Proceedings of the Standing Senate Committee on
Legal and Constitutional Affairs
Issue 31 - Evidence - May 14, 2015
OTTAWA, Thursday, May 14, 2015
The Standing Senate Committee on Legal and Constitutional Affairs, to which was referred Bill C-2, An Act to amend the Controlled Drugs and Substances Act, met this day at 10:31 a.m. to give consideration to the bill.
Senator Bob Runciman (Chair) in the chair.
[English]
The Chair: Welcome, colleagues and invited guests, members of the general public who are following today's proceedings of the Standing Senate Committee on Legal and Constitutional Affairs.
We are continuing our examination of Bill C-2, An Act to amend the Controlled Drugs and Substances Act. Bill C-2 creates a separate exemption regime for the operation of supervised consumption sites in Canada. This is our third meeting on the legislation. As a reminder to those watching, these committee hearings are open to the public and are also available via web cast on the sen.parl.gc.ca website. You can find more information on the schedule of witnesses on that same website under Senate committees.
For our first panel of witnesses this morning, we welcome from the Canadian Medical Association, Dr. Jeff Blackmer, Vice-President, Medical Professionalism; Jean Nelson, Director, Legal Services; and by video conference from Vancouver, a familiar face from the Canadian Police Association, Tom Stamatakis, President; and from Canadian Association of Nurses in HIV/AIDS Care, Marilou Gagnon, Expert Advisor Policy, Research, and Advocacy; and from the Canadian Centre on Substance Abuse; Rebecca Jesseman, Director.
I will remind our witnesses of the five-minute opening statement. I will try to keep you on that timeline as much as possible. We will begin with Dr. Blackmer followed by Mr. Stamatakis, Ms. Gagnon and finally, Ms. Jesseman.
Jeff Blackmer, Vice-President, Medical Professionalism, Canadian Medical Association: I would like to thank the Senate committee for the opportunity to contribute to the study of Bill C-2, An Act to amend the Controlled Drugs and Substances Act.
The CMA represents over 80,000 physicians in Canada. We are deeply concerned with Bill C-2, and we recommend that it be replaced by legislation that recognizes the unequivocal evidence of benefits of supervised consumption sites. We do not believe that amendments will be sufficient.
Addiction is a serious, chronic and relapsing medical condition for which there are effective treatments. Let me be clear that addiction is not a lifestyle choice. Those of us in medicine know that there is a dire need for complementary approaches to substance use, and these include harm reduction. The CMA fully supports harm reduction strategies. Harm reduction is a clinically mandated and ethically sound method of care and treatment, which in this case aims to reduce deaths and disease, even in the face of continued exposure to a potentially harmful substance.
The use of harm reduction strategies is in keeping with the physician's ethical obligations as outlined in the CMA's Code of Ethics.
Supervised consumption sites are an example of a harm reduction program that can increase access to health services for hard-to-reach and vulnerable populations, which are experiencing unacceptable levels of death by overdose, as well as diseases such as HIV/AIDS and hepatitis C. This population also has increased hospital and emergency service utilization. Many of these health problems are not actually due to the consumption of the drugs themselves, but to the injection method and the lack of sterility of the equipment.
Supervised consumption sites also meet the needs of the communities that are struggling with a crisis situation with open drug consumption and discarded needles. Public acceptance is actually high in most communities where they have been established and this acceptance increases over time.
Drug use is an extremely complex medical and social issue and collaboration amongst health and public safety professionals and society at large is absolutely essential.
Specifically the CMA is concerned with a number of issues.
First, Bill C-2 contradicts the spirit and intent of the unanimous decision of the Supreme Court, which stated that the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on the possession of illegal drugs.
We maintain that passing Bill C-2 in its current form could prevent Insite from obtaining a renewal of its exemption to section 56 of the CDSA. The likely consequence of that would be further costly litigation.
Second, Bill C-2 could impose multiple and significant barriers to providers of health services to obtain an exemption. From the five criteria in the Supreme Court ruling concerning Insite, Bill C-2 now lists 27 onerous requirements, which could necessitate extensive resources and funding. We believe that the preamble states the real intent of Bill C-2, that exemptions will only be granted in exceptional circumstances.
This bill does not address how the minister is to weigh the information submitted in order to guarantee impartiality. Even after meeting all the requirements, the minister still has the sole discretion to decide whether or not a site can open.
Third, we believe that Bill C-2 does not strike a balance between the public health and public safety goals of the CDSA. Insite has been one of the most researched public health interventions to date. I want to make it clear that the evidence is rigorous, scientifically valid and thoroughly peer-reviewed, and it shows unequivocally there has been: a reduction in the overall rate of needle sharing and in deaths due to overdose; increased access to addiction counselling and increased enrolment in detox programs; opportunities for HIV prevention through education, with links to HIV treatment and services; reduced public drug injections and publicly discarded syringes; no increase in levels of drug dealing or other drug-related crime; and cost savings because of risks of infectious diseases, intervening early in health issues and reducing the need for emergency care.
We strongly believe that supervised consumption sites represent an important component of a medical, ethical approach to addiction that must be based on evidence and not on ideology or public opinion. The CMA recommends that Bill C-2 be replaced with legislation that recognizes the unequivocal benefits of supervised consumption sites.
Thank you, Mr. Chair.
Tom Stamatakis, President, Canadian Police Association: Good morning, Mr. Chair and members of the committee, and thank you for the invitation to address you this morning as part of your continued study on Bill C-2.
I know it has been barely two weeks since my last appearance before you on C-377, but for the benefit of those who may be watching, I have the privilege of serving as the President of the Canadian Police Association, an organization that represents almost 60,000 frontline police personnel, both civilian and sworn members across Canada.
My opening remarks today will be brief, however I have closely followed the testimony given by other witnesses before this committee, as well as during the study of the legislation in the House of Commons. The term evidence- based seems to be used quite often. I would offer the following to you today, which should give you an idea of my experience in this area and why I particularly appreciate having the opportunity to present to you.
I have served for 25 years as a constable with the Vancouver Police Department and I'm currently, along with my duties with the CPA, the President of the Vancouver Police Union where Canada's only supervised drug consumption site operates. I believe I can provide you today with an important and firsthand view into how these sites can have a negative impact public safety in the communities that they serve.
From a frontline policing perspective Bill C-2 is an important piece of legislation that our association wholeheartedly supports, as we believe it strikes an appropriate balance between the needs of protecting community health while taking into account the very real concerns that have been raised by all levels of law enforcement and members of the community regarding supervised drug consumption sites.
During the study by the House of Commons committee, concerns were raised by opponents of this legislation that the conditions imposed by this bill are onerous and will be difficult to meet for organizations seeking to open new sites.
As a police officer, I am somewhat sympathetic to concerns that paperwork and regulatory frameworks can be difficult and at times even next to impossible to work within. However, I can say that this is the environment that law enforcement professionals work within every day. We don't have the option to cut corners or take the easy way out. Our efforts must be meticulous to pass muster by judges, Crown and defence attorneys, community stakeholders as well as the myriad of oversight bodies that constantly police the police. I don't think it is asking too much of those who wish to work with illicit and dangerous drugs to meet the same standard.
I don't particularly want to use my appearance here today as a platform to re-litigate the merits or drawbacks of supervised drug consumption sites, but while I will certainly concede that proponents of these sites are passionate advocates who are sincere in their beliefs, I can say that as a police officer who has patrolled and worked in the Downtown Eastside that there's a significant public safety cost that absolutely must be considered when thoughts are given to opening new sites.
The simple fact is that drugs that are consumed at these sites are illegal substances. An individual doesn't walk into their local pharmacy to obtain their drug of choice. There's a criminal act that takes place with the simple procurement of their drugs. With the grey area that has been created around Insite in the Downtown Eastside, our officers are asked to exercise incredible discretion in their policing efforts, but the drug dealers are ready and particularly eager to exploit this discretion to the fullest extent possible.
Another unfortunate truth is that those who are using these drugs are not using their discretionary income to buy their illicit drugs. They are resorting to often desperate and most often criminal behaviour in order to obtain the resources necessary to purchase drugs. This leads to an increase in theft, assault and prostitution in the immediate area around the site where they will sometimes attend to inject drugs.
All of this comes at a cost. There are very few unbiased observers who would walk the Downtown Eastside of Vancouver and claim, using only the eye test, that Insite is an overwhelming success. While I wouldn't claim that every problem in the neighbourhood is the result of the presence of Insite, it is an unfortunate and unavoidable by-product of its continued operation.
This isn't to suggest we should turn our backs on those who have fallen victim to addiction. It would be impossible to list all the initiatives taken by police services and other agencies cross this country to deal with drug consumption, and I firmly believe we can build on those programs that have been found to be successful. But while anti-drug initiatives vary widely in scope and operation, the one constant is that public safety is never jeopardized and that the protection of our communities' most vulnerable is always paramount.
Unfortunately, the debate around Insite and any other proposed consumption sites has become extremely charged and, in a number of cases, very personal. I have witnessed and been targeted by those who don't appreciate my advocacy on behalf of my members in opposition to these sites.
While I try to see this debate from their perspective, I hope today they might try to see it from mine. I've walked the Downtown Eastside, I've spoken regularly with the police officers who are given the difficult and dangerous task of patrolling this area on a regular basis, and I can say without a doubt that while studies may trumpet the health benefits of supervised drug consumption, those same studies always underestimate the public safety cost that comes as a result.
In our estimation, Bill C-2 is a reasonable response to the Supreme Court of Canada decision that allows Insite to continue operations. This proposed legislation doesn't close the door on new consumption sites, but it sets an appropriately high standard that needs to be met before the sites can open. It asks for input to be sought from a number of stakeholders, including law enforcement, and our association appreciates the steps taken by the government in this regard.
I would like to conclude by offering one suggestion for amendment within the legislation. Clause 56.1(3) specifies the consultation conditions that need to be met before the minister authorizes any new supervised drug consumption site. Subclause (e) says that a letter may be obtained from the head of the police force that is responsible for providing policing services to the municipality in which the site seeks to operate.
While this is a good first step, I believe that the legislation should go further.
The Chair: Mr. Stamatakis, I'm going to have to cut you off there. This is becoming routine for us; I recognize that. I hope you do. We do have your written submission and we're going to move on to our next presenter, Ms. Gagnon.
Marilou Gagnon, Expert Advisor Policy, Research, and Advocacy, Canadian Association of Nurses in HIV/AIDS Care (CANAC): Thank you, Mr. Chair, members of the committee for allowing us to present today. Our organization, the Canadian Association of Nurses in HIV/AIDS Care, represents nurses working with people who are at risk of or living with HIV. Many of the nurses we represent have direct experience working at Insite and working with people who use drugs in the community, the clinic and the hospital.
It has been clearly established that the care provided in supervised injection sites falls within the legislated scope of the practice of nurses in Canada. In these facilities, nurses work directly with patients by establishing trust and building relationships; assessing their level of knowledge and understanding of potential harms associated with injection drug use; providing harm reduction education; ensuring access to clean supplies; preventing risky injection practices; monitoring for signs of drug overdose or anaphylaxis; and intervening in emergency situations.
Nurses also provide primary health care to patients in supervised injection sites, including immunization, HIV testing, wound care, screening for sexually transmitted infection and counselling. Based on their assessment, nurses refer patients to addiction services and other services that are hard to access for people who use drugs, like housing and food support.
Supervised injection sites offer a point of contact between health care providers and people who use drugs. These sites cannot be solely defined as places where people inject illegal drugs. Defining supervised injection sites as such has resulted in a narrow understanding of the activities that take place in these sites. Most importantly, it has contributed to the development of a bill that has little to do with health, in our opinion, and more to do with public safety, which would explain why this bill was studied by the Standing Committee on Public Safety and National Security of the House of Commons and not the standing committee on health.
Bill C-2 emphasizes the perceived risk to public safety over the empirically demonstrated benefits associated with supervised injection sites, including the health benefits.
This is not consistent with the Supreme Court of Canada ruling on Insite. As a result, it could effectively deprive people who use drugs of essential, life-saving health care services.
While Bill C-2 emphasizes the need for consultation, we see no evidence of consultation in the making of this bill. While Bill C-2 emphasizes the need to listen to the community, it has failed to take into consideration three important communities: all the Canadian researchers who have worked to build this solid body of evidence on supervised injection sites; health care providers who provide services in these sites; and people who use these sites.
In its current form, we consider that Bill C-2 creates unnecessary obstacles to the implementation of essential, life- saving health care services by imposing an excessive application process, giving discretionary power to the minister and failing to differentiate between opinions and evidence.
Bill C-2 undermines harm reduction nationwide by making access to supervised injection sites more difficult, thus resulting in many missed opportunities to reduce the harms of injection drug use and increase access to health care services for people who use drugs.
Bill C-2 fails to recognize that supervised injection sites provide a safe environment for nurses to work in because outreach nursing care has to take place no matter what. If this means nurses going out in back alleys, hotel rooms and on the streets to provide care, this is what will happen in Canada if we don't have supervised injection sites.
Bill C-2 presents ethical concerns for nurses because they have to provide safe, compassionate, competent and ethical health care based on empirical evidence, and evidence from more than 90 supervised injection sites worldwide tells us that supervised injection sites work.
Nurses have to promote the highest possible level of health and well-being for their patients, and for us, this starts with meeting the patients where they are. Nurses also have to preserve the dignity of their patients, including the right to life, liberty and security. For people who use drugs, this means accessing supervised injection sites. Nurses have to promote justice by supporting policies that overcome barriers to health care, ensure greater equity and address broader social issues.
For us, Bill C-2 fails to support us in achieving this goal.
I will gladly take questions in English or French.
Rebecca Jesseman, Director, Canadian Centre on Substance Abuse: Good morning, Mr. Chair and members of the committee. My name is Rebecca Jesseman, and I'm interim director with the Canadian Centre on Substance Abuse or CCSA. I'm here on behalf of our interim CEO, Rita Notarandrea, who sends her sincere regrets she can't be here with you today.
First, I would like to thank the committee members for inviting us to discuss Bill C-2, An Act to amend the Controlled Drugs and Substances Act. For those of you unfamiliar with CCSA, we were created by an act of Parliament over 25 years ago to bring together government, not-for-profit organizations and the private sector to find common solutions to substance abuse issues. We have a legislated mandate to provide national leadership on reducing alcohol and other drug related harms. Promoting evidence-based advice to shape policy and programs is a core part of this mandate.
In respect of our time constraints, my presentation will be brief. If you would like more information about the points I will cover, I have provided the clerk of the committee with our October 27, 2014 written submission to the House of Commons Standing Committee on Public Safety and National Security on this same issue.
To begin, as you know, substance abuse is a complex health and social issue that impacts all Canadians. As you may also know, only a small minority of Canadians use injection drugs.
However, injection drug use can have a disproportionate impact on individual health and safety due, for example, to increased risk of blood borne virus transmission, overdose and soft tissue infection. It can impact community perceptions of safety and public disorder and, as mentioned by my colleagues, have significant impacts on enforcement and public health resources.
Based on the evidence, the implementation of supervised consumption sites as part of a comprehensive continuum of services can be an important part of reducing the harms associated with injection drug use. It is in this context that supervised consumption sites should be considered — as part of a continuum of options spanning from prevention and early intervention to treatment and recovery.
International evidence indicates that supervised consumption sites achieve the objectives of increased access to health and addiction care, reduced overdose fatalities, reduced transmission of blood borne viruses such as HIV, reduced soft tissue infections and improved public order.
A vital part of ensuring that a supervised consumption site achieves these objectives is establishing these sites where they are most needed and in a manner that reflects best practices.
CCSA therefore supports the development and implementation of an evidence-based application review process for the establishment and operation of supervised consumption sites.
CCSA also recognizes that public health and safety initiatives like these, including needle exchange programs, methadone clinics or halfway houses, often bring concerns to area residents.
Bill C-2 contains many of the necessary ingredients for establishing effective site locations that align with Canadian international research and experience. However, some components would benefit from increased clarity regarding their interpretation, in particular, the proposed standards of evidence for evaluating information required in clause 56, exemption applications.
CCSA is suggesting there is a need for more clarity as to what standards will be used to determine whether objections expressed by stakeholders are sufficient grounds to deny an application and on how the adequacy of proposed responses to stakeholder concerns will be evaluated. CCSA emphasizes the importance of addressing the complex issue of substance use through a public health approach grounded in evidence.
In conclusion I would like to thank you for your attention and note that CCSA is ready to assist and provide more information to members of the committee at your request.
I'm happy to answer any questions you may have.
Senator Baker: Thank you to the witnesses for the expert testimony we've heard here today on this bill.
To have the Canadian Medical Association and the Canadian Association of Nurses take such a firm position, is extraordinary.
My question is to the Canadian Medical Association, Dr. Blackmer, and perhaps as well to the legal team headed by Ms. Nelson.
Doctor, I was listening to you and then I went back to your remarks and I heard you say that the bill should be replaced. You didn't say anything about amending it in your statement, but you said the bill should be replaced and I think you added then that you can't just amend it.
You pointed out that the purpose of the legislation is usually seen in the introductory preamble to a piece of legislation. You're absolutely correct on that.
Could you explain to the committee in more detail why this bill cannot be amended and why it would have to be totally eradicated and replaced by another piece of legislation? Could you give us some specifics on that?
Dr. Blackmer: Thank you, Mr. Baker. We had discussions internally about whether we could propose amendments, whether we thought there was a process through which we could suggest some modifications to the bill that would strike that balance between health care and public safety, and we felt that the bill as currently constituted was simply too unbalanced in terms of the health care provider's perspective. We were unable to come up with a set of amendments that we thought would help bring that balance back towards the health care provider's perspective.
Because of that we felt that, in fact, a new bill would be required. We couldn't think of another way to try and achieve the aims of doctors who are working with these populations other than a new bill.
Senator Baker: Ms. Nelson, do you have something to add to that? You are the legal expert for the medical association.
Jean Nelson, Director, Legal Services, Canadian Medical Association: Thanks very much, Senator Baker. Just to amplify what Dr. Blackmer said, I went back to the Insite decision and reread it last night. The key paragraphs for me are paragraphs 152 and 153.
The premise that the Supreme Court starts on is that generally exemptions will be granted because the evidence and the court's analysis is clear that it saves lives. Then it goes on to say that when exercising discretion, these are the elements the minister may consider.
Whereas, when you look at Bill C-2, you don't have that fundamental premise of paragraph 152 in the principles section, it doesn't have a fundamental presumption that it is going to protect safety and lives.
To Dr. Blackmer's point, you need that firm foundation at the outset so everything that comes from it, cascades from it, is not informed by that principle that is really key in the Supreme Court unanimous decision.
Senator Baker: Thank you.
[Translation]
Senator Dagenais: Thank you to our witnesses. My question is for Mr. Stamatakis. It's always a pleasure to see you. I think we see each other more often now that I am a senator than we did when I was with the Canadian Police Association.
You're very familiar with Vancouver's Insite clinic and you would often talk to us about it when I belonged to the Canadian Police Association. I believe you mentioned it in your presentation. Has the Insite clinic led to more crime in Vancouver? Has it led to more homeless people in Vancouver? Has it attracted drug users to Vancouver? You said that new sites being opened would have to take into account the public safety cost. Standards for new sites will have to be very high. So I'd like to know what you think those high standards should be.
[English]
Mr. Stamatakis: Starting with your last question, I think the standards should be high. I think it's totally appropriate to engage in consultation and include the law enforcement community in that consultation, including the local law enforcement agency that's operating and the police association heads, in the area. Because they're not restricted from forthright comment around the effect, and that's, I suppose, the issue.
As I said in my opening comments, the public safety aspect of this has been completely underestimated and minimized. In 2003, when this approach was being proposed, we didn't oppose it. We were very open to new ways to deal with what is a chronic problem.
There is increased homelessness in Vancouver. If you walked into the Downtown Eastside, in the five-block radius around Insite — not to attribute everything that goes on there to Insite — I would argue that it's worse today than when I started in policing 25 years ago. I don't think, from a public safety perspective, that the claims around the gains made are accurate. We have to reallocate resources to that Downtown Eastside area and have since it was established, and continue to have a disproportionate number of our members deployed in that area because of the crime issues in that area related specifically to theft, assault and drug trafficking.
We have a whole black market industry around stolen property in that area, and it's stolen property being fenced to acquire the funds needed to purchase the drugs. There is a huge public safety cost, and that can't be minimized; it has to be considered.
I'm not a medical practitioner, I don't profess to be. I'm not an expert on that piece of it. What I am concerned about is the public safety piece, and that has been minimized throughout this discussion and debate. I have read all the literature, I have examined all of the research projects, I have tried to inform myself so I can understand the issues more clearly, and I think there are some issues around that.
Senator Jaffer: Thank you to all of you for your presentations. One thing I don't think we have raised, because you are in the caring professions, doctors, nurses, the one person we have not talked about is the patient, the person who uses this site. I can't imagine the uncertainty they have. I come from Vancouver; I work in the area of Insite so I know that area well. There is the uncertainty among people who use the facilities and those who care for people in that position.
Can you explain what must be their situation now when they don't know if this site is going to be open?
I don't know if you saw the proceedings yesterday but there was a discussion about overdose. If I'm not mistaken, I understood that within the premises no one has died of an overdose, but the concern was raised about people after they left the place, say a few hours later. Have there been deaths because of overdoses that didn't happen at Insite but afterwards?
Dr. Blackmer: That is an excellent question. We have many good examples in Canada of physicians and other health care providers who work with these populations, the most vulnerable patients in our society who really require access to health care resources. We know that the cornerstone of treatment for addiction is prevention first, treatment second and harm reduction third.
What you are doing by eliminating some of the opportunities for harm reduction is taking away a foundational pillar of intervention for these very vulnerable patients. We have good examples of harm reduction which are supported, things like methadone clinics and needle-exchange programs, and these have proven to be effective, just like the supervised consumption sites.
For health care providers, this is analogous to tying one hand behind our back. On the one hand, we're asking physicians, nurses and others to care for these populations. We applaud them. We hail them sometimes as heroes. We give them the Order of Canada, and yet we want to make sure that we have all the tools at their disposal and that we're not limiting the types of interventions that they can use.
You're absolutely right about the issue of overdose. The aim of these types of facilities is not to prevent overdose. We know these things will happen. These things will happen regardless of whether they take these drugs in the facility or out on the street. The aim of these facilities is to prevent death and I think we can all agree that's a laudable goal. We know this works. When we look at statistics from other cities that don't have these sites, the ratio of deaths by overdose is quite high, whereas at Insite it's essentially zero, so we know it works in that regard.
Ms. Gagnon: I want to clarify what you mean by insecurity. Do you mean insecurity that people would face if Insite does not remain open?
Senator Jaffer: They don't know how long it is going to be open.
Ms. Gagnon: From a nursing perspective, it's acknowledging the amount of work it takes to create relationships with people whose trust in the health care system has been difficult because of accumulating negative experience, especially in the emergency department, and usually this is where people who use drugs will find access to care.
I've worked for five years there in downtown Montreal, and I know how negative experiences accumulate to a point where people would sometimes prefer to die than present themselves at the emergency room. When you are faced with populations of negative experience after negative experience over a lifetime with health care providers, and you're granted an opportunity as a nurse to rebuild that trust and eventually work with a person over months and years to maybe consider the option of going off drugs or maybe not, it requires a lot of work and trust building if it happens.
The insecurity would also come from the providers, thinking about all the work and energy and trying to rebuild that trust. With providing health care in general, if that trust is not there, we're not going to have any success. People continue to present very late with complex conditions, including endocarditis, septic shock, dying of overdose, and collectively as a society we will have failed to provide essential care to this population.
Senator Plett: Thank you, witnesses. I want to echo what my friend Senator Baker said in support of our medical associations and the fact that they are taking such an interest in this legislation, especially given the fact that you are sworn to try to save lives and make people well instead of adding to their addictions. So I am truly amazed as well.
I have two questions for Dr. Blackmer and one for Mr. Stamatakis.
Dr. Blackmer, you have been complimentary about Insite and the good they do. Has drug use gone down in the city of Vancouver? Not have there been more or fewer overdoses. Has drug use gone down in the city of Vancouver as a result of Insite? And why is it that Vancouver has the highest rate of HIV and hepatitis C when they have something like Insite, which I would think would reduce the rate of HIV, not increase it? Yet Vancouver has the highest rate of all major cities in Canada. Those are the two questions, and then a short one for Mr. Stamatakis.
Dr. Blackmer: Thank you, senator. As far as I know, drug use has not gone down since Insite opened, but perhaps an important point to note, as far as I know it has not gone up either.
In terms of the issue of the infectious diseases, you're right; the evidence doesn't show a reduction in HIV/AIDS or hepatitis C. I would note these are extremely complex diseases, and injection drug use is absolutely one factor. There are other factors around social situations, unprotected sex and other various risk factors outside of that as well. Certainly it's something that has been measured. It's a relatively small population being looked at that uses Insite, but it's something that requires further study as well.
Senator Plett: I don't think there's any evidence that Vancouver is a city that has more unprotected sex or has any of these other things. The one thing Vancouver has that is unique is a safe injection site. I think that's the only thing in Vancouver that is, in fact, unique.
Mr. Stamatakis, in your experience in Vancouver, is the first and primary goal of safe injection sites, Insite, to discourage drug use and help those suffering from drug addiction to get clean or is their first priority simply to give them clean needles?
Mr. Stamatakis: What I would say in response — and it is part of the concern I've held for many years — is that there has been a disproportionate amount of attention paid to Insite. The fact is that I think we should be paying more attention to prevention, to education, to treatment. The treatment should of course be left to the health professionals.
I can tell you that in Vancouver we don't have a needle exchange program; we have a needle distribution program. There are needles strewn all over the city at all times. That poses a significant health risk not only to the members I represent but to community at large, particularly around schools and playgrounds where kids congregate. Most addicts, particularly those who are the most marginalized, don't go to Insite. They're still injecting in the alleys and reusing needles. They're still engaging in very risky behaviour that does contribute to deteriorating health.
The point here is that this was supposed to be a comprehensive or holistic approach to dealing with a very serious problem in the city of Vancouver and unfortunately it seems to have morphed into this disproportionate emphasis on this one approach, and I think that has come at a cost to public safety of the entire community. And it's come at a cost to those people who need the kinds of services that have been described today. They very much need them.
One of the frustrations that my members have is that there was supposed to be a component in this project that included a police liaison as part of the comprehensive approach. That never happened. The views of the police who have been redeployed into that community have been largely ignored. I think that overall, it hasn't realized the benefits that people were anticipating.
Senator Batters: Thank you, Mr. Stamatakis. Welcome back to our committee and thank you for being here today. The Canadian Police Association front line police perspective, 60,000 strong, as you indicated, is crucial to our consideration of this legislation.
For this particular bill, you have some vital experience in the heart of this matter with your 25 years of experience as a constable with the Vancouver PD, and right where Insite operates. I'm wondering if you can please give us your views on whether this bill strikes the appropriate balance.
Mr. Stamatakis: Absolutely, it does. It provides the opportunity for the type of consultation that frankly didn't occur when Insite was first established, and that should occur, so that we're not only acknowledging the risks for the targeted group that Insite targets but we're also looking at the risks for all the other people.
For example, in the Downtown Eastside, we have many retired people on pension. We've had to run project after project to try and protect those people who were being brutally robbed of their resources by addicts who were trying to get the illegal drugs they needed to consume. Frankly, most of them aren't consuming those illegal, harmful drugs in Insite. They're still consuming in the alleys.
I surveyed the members who were redeployed into the area because I was worried. Maybe I'm missing something. Maybe those police officers that are actually working in that neighbourhood, embedded in that neighbourhood, are seeing something different. Only 4 per cent of those members said they saw a positive insight as a result of Insite being established in that neighbourhood. Only 6 per cent believed that it reduced incidents of public injection or discarded syringes. Only 1 per cent said it improved the quality of life in the neighbourhood. Most said that they didn't see any reduction to harassment, begging, street vending of drugs, public urination, prostitution or drug-induced psychosis.
All of this information has been largely excluded from the research that has been done or completely minimized, so there's a skewed view in terms of what the effect is.
The continuum of care should absolutely be left to the medical health professionals. But there needs to be significant consideration given to the public safety piece and the impact on quality of life for all citizens in a neighbourhood, where a site like this could be established.
Senator Batters: Briefly, at the end of your opening statement this morning, you discuss a small possible amendment to Bill C-2. Obviously we're getting nearer to the end of this parliamentary session, prior to an election in the fall, and given your organization's strong support for Bill C-2, I'm wondering if you would support this bill, even if that particular small possible amendment was not made, given that we're under a very crucial and short time frame here.
Mr. Stamatakis: Yes. We support the bill. We support what's being proposed in the bill. This was just a suggestion that we think could ensure that the consultation is even more complete.
Senator White: Thanks to all of you for being here, particularly Tom Stamatakis. I know you come here often via video conference. I'm not going to speak to the medical part. I don't have a background as a medical doctor or professional, but I do as a community health provider, I guess, in many ways.
I want to talk, if I can, Tom, around the number of resources that you estimate were re-profiled after Insite went into place. Vancouver has about 650,000 people. Ottawa has about a million. If I were to re-profile 100 officers in Ottawa to one location, I would have seen a dramatic reduction in crime. Can you explain how many were re-profiled to the Insite area and what the impact was? Many would argue that crime didn't go up. I want to hear why you think that didn't happen.
Mr. Stamatakis: Crime didn't go up because we reallocated almost 80 officers to essentially a five-square block area in the Downtown Eastside to manage all of the public order, public safety crime issues that were occurring in that particular area, which became the epicentre of drug use, drug trafficking and all the crime related to that, and still is. I talked earlier about the significant problem that we have with the open market for stolen property in the downtown area directly tied to issues related to drug use and trafficking in the Downtown Eastside.
Even though crime didn't increase in that area, I think it can't be attributed to the creation of Insite, in my view. That should be attributed to the fact that we reallocated resources. However, we also created tremendous issues in other parts of our city because those resources had to come from somewhere else. New resources weren't created from additional funding; so we had to reduce staffing levels in other parts of the city. In fact, in one particular part of our city, which we call District Four, the southwest part of our city, crime immediately spiked, particularly property crime. In my view, a further consequence of the creation of Insite relates to the impact it had on another neighbourhood.
Senator White: We use the words "harm reduction'' regularly. I support the three-legged stool. How I support it is a different story, but do you also agree that harm reduction must be the harm that is going to occur to local citizens and community members, not just those who directly use such a facility?
Mr. Stamatakis: That's exactly why I'm here and why I've spoken on this issue for many years, because that, in my view, has been largely ignored. Again, it is disproportionate focus on a very serious issue that needs a lot of attention, but not at the expense of the community safety in the broader community.
Senator McInnis: Thank you all for coming.
Mr. Stamatakis, one of the difficulties I have here — and we've heard what you've had to say about the attraction of crime to these areas. We've heard or I've read similar views from the Toronto Police Association, the Ottawa Police Association. The police, law enforcement, are going to be part of saying whether or not a site is suitable. So how do you do that? Before a site is located, it may be fine. But I'm hearing you and others say that it will not be, that there will be an attraction of crime. So how can you, law enforcement, objectively be able to say that a given site is suitable?
Mr. Stamatakis: I think the approach that most law enforcement agencies would likely take, and certainly it would be the approach I would take, is that I would want to have a discussion around, "Well Ok, if we're going to establish a safe consumption site in a neighbourhood, then what else has to go along with that? What are the additional resources that will be required to manage the public safety issues that arise and then have an impact on that neighbourhood? What other resources do the police need?''
For example, if I'm a police officer patrolling the Downtown Eastside and I come across an addict and I think that person is in immediate need of care then what do I do? What are the protocols around where I take that person? How do we ensure they get into some kind of treatment facility or a detox facility, if that's what they're looking for? The point for me would be: let's look at longer-term solutions. Right now we're not coming up with longer-term solutions. The police do a good job of responding to crises. The problem we have is that we intervene, we take the person somewhere and a couple of hours later we're dealing with them again because they're on to their next fix or some crime so they can get the drugs for their next fix. The law enforcement piece around consultation is around the resources piece and the broader public safety issues in that particular neighbourhood.
Senator McIntyre: Thank you, witnesses, for your presentations.
Dr. Blackmer, in your opening statement you mentioned that passing Bill C-2 in its current form could prevent Insite from obtaining a renewal of its exemption to section 56 of the bill.
According to Justice officials the expectation is that once the bill receives Royal Assent, the process would apply to any applicant, including Insite. I further understand that in terms of renewal, there would be two additional criteria: First, evidence, if any, of any variations in crime rates in the vicinity of the site during the period that the site was operating; and evidence of any impact of activities at the site on individuals or public health during that period.
Bearing that in mind, don't you think these are reasonable criteria for an establishment like Insite to follow?
Dr. Blackmer: I think those are some of the criteria that should be looked at. I note with interest, and I certainly defer to my colleagues in law enforcement and other areas who are much more expert on issues such as this, in the Supreme Court ruling in paragraph 133, where they state, "No discernible negative impact on public safety,'' which seems to be not consistent with some of the other things we've heard. Things like variation in crime rates, and we've heard some possible explanations for those, would be one factor to be considered, as well as the impact on public health, both in terms of the surrounding environment and the people who are using these sites.
So while I certainly recognize that those are some of the factors that need to be considered, we continue to be concerned that the overall approach is unbalanced in terms of the direct health impact on the individuals using these sites.
Senator Eaton: Thank you very much. This has been very interesting. I'm new to the committee. I was wondering whether you had looked at what other EU countries do in terms of heroin addiction, in England, for instance? Have you found any other examples in other countries where sites like Insite are working?
Dr. Blackmer: Thank you. I'll address that briefly and I know my colleague may have some comments on that as well, if that's okay, senator. There are some international studies that show very good results from these types of facilities. We've been focusing a lot on Insite and rightly so, but we know from the preponderance of the evidence: these sites work; the support in the community is high; and it tends to go up over time.
Senator Eaton: Those are sites like Insite. They are not addicts who can go to a drugstore, register as an addict and get what they need. Is that right?
Dr. Blackmer: That's what I'm speaking about. Those programs exist as well, particularly in Scandinavian countries, but elsewhere also. They tend to be fairly highly accepted and the return to activities within society for individuals who use those types of programs tends to be very high, whether that's return to work, return to family life or whatever they were doing before the addiction. So there's good evidence around the success of programs like that, as well.
The Chair: Members, we have some time for a brief second round. I'll begin with the deputy chair, Senator Baker.
Senator Baker: Very briefly, I'll put a question to Mr. Stamatakis and also to Dr. Blackmer. My question to Mr. Stamatakis is this: It appears as if you have an opinion at variance with that of your police chief on this subject. I don't know if I'm reading this correctly, but perhaps you could explain to us why that appears to be the case.
Dr. Blackmer, you said this is going to lead to costly litigation, in your estimation. Could you further explain that?
Mr. Stamatakis: Yes, I have a different of opinion with my police chief — this one, the one before, and the one before that, probably.
Senator Baker: Why is that?
Mr. Stamatakis: The simple explanation is that I base my opinion on my own experiences and the feedback I get from the members I represent. Unfortunately, the chief, in my view, is appointed by a board that is appointed by various groups — political groups, perhaps — and are very much influenced, arguably, by different agendas that come into play on difficult issues like this.
I'm a bit less fettered.
Senator Baker: You sure are.
Dr. Blackmer: Thank you, Senator Baker. I'm certainly not a legal expert or scholar, but I look to the Supreme Court ruling again and in paragraph 148, they said they were looking for a remedy to avoid litigation. I think we've seen numerous examples as of late where Supreme Court rulings have led to different types of interventions that have further resulted in litigation.
It seems our opinion is — and we've consulted again with legal counsel — that the way Bill C-2 is laid out is not in keeping with the Supreme Court decision, and we anticipate — having spoken with different people involved in this type of an issue — that if it were to go forward, we will almost certainly see litigation as a result.
We're also concerned about the imbalance between the resources of the various parties. We're not talking about folks or groups with unlimited resources who are fighting to keep Insite open versus the other side. So there's a bit of an imbalance there, as well, that concerns us.
Ms. Nelson: On that point, in the Morgentaler decision, the Supreme Court said that the courts are empowered to act where administrative procedures deny right of access under penalty of the criminal law. You have that in the Supreme Court from 1988, as well.
Senator Batters: Other than Mr. Stamatakis, do any of the other witnesses on this panel currently live in Vancouver? No? Okay, thank you.
Senator Jaffer: To the witnesses who provide health care, I understand that Insite also leads to other services that look to the long-term: people to get a place, detox, rehab, et cetera. Can you address the collateral services that come with having a place like Insite?
Ms. Gagnon: We have a lot of data on this, showing that around 65 per cent of people who use the services at Insite actually require wound care. There's a lot of wound care involved in providing services to people who use drugs, in general, but this is a point of contact you can really make use of to prevent severe infections due to injection drug use and complications like septic shock and endocarditis that require prolonged hospitalization and ICU admissions.
This is a piece we know for sure is really strong.
We also work in terms of prevention. It's a point of contact for immunization. You can use it for testing for things like sexually transmitted infections, HIV, hepatitis C — initiating treatment and connecting people to care, as well. For HIV, particularly — I can speak on that specialty, because that's mine, really — when someone tests positive, you really need to work hard at that moment to link people to care, especially if that person is from a marginalized group or is someone who has had a bad experience in health care in general to ensure that person is connected to care.
There are a lot of activities around education and harm reduction, and accessing supply but also the knowledge; like how to keep your veins functional in the long term, how to inject properly so your techniques are safe but also preserve vein function, which is really important for people who use drugs. It is not just for them to continue to inject — if they do wish so, we'll still be there to offer care to them — but if one day, they require health care, they need vein access, so this is also an important piece.
The Chair: I'm trying to get all the senators in here.
Senator Plett: I would like to ask the witnesses around the table here just one question as individuals rather than as professionals. You all obviously have homes in whatever communities you live in. Given that Tom Stamatakis from the Canadian Police Association and other police enforcement people have clearly indicated that such facilities lead to an increase in criminal behaviour in the community, not a decrease.
So as individuals, as homeowners, do you believe that the community should have a strong voice in whether this type of facility opens up in your neighbourhood?
Ms. Jesseman: I would take that in a different direction and say that this is an opportunity to start a dialogue on why there is stigmatization of people who use drugs and to take the opportunity to educate communities about the fact that addiction is a disease and, as my medical colleague stated, not a lifestyle choice.
Senator Plett: That, of course, wasn't my question, but thank you.
Ms. Gagnon: I live in Hull, and on the other side of the river are a lot of people who use and inject drugs. I want to point out that whether we open a supervised consumption site or not, people inject, no matter what. This is not a decision based on whether opening a supervised injection site will have an impact on people who inject. People are injecting drugs as we're speaking.
These sites are about life-saving and essential health care services not necessarily about having a real impact on the number of people who inject.
Community consultation is one thing, but having an equal say in life-saving essential health care services shouldn't be the same for the everyday general population receiving health care from a provider. I think there needs to be a balance, to speak to Dr. Blackmer's point, where expertise and science has more weight than public opinion. I think we've heard from Mr. Stamatakis that opinions do change and that, even within the police community, there seems to be a wide range of opinions.
Senator Plett: You should be politicians.
Ms. Gagnon: That might be my next move, so watch out.
Dr. Blackmer: In the Supreme Court ruling, one of the five considerations they recommended was community opinion and support. I think we all recognize that's an important factor. But to my colleague's point, it certainly should not be the deciding factor.
Ms. Nelson: I look back to the Supreme Court decision as a lawyer. Paragraph 28 talks about the Chinese Business Association being supportive of Insite. I go back to the Supreme Court decision. They had a three-week trial with many experts, and that's where I ground my findings and facts.
Senator White: Just a follow-up, Ms. Gagnon, if I may. You talk about what access these people would have to medical facilities as a result of Insite. Isn't it true that our community health centres provide exactly that service now when they go to pick up needles, when they go to homeless shelters, when they go for meals? They get exactly the same service you just described at an Insite facility.
Ms. Gagnon: I would not say they have the exact same services. The core service being provided here is being able to inject yourself while having access to health care providers.
Senator White: I mean around wounds, cuts and testing. They go to a medical facility to pick up needles. They're obviously getting the same service they would whether they are injecting in that facility or not; isn't that right?
Ms. Gagnon: The difference in the point of contact is that if people come to inject and you start to build up trust, they will come to you for services that they may not go to because of trust-building.
Senator White: I keep hearing the word "drugs.'' We're not talking about pharmacological drugs; we're talking about tar — poison. We're not talking about something that a pharmacy has developed and approved. We're talking about something that kills people, that we're going to allow them to inject into their veins.
Ms. Gagnon: I want to respond by saying that people inject fentanyl — and I've administered fentanyl almost every day of my career as a nurse — and people inject heroin. Chemically speaking, it's not very different from morphine.
Senator White: That's not what they're injecting though. That's not what they're buying on the streets.
The Chair: I want to thank all of our witnesses for appearing today. We very much appreciate your input into our consideration of Bill C-2.
For our second panel today, I would like to introduce Donna May and Dean Wilson. By video conference from London, Ontario, representing the Urban League of London, Mr. Greg Thompson, President.
Again a reminder that this panel is scheduled for one hour. To the witnesses, you each have five minutes for your opening statements, and I will try to keep you to that. We will begin with Ms. May, followed by Mr. Wilson, and finally Mr. Thompson.
Donna May, as an individual: Thank you, senators and committee members. I appreciate the opportunity to have my voice heard here today and to have the opinions of myself and my deceased daughter, Jac, considered by the Senate committee.
I believe we can all agree that the lived experience that comes from being a mother of an addict and the point of view of an addict who has lost everything including her life to her addiction is most valuable to these proceedings.
I will begin by admitting to you that prior to January 2012, my views and opinions on safe injection sites would have mirrored those of our current Prime Minister and our Minister of Health. My conservative upbringing had allowed me an opinion and provided me reason to take a stand that, in truth, I had absolutely no meaningful education in or experience with. If not for a phone call on January 9, 2012, I may never have opened my willfully blind eyes to see things as they truly were.
The call that came on that day began my personal journey into the realities of addiction and forced me to consider the undisputable science, the statistically supported epidemiology and the plethora of studies that have been conducted on the subject. It had me rethinking my position and checking in with my heart while disregarding what my head had always told me. It had me considering the issue of addiction from an addict's point of view.
The caller that night told me that my daughter, Jac, had presented in their emergency room with flesh-eating disease and was about to undergo surgery to amputate both of her legs, hoping that in doing so, it was going to save her life. I was also told that her problematic substance use had left her malnourished, critically immune deficient, and that she had been brought in from the streets, where she had been living for quite some time.
On my arrival at the hospital, I was informed that my daughter had not received treatment in time and would soon lose her life. Unsanitary conditions that surrounded her when she injected the additives used to cut the heroin and the needles that she had shared while living on the streets were all determinants that would lead to her death. The caller also pointed out to me how preventable each of these situations would have been had a safe injection site been available for my daughter's use.
At the age of 55, I was about to be widowed from my 34-year-old daughter, and I had to accept the fact that I had missed or dismissed every single opportunity to get my girl help up to that point, and it was now too late.
As you might imagine, I was paralyzed by this acknowledgment. The worst of it all, though, is that I had absolutely no idea how to make things better.
My daughter, on the other hand, knew exactly what had to be done, and she had the courage to ask me to stand up after her death and speak in favour of addiction and addicts, to use her voice to support them. She simply asked that I take the time to understand what it was like to be a person with a disease of addiction and to share that knowledge with others.
If I were to impose on you, I would ask you this one question: If smoking, drinking, sugar, salt, even negative thinking, all have the potential to significantly impact our health, why are we not required to jump through hoops to prove the efficacy of treatment for smoking cessation, alcoholism, diabetes, heart disease, high blood pressure, anxiety disorders or mental illness? I'm wondering what your answer to that question would be.
What is it that is so difficult between any other medical condition and the condition of addiction that would be just cause for imposing such onerous sanctions to be met before one is able to open a safe injection site? Sadly, my personal belief is that the only difference is our attitude towards the name of what that disease is.
The gift that has come out of losing my daughter was that I recognized I lacked compassion for addicts and for addiction itself. I was ignorant of the condition, and that ignorance only fuelled my fear. I'm also afraid that I'm not alone. Not until I allowed myself to question how I had formed these misguided beliefs and allowed myself to determine their efficacy did I recognize how wrong I had been.
I'm now here asking you to clear your mind, to revisit each of the 27 conditions that Bill C-2 requires be met before an application for a safe injection site is considered. I'm asking you to see each of these conditions through my daughter's eyes and through the eyes of anyone suffering from addiction, and then tell me I'm wrong in asking you to right the wrongs that Bill C-2 will impose.
Dean Wilson, as an individual: Thank you for letting me have this opportunity. I remember a Canada that once waged peace, not war; a Canada that invested in universities and not prisons; and a Canada that held up our most disenfranchised and said, "You count because you, too, are Canadian and we don't leave anyone behind.'' But alas, that Canada is slowly but surely being eroded by legislation such as Bill C-2.
What Bill C-2 essentially says to our most misfortunate is "Go die in an alley.'' I was one of the plaintiffs in all three trials over Insite, and all three judgments agreed with the science. Insite did what it said it would do.
Contrary to what Mr. Stamatakis opines is that crime has actually gone down around the centre, and we have more people entering detox and treatment and staying longer. I know. I am one of those people. I was addicted to heroin and cocaine for almost 40 years before I entered the Insite centre and started my long journey towards sobriety.
What bothers me is that people believe that treatment and harm reduction protocols are mutually exclusive. They are not. They are both part of the same health continuum. We wish that all people would take up standard treatment, but that is not the case. Many have had extremely bad outcomes when dealing with the health system, and those are the ones we target at Insite. Many of those resistant to standard treatment blossom under our regime. I know it sounds paradoxical, but by allowing them to use the consumption room, we are able to build relationships that allow those who are resistant to enter into more traditional protocols.
I am aware that the government believes only in those traditional treatments, but that also is an out-and-out lie. The last Auditor General report dealing with the drug issue stated that out of every dollar spent, 95 cents goes towards enforcement, leaving only 5 cents for things like treatment and those silly antidrug ads that make my kids chuckle. This incenses me to no end as there is absolutely nothing humorous about addiction.
It is also ironic that it took Insite to open the first new detox and treatment centre that I am aware of in Vancouver in the last 25 years.
We also have the courts on our side. The Supreme Court voted nine to nil to support Insite. That included four of the most conservative judges on the bench.
I ask myself why the government is so resistant to Insite. Are their reasons solely based on ideology? If that is the reason, I will hold everyone involved personally responsible for any deaths that occur due to the interruption of services at Insite.
We have now been open for over a decade and the world has not ended. In fact, we have saved hundreds from deaths due to overdose and prevented thousands of HIV and HCV infections. That alone has saved millions of dollars, and for a government that prides itself on fiscal responsibility, you would think that they would support any cost- saving initiative.
We also have science on our side. Out of the almost 100 peer-reviewed articles on Insite, only one has not supported the centre, and we now know that the RCMP actually paid for that research, so I can hardly put much faith in it. We have documented everything that has happened at the centre, and the numbers continually support our efforts.
Now, on to the bill. I have been involved since the very beginning. I was present at the original meetings held by Health Canada, where we spent days on how to keep the community safe while offering these services. We engaged the Province of British Columbia, the City of Vancouver, and the Vancouver Police Department and came to a consensus that appealed to all of us. We then went to the people of the city of Vancouver and they supported this initiative overwhelmingly.
This new Bill C-2 puts too many cooks in the kitchen. It gives a voice to those who do not have a vested interest in the drug problem. It also puts an undue burden on those who need this service. This is exactly what the nine Supreme Court justices voted against. So again I ask: Why is the present government against this life-changing centre?
In closing, I would like to add that I truly hold the higher moral ground in this argument. I choose to help save the lives of the world's most unfortunate. The only comparison I come up with when looking into where a medical condition has been criminalized is with the lepers of Biblical times, and we all know who supported them. I would also venture that were Jesus alive today, he would support any initiative that would save the most vulnerable lives.
And I'm going to add one more thing from my written statement. Not all crime is committed by addicts. In fact, I don't think Senator Duffy is an addict, but then I may be wrong.
Greg Thompson, President, Urban League of London: Good morning, honourable senators, ladies and gentlemen, and my apologies for not being able to make that trip to Ottawa today. I have the privilege of speaking with you today in my role as the president of the Urban League of London, a not-for-profit that acts as an umbrella for neighbourhood associations across the city. With no paid staff, the league is as grassroots as it gets. Our focus is on supporting healthy and dynamic neighbourhoods. I'm not here to engage in debate on the merits of safe consumption sites as good public health policy. I have no expertise nor do I have preconceived notions on the matter.
For those who view neighbourhood level organizations as "nimby'' factories and expect that I am here to offer knee- jerk arguments against the safe injection sites, there may be some disappointment. If the evidence leads me there, I, like most people I know, am quite willing to accept that safe injection sites offer positive public health outcomes for IV drug users and that allowing such sites to operate can be sound public policy.
However, coming from my own Downtown Eastside neighbourhood here in London, my lived experience provides its own kind of knowledge; namely, that social services providers generally do a poor job of integrating themselves into functioning neighbourhoods and business districts in ways that promote the best interests of their clients and the surrounding community.
These well-meaning people suffer far too often from what I like to call "treatment brain,'' which I define as the belief that the only thing that should matter to the operator of the service is that the clients they serve receive the services they offer and that anything else that happens as a by-product of providing these services once the client exits the building is someone else's problem and not their responsibility. This is where the disconnect occurs between community health and healthy communities.
My city was one of the first to implement zoning controls for methadone clinics as a way to attempt to mitigate these negative social and economic impacts. As a result, I have spoken with hundreds of neighbourhood folks right across the country who are trying, in their own neighbourhoods, to balance the legitimate needs of the most vulnerable among us to receive the services they need and the equally legitimate needs of local residents to operate businesses and circulate freely within their neighbourhoods free from abnormal levels of antisocial or criminal activity.
We must remember that the safe injection sites would exist not only as idealized locations on the harm-reduction continuum of service, but also in real brick-and-mortar locations, which would likely be in business districts in downtowns.
We note that the legislation as written requires the applicant to solicit community input on the impacts of the activities at the site and to make a determination of relevant community concerns and potential mitigation measures as part of the application for an exemption. We cannot state strongly enough that this just isn't good enough.
Representatives from the affected neighbourhood must be allowed to formally participate with the applicant in a legitimate community evaluation of local impacts and mitigation measures that would form part of the application file. If the exemption is considered prior to the selection of a particular site in the municipality, then the approval by the minister ought to be contingent on the receipt of this community impact statement once the site has been selected.
Real collaboration between groups with competing interests can be hard and messy, but the outcomes will almost always be superior. A requirement for meaningful collaboration between applicants and affected neighbourhoods would clear the way to a better understanding of one another's perspectives and result in legitimate accountability and feedback loops between the parties. It would also enable some real creativity and innovation to emerge in shaping how services can be delivered in ways that are not only respectful of the local neighbourhood but also of the service provider and, most importantly, the clients they serve. Give people the chance to do the right thing, and they will often surprise you.
Thank you for giving the League the opportunity to participate in your deliberations.
Senator Baker: Thank you to the three presenters here this morning.
Mr. Wilson, you said in your presentation that you were addicted to heroin and cocaine for almost 40 years.
Mr. Wilson: Yes, sir. In fact, over 40 years.
Senator Baker: Over 40 years.
Mr. Wilson: I'm 59.
Senator Baker: You visited Insite. Could you explain to those people watching and listening and to the committee just how Insite was able to help you overcome this addiction?
Mr. Wilson: What people don't realize about Insite is it is a three-storey building, and only one small part of the first floor is the consumption room. The next floor is totally dedicated to a 24-bed detox, and the third floor is treatment and transitional housing. When you leave detox and have to wait four months to get into treatment, you are allowed to stay there so that you don't go back to where you were and throw away those 10 days of detox before getting into the treatment centre.
By using the center as an injector — because at the time I was semi-homeless, at least couch surfing — they knew I wanted to get out. Nobody wants to be an addict, and nobody wants to be an addict in the Downtown Eastside.
They kept saying, "Well, Dean, you only have to go upstairs.'' I said, "Yeah, yeah. I have been to detox. It's not going to work.'' I've been in 25 detoxes and never stayed more than 19 hours.
I tried three times with Insite. The third time, which was six years ago, I walked away, and I'm here today as straight as you are, sir.
Senator Baker: Were you ever charged with possession of any of these —
Mr. Wilson: Yes, sir.
Senator Baker: These are Schedule I drugs, and trafficking of a small amount, life imprisonment, very serious offences. You were able to go into the safe injection site.
Mr. Wilson: Yes.
Senator Baker: Did you inject the cocaine and heroin or did you inhale it?
Mr. Wilson: I wouldn't waste it in my nose, sir. I put it right in my arm.
Senator Baker: You went through that procedure of going there and eventually progressing up.
Mr. Wilson: Well, what happens is when leaving there — and answering your earlier question — we don't want anybody leaving and walking right out and dying. We have what we call the "chill room.'' They go in and sit down, and we watch them for 15 minutes. In that time, the people who work there start talking to people, and that's where I would say, "Geez, I hate this. I wish I didn't have to come here.'' They kept hounding me, and it's the best hounding I ever had besides what my mother used to say to me.
Eventually it got through. I just said, "That's it. I want to go upstairs.'' They marched me upstairs right then.
Senator Baker: Do you work there now?
Mr. Wilson: I do not work there now, no.
Senator Baker: There's a provision in this bill that says anybody even with a youth criminal justice record has to be exposed if they work or assist in those centres.
Mr. Wilson: Right.
Senator Baker: What do you think of that provision?
Mr. Wilson: The way it is right now, there are two on at all times, addicts that could be active — they might not be — that only work in the chill room. They're not allowed to go anywhere else in the building. Those are the people we use to recognize if anybody is about to go into an overdose, because there's nobody better than an addict to watch another addict if they're about to die.
I think we need those people in there, because in 2002, when Health Canada brought me here to Ottawa to talk about supervised injection sites, they said there'll never be anybody with a criminal record or an active addict in that building except in the consumption room. I said, "Then we won't open them, because it won't work if we don't have people who understand the other person.'' I don't want them in the consumption room. That's no good. But in the chill room, it works beautifully. It worked with me.
We have higher retention rates and longer stays than any conventional detox in the Lower Mainland.
[Translation]
Senator Dagenais: I'd like to thank all three witnesses for being here today. My question is for Mr. Thompson.
Mr. Thompson, you weren't planning to discuss the issue of supervised injection sites. Nevertheless, if empirically sound healthcare services are to be delivered to patients safely, in a competent and compassionate manner, they have to be provided in hospitals and clinics.
In my view, we need to encourage people to seek treatment. We need to educate people on safe versus risky injection practices. We need to encourage users to overcome their addiction and we need to put drug treatment programs in place.
I'd like to hear your thoughts on that.
[English]
Mr. Thompson: Thank you for the question. I agree with everything you say. I can speak for the people I know.
The organization I represent has no qualms with Bill C-2. Our issue lies with the recognition of the impacts that will be felt by neighbours in which these sites exist, is that the bill hasn't gone far enough.
We need to have some formal recognition that clinics, safe injection sites, exist in actual neighbourhoods. We want these neighbourhoods to be inclusive for everybody. The only way we can do that is if we have trust between service providers and surrounding neighbourhoods.
That's really the perspective that I hope to bring this morning to these discussions. Let's not forget that this is not about demonizing anybody, and let's not forget that the ability of all folks to circulate in their neighbourhood is also a public health benefit.
Senator Jaffer: Thanks to all three of you for your presentations. They are very tough presentations to hear, so thank you for taking the time and the pain to come here for us to hear you.
I have my first question for you, Ms. May. When I was listening to you, the word that kept coming to me is "stigma.'' It's easy for those of us who have had life easier to not understand the challenges other people have. The Supreme Court made it very clear that this was a disease. Unfortunately, many of us don't see it as a disease. You have gone through this journey. What do you think we should be doing to deal with raising the awareness of Canadians that this is a disease and to stop stigmatizing people who have this disease? What kinds of messages?
Ms. May: Thank you for your question, Senator Jaffer. I've been working on this since my daughter passed away. Public education is a total necessity in this case. I have been working with many people, many organizations to produce a program similar to the Bell Let's Talk program where public education and awareness is made available to those who, fortunately for them, live a nice lifestyle. They don't have to deal with the things that I have had to endure.
I think a very important first step would be for our politicians to recognize it as a disease, listen to their constituents in the community. I know that I have knocked on many doors of our MPs, our MPPs and my councillors, and they seem to treat it as this horrid thing, please don't bring this up with me. But the reality is it could be anybody's child. It doesn't have to start with a street drug. My daughter's addiction did not. It started with a prescription for Oxy when she fell down the basement stairs. What she found was that it quieted the voices in her head and she had an undiagnosed mental illness problem.
More to your question, though, I think it is people like me — moms, dads, family — who can stand up and boldly speak. Believe me, this isn't fun; I've been stigmatized and discriminated against myself because of my daughter's substance use. I am the mother of an addict. My daughter died. I'm going to make changes and I'm going to fight for them right till my end.
Senator Jaffer: Mr. Wilson, you heard the police officer speak. We ran out of time, so I couldn't ask him this question: Insite is only one part of the drug policy of Vancouver. Vancouver is a large city with lots of problems. It can't answer all the questions.
He was saying there are needles elsewhere. Of course there are, because Insite just deals with a small population downtown. Can you address what he was saying?
Mr. Wilson: Geographically in Vancouver, there are 10 square blocks we call the Downtown Eastside, and those 10 blocks have been known as a pretty rough area since back in the days when we had a lot of economy going, when we had the miners and the forestry people, and we have all these hotels. They're all now very disreputable and all of those people have moved out. They were taken up by people on welfare because it was the only place you could get a place to stay for the $375 a month that welfare would give.
All of a sudden, because of those policies, we now have all these people who are on welfare and addicts moved into this one centre because it's the only place in Vancouver in the Lower Mainland where you can afford to live. Obviously, now that we're surrounded by water on three sides and the city is starting to move down our way, we're in the middle of this gentrification battle. I was part of the Woodward's development. We've done marvellous work.
As you say, Senator Jaffer, Insite is just one small bit. I wish that we had more treatment centres. I had to wait in the old times to get into detoxes. I had to wait for months to get into treatment.
I wish that everybody would just say, "Okay, I can handle standard treatment,'' but some are resistant. And the ones who are resistant seem to cost us the most in both medical and judicial systems.
As I say, it's kind of paradoxical, but by allowing them this small little thing, we seem to have gotten to them and we've been able to talk to them. They got to me, and I was no poser man. I was an out-and-out addict for 40 years. Anybody who can change this dog, it has to be something.
Senator Plett: Thank you to the witnesses, specifically Ms. May and Mr. Wilson. Thank you for being here and sharing your story, Ms. May.
Congratulations to you, Mr. Wilson, for being able to kick this terrible disease.
My question, however, is for Ms. May, and I want to be very sensitive when I ask this. In your presentation, you've used smoking, alcoholism, diabetes, heart disease, high blood pressure and so on and so forth, and you talk about the treatment for these. Of course, I'm one of many people who have high blood pressure and my doctor is trying to bring that blood pressure down. He's not trying to help me just stay alive without it; he's trying to bring my blood pressure down.
Our colleague Senator Batters has for years been working actively with people with mental illness and trying to deal with those issues, and was just recently awarded quite a prestigious award for her work in that.
Ms. May, we have heard so many people here talking about Insite and the good work that Insite does, but I have yet to hear one of them, except for Mr. Wilson today, to some extent, saying that we are working at trying to get people off of these drugs.
Would you not agree, Ms. May, that even for Insite, a place where people can go where they aren't stigmatized, they will get a clean needle or whatever the case may be, their primary focus at that point should be to help these people get off of these terrible addictive drugs?
Ms. May: Thank you for your question. I'm going to use the analogy of leading a horse to water and making them drink. Can you?
There were multiple times that I remortgaged my home, took out lines of credit, drained my personal savings, dragged my daughter into detox. There were times when I locked her in a room, thinking that it was the best thing for her. Our laws don't provide me with the opportunity to demand that she get treatment, and I don't think anybody who isn't ready to receive treatment will receive it the way that we think that they should.
I don't know that my daughter ever would have accepted treatment or that she ever would have been successful in being sober. There were a number of things that happened in her life, some childhood traumas, the death of her father, my living outside of her city, which contributed to all the angst and everything that fuelled her mental illness.
As I stated before, the Oxy that she found made her well and made her able to function in society. What happened was the doctor stopped prescribing it. She turned to the street, and when she couldn't get it on the street, she turned to fentanyl. When she could no longer get fentanyl because the Patch for Patch program came in, she turned to heroin. It was just a progression down the street.
Had proper mental illness procedures been implemented and she had been diagnosed correctly, I don't think I'd be sitting here talking to you today, and I would be very happy with Bill C-2.
Senator Plett: Of course, I think we all realize that doctors prescribe drugs far too easily. I certainly support that, but that's a different issue.
You've said that you were prepared to literally give your life to help your daughter, and I'm sure you would have done that.
Ms. May: I am now.
Senator Plett: But the question still is that even though we need to do it with love — Mr. Wilson used the example of our Lord and saviour and the love that he showed. Do you not agree that our main objective should still be to get them off of the drug? And if that's not possible, it's not possible, but that should be the main objective for all health facilities, if you will. Insite is being called a health facility.
Ms. May: I spent the last six months at my daughter's side watching her die. Would I have preferred her to be sober? I have to be really honest with you on this. At that time, no, I would not have preferred her to be sober. She had gaping wounds. She was in horrific pain from cryoglobulinemia and granulocytosis, diseases that are known to injection users. It had gone too far. At that point, no, I wanted her to keep using. I did not want to see the pain she was in, both psychologically knowing that she was dying and physically in pain.
When there was a chance, maybe two years prior, yes, my goal was to have her healthy and sober, but that wasn't her goal.
Senator Fraser: Thank you to all of the witnesses. All three of you are saying important things.
Ms. May, your daughter and what you have said about her and her last wishes, sounds like a remarkable woman, and she has a remarkable mother.
Ms. May: She was very inspirational.
Senator Fraser: I take it that your daughter was not living in Vancouver?
Ms. May: My daughter was living all over the place, actually. She was in Sault Ste. Marie for the majority of her drug use.
Senator Fraser: So she was not there for —
Ms. May: She had visited Vancouver.
Senator Fraser: She couldn't have access to a safe injection site.
Ms. May: Correct.
Senator Fraser: She was not near Insite. Did you ever talk to her about safe injection sites?
Ms. May: I'm sorry, as she was dying?
Senator Fraser: At any time.
Ms. May: Yes.
Senator Fraser: And did she think that would have made a difference, the availability of something like Insite?
Ms. May: What she mainly talked to me about was how dehumanized she had felt and how she'd felt there was no support, no consistent support. There was one person in her life who was actually a welfare worker who did reach out and really try to get her into a position where she could get the treatment, the housing and the welfare money she needed. But when you're high 90 per cent of the time, you don't follow advice.
Senator Fraser: It's interesting you used the word "dehumanized.''
Ms. May: She was dehumanized by me, by her family, by society.
Senator Fraser: Last night we heard a witness from Insite say that one of the things he thought was important about Insite was that when addicts go there, they are no longer dehumanized and they are no longer confined to the society of other addicts. On the strength of your now very considerable knowledge of that world, do you think that's an important element?
Ms. May: It absolutely is. There's nothing more important than having somebody who is addicted to a substance be able to walk into a place and feel that they are welcome, that people understand what they're going through, whether it be coming down or going up. All the things that I didn't understand and didn't care to understand about my daughter could have been found for her in a site like that.
I can't say enough good things about Insite and the services it provides, and I didn't come to that judgment lightly. I had to educate myself. I had to see for myself. I had to work with people like Dean, interview them, talk to them, find out what it was that would have made a difference or could make a difference for them in their substance use.
I'm not directing my position at sobriety. I'm talking about keeping them safe and letting them live for another day, recognizing that they are a human with a disease and build them that way. Yes, my end goal is always to have sobriety, but really, who of us is sober? We all have something that elevates our moods, all of us.
Senator Fraser: They do say that people who jog do so in part because they get a high. I do not jog.
Ms. May: I exercise like crazy.
Senator White: Thank you. My condolences for your loss.
Ms. May: Thank you.
Senator White: I wanted to ask Dean a question, if I could. You talked about crimes being committed by drug addicts in particular, in the community you live in. I've heard numbers. I've heard the 48 crimes per addict per day and the 20 crimes per day for some addicts.
How many crimes per day do you estimate you and the people you were hanging around with were committing every day to satisfy your addiction, understanding that you have parliamentary privilege here; that you can say what you like without it being held against you?
Mr. Wilson: Whether I have that privilege or not, I always say what I want to say.
I didn't do a heck of a lot of crime because I've always been pretty good with my mouth in doing things and I've been fairly intelligent. I've always been able to make money, but for many that's not an option. With women, it's only one thing; they sell their bodies. That's it. With men — let me say, when I say property crime, the crime I did, most property crime is done by addicts. Let's face it. The big dollar crimes —
Senator White: Different story.
Mr. Wilson: — addicts don't get anywhere near that. If somebody breaks into my house, I'm pissed off like everybody else is. I don't think it's right. I've always said, and as my old partner used to say, if somebody steals a car and says they did it to get drugs, they're still a car thief. Let's face it. But the thing is that they're being driven by something that is controlling them and that they can't stop. If we don't do anything about it, they are continually going to steal those cars.
Senator White: I appreciate that. Thanks for your honesty. When we consider this, we're considering it within the paradigm that we've already developed, that people will commit crimes to get money to buy drugs illegally to use them in a facility that's provided by health care. That's what we're talking about, but there are alternatives to that.
The United Nations have talked openly and positively about the Swedish drug policy, for example, that doesn't use harm reduction as the third leg of the stool; it's prevention, treatment and control. They actually force people who commit crimes to buy drugs into treatment, and the success rate they have, according to the United Nations, is higher than ours.
Mr. Wilson: Let's be honest about Sweden. They have the lowest drug rate amongst any of the countries in the free world. Second, they have treatment on demand. If I want treatment, there's no such thing in this country, sir. You want to get into a detox, you wait 35 or 40 days, and by then maybe your situation has changed. If you want to get into treatment, it's a good three to four months.
Senator White: I appreciate that. In Ottawa it's six months. In fact, I was looking at British Columbia, and it's anywhere from six weeks to four months for treatment.
So instead of 100 officers being reprofiled or hired, and the $15 million that would cost — instead of the $3.5 million just for the supervised injection site — not for the rest of the facility, which I appreciate provides a very good community service. Wouldn't you rather see that $18 million better spent on providing immediate residential drug treatment to the people who need it most?
Mr. Wilson: Yes. I will be honest: I think that we need a lot more standardized treatment. But you know what? Just like with all alcoholics, there are going to be those that are resistant. Are we going to allow them to spread HIV and HCV into our communities because we're saying, "Okay, they're not like everybody else; they're resistant to treatment, so we will forget about them?'' No. We have to include them in the same package. If that is opening one little site that has been open for 10 years, and the world has not ended, then so be it.
If we spend $3 million on a small group of people that are probably costing the health and the judicial systems millions and millions of dollars, I think it is a small price to pay.
I'm not suggesting that we put them everywhere, willy-nilly. I think we need a comprehensive look at whether it's going to be good for the community. Somebody mentioned earlier that harm reduction also means harm reduction to the community. I firmly believe in that. And we have got to look at everybody in that community.
But Vancouver saw that we needed something different, because it wasn't working. Now 76 per cent of the City of Vancouver supports that small, little building.
Senator McIntyre: Thank you all for your presentations. Ms. May, my sympathies for the loss of your daughter. I'm sure you did everything it in your power to help her.
Mr. Wilson, I'm glad to see that you left the first floor of Insite.
Mr. Wilson: So am I, and so is my family, to tell you the truth.
Senator McIntyre: One never knows. Maybe one day you will take up running.
Mr. Thompson, in your brief, you mention the requirement for meaningful collaboration between applicants and affected neighbourhoods. As you know, the bill calls for three levels of consultation. The first level is the letters of opinions from the provincial health ministers, public health officers and law enforcement officers. The second level of consultation is with professional licensing authorities, physicians, nurses and community stakeholders. Finally, the third level is the 90-day public consultation period, where a broad range of stakeholders, particularly those working and living in those communities, would be consulted.
Are you satisfied with this process as framed under Bill C-2?
Mr. Thompson: Thank you for the question, senator. No, I'm not; nor are we in the City of London. I suspect that lots of neighbourhood groups across the country won't be, either. It is for this reason: We have lots of opportunities for community consultation in planning matters at the municipal level, but they're not always meaningful. So when I hear a requirement such as 90-day window for community consultation, I think that's fantastic, and a safe injection site would be of interest to lots of communities across the municipality, pro and con, but the social costs and economic costs imposed on a community are imposed on one community. I call that the "affected neighbourhood'' — the neighbourhood that immediately surrounds that.
This is nothing to do with not wanting the best services for the most vulnerable among us. It is about recognizing that all harm-reduction facilities exist in a particular place and in a particular local context. I think that requires that the applicant give a higher regard to trying to involve local people in discussions about how we measure impacts and how we mitigate them. And that has nothing to do with trying to design harm-reduction strategies. That's about the stuff that happens outside the door.
Senator Batters: Ms. May, I'm very sorry for your loss, and I hope that you will find that what you are doing here and what you continue to do with her memory helps you in your journey.
Mr. Thompson, you were just talking about a particular local context, and you have a significant particular local context in your community of London, Ontario, where you are the President of the Urban League of London. Could you tell us a bit more about your experience in London, Ontario, dealing with this very issue, the issue of safe injection sites?
Mr. Thompson: Thank you for the question. We have no experience in London dealing with safe injection sites, of course, because we only have that network of de facto sites that operate in every major urban centre, public health units and community health centres and things like that.
Senator Batters: So I can get you to the point, I'm speaking specifically about something from a few years ago. There was a proposed site that was discussed, and I have read an article talking about the firestorm of opposition that was predicted for it. You were quoted significantly in that, so I'm just wondering if you can take us back to that and what you found in that time frame, dealing with the community of London and what was proposed at the time.
Mr. Thompson: Yes, I think it was my ward councillor at the time who made the comment and politicized an issue that I don't really think needs to be politicized in that kind of nonproductive way.
These kinds of discussions are always difficult, and nobody in any municipality and in any neighbourhood can predict how one's neighbours are going to react to things like that. So, in all fairness, in that particular case, there was a firestorm of opposition because the question was mooted. It came out of thin air; it came from nowhere. Particular sites were being talked about. There was no way for people to truly understand what the impacts of that would be, other than the impacts that we know we have with methadone clinics and dispensing pharmacies. That's our example of impact.
With no rules in place, with no idea of who was operating the facility, what the facility was going to be about and not really understanding the science behind safe-injection sites, it got politicized and became a challenging issue for everybody in the City of London to deal with.
I don't know if that answers your question.
Senator Batters: I'm looking at this article by Jonathan Sher of the London Free Press from Monday, October 14, 2013. In the article, it says:
. . . But if public health officials convince their board to try to make London the second city in Canada to provide a secure place for heroin addicts and others to shoot up, they'll find Thompson directly in their path.
They have you quoted as saying: "There will be a firestorm, and I'd be at the head of it along with a lot of reasonable people.''
Did they misquote you in that, or did you say that at that point?
Mr. Thompson: Mr. Sher did misquote me. We had this discussion locally. At that point, knowing what I knew then, and being responsible for a particular neighbourhood in which many people feel has a concentration of social service agencies in it, I would have been at the head of that. I wouldn't have used those words, and I think we have all grown a lot since then. I hope we have grown a lot since then.
Senator Batters: Later in the article — it is not a direct quote — but it said:
. . .Thompson says there's a difference between the East Vancouver neighbourhood that became home of the injection site and every community within London. The former was already so overrun by drug addicts that an injection site couldn't possibly make the area worse. . .
Again, was that a mischaracterization?
Mr. Thompson: It was definitely taken out of context. These are discussions I have had with Mr. Sher after the article was written.
Senator Batters: Did they write a retraction or clarification to that?
Mr. Thompson: I don't think they did, but I don't think that, at that point, anyone thought it was going to be that important. I certainly didn't. I moved on to other things.
Senator Baker: Ms. May, I think that you have given us an excellent reason to support the safe injection sites. I mean, you have outlined exactly why Mr. Wilson is absolutely correct in his judgments. Thank you.
[Translation]
Senator Dagenais: I'd like to come back to Mr. Thompson. Obviously, drug use is a complex issue. Tackling it requires the cooperation of both health and public safety professionals, and society, at large, needs to have a say as well, as you mentioned. You said places like injection sites shouldn't prohibit neighbourhood residents from circulating freely.
Do you agree that we have to ensure injection sites operate in accordance with high standards, as Mr. Stamatakis indicated, before opening new ones? And the standards I am referring to are actually very high.
[English]
Mr. Thompson: Yes, I do. We need to be intentional in how we design these kinds of facilities, if these kinds of facilities go forward. We have to design it in a way that the facility interacts with the street — because these facilities are almost always in downtown or downtown-adjacent neighbourhoods, in secondary business districts which typically act as the centres for functioning neighbourhoods.
Yes, these are exactly the kinds of questions: How do you mitigate potential negative impacts? We need to wrap our minds around that. It is for that reason that I suggest that collaboration between the local community and the service provider is so important.
Senator Plett: Mr. Wilson, in response to Senator White's question, you did talk about crime rates. Mr. Stamatakis told us clearly that they had reallocated 80 police to a five-block area around Insite. I'm not sure that I understood you correctly, so I don't want to put words in your mouth. I apologize if I'm not stating this correctly, but I fail to see how Insite — it can probably help in many areas — can help with crime rates because the drugs still have to be purchased. They're still illegal. Insite isn't giving drugs. They're only giving a needle. So the drugs still have to be purchased.
Where does this help with the crime committed by the addicts? They still have to find the money — prostitution, robbing, whatever.
Mr. Wilson: I'm glad you asked this question because I was about to say something to Senator White. Do you know for the three budgets prior to even talking about supervised injection, the police were asking for those 80 police officers to be reallocated there anyways. They should be happy Insite opened because until then the Police Board denied them. It was only when the supervised injection site came on that they actually said, "Yes, we will do it.''
Senator Plett: Please answer the question: How do the people get the drugs?
Senator Baker: That's an answer.
Senator Plett: It is not an answer.
Mr. Wilson: I'm explaining something, sir. It also sets in the second motion. I'm also an advocate for the heroin prescription trials. I have also worked very hard and we have also had a successful program there. With the combination of both of those, they won't have to go get their drugs on the street. Not only that but for the first time in any addict's life in the Downtown Eastside, somebody was actually caring about them. They started caring about themselves. I don't know why and again it is paradoxical, but it is proven by science — people started using less.
Senator Plett: Giving them drugs won't help them use less. But thank you for your answer.
The Chair: On behalf of the committee, I want to thank you all of you, as Senator Fraser said earlier, you have been excellent witnesses. You have given us a lot of food for thought. We very much appreciate you being here.
Members, we will now adjourn.
(The committee adjourned.)