took the trouble to come up and meet with us.

Mr. Wilson: Thank you very much, senator.

Senator Lawson: I have just one question. Years ago when we were dealing with what we thought was a new problem, alcoholism, we used to call it dealing with human relations and in selecting people to deal with it, we found that the only time we had any success was when we hired recovering alcoholics to deal with the problem. You asked the question "Who better than you." I can tell you, there is nobody better than you with your background and your experience. I commend you for your commitment. In the Mayor's presentation about heroin-assisted treatment in Montreal, Toronto and Vancouver there was a small number, 240 nationally, of long term heroin users to investigate the efficacy of using heroin as a drug treatment process. What is your response to that? Do you think that is a positive move? Are you familiar with that? Is it working?

Mr. Wilson: I think it is mandatory that we get going on that immediately. The CIA funded it up to $4 million right now. We asked for $5.6 million. If you examine the Swiss heroin trials, the numbers are astounding. There is no homelessness and 40 per cent employment. The fact is, after 18 months, 17 per cent of the 1,200 cohorts in Switzerland were in abstinence-based treatments. Those numbers are astounding. You cannot tell me that anybody is getting those numbers right now with standard status quo treatment. Actually, the Swiss consider heroin maintenance a treatment because so many people actually say "Well, I am stabilized now, I have my life back," then they say, "Why am I doing this? I do not even want that heroin now, so please wean me off." After 18 months you are considered as being abstinent. Seventeen per cent is an incredible amount for people who are supposedly being enabled by a heroin maintenance program. It is mandatory that we go with that one immediately. The numbers speak for themselves.

In England heroin has been prescribed since the 1920s with a great deal of success. Canada has been listening to the American agenda for too long. The British said no in 1920 - they said, "Stuff it, no. We do not prescribe heroin to the addicts. We are not going to prescribe anything," and the government backed off and so did the US government. However, here the College of Physicians and Surgeons folded in 1948. It is still legally allowed to prescribe heroin in Canada in a hospital setting. We have got to get on to that.Once I got stabilized somewhat, I knew that there was a life out there for me and, therefore, next week I, myself, am going into a program, a rapid opiate detoxification program. I want to get straight now, but that is because I was stabilized. If we get people stabilized and on methadone, heroin or whatever they need to get stabilized, we will be able to take them out of the scene and they will realize that there is more to life so that they do not even want to be going to this menial place every morning. They will not want that because they know they have a better life. We will be able to do that, and the framework will be the anchor for the whole way of doing it.

Senator Lawson: I have one other question. You think it is time, with the success of this program and success overseas that you talked about, to expand this program to other parts of the province. We heard evidence this morning that this seems to be spreading all over. Is it time to do that? Do you think the savings in lives and in medical costs would be such that they would make the program economically feasible as well?

Mr. Wilson: The Rand Corporation, a right-wing think tank in the United States, did a study about 10 years ago, which concluded that every $1 spent on harm reduction saves between $7 and $11 down the road. Considering the way governments are mandated right now to save money, I think that you have to do it or we cannot save money. Every community must do what it takes for their community.

I am advocating for safe injection sites in the Downtown Eastside because it is a huge open drug scene. There is public nuisance in open drug scenes. I do not want my grandmother sitting beside somebody injecting heroin on a bus. People should have a safe place to go. I am not saying that Red Deer, Alberta should have an injection site, but it should have what it takes to tackle its problem. If there are a lot of young people, then we should ask the young people what they require to have peer support and to get them out of this situation. If we have a huge open drug scene like that in Maisonville in Montreal, then we should provide safe injection sites. Do whatever it takes is what I recommend.

Let us be flexible and let us not throw anything out. As I said, needle exchange and methadone were completely controversial no more than 10 years ago. Now we think of it as regular science and regular medicine.

I have a little anecdote about Germany. When the first safe injection site was opened, there were 600 people from the neighbourhood who said. "Not in my backyard." It was opened anyway. Three months later there were 35 people. Six months later not one person showed up because it has become standard. People understood what the injection site did. It took the people out of the scene. We must start dealing with that. The domain for treatment and doing this is not just for ex-addicts. Everybody who is involved has to participate and to those that do not produce, just as anywhere else in this day of shortage of dollars, farewell.

Senator Jaffer: Mr. Wilson, you have done a very interesting and moving presentation and I thank you for that. I just have one question. I do not know if you were here this morning when the Mayor spoke. In his presentation he talked a lot about pushers, users, drug addiction being a disease and about different treatment. I would like to hear from your experience, are you getting different treatment at this date? What is your experience?

Mr. Wilson: There is not a lot being done right now. We have had a little success in having the one access for the detox. The paradox is that we need the drugs, so the dealers are there. I definitely do not support billionaire narcotics traffickers at all. If we had heroin maintenance, we would not need that, but there is not much accessibility now for most people. There is not much there. It is mostly abstinence-based treatment. If we could take people into programs where they have some kind of input and are allowed to design the program, they would say, "Okay, right now I am not really for total abstinence," and we would say, "Fine, instead of injecting heroin, why do not you try smoking it for a bit." We could slowly bring them in.

I mentioned low threshold methadone, but I do not know if you know what that is. That would be where somebody who is not on a regular methadone program could go into a pharmacy or a clinic downtown. If a girl was about to get into a "bad trick" car, or if I were just about to rob a gas station because I do not have $10.00, 30 milligrams of methadone could be given right then. People could drink it and leave. They might not come back for four days. We could take that at-risk situation and dismantle it right away by giving them some methadone. If someone keeps coming back three or four times, then we could say, "You have been here twice or three times this week. Maybe you want to get on the program all the time."

If I have the methadone and they are here, I have their attention. Treat them with kindness. There are a lot of strategies. It has been proven that 80 per cent of addicts do not ever enter any kind of health continuum. We must come in with low threshold deals so we can get people in to start the dialogue and then go from there.

Even later on when we do work and stuff like that and life skills training, that, again, has to be low threshold. Maybe people can work for two hours every three days. This would get them going and empower them by giving back their self-esteem. These are the kind of strategies we have to select. You cannot just say, "We have an abstinence-based program, come in." Nobody is going to stop there. Some do, but we have to get them in the door, and if that takes just 30 milligrams of methadone once every four weeks, who cares? At least we get to talk to these people and we can go from there.

The Chairman: I have a final question on cannabis, which I cannot avoid. What information can you give us regarding the use of cannabis in Vancouver?

Mr. Wilson: I think that the medicinal use of cannabis -

The Chairman: Is it a problem?

Mr. Wilson: No. The enforcement against it is ridiculous. Programs have proven to work in a number of medical situations. Where this really works is with patients that are HIV/AIDS and wasting diseases such as hepatitis C, later on. It builds appetite and a number of things. About 75 per cent of the population in this country supports decriminalization or legalization. Let us just do it. It is simple and I cannot understand why this is taking so long. As far as pot is concerned, we should just get it on and get it done. Marijuana works. It is an applicable medicine. I do not want my 15-year-old kid just smoking it. We should make sure we teach them the right way.

The Chairman: Thank you, Mr. Wilson, for your answers and your testimony. We will stay in touch. If we have other questions I will write to you.

Mr. Wilson: Thanks very much.

The Chairman: We will now have Mr. David Mossop, a lawyer from the Community Legal Assistance Society. Mr. Mossop, welcome.

Mr. David Mossop, Community Legal Assistance Society: Mr. Chairman, I would like to just say a few words about our organization. We are a non-profit society in British Columbia and were incorporated in 1971. We provide Legal Aid services to low income people and disabled individuals. We have a budget of approximately $1.5 million a year. We have eight lawyers and about six paralegals and support staff. We operate out of three offices, one of which is the law school. We have a lawyer who supervises volunteer law students who run about 20 clinics a year and see about 6,000 people a year. We have a main office just a couple of blocks from here in downtown Vancouver that does Superior Court litigation in the area of poverty and disability. The largest amount of our staff is at Riverview Hospital, where we represent patients civilly committed under the Mental Health Act, and those persons found not criminally responsible because of mental disorders, NCRMD, under the Criminal Code and we represent them before the review board that determines whether they are to be released into the community. Some of these individuals have not only mental health problems, but substance abuse complications and we are involved in that.

Having made those preliminary, introductory remarks, I would say that I am here not to talk about the human cost. Other people have done that forcibly today. Rather, I will talk about safe injection centres and legal obstacles involved in getting them off and running. I also would like to comment on how I think the recent events of September 11 affect the drug situation, concerning our legalization of drugs.

There are obstacles in setting up safe injection centres because there are questions about whether the people who operate those centres could be charged with possession of drugs by the prosecutors. This is up in the air. There is an argument that they could be because they are acquiescing and controlling and allowing people to bring in the drugs. The simple answer is there is a very simple solution to this: the federal cabinet has the power, under the Controlled Drugs and Substances Act, to allow this and the Minister of Health has this power. All that is lacking is the political will to see it through.

We are not talking about changes in federal legislation. We are talking about the political decision to follow it through. I might say that, in my view, the federal government should not only licence a number of centres, it should fund these centres on a national basis. There is precedent for this. In the early 1970s, the federal justice department funded community law offices as pilot projects for three- or four-year periods to determine if they were viable and allowed the provinces to fund them. The federal government could do this. It should also seek the co-operation of the provinces to set up these centres. If the provinces do not wish to do this for political reasons, the federal government still has extraordinary power to declare these centres to be for the general advantage of Canada and it could run the centres. I would undoubtedly consider this a last resort, but ultimately the federal government can do this if the provinces do not cooperate.

I might say also that there is an argument - hopefully we will not get into litigation - that under the Charter of Rights and Freedoms there is a doctrine that has developed in this country on duty to accommodate people with disabilities. It may be that drug addicts have a Charter right to have access to facilities for treatment and access to safe injection centres. This is not something that we should litigate. It is a political decision. Hopefully that possibility will spur politicians to make a decision.

The Chairman: Was it ever tried in court or ever challenged?

Mr. Mossop: It has not been tried yet, but I would say that the distinctions of the Ontario Court of Appeal regarding medical marijuana are beginning to go that way. In the legal profession, lawyers feel that the legal system has failed completely in this area. I think, considering the short jail sentences given out by the courts, many of the judges feel the same way. We have lost the war on drugs.

I wrote a bit about the events of September 11, which, first and foremost, are great tragedies for friends and families who lost people in the United States and in Canada for those Canadians who were killed. That has had a ripple effect. It has affected our airlines and it has also affected the mail. I noticed today on CNN that the FBI is pulling people out of drug enforcement and putting them into the war on terrorism. We can save money in law enforcement by slowly legalizing drugs in various formats, through safe injection centres and heroin maintenance programs. It will be an evolutionary process. We can also redirect our law enforcement personnel into other areas of priority in our system, including terrorism.

Those are the comments that I want to make. There are provisions in our law that allow us to adequately serve the addict community with a variety of resources that have been talked about today, including safe injection centres and maintenance programs, and all we need is the political will to proceed with that.

The Chairman: Have you or one of your colleagues at the Legal Aid Centre been involved in drug-related test cases or Charter litigation?

Mr. Mossop: We have not been involved in specifically drug cases. We have been involved in a fair amount of litigation involving disabled people, within the duty to accommodate. At this point in time, it would be better to allow the politicians an opportunity to deal with this issue, though I have a fear that there is reluctance to deal with the issue at this point in time.

The Chairman: Have you examined the new regulation on medical use of marijuana?

Mr. Mossop: Yes.

The Chairman: Do you have any recommendations or comments?

Mr. Mossop: Medical use is a first step in the process of decriminalization of marijuana. It is estimated there are 20,000 growing operations in British Columbia. There is no way that the criminal justice system can deal with that issue, period. You cannot legislate in terms of prohibition. You can regulate it, but you cannot prohibit it. That has been a failure. I would think that most lawyers feel that way.

The Chairman: I have one last question, and of course we are going to be in touch with you if we have any further questions. You refer to the Parker case in Ontario, which deals with the medical use of marijuana. As you know, the courts used Section 7 of the Charter, as the Supreme Court did a few years ago concerning the abortion case. As a lawyer, do you think there is a pattern there, a trend, that freedoms rights have not been enough used by lawyers to argue on freedom and liberties?

Mr. Mossop: I agree with you. I think the Parker case is the beginning of the process that lawyers will use to try to get access to services, including safe injection centres. Litigation takes a long time. It would be better if the politicians would bite the bullet and start off this process. I understand the limits of politicians. They cannot suddenly say, "We are going to legalize drugs." The more politically acceptable way is to employ a process of slowly increasing the situations in which the drugs can be used in some sort of controlled session or controlled method. It will be politically more acceptable to do that gradually over a period of time than to expect it to be immediate. Although I would favour immediate change, I think politically it may be difficult to deal with that. The federal government has a lot of power to do something about this if it wants. There is a lack of political will.

Senator Jaffer: I just have a quick question. Mr. Mossop, you probably have to defend a lot of people who are charged with drug offences; is that correct?

Mr. Mossop: I do not handle criminals in court. My main dealings and experience in our organization is with people found NCRMD, not criminally responsible because of mental disorders. I also have a significant number of cases of substance abuse. We have a very good system under the Criminal Code for dealing with that and there is a review board with a psychiatrist, a social worker and a lawyer. Offenders are kept in the hospital and then they are conditionally discharged. They are usually put in a halfway house as they slowly evolve. Usually the halfway house, in substance abuse cases, is away from the Downtown Eastside.

Senator Jaffer: Of the total budget, do you have any idea how much of the moneys are used for drug related charges?

Mr. Mossop: I do not have that information, but I think a significant amount is used in direct charges from the federal government for trafficking, in the Legal Aid budget for defending and in other associated crimes of individuals seeking money to pay for their drug addiction. That is a major part of the criminal process.

The Chairman: Thank you, Mr. Mossop. As I told you, we will keep in touch, and if there are further questions we will write to you.

Mr. Mossop: Thank you.

The Chairman: I wish to thank everyone for attending today.

The committee adjourned.