Proceedings of the Special Committee on
Illegal Drugs
Issue 22 - Evidence - Afternoon sitting
OTTAWA, Monday, June 10, 2002
The Special Senate Committee on Illegal Drugs met this day at 1:04 p.m. to reassess Canada's anti-drug legislation and policies.
Senator Pierre Claude Nolin (Chairman) in the Chair.
[Translation]
The Chairman: We are resuming the work of the Special Senate Committee on Illegal Drugs. We have with us this afternoon the Executive Director of the Canadian Centre on Substance Abuse, Mr. Michel Perron. Thank you for accepting our invitation.
We have an hour and a half at our disposal. You can start with a presentation, which will be followed by questions. Based on the presentations by your departmental colleagues who preceded you this morning, it is clear you have a huge responsibility and it will be quite a balancing act to be able to reach all those objectives with such a minimal budget. We are looking forward to your presentation. You have the floor, Mr. Perron.
[English]
Mr. Michel Perron, Executive Director, Canadian Centre on Substance Abuse: Honourable senators, it is my pleasure and honour to appear before you today as you near the end of your public hearings.
As I prepared for today, I reflected on what I thought might be most useful to you at this stage of your investigation. I know you have heard from many of my colleagues across Canada; that you have toured, and are touring, Canada extensively, and have heard a wide breadth of comments ranging from the most visceral to the most philosophical.
Nonetheless, I felt that my presentation and the views of the Canadian Centre on Substance Abuse, CCSA, will offer a unique perspective that I am fairly confident has not been presented yet. This is in large part due to the CCSA's unique role. Also, Dr. Sansfacon requested that I focus on what Canada needs in relation to information and research.
Finally, I will conclude by outlining how information fits into the overall context of a national drug strategy.
[Translation]
The Chairman: I would ask you to speak more slowly because everything you say is written down for posterity. If you want it to be correct, you have to speak at a reasonable speed.
Mr. Perron: I apologize to the interpreters.
[English]
Mr. Perron: At the outset, I would like to state that my presentation begins with the premise that this committee's mandate and interests, which are primarily related to cannabis and whether we should offer legalization or decriminalization, and are important aspects that need to be debated. However, undertaking either of these specific strategies in the absence of a properly constructed national drug policy framework or strategy is akin to arguing over whether we should put leaded or unleaded gas in a car with no motor.
I would like to begin by providing you with an overview of the Canadian Centre on Substance Abuse so that we may better understand what it is. The CCSA was created by a federal act of Parliament in 1988 as Canada's national non- governmental organization on addictions. Specifically, our act stipulates that we are responsible for a number of issues, which are listed in the prepared text submitted for your consideration, including: Promoting and supporting consultation among governments, the business community and labour; contributing to the effective exchange of information; facilitating and contributing to the development and application of knowledge; promoting increased awareness; and the development of realistic and effective policies aimed at reducing harm.
[Translation]
In summary, our mission is to consolidate the efforts being made across the country to reduce the ill-effects of alcoholism and drug addiction on health, society and the economy. The creation of a national non-government organization such as the CCSA was a pioneering measure.
Since then, several other foreign governments have set up independent organizations similar to the CCSA. Today, a number of them are known as observatories.
By setting up such an organization, the federal government knew that the CCSA could facilitate relations with non- profit organizations, the private sector and the provinces as well as play an important complementary role outside of government.
When it was founded in 1998, the CCSA was under the Department of Health, a situation that has not changed. The CCSA had received an annual subsidy of $2 million in 1998 that was recognized as being the minimum amount required for that organization.
However, during the period of budget cuts following the program review, our budget was reduced to $500,000 per year. We immediately had to cut our staff, and some of our employees became contract workers, a situation which still prevails.
Since 1997, the CCSA has basically survived by working for a number of departments on contract. Those contracts ensured our survival, but significantly hindered our efforts to fulfill our legal mandate in a proactive way.
I do, however, have the pleasure of informing you that very recently, Minister McLellan increased our base funding to $1.5 million — a provisional measure — until the implementation of a new anti-drug strategy. Thanks to that increase, the CCSA can stabilize its activities and Canada runs a lower risk of losing its only collective memory as well as the only drug addiction specialists working at the federal level.
It is important to note that the CCSA is not a pressure group; Canada already has many of them. The CCSA acts more like a leader and plays a consultative role by recommending relevant action plans that are prepared based on sound research.
[English]
The CCSA offers a variety of services, as the chairman has alluded to in his opening remarks, and we do a lot with very little. It is through partnerships with government departments and other partners that we are able to do this. However, we are very much scratching the surface of the capacity of our organization.
In the areas of information and reference, we have the only national clearing house on substance abuse information. We also have the national fetal alcohol syndrome and fetal alcohol effects information service. We do a fair amount of work in the area of information development. We had the only complete compendium of statistical resources for Canadian addictions data in the Canadian profile. We have undertaken some cost studies, which I will speak to in a moment. We have created a researcher database to identify who is doing what research in what area in Canada so that we can better lever our efforts.
We are also working in the area of gambling. We have established best practices and a training business line, if you wish. We are doing that for prevention programs for youth, for treatment protocols and for fetal alcohol syndrome and fetal alcohol effects. Finally, we undertake policy formulation, which is at best ticklish, trying to take on the issues that are difficult for some departments or agencies to take on by themselves. We bring together a multisectorial group to look at such issues as harm reduction, cannabis, drug treatment courts and so on.
Finally, honourable senators, one of our strengths is the fact that we work in cooperation with a multitude of partners. We have active networks trying to accomplish specific goals with the research and academic community and with the municipalities through the Federation of Canadian Municipalities. We have a network called the Canadian Community Epidemiology Network on Drug Use, or CCENDU, and another one on policy called Health Education and Enforcement in Partnership and another on information, the Canadian Substance Abuse Information Network.
I would perhaps not be telling the entire tale if I did not mention that many of these networks are fragile in their current state but are well-poised, with an appropriate investment, to provide a huge return on our investment. We do a fair amount of work in the area of communications, including our annual report which is tabled to Parliament and to the provincial legislatures. I have also brought along some copies of our newsletters.
I would now like to touch on four other areas: a review of our past national drug strategies; what we know about addictions in Canada today; some inherent challenges to using statistics; and where we believe we need to invest for the future.
Our first foray into developing a national strategy occurred in 1987 when then Prime Minister Mulroney declared a drug epidemic in Canada. It was also at that time that Mr. Reagan declared another war on drugs in the United States. Our first Canadian strategy provided $210 million in incremental new funds to develop a balanced approach to drugs — not necessarily a 50-50 split of funds but rather a philosophical balancing of efforts between reducing the demand for, and supply of, drugs. The health minister was designated as the lead minister for the strategy, and that has carried through to today.
A second five-year strategy began in 1992 with a commitment of $270 million in funding, again championing a balanced approach. We have never espoused a war on drugs. That is strictly a U.S. phenomenon, although the Canadian media seems to be enamoured with the term.
[Translation]
In 1997, the government carried out a program review that led to several budget cuts in all departments, including Health Canada. The anti-drug strategy was not spared and it was not renewed in 1997. Since then, the federal government has provided very few new funds for that type of activity.
Canada currently has no national strategy. We therefore simply do not have research data to guide us. In fact, no one knows the extent of drug consumption or prevalence in Canada because no national inquiry has been done since 1994. We therefore have to come up with hypotheses and resort to other tools to get a picture of the current situation in Canada.
In 1996 — a study from six years ago — the CCSA published its first personal study on the estimate of socio- economic costs and health problems caused by alcohol and drug abuse. At that time, we estimated that alcohol, tobacco and illicit drug abuse cost Canada over $18 billion. Those costs are broken down as follows: $9.5 billion for tobacco, $5.7 billion for alcohol and $1.4 billion for illicit drugs. We also found that the abuse of alcohol and other drugs was the cause of one death in five and of nearly 10 per cent of hospital admissions in Canada in 1995 and 1996. In fact, 6,500 Canadians died and 80,000 were hospitalized. We now also know that the use of injection drugs is responsible for 50 per cent of new cases of HIV and 80 per cent of new cases of hepatitis C. Canada has approximately 125,000 injection drug users. About a fifth of them will get either HIV, hepatitis C or both.
There is no doubt therefore that alcohol and drug abuse is costly to Canadian society. The price to pay is not entirely or solely in dollars, but also — and I would say this is equally important — in physical and psychological suffering.
When the CCSA started its first study on these costs in 1996, it discovered very quickly that there was insufficient data to get an accurate estimate of the costs of drugs and crime. As a result, in cooperation with several of our partners, we started a study to determine the extent to which criminal behaviour is in fact caused by the use of psychoactive substances and to determine which of those substances were more likely to lead to criminal activity. That study was completed and recently published. It is important to note that it is extremely difficult to determine the role of drugs and alcohol in crime.
[English]
The main findings of the report, which drew from a series of interviews with inmates and police officers and from a secondary analysis of data, confirmed the close association between the use of alcohol and other drugs and criminal behaviour. It indicated that a substantial portion of this association is causal. In other words, but for that drug use, the crime would not have occurred.
In addition, inmates in both federal and provincial prisons were more likely to be dependent on alcohol and drugs than their counterparts in the general Canadian population. In all, 38 per cent of male federal inmates were dependent on at least one of these substances. One of the more significant findings in this study was that alcohol-dependent inmates were twice as likely to have committed violent crimes as a more serious crime compared with those dependent on drugs.
The authors, Dr. Serge Brochu and Dr Kai Pernanen — and Dr. Brochu has appeared before this committee — estimated that between 40 and 50 per cent of crimes included in their study can be attributed to at least one psychoactive substance, either alcohol or drugs. However, between 10 and 15 per cent of crimes studied by the authors can be attributed to illicit drugs only, between 15 and 20 per cent to alcohol only, and between 10 and 20 per cent to a combination of alcohol and illicit drugs.
That gives us a picture of some of the costs. Now let us look at who is using what. I am quoting figures from the 2001 Ontario student drug use survey. However, to really understand what these numbers mean, I would suggest that we pretend for a moment that we are those students from grades 7 to 13, as many of us are their parents, grandparents, aunts and uncles.
Sixty-six per cent of us in this room, as students in grade 7 to 13, used alcohol in the past year. Twenty-eight per cent of us, that is, our sons and daughters, had heavy drinking episodes. Thirty per cent of us have used cannabis in the past year. That is one out of every three people here. Fourteen per cent have used hallucinogens. Seven per cent of us have used ecstasy.
Remember, these statistics are those of youths in grade 7 to 13 in Ontario. We do not have complete survey data from other provinces, but there is nothing to suggest that the numbers would be considerably different.
With respect to adults — and again we drew from Ontario data — we saw that 35 per cent of Ontarians report using cannabis at least once in their lifetime, while 11 per cent report using it in the past 12 months. Sixty per cent reported using cocaine in their lifetime, with one per cent using it in the past month. In our very scientific parlance, we call these the ``gee-whiz figures.''
What does this mean to us here today? I am not presenting these numbers to demonize use but rather to expose the reality that drug use is, and likely will always be, here. The challenge is to manage the risks associated with this behaviour. That does not mean that we do not try to mitigate those risks. We need to ask ourselves what can we reasonably achieve? What are our goals?
[Translation]
Before broaching that topic, I would like to talk about the challenges inherent in the use of statistics. As a researcher, Mr. Sansfaçon can tell you better than I can. If you play with the figures long enough, you can interpret them however you like. Researchers are looking for comparability, validity and reliability. With regard to comparability, provincial and municipal surveys on the source and frequency of consumption are useful, but they make valid and reliable comparisons difficult. Moreover, the other governments have different data that are difficult to analyze because they use different methods when collecting the data and applying the results. Validity means the level of trust that we measure, what we want to study. That is not as obvious as it might seem, especially when we deal with issues related to social policy.
Reliability means the ability to repeat a study several times. In Canada, we must have some measure of reliability so that we can reproduce a standard survey model, which leads us to ask the same questions over a certain period of time.
[English]
We would like to suggest where we might need to invest our time and our resources. The question begs to be asked: Where should we focus our efforts in the area of data and information collection? I would suggest that we need to build a cycle of data collection. We need to build a tray of tools in which we can invest on a regular basis and begin to expect results on a longer term.
For instance, we are suggesting that we need to have yearly school-based, standardized surveys developed nationally and implemented provincially on drug use prevalence and impact. Very few provinces report regularly. We often look to Ontario because they do. There is a significant gap in our knowledge about this important population. We should strive to develop a process that will yield comparable data, not only among the provinces but also between Canada and other countries.
Also, you will note that I referred not only to prevalence but to impact data as well. It is critically important that we strive to learn more about how use and abuse, however you wish to frame it, are impacting on the daily lives of Canadians. We need to undertake yearly special population surveys on high-risk populations, such as women, injection drug users, high-risk youth and incarcerated populations. We need to pay particular attention to those populations that are not easily captured in mainstream data collection efforts or who, by their nature, require closer examination. We should also turn our attention to yearly epidemiological trend data from the Canadian Community Epidemiology Network on Drug Use, CCENDU. As I mentioned earlier, CCENDU is an exceptionally well thought out network, but fragile in the sense of monies available for it to do its work.
We also should have yearly departmental reports on objectives and performance indicators met. Picking up on the Auditor General's report and comment, all levels of government must do a better job of identifying its goals and objectives and publicly reporting on yearly progress to meet these.
We need to look at both output and outcome data to better understand the impact of our efforts. We should undertake tri-annual national general population prevalence impact surveys.
There is no question about it, we need this information. We are proposing that surveys be completed at least every three years. It might be expensive, but frankly it pales in comparison with continuing expenditures on projects and programs without knowing the location and size of the problem.
We would suggest that you also replicate tri-annual cost studies as we did in 1996 that feed off prevalence data so that we can have regular cost estimates. The purpose of quantifying costs is not simply to identify how expensive the problem is but rather to identify where the costs lie, which costs are avoidable, and how we should invest to reduce these. The purpose of repeated cost estimations will enable us to move towards a greater level of efficiency and cost effectiveness.
We should look at tri-annual macro-evaluation reports. This will be tough, I know. The evaluation reports should be based on a strong, robust and well-thought-out evaluation framework based on performance and measurable objectives. Ideally, this would be strategy-wide and multi-governmental. I realize the challenges inherent in that. However, the evaluation is needed to influence, shape and administer our efforts. Without regular evaluation, we simply cannot close the loop on our data requirements.
We need to commit to making this information public and to be held accountable for the results. Consider that in 2001, the Auditor General noted in her report that the federal government is unaware of the resources spent to address illicit drugs, that there is no national data on illicit drugs convictions, and that the federal government has not set out clear objectives. With this type of attention and focus, one would think that this would spur on an immediate, proactive response. Instead, and unfortunately, very little has been done to address this situation.
Taking a page from other countries that have invested much more heavily in this area, it would be advisable that our data collection process and dissemination be as transparent and as neutral as possible. This role is often plagued by observatories. We should consider how that might apply here and, quite respectfully, how an organization such as CCSA, which is arm's length from government, could be used in that regard.
As we gather all this information and look to it for signs and directions, we should be very specific as to how these fit into our overarching goals and objectives with respect to drug policy in Canada. Stated another way, what harm are we trying to redress by implementing a specific strategy or remedy? We generally categorize harm into health, social or economic impacts. As we begin to change and reshape our policy, we need to ask ourselves repeatedly: What harm are we trying to redress?
For instance, are we trying to redress the economic harm of productivity losses as a result of alcoholism? Are we trying to reduce the health care impact of an overstressed system or reduce overloaded court dockets? Are we looking to reduce the social harm of having a criminal record associated with drug use? Are we looking to avoid victimless crime? Do we want to suppress the black market? What health harm are we trying to address with our specific intervention? Are we interested in balancing the difference between dangers of illicit drugs versus legal drugs? Do we feel that the reaction to the drug use is disproportionate to the health harm?
How do we balance one priority against another and what information do we need to do this right? Given this committee's specific interest in the issue of cannabis, I would ask: What harm are we trying to redress by decriminalizing simple possession? It is my view that the seemingly endless debate — and you have cleared up much of it — about decriminalization and legalization, as well as the misuse of those terms, distracts us from the more important issues that need to be addressed, including the need for national prevention programs, access to known, proven efficient drug treatment programs and data and monitoring to guide our investment.
I would submit that, regardless of intersecting and conflicting opinions in this field, and perhaps even within this room, we all agree on building a healthier and safer Canada. We need to ask: Where does a cannabis possession decriminalization policy fit within our overarching drug policy framework? As I mentioned at the outset, to focus solely on that when we have no national strategy is like arguing whether we should put leaded or unleaded gas in a car with no motor. We need to build a motor.
[Translation]
The CCSA therefore fully agrees that there must be a solid, integrated and coordinated approach. Canada has not yet adopted a solution, but hopes that our work will speed up the entire process. We must have a strategy to deal with primary, secondary and tertiary prevention. Our goal must be to reach Canadians throughout their entire life, in other words from pregnancy right through until death.
We must design a relevant national strategy that is not solely federal in scope. We need a strategy where the funds invested by the various levels of government provide the biggest return on investment for everyone. The good news is that the current Liberal government, in Part III of the Red Book, made a commitment to define a new national anti- drug strategy by allocating $420 million over the next four years. We are looking forward to the government keeping its promise.
There must nonetheless be solid coordination both within and between departments as well as between governments. All levels of government must play a major role. We must also determine how a national anti-drug strategy can do more to encourage and support other major government priorities such as the National Homelessness Initiative, the Canadian Strategy on HIV/AIDS, Canada's Innovation Strategy and the Aboriginal Strategy.
[English]
The question that is often asked is: How much should we put into drug programs? If your chief financial officer came to you and said, ``We have an $18.4 billion problem,'' how much would you be prepared to invest?
In closing, I leave honourable senators with some points to consider as you go about providing the foundation for building a new drug strategy. We earnestly need to develop a comprehensive drug strategy that looks at the range of population and drugs. We need to capitalize on the opportunity to move from a balanced to an integrated approach. Recognizing that there are two sides to a coin does not mean that those sides ever see each other. We need to use that coin wisely.
We need to develop a clear leadership and coordination framework for the federal government, both intra- and inter-departmental. We need a strategy that is led by the federal government, but which includes provincial and municipal governments. This issue does not rest entirely on the back of the federal government. We need a strategy that leverages federal investments for maximum return. We need to optimize the risk management role that non- governmental organizations and other partners can provide. Sometimes it is best if the government does not lead on certain issues. NGOs can lead and are prepared to do so. A strategy needs to be developed that will serve as a model for other countries.
It would be nice if the Australians were to cite our strategy for a change, instead of vice versa. We need to build a vision that looks beyond the immediacy of current crises, such as injection drug use and cannabis.
[Translation]
Senator Nolin: Mr. Perron, you are our last witness. You have given a good summary of the challenges before us in the drafting of our report. When reading your text, I get the impression I am reading the work plan we had prepared at the beginning of our work. In just a few short minutes, you were able to provide an excellent summary of the scope of our task.
[English]
Senator Maheu: I am glad you are the last witness. It is something that will stay with us, and I am not saying that because I am tired of the hearings. Your whole presentation is something that I find very interesting.
How long do you think it would take to really set up a strategy that would show Canadians how serious we are about the drug problem and what we are prepared to do about it? I know there is a significant amount of money involved. As you said in your presentation, however, there have been promises made and it is about time we put this one to good use.
Mr. Perron: I could not agree with you more. One of the other questions I would ask is how long are you prepared to invest in this strategy? That is another way of looking at it. There is a book on drug policy in Canada called Panic and Indifference. It seems to mirror our cycles of investment at times where we have this panic, we throw money at it and then we forget about it. We are not indifferent, but other priorities come to the fore.
The issue of a sustainable drug strategy is what is required over the long haul. How long will it take to set it up? We are under way now in setting one up. It is important that we look at some priority issues. I would suggest that we could initiate some fairly immediate data collection efforts just to get a sense of the size of the problem in Canada. Whether that would be some of the data elements I suggested here, such as a national prevalence survey or an impact survey in order to get a sense of who is using what and where, that could be done quickly.
Your process and your discussion with Canadians is very much central to how we build our drug strategy. Admittedly, Canadians will be saying, ``How does this fit in with the parliamentary committee and where do the two twin together? Where does this percolate up into?'' I would suggest that, over the course of the next few months, and it is to be hoped in reaction to your committee's report, that the government could be well poised to moving along on a drug strategy. We held a national conference with a number of stakeholders over a year ago now and they said that if we could just ask the government to pause, think, and then act. That is important.
Your committee is doing the thinking part now, reflecting on a long-term strategy where we know we are investing over more than four years, more than a political cycle and setting in place a structure that will leverage your investments over a longer term. Honourable senators could do much in a short time, but you must also recognize the longer term investment required.
Senator Maheu: Why do you think that governments, in the past, have thrown money at things such as drugs, knowing full well the risks of hospitalization, the medical costs, the internment costs for our prisoners, for those who are going to prison because they are committing crimes all related to drugs? Why do you think we continue to throw money at these things and keep pulling it back when times get tough? If we are serious about health problems, if we are serious about incarceration costs and we do not want to start building more prisons, like some of the other countries in this world are doing, why do you think they keep pulling the money back, only to throw it out again and then pull it back again?
Mr. Perron: There is a fiscal reality. If you had a choice to invest in drugs, health care or day care, or what have you, there are difficult decisions to be made. Having said that, the drug issue is not an easy one to get into, unlike cancer. Everybody knows cancer is bad; there is no debate about that. There is not a little bit of cancer that is good. Everything is bad about cancer. The drug question is much more difficult to nail down. How much is good alcohol or bad alcohol? When do we get into abuse? What senator, politician or other public figure wishes to be known as the poster person for addictions? We call it ``Narcotics Anonymous'' for a reason. These are anonymous constituencies. Therefore, we have a huge stigma issue.
Few people want to stand up and say, ``We need to address addictions,'' because I think it gets too close to home. Many of us drink and smoke. Though smoking is not fine, drinking occasionally is acceptable. The point is: Want do we want to do with our drug policy? In the past, there has been this sort of demonization or polarization of views: You must legalize or prohibit. There is more that can be done in between.
It is this clear articulation of what is the impact of our drug policy today that is hampering our being able to convince those who need to invest in it to put the money where it is needed. We are lacking a significant amount of data. The costs alone should speak for themselves, but they do not. There is a social, moral and economic issue. We need to bring the three issues together in a non-partisan way and say, ``Here is what we need to do to invest.'' That is what, perhaps, was hindering the longer-term investments.
Senator Banks: I wish to add my compliments to those of my colleague. You have reinforced some of our frustrations, which is the best I can say. Is there any sign of the $420 million yet? Do you have any of it yet?
Mr. Perron: No.
Senator Banks: Are you the organization to which some of that money would logically go?
Mr. Perron: I would hope so.
Senator Banks: What is happening?
Mr. Perron: Frankly, there are some timing issues. The work of these committees, I think, has held up implementation of a national strategy.
The Chairman: Are you telling us it is our fault?
Mr. Perron: I am telling you what I hear my colleagues saying, that it would be odd for the government to roll out a fleshed-out drug strategy when we have two committees undertaking extensive work in the area. I think that was one of the considerations.
Senator Banks: Do you think the money will follow?
Mr. Perron: We are getting close to that four-year term. I would certainly hope so. If it comes from two chambers, with a sounding, a common goal and vision and a coherence of messages, we will have a much better chance of that happening.
Senator Banks: You have suggested that we have to have a comprehensive drug strategy, which I take to mean that you include liquor, heroin, pot and everything in between. Is that asking too much? You are in the driver's seat and charged with this. I cannot think of a good automotive analogy such as the one you have made, but that is an awfully big truck. Might we not be better off to try to find five SUVs instead of a 16-wheeler?
Mr. Perron: I will see if I can respond with an equally good automotive analogy. I recognize the challenge of what I am proposing; that is, a comprehensive strategy. Nonetheless, if we do not turn our minds to the overarching four corners of the box, we will have a hard time getting out of the starting blocks. If I may say, for cannabis alone, the reason I am looking at an overarching policy is that we need to figure out where cannabis fits in with alcohol, tobacco, cocaine and other things. To look at it individually or singularly provides a great deal of information, but there are few single, individual parties in Canada. There is a multitude of parties and of occasions where young people will be faced with all sorts of drugs. At the end of the day, it speaks to what we want to do with our drug policy, if we look at it on a drug-specific basis. We want to make Canada a healthier and safer place to live and, therefore, articulate that in a different way as opposed to being drug specific. A comprehensive strategy is the way we have to look at things.
Senator Banks: In the end, I agree, because all those things bump into each other. Since our committee at the moment is focused particularly on cannabis, our frustration, which is one you have indicated you share, is that there is an awkward circle that seems to be unbroken. We cannot move in that direction because we do not have enough research. We cannot do any more research because we are constrained by conventions and certain aspects of the law, and it seems extremely frustrating to us. I know there are good reasons for all those positions, but there they are, and sometimes they work at sixes and sevens.
Am I right in assuming that we know less about cannabis in terms of statistics — measurable things and reliable research — than we do about any of the others? Is that true?
Mr. Perron: It is quite likely. That is fair comment, particularly when you consider the grey zones with respect to cannabis. Does it have a therapeutic use? If so, does administration by smoking it debalance it, or do we want to look at specifics? There is a cloud of misinformation and confusing information with respect to cannabis.
Senator Banks: We know a great deal about heroin, which has had double blind tests in all three stages. Let us talk about medicinal use of cannabis for a moment. Nobody is now undertaking the serious, long term, large scale research to which you have referred, which would put us, as you have suggested, in a place where everybody else would be looking at what Canada decided, and it is so extensive that it is irrefutable with respect to medicinal application of cannabinoids in whatever form. Somebody needs to do that, and we understand all of the good reasons that the pharmaceutical companies will not do it. It will fall to either an absurdly rich philanthropist, which is not all that likely, or to governments.
Would your organization be the logical one to contract long term, large scale research on the medicinal or non- medicinal effects of cannabinoids?
Mr. Perron: I would certainly suggest that the mandate given to us in 1988 is the appropriate one for us. Clearly, we do not have the internal capacity to do it, nor do we have the funds to do it. We would not, of course, work in a vacuum in the absence of government processes. If you are looking for an arm's length, quasi-independent organization, because we do receive funds, an organization such as ours can be useful in undertaking that type of work. We also need to draw on other expertise that we have, and that have invested in Canada to use their services, such as the Canadian Institutes of Health Research. How is it that the CCSA, working with the Canadian Institutes of Health Research, Health Canada and other areas, can work together? It is not just one, but certainly our organization, I think, given our independence, neutrality and objectiveness, or our intention to be so, would be a good start.
Senator Banks: Somebody needs to drive the bus. One of the frustrations is that everybody is saying we must coordinate with those guys, be careful not to step on their toes and we need to include what they have found, but somebody has to be in charge. Otherwise, it will not happen.
I think you have answered my question in the affirmative. Your organization would be in a position to do that, particularly if you received funding that was either absolutely reliable, or large enough, or guaranteed to be long term that you could undertake this project without further parliamentary appropriation for that specific purpose. You could be the one to drive the bus and take into account what CIHR and everybody else is saying.
Mr. Perron: Ultimately, that bus driver will be the Minister of Health. We are speaking of research that will affect the Controlled Drugs and Substances Act, and the decision to heed or to follow that advice rests with the Minister of Health.
Senator Banks: I am not talking about changing legislation; I am talking about pure research. Whether someone acts on it is another question.
Mr. Perron: You are asking who is driving the bus. We can do the research; whether we get it going is another question.
Senator Banks: Once you have funding earmarked for that specific purpose — and perhaps as a condition of the funding you would be at arm's length — therefore the research that you would undertake would not be subject to question in terms of political influence.
Mr. Perron: I am sure there would be some questions. To remove ourselves completely from the subject of any questions would be laudable, but certainly some way toward that.
The Chairman: To help the discussion, let us compare that to the Auditor General. He or she is funded by Parliament through the Main Estimates, but no one is questioning the budget of the Auditor General, except parliamentarians. However, no one is questioning the appropriateness of scrutinizing Public Works. No one is questioning that. Of course, at the end, someone is controlling the appropriation. Parliament would do that.
The word ``political'' is probably not a good one. It is not political in terms of parties; it is political in terms of whether doing such a thing would bring into question your being re-elected, and of course politicians in the House of Commons want to be re-elected. That is credo number one of being there.
We are concerned about altering their perception of what will be good in 10 years, instead of what will be good for us, whoever forms the government, in four years. We are comparing that sort of independence to that of the Auditor General.
Senator Banks: Let me add one other possible comparison to the foundation for innovation, for example, where it is a big parliamentary appropriation sufficient to undertake an entire program of research like this on the basis of some reasonable cost projection, so that the money comes once. Whatever would be determined, X number of dollars would be the real costs.
It might even be enough money that, by employing a combination of living off the resources produced by that amount of money and a certain amount of the capital, you would be able to arrive, 10 years down the line, at the kind of irrefutable research that is needed on this question.
Those, then, are the two kinds of comparisons: One is a parliamentary appropriation, which might be annual and would not be questioned, and the other is a lump sum, as in the Foundation for Innovation. Would one of those models work?
Mr. Perron: I am sure that both models could be put into place in some form. As a result of the cuts that we in the CCSA have withstood, we have turned our minds to our long term survivability and thought about the creation of a foundation of the sort precisely along those lines — more to keep our doors open than to undertake the type of research that you have suggested.
At the end of the day, we look back to the 1988 act, which is still current and topical, as to what it is that the government of the day wanted us to do. I would suggest that if you deliberate along those lines in reviewing that act, you would find that we are mandated to work within the portfolio of the Minister of Health. That is appropriate, I think, in the sense that the Minister of Health has been designated the lead minister for Canada's drug strategy. It gets confusing now because we do not have a national drug strategy. If we had one in place, I think the work we could do with the minister would be considerably stronger. I believe the minister is sympathetic to that.
As we conduct our research, if we are seen still within the umbrella of the portfolio of the Minister of Health but as quasi-independent, it would be helpful as well. There are a number of variations, however. We need to ensure, as we go forward with the new drug strategy, that there are monies and processes put in place that will assure, as much as possible, an independence and transparency with respect to the development of research monies and research processes that go beyond a federal government's interest but touch on a national one. The same would hold true for data collection, programs and policies, best practices — a variety of issues. We are not simply a research organization.
I am not sure I am answering your question, and I apologize if I am not. We can be a variety of things, but we also have to respect the spirit in which the CCSA was first conceived.
Senator Banks: The Ministry of Health is exactly appropriate to what I am asking, because I am not asking about data with respect to other aspects of drugs: recreational use, trafficking, the illegality and the immorality, if that exists. I am talking about research having to do with the medicinal efficacy of cannabis. However, you have answered the question fully.
[Translation]
The Chairman: I understand your answer. The mandate you have from the Health Department is the one you have had since 1988. We are concerned about the independence of an organization that is both an observatory of psychoactive substances and a research institute. That is more than you would find in Europe. One single independent organization would follow the development of trends and provide up-to-date information.
We think such an organization must be independent. Earlier on, I spoke about internal policy. The problem with external policy is that it is national in scope. Can you imagine a health minister imposing national obligations on a quasi-independent organization, in the name of national interest? That would go against the organization's statutory objectives. We do not want that to happen.
Do you see we are having a little trouble with this question of independence? We would like to know what is going on and we would like to know what to do to fill the gaps.
Mr. Perron: It is important to work in partnership with the key players and not in a quasi-independent manner. We cannot completely divorce ourselves from the federal government given our role. Otherwise we would be a completely independent research centre. In my view, we have been given an appropriate amount of independence in the legislation. The fact that I report to a board of directors, the majority of whose members are appointed independently, shows that the structure is relatively independent. It can respond to questions of independence. The question is whether we should be more independent and to what end? That is a difficult question.
The Chairman: I understand. We will try to reconcile those viewpoints. You have a lot of experience in psychoactive substances and so does the centre. As far as cannabis is concerned, we are trying to define the groups. We want to go beyond the substances to try to define the terms ``use,'' ``high-risk use'' and ``excessive use.'' Those are the three major user groups we want to examine. Can you shed some light on that?
Mr. Perron: In 1998, the CCSA drafted its own cannabis policy. We identified four recommendations that the board approved. I will read them:
[English]
1. The severity of punishment for a cannabis possession charge should be reduced. Specifically, cannabis possession should be converted to a civil violation under the Contraventions Act.
2. Diversion of cannabis offenders to treatment or community service should be available, particularly for heavy users and those experiencing problems from the use of other illicit drugs, but diversion will not resolve the difficulties involved in cannabis enforcement.
3. Any change in law should be subject to systemic evaluation of its impact on cannabis use and indicators of cannabis related harm, as well as impacts on criminal justice practices and costs.
4. Any change in law which reduces the consequences for a cannabis offence should be accompanied by a strong message that this does not signal less concern with the potential problems caused by cannabis use.
[Translation]
The Chairman: We must categorize our work. We realize we have legislation that encompasses everyone. Not all users have health problems. Health problems are sufficiently important for us to deal with them adequately, which brings us to the question of prevention. However, we realize it is somewhat unrealistic to do prevention for all users, given the consumption trends in Canada. So you reduce the size of the target group.
Two groups concern us more than habitual illegal drug users. If you look beyond the illegality, you realize that they are not the ones we should be concerned about, but the group who abuse substances and ways of preventing this abuse. That is where our problem lies. How do you define that?
Mr. Perron: I am going to answer by asking a question. I asked the following question in my remarks: What harm are you trying to reduce? Are you trying to reduce the impact on the health of substance abusers? What steps should be taken? What harm is our policy attempting to resolve for users? We are attempting to reduce the impact of a criminal record for the simple possession of marijuana. I think we should be thinking about decriminalization.
When you get more deeply into your discussion, you will have to ask the following question: What harm are you attempting to address and what is the best way of doing so with the substance abusers? It is important to get to them before they become substance abusers.
Moreover, why are these people using drugs? You must study the user population in context. We have seen that 30 per cent of young people have used marijuana in recent years. The vast majority do not continue to use. A specific minority do. If we talk to addicts today, the vast majority who are using drugs on a chronic basis are doing so to try and cope with a problem that goes beyond youthful experimentation. We are talking about a problem with respect to violence, sexual abuse, among others, something that appeared in their life a lot earlier on.
The group of substance abusers is different from the group of users, but we still need to have tools in place to help them. Access to treatment is not always easy in Canada. If someone determines that they have a problem with cannabis and wants treatment somewhere, it is not easy. If it is, on occasion, there are waiting lists. When someone wants to stop using, they need help immediately. We must have treatment programs in place and clear messages regarding prevention for substance abusers, to the extent that it is possible.
When Mr. Allan Rock was Minister of Health, he announced a new $400-million tobacco strategy. The next day, an announcement was made regarding the use of cannabis for therapeutic purposes. I understand that few young people watch CPAC, but the ones who do will be wondering what message we are trying to send. We must clearly state the objective of our drug policy.
The Chairman: I understand.
Mr. Perron: I do not have an answer for you.
The Chairman: We had a policy, for what it is worth, but we did have one. Now, we are talking about a new generation. We must be more pragmatic and try to examine the real problem.
In your terminology, you used the term ``toxicomanie retrouvée'' in connection with your organization. We are trying not to use that term because the World Health Organization almost sent us that message in 1964. So we will not use it. But you are not alone.
The list of terms is very important, just look at the word ``drug.''
Mr. Perron: ``Harm reduction.''
The Chairman: Yes, ``harm reduction'' is a term that appears a bit negative to us. So we understand the objectives and we are trying to explain it differently. Terminology is important.
As regards the issue of funding, I am going to go back to the issue of independence. In one organization versus two — I am going to try and ask you to be objective in your answer — is it preferable to have a monitoring centre and a research agency, in other words two independent organizations that both report to Parliament, or just one?
When I talk about funding, forget about the cost. We need to deal solely with objectives.
Mr. Perron: If you want an independent research organization that is untouchable, it is important to keep it as focused as possible on its current mandate. If it is preferable to have two organizations, one for research and the other for monitoring, I would say that yes, having two would make sense.
However, we already have an organization of research institutes in health that was developed for that purpose, to promote innovative research in Canada, and which uses all kinds of processes to ensure a certain degree of independence.
We could combine the two roles: research and monitoring in the same organization, but having recourse to other organizations such as the institutes of health research and others to ensure independence.
The Chairman: Research on cannabis for medicinal purposes is one of our concerns. We have come to the conclusion that since pharmaceutical companies will not fund this research, the government should. If one organization comes to the conclusion that there is a series of research areas identified where research work must be undertaken, will the independent organization leave it up to the will of the different scientific research bodies to develop the research protocol? What research will be undertaken? How will we achieve the results? Will the independent organization establish what it wants from the outset? Are the protocols and the research organizations just there to carry out this research? Do you see what I mean?
Mr. Perron: Yes.
The Chairman: We want research to be independent, and we want it to be conducted. But we do not want it to be dependent on good will; even if the conclusions may well be sensitive.
Mr. Perron: Developing a research agenda, establishing the necessary research priorities in Canada, should not be done solely by the organization responsible for research. It must reflect the opinions of the various partners, the various experts in the field once we have established what we have heard and what we must do in terms of research and the protocol that we want to fund. The first priority should be to understand the opinions of the various partners and not just the research organization.
The Chairman: Let us try to compare ourselves to the Americans. What is happening in the United States in terms of their models?
Mr. Perron: It would be NIDA.
The Chairman: In your opinion, is that organization independent?
Mr. Perron: That organization is the closest to what you are describing.
The Chairman: It works as a monitoring centre and conducts research.
Mr. Perron: It clearly does a lot of research. I do not know to what extent it plays a role as monitoring centre. The ONDCP has a bit of a role as a monitoring centre nationwide in the U.S.
In the United States, the NIAAA, the National Institute on Alcohol Abuse and Alcoholism, makes a distinction between drugs and alcohol. In Canada, we should put these organizations together. We should not have two separate organizations. I do not know to what extent this organization would have a role as a monitoring centre.
The Chairman: In your opinion, is the NIDA independent enough? Since we were the first to create such an institute, and given that we have strayed from our initial objective, should we not remedy the situation as quickly as possible?
Mr. Perron: The NIDA is not independent enough. Having said that, I do think that the majority of people have confidence in their research, mainly because of the process that has been put in place to develop protocols. I am sure that they do not please everyone. The NIDA pours a billion dollars into research each year. I do not think you should create a similar-type NIDA in Canada without having at least consulted the people who are very familiar with the organization: its structure, its relationship with Congress, the funding available to guarantee some independence. I am not familiar enough with the structure.
The Chairman: We will ask them the question. As regards the federal, provincial and municipal levels of government, how could we coordinate everything?
Mr. Perron: For starters, it would interesting to initiate a dialogue with the provinces and for all ministers of health to discuss developing a national drug strategy. The same thing should also be done with the ministers of justice. In developing our new national strategy, it would be important to ask the provinces to appoint someone who would act as their spokesperson on the development of a new strategy so that the provinces are prepared to sign an agreement with the federal government and to determine their responsibilities.
We could start by determining the roles and responsibilities of the federal government and the provinces. If we were to ask the provinces, I am sure that they would agree with treatment, but with funding provided by the federal government. That is an ongoing debate.
First, you would have to bring together the key federal stakeholders to identify an appropriate role that the federal government can play, and secondly, discuss with the provinces what they feel their role is. If both agree, all that remains to be determined are the municipal or regional responsibilities. The division of the roles and responsibilities among the various levels of government is not black and white and that is making the issue complicated for us.
[English]
Senator Banks: This is an observation, not a question. I understand what you just said, but a process of getting the provinces together to decide on jurisdictional questions in this regard, and on deciding who will drive the bus on the research is, in my personal view, a non-starter. That is something that we must do.
I remind everyone that we are talking about research. We are not talking about the imposition of law or the division of responsibility. Research ought to be so irreproachable, irrefutable and pristine in the methodology that has driven it —
Mr. Perron: My apologies, senator. I misunderstood the question as being how, as we develop a new national strategy, we bring on other levels of government.
Senator Banks: Quite so. With my apology, also. I was referring back to my old question. You are quite right.
[Translation]
The Chairman: You must agree that we need, from the outset, a partnership with the provinces and municipalities. Each level of government, according to its responsibilities, has an important role to play in one of the problem areas, which is health care, be it in the cities or provinces. All of the partners around the table should establish a five-year plan. What would you think about that kind of a recommendation?
Mr. Perron: Everyone would appreciate it. We attempted a similar approach in Winnipeg in December 2000. We brought together 70 stakeholders from key organizations to work on the first step: where should we go and how should we start?
The Chairman: The Australians have adopted that approach.
Mr. Perron: Yes, and they work that way regularly. With a sense of partnership you can make allies. By reaching out the way your committee and Ms Torsney's have, you are also going to encourage people to cooperate with you.
The Chairman: It is not because we are not trying.
Mr. Perron: I simply wanted to raise this point because when you go to Winnipeg or Regina, you want to make sure that it yields results. I am saying this respectfully. Having said that, a national conference on priorities is entirely appropriate. There will be a world forum on drugs on September 23 in Montreal. We are inviting people to come and see us to tell us what they think about the issue in Canada. It will perhaps give us enough impetus to undertake the work that you are suggesting.
The Chairman: Thank you very much, Mr. Perron. We are wrapping up our hearings with your testimony. We will be meeting privately with two American witnesses in the next few days. There is no doubt that the substance of these meetings will be taken into consideration and appreciated when we prepare our recommendations.
I want to thank everyone who has worked with us over the past 24 months. Having said that, I will adjourn these public deliberations of the Special Senate Committee on Illegal Drugs.
The committee adjourned.