Moved second reading of Bill S-229, An Act respecting the development of a national strategy for the decriminalization of illegal substances, to amend the Controlled Drugs and Substances Act and to make consequential amendments to other Acts.

She said: I rise today to speak to second reading of An Act respecting the development of a national strategy for the decriminalization of illegal substances, to amend the Controlled Drugs and Substances Act and to make consequential amendments to other Acts, or more simply titled, the Health-Centred Approach to Substance Use Act. This bill is extremely important to me. As a former front-line police officer, I have seen first-hand the often tragic consequences of substance use. This has been most recently reflected in a Canadian Association of Chiefs of Police report, an unlikely group that we wouldn’t normally expect to support this. I would contend that the current criminalization in the oft-quoted war on drugs approach has proven to be ineffective and ineffectual. Transitioning to a health-based approach is beneficial not only for the people who use substances, but also for the police, the justice system, and health and social services.

Canada is not immune to the presence of drugs and substance use. We are currently overwhelmed by an overdose epidemic, in large part due to the presence of fentanyl and carfentanil in Canada’s street supply. These toxic synthetic opiates have infiltrated not only large urban centres but small towns, including Indigenous and rural communities. Late last year, I spoke with Matt Ingrouille — who has been an officer with the Saskatoon Police Service for 14 years — about his experience working on the street with people who use drugs. He said:

The lowest end of the drug trade is a violent and desperate place . . . . The rise of fentanyl, which was initially used to taint our heroin supply, is now a drug of choice for many. In 2018, the opiate crisis brought us a death every two hours in Canada; 2019 brought 3,823 deaths . . . . Each of these deaths brought pain and suffering to Canadian families and a drain on resources for first responders.

Statistics Canada information from 2019 verifies what Constable Ingrouille is seeing in Saskatoon. Among all drugs, possession of methamphetamine has an incidence rate in Canada of 29 per 100,000 of the population. This incidence rate is second only to the importation and exportation of cannabis, which remains an offence in Canada after legalization. Police services across Canada have indicated that the illegal use of methamphetamine is a growing issue and could be contributing to increases in other types of crime, including violent and property crime.

British Columbia, which continues to be a hub of substance use in Canada, has seen its highest number of overdose calls for medical services in 2020; there were 27,067 calls, which is on average 74 calls per day or one every 20 minutes. In all of 2020 in British Columbia, there were 1,724 suspected illegal drug toxicity deaths, and 2021 has seen 174 deaths in January alone and another 155 deaths in February alone. Four out of five health regions saw an increase in overdoses, and overdose calls were up dramatically in rural areas of this province. It is not just the big cities. Take Fort Nelson for example. They had 20 calls related to overdose. While this number may seem small, Fort Nelson has a population of under 3,700, and 20 calls was a 233% increase over 2019. Perhaps to drive the point home, in 2020, nearly 500 more people died of an overdose than of COVID-19 in British Columbia.

From January 2016 until September 2020, there have been almost 20,000 apparent overdose deaths across Canada. According to the Government of Canada statistics, there were over 1,628 apparent overdose deaths in one quarter alone, April to June 2020. This is an increase of 58% compared to the first quarter of 2020 and an increase of 54% compared to the same time frame in 2019. Calls for help are up across the board.

It is very clear that Canada has a substance use and overdose problem. The current policy of criminalizing people who use drugs has little deterrent effect. Statistics from 2017 show that 30% of all drug offences in Canada were for possession other than cannabis. That’s almost a third of all substance-related arrests. Statistics Canada indicates that from 2010 to 2019, the number of possession-related incidents and charges have increased year over year for most drugs. The drugs that are exceptions to this are cocaine and ecstasy, but overall, the trend is pointing to more incidents and more charges.

The picture I’m trying to paint for my honourable colleagues is that substance use and overdoses are increasing rapidly and dangerously, as are the number of arrests and charges. If criminalization was the way to address substance use, I submit that we should at least see a decrease in use and overdoses, but this simply is not our reality. We must consider an alternative route to assisting those with substance use and addiction problems, and that is what I hope the bill will do.

Bill S-229 will do two things: It compels the government to create a national strategy in order to decriminalize possession of illegal substances for personal use, and it actually follows through with the decriminalization of possession of illegal substances for personal use by repealing certain provisions of the Controlled Drugs and Substances Act at the federal level.

A national strategy would enable appropriate discourse among governments on such a complex issue. There are many factors that need to be considered when suggesting a shift in policy as critical and immense as the one before us today. The idea of decriminalizing possession of illegal substances for personal use constitutionally would require consultations with the provinces and the territories as they are the administrators of health. But public safety and judicial lenses are necessary as well when taking all factors into consideration. Decriminalization intersects many institutions, necessitating leadership and expertise at all levels of government.

Along with government expertise, the health community, the policing community, Indigenous perspectives — those would be crucial — provincial and national organizations and associations, relevant regulatory bodies, those with substance use disorders and so on will all have relevant experience to make the strategy as fulsome and encompassing as possible. Consultations are required to develop the best strategy possible and are mandated in the bill.

There are many considerations laid out in the bill that will contribute to a national strategy, for example, setting specific national objectives to improve the health of those managing a substance use disorder; modifying health and social services to increase access and availability; and defining the roles of players in the health system, in the social services, in police services, or any other actor in the decriminalization regime. It also indicates that an administrative sanctions regime must be considered. This doesn’t mean they must move forward with such a regime, just that it must be studied to see if it is worthwhile in our Canadian context. If deemed not applicable, the relevant government can do away with it. This list, however, is not exhaustive and the discussions can include other topics of import not found within the confines of this bill.

After the national strategy has been developed, there is an obligation to report it to both chambers of Parliament and to subsequently publish the report on the Minister of Health’s website.

The second part of this bill will actually decriminalize the possession of illegal substances for personal use. Now we have used the term “decriminalization” many times. Let me tell you what it means and what it doesn’t mean. A 2014 report by the Global Commission on Drug Policy defines decriminalization as a term:

Most commonly used to describe the removal or non-enforcement of criminal penalties for use or possession of small quantities of drugs or paraphernalia for personal use . . . .

So, there are still penalties but not criminal penalties. Decriminalization can either be de facto — meaning informal and non-legislative and is an approach currently being explored in Vancouver — or de jure, which is reflected in formal policy or legislation.

Section 4 of the Controlled Drugs and Substances Act would be repealed. This section of the act outlines the offences and punishments for possession of illegal substances, and with the removal of this section, so too would be removed the criminal punishments associated with the behaviour. This bill is taking a de jure or formal policy approach to decriminalization. I draw to your attention, however, other sanctions associated with illegal substances, like trafficking, would remain in place and unaffected.

An important aspect of Bill S-229 can be found in the “coming into force” provision that occurs in two parts. The national strategy portion commences upon Royal Assent, but the actual decriminalization portion comes into force on a day to be fixed by order of the Governor-in-Council. There is a very specific reason for this, explained best in the report of the Canadian Association of Chiefs of Police in July 2020 on decriminalization. It states:

It will be key in a Canadian context that treatment facilities are established and operational ahead of decriminalization and have the capacity to take in individuals diverted through police contact. . . .

The national strategy must be considered and completed before the decriminalization of possession of illegal substances for personal use. Otherwise, we would be putting the cart before the horse. Without the necessary time allotted for all levels of government to ensure proper supports are in place, the decriminalization of illegal substances would create a scenario in which first responders, usually police officers, would have nowhere to divert those needing treatment-facility support and would instead exasperate the current challenges they face. Supports must be in place before we decriminalize should we wish to have positive outcomes.

Honourable senators, now that I have explained what the bill does, and keeping in mind the statistics I mentioned earlier in relation to Canada’s circumstances, let me tell you why I believe this bill is necessary. For over a century, Canada’s status quo has been to criminalize people who use drugs. This is not only a Canadian reality. Criminalization has not curbed drug use in comparable nations either.

Criminalization of possession for personal use stigmatizes and marginalizes drug use, those who use drugs and the communities in which they live. I’ll speak more to this later. But it leaves people — including many young people — with criminal records, which can then lead to their exclusion from education and employment, and, in turn, increases their vulnerability to social, health and economic problems. It becomes a vicious cycle. It also deters those who use drugs from accessing the health and social supports that are available and designed to help them. They fear criminal repercussions for even attempting to get help. It increases people’s vulnerability to criminality, violence and health risks. Perhaps more importantly, criminalization has proven to have no deterrent effect. You need only look at the statistics.

The judicial system is crowded and slow in part because of the prosecutions of non-violent, drug-related offences. It increases costs throughout the criminal justice system by having to allocate sufficient resources to law enforcement, the judiciary and correctional facilities to just maintain the current standard. Consequently, it leaves a scarcity of resources for public health and social development approaches. It also contributes to the promotion of infections such as HIV and hepatitis C due to unsafe injection practices such as the reusing or sharing of syringes in unsafe vicinities.

Much of this is attributable to the visible drug use found on the streets of cities, and it’s what many people picture when a discussion about illegal drugs is broached. The individuals on street corners are some of our most vulnerable, but they are not the majority of those living with substance use disorder or even those dying from overdoses. A November 2019 report from Public Health Ontario — the province I live in — estimates that over 75% of individuals who overdosed were located in private residences. The pandemic has driven this home.

People who use illegal substances are found among all races, ethnicities, genders and socio-economic status. Whether diverted by emergency services or seeking out their own help with personal substance use, the health supports must be able and willing to take on people from all walks of life in order to have an impact.

Tackling drug use as a health issue would be a positive step forward in diminishing the crisis we face in Canada as well as drug use generally. Decriminalization takes a few steps in this direction but not without appropriate health supports and treatments. I’m hoping that the national strategy will address these supports to find a path forward in a comprehensive and holistic way.

Honourable senators, there is so much evidence in Canada and internationally that demonstrates that the current tactics of prohibition and imposition of criminal sanctions for personal possession and use of drugs are ineffective. Decriminalization has been the recommended approach by stakeholders and organizations all over the world, such as the World Health Organization, the United Nations Office on Drugs and Crime, the United Nations System Chief Executives Board for Coordination, the Global Commission on Drug Policy and the Drug Policy Alliance in the United States. I assure you there are many more.

In Canada, this call has been echoed by the Canadian Public Health Association, the Canadian Mental Health Association, the Canadian Nurses Association, the Canadian Drug Policy Coalition and most recently by the Canadian Association of Chiefs of Police. Again, I name only a few.

The House of Commons Health Committee made this recommendation in their report entitled Impacts of Methamphetamine Abuse in Canada:

That the Government of Canada work with provinces, territories, municipalities and Indigenous communities and law enforcement agencies to decriminalize the simple possession of small quantities of illicit substances.

This notion is exactly what I envision for the national strategy portion of the bill before us today, but with wider consultation than those listed in that recommendation. As mentioned previously, there are many topics of discussion that revolve around decriminalization that are integral to an effective and compassionate health regime. Working with the provinces, territories and other stakeholders, as stated in the House of Commons Health Committee report recommendations, can be found in a national strategy process.

There are many elements that must be considered when taking a health approach to substance use. Supervised consumption sites are already operational in many Canadian cities and there is evidence to suggest there are benefits to these sites, some of which include decreased fatal overdoses; decreased drug litter; decreased high-risk injection practices; decreased public injections; and an increase in contact with health and social services, including substance use treatment services among marginalized clientele.

Yes, opposite reports have also stated that litter has increased and there was a reduction in clientele for local businesses. It seems there is a fight for every site, no matter the benefits for those who need them which, in some circumstances, is the benefit of living rather than dying.

For example, in Barrie, Ontario, which is located very close to where I live, a group of business leaders in the city has raised concerns about the supervised consumption site in the downtown core. This is in a city where the overdose rate is eight times higher in the health unit than the rest of Ontario, but it’s an important discussion that needs to be had. It’s always a balancing act. Perspectives on the use of these sites are dependent upon the respective communities and their degree of tolerance toward drug use and overdoses, but the positive effects for people who use drugs are unquestionable.

Another health-based option that could be considered through the national strategy process — and should be considered — is an increased safe supply of drugs. Fentanyl and carfentanil have had a devastating effect on the street supply, while additives and contaminants to street-level drugs have been a mainstay for quite a long time. The introduction of fentanyl and carfentanil into the Canadian market has created a situation where the traditional street-level supply is deadly and increases the risk of overdose. In terms of the creation of a higher risk for overdose, the BC Coroners Service is now seeing common opioids being contaminated with benzodiazepines, such as Valium or Xanax. While it is possible to reverse overdose effects of opioids with naloxone, naloxone itself can’t fend off the overdose symptoms of benzodiazepines. This is creating a situation where naloxone isn’t preventing overdose deaths. Constable Ingrouille, mentioned earlier, signals an additional problem with the influx of fentanyl in our society:

As fentanyl began flooding into the market, Canada saw a dramatic reduction in methamphetamine prices. The drug once used only by a small group of users due to its relatively high cost, saw a shocking price reduction. What once cost a user $30, now only costs $5. The dramatic reduction in price shows that Canada’s methamphetamine supply is linked with the fentanyl supply . . . . Five dollar meth, means that now every user can afford to be a trafficker and we are seeing methamphetamine addiction spread like an STI across our country.

Fentanyl and carfentanil have created a situation where the street-level drug supply is more toxic, leading to increased numbers of overdoses while at the same time causing reductions in the price of drugs laced with these synthetic opiates, making them easier to obtain and resell.

What can we do to combat this current trend?

A safe supply of drugs reduces the chance of overdose as the product is “cleaner,” so to speak. It is far easier to ensure the right dosage is administered with a substance that is regulated and with an understanding of what’s in it and, more importantly, what’s not in it. Safe supply can be both treatment with pharmaceutical-grade medications and harm reduction through quality-controlled alternatives. But to achieve the sought-after harm reduction, safe supply needs to be accessible and flexible. Delivery options could include mobile clinics, safe consumption sites or community health centres. Constable Ingrouille had this to say about safe supply:

When drug users no longer need to access the criminal market to receive their substance, there will be a dramatic decrease in associated crimes. Our prisons are filled with individuals who were born into trauma and developed substance use disorders. The only means of supporting their addiction was through associated crime. This associated crime is burdening police services across our country.

So not only is a safe supply of drugs necessary for consideration to prevent overdose deaths, but it also has the potential to prevent associated crimes of substance use, such as thefts and break-and-enters.

With a safe supply of drugs comes a safe supply of needles. A safe needle supply would diminish reuse and sharing, and could help reduce cases of hepatitis C, HIV and other blood-borne infections and viruses.

A process that has been used prevalently in Europe for over 25 years has been drug checking. Drug checking involves analyzing drugs in an effort to mitigate the risk of hazardous contaminants such as fentanyl. While there hasn’t been much research on the health implications of drug checking, there is evidence to suggest that it can be a component of a comprehensive harm reduction strategy. Drug checking helps by decreasing the presence of contaminated drugs in a community, helping to monitor the local drug supply to inform public health initiatives and providing opportunities for intervention, education and referral to services if needed.

Other innovative harm reduction strategies can be found at the municipal or community levels. For instance, Abbotsford in British Columbia has deployed a strategy called Project Angel. It connects people experiencing substance use, mental health challenges, homelessness and related issues with important supports and services. This program was developed between the Abbotsford Police Department and those with lived experience of substance use. Essentially, anyone can refer someone to Project Angel and then those great people will match them with a peer support worker who will help them with whatever is needed. It can be anything from a conversation over coffee to a connection to a treatment program.

Chief Constable Mike Serr of the Abbotsford Police Department says that many crimes in the community are merely survival crimes committed by repeat offenders. For example, someone whose drug habit costs them $100 a day would need to steal upwards of $1,000 worth of goods. Chief Serr states, “If we can divert 10 people who are doing that, the change we can make is significant.” Project Angel is one of the ways diversion is taking place.

Colleagues may also know that there are community-based programs in Ottawa. Even the nation’s capital isn’t immune to substance use. Ottawa Inner City Health, stationed just a few blocks away from the Senate Chamber in the Byward Market, deploys multiple programs to help some of Ottawa’s most vulnerable, including those with mental health issues, homelessness and substance abuse disorders.

OICH, run by Dr. Jeff Turnbull, is seeing some compelling evidence in which treating substance use with health approaches and treating people with dignity creates positive outcomes. In 2017, OICH started the first supervised injection site in Ottawa, which has now become one of the largest in Canada, with over 100,000 visits in its first year. Dr. Turnbull says there are about five overdoses a day but there haven’t been overdose deaths.

OICH is also running a residential managed opioid program, a first for Canada. This program involves 25 participants addicted to heroin who have been offered lodging in Hintonburg — just west of Centretown — as well as a safe supply of pharmaceutical-grade heroin, also known as hydromorphone. A year after implementation there have been no overdoses or deaths in this vulnerable group.

These health-based approaches cannot operate in their own singular vacuums; there must be interplay between them to achieve the desired goals of reducing harms and deaths associated with substance use. But in order for these somewhat contentious treatment options to be considered across jurisdictions in Canada, public perceptions around substance use must change.

The current approach of criminalizing those who use drugs has clearly led to a stigmatizing and marginalizing effect. More and more, these people have been pushed to the fringes because any attempt on their part to reach out or better their lives is met with resistance by many sectors of society. A fear has been generated in even asking for help. The UN system coordination Task Team on the Implementation of the UN System Common Position on drug-related matters stated in their 2019 report:

The criminalization of drug use for other purposes than medical and scientific ones can . . . increase stigma and discrimination and thus deter affected persons from seeking treatment and rehabilitation services, thereby rendering them more vulnerable to violence and abuse from both private and state agencies.

A report of the Johns Hopkins – Lancet Commission on Drug Policy and Health indicates:

Not only do punitive laws drive [people who use drugs] away from health services, they may also contribute to stigmatising or disrespectful treatment in health services.

If our current system of criminalizing people who use drugs is creating stigmatization and driving them away from available health services, then it is clear we have a perception problem around drugs. It doesn’t help that this stigmatization has been ingrained in us for decades. Drug use has been framed as a moral, ethical and societal wrong and has been perpetuated since the creation of the Opium and Drug Act of 1911.

Honourable senators, the perception of drug use as not only a legal wrong but also a moral or societal wrong is part of what is keeping the status quo of criminalization in Canada. We have to move away from the inaccurate and condescending terminology surrounding substance use if we want to bring a health approach to it.

For this reason, in Bill S-229 the word “illegal” was chosen consciously rather than using the term “illicit.” “Illicit” implies that drug use is forbidden — not only at a legal level but also at a moral, societal or principled level. It would be undermining the bill to say that substance use disorders should be treated in a health-focused manner but imply through the words used that it remains morally or socially wrong. In order to change perceptions, sometimes we need to change terminology in order to make a topic more palatable and remove misconceptions. The more appropriate term “illegal” indicates that this is only forbidden or wrong according to law. While I may still on occasion use incorrect terminology, I am trying to make a conscious effort to normalize “illegal” rather than “illicit.”

It won’t be an easy task to change perceptions about drug use. The “out of sight, out of mind” or “ignorance is bliss” approach has been thoroughly ingrained in our society. It will take political actors and a bold stance to move this forward for the next generation to pick up and address in its entirety.

A 2014 Canadian Public Health Association report substantiates this assertion. In its research it found that:

 . . . with the adoption of a public-health-focused drug policy in Switzerland, the perception of opioid addiction among Swiss youth has changed from that of a rebellious act to one of an illness requiring maintenance and treatment.

A strong step towards changing perceptions around drug use and misuse would be to decriminalize illegal substances and provide health-centred treatment options. This would become more normalized the longer it is in place and would then alter the perspectives of our future generations.

With the advancement of decriminalization, those who use drugs would be less fearful of criminal sanctions and could seek out proper health supports, either on their own or through diversionary measures, should they come into contact with police or other first responders. This would, in turn, reduce some of the stigma and perceptions around substance use. Decriminalization is possibly the most important initiative to change perceptions.

Colleagues, substance use and how to deal with it is an issue many countries are wrestling with, and Canada can learn from their experiences. Other jurisdictions have moved quickly and efficiently, and their knowledge and best practices are worth examining.

Portugal decriminalized possession for personal use of any drug through statutory reform in 2001 and is a leading example of approaching substance use through a health lens. Portugal created the Dissuasion Commission, whose job it is to implement the decriminalization model and impose administrative sanctions, though they prefer to take other actions such as offering voluntary referrals for treatment, harm reduction or other social and health services. It is up to police to determine whether possession of a substance is for personal use, which is usually equivalent to 10 days’ quantity. If deemed personal, police will refer the individual to the Dissuasion Commission. If it is deemed that one holds more than the 10-day threshold, criminal proceedings will be initiated, but the courts can take into account the person’s circumstances and other considerations to determine if it was, in fact, for personal use.

This Portuguese law went hand in hand with significant investments in harm reduction, treatment and prevention. Because of these investments, Portugal has seen reductions in overdoses, in transmission of blood-borne infections and viruses, and in prison overcrowding. Portugal has also seen increases in access to treatment and the ability of law enforcement to focus on organized crime and trafficking of substances.

In 1999, before decriminalization took effect, Portugal had 369 overdose deaths, 907 new HIV cases due to injecting, and there were 3,863 people incarcerated for drug offences. In 2016, 17 years later, Portugal had 30 overdose deaths, 18 new HIV cases due to injecting and 1,140 people incarcerated for drug offences. While decriminalization doesn’t explain the extent of these reductions in itself, they are drastic enough to demonstrate that decriminalization did have an effect in Portugal.

Switzerland’s decriminalization regime has been in place since 2013. If found in possession of scheduled drugs other than cannabis by the police, the administrative penalties can include a fine, confiscation of a driver’s licence, referral to a voluntary treatment or, if a minor, a referral to an education course. It is interesting that this also applies to the supplying of drugs where there is no financial gain, such as freely sharing with a friend. There is no threshold amount in Switzerland for police to use as a determinant of personal use. It is assessed case by case, and that is what differentiates its model from Portugal.

In the Czech Republic it is also the police who are the decision makers on whether to pursue criminal proceedings or take an administrative route. They assess more than just the quantity of drugs in possession. They also assess the intent of the person. Akin to Portugal, the police focus more on severe drug crimes rather than those using them. This reduces the stigma, while at the same time it creates more trust in first responders.

If we move to our American colleagues, in Oregon Measure 110, the decriminalization of substances, was passed just last November. Oregon is the first U.S. state to take this step, and we are already seeing other states following suit. For example, Bill S1284 in New York and Bill HD3439 in Massachusetts have already been introduced, and Washington State, Virginia and California have all signalled their desire to move forward with decriminalization in some fashion. The Oregon legislation eliminates criminal penalties for possession for personal use and administrative sanctions are then attached, which could include a maximum fine of up to $100 or the completion of a health assessment with an addiction-treatment professional.

Measure 110 goes further. It also mandates the establishment of at least one addiction recovery centre in each existing coordinated care area in the state. These centres triage the acute needs of patients, free of charge, and provide connections to other services. How did they fund it? Oregon previously legalized cannabis, and with legalization came taxation. Much of the quarterly tax account balances above $11 million from cannabis is redirected to the Oversight and Accountability Council also established in Measure 110. This council provides grants to existing agencies or organizations to establish the centres. It is mandated that these centres open by October 1, 2021, so there isn’t yet any longitudinal data to form conclusions, but pulling tax dollars made from cannabis sales is certainly something Canadian governments can look at in our approach.

As you see, other countries have taken a de jure or legislated approach to decriminalization already. Many of the example models given have been around for some time and offer valuable insights and potential best practices into what a Canadian model could strive to look like. Should we use thresholds like Portugal and the Czech Republic and, if we do, where should they be set? Who will be the initial decision maker? In all given examples, it is the police who make the first determination because they are the first to run into them. There are a couple of questions set out in the national strategy for consideration.

The final question that could be asked is: Does decriminalization conform to Canada’s commitments under international law? As legalization of these substances is not currently being sought in this bill, the short answer is yes. As many of us learned in the Forty-second Parliament through the Bill C-45 process of legalizing cannabis, Canada is a party to three international drug conventions: The 1961 UN Single Convention on Narcotic Drugs, the 1971 UN Convention on Psychotropic Substances and the 1988 UN Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

Certain articles within these conventions decisively indicate that possession and use of drugs must be criminalized at the domestic level. For instance, Article 4:

The parties shall take such legislative and administrative measures as may be necessary . . .

c) Subject to the provisions of this Convention, to limit exclusively to medical and scientific purposes the production, manufacture, export, import, distribution of, trade in, use and possession of drugs.

Article 33 of the same convention simply states: “The Parties shall not permit the possession of drugs except under legal authority.” While these articles indicate an absolute, the convention against illicit traffic, the most recent convention, provided some leniency in terms of the use and possession in Article 3 of that document. It reads as follows:

. . . in appropriate cases of a minor nature the Parties may provide, as alternatives to conviction or punishment, measures such as education, rehabilitation or social reintegration, as well as, when the offender is a drug abuser, treatment and aftercare.

University of Ottawa Professor Line Beauchesne agrees with this understanding. In her brief to the Standing Senate Committee on Foreign Affairs and International Trade during that committee’s study of certain elements of Bill C-45, she stated:

While the conventions demand prohibition, it is up to the parties to determine how stringent the restrictions are. Under the conventions, criminal sanctions are supposed to be proportional to the seriousness of the offence, but governments decide on the degree of seriousness.

This degree of seriousness must be balanced with the available evidence. It is a statement in itself that the UN Single Convention on Narcotic Drugs as well as the UN Convention on Psychotropic Substances both begin with, “The Parties, Concerned with the health and welfare of mankind . . .” in their respective preambles. Health should be at the forefront of personal substance-use issues. It’s not only indicated in the preambles guiding international laws on drugs, but also in the overwhelming evidence in support of this notion since these conventions were first drafted and adopted.

Honourable senators, the pursuit here is for decriminalization, not legalization. As a result, Bill S-229 would in no way be in contravention of Canada’s international obligations on drug issues. There is a nod to health being a primary reason for the development of these conventions and an explicit reference to alternatives to criminal conviction in cases that are minor in nature, such as possession for personal use cases. This bill’s very intentions are to ensure that illegal substances remain illegal, while at the same time requiring safer, healthier choices for those in need of them.

Honourable senators, before I conclude, let me read to you some headlines that I’ve rounded up in just the last number of months. From January 2021, these are the headlines: “B.C. paramedics responded to record average of 74 overdose calls a day in 2020: BCEHS” from the CBC; “Rows of white crosses in downtown Sudbury, Ont., honour those lost to opioid crisis” from the CBC.

From February: “‘I surrender. Just please help me’: A son’s moving note to his parents underlines the pain of addiction” from The Globe and Mail; “Toronto Public Health announces record of opioid-related deaths in a month: 38” from the Toronto Star. “Stigma, isolation, inadequate services blamed for highest opioid death rate in BC’s north” from the Toronto Star; “Opioids killed my brother but societal inaction was the cause” from The Globe and Mail.

From March: “Overdose deaths continue to climb in Manitoba, renewing calls for government action” from the CBC; “Opioid-related overdose deaths jump by 59 per cent in Ontario” from The Globe and Mail; “Substance users need solidarity and support, not judgment” from the CBC; “B.C. records deadliest February yet for illicit drug overdose deaths” from the Toronto Star.

From April 2021: “‘Harm is happening right now’ as overdoses increase in Regina, says Regina police chief” from the CBC; “Battle against rising overdose deaths must involve ‘the entire community’” from my hometown newspaper OrilliaMatters; “‘Demonizing’ substance use won’t stamp out toxic drug supply, says mother of overdose victim” from the Toronto Star; “Can we beat addiction by making it a crime? No” from The Globe and Mail.

Senator Boniface, I’m sorry, your time has expired. We have to move to the next speaker.

Honourable senators, I rise today to speak in support of Bill S-229, An Act respecting the development of a national strategy for the decriminalization of illegal substances, to amend the Controlled Drugs and Substances Act and to make consequential amendments to other Acts. The abbreviated title of this bill is the Health-Centred Approach to Substance Use Act.

A primary focus on health rather than punishment is what has been missing from our national approach to controlled substances. For over 35 years, I practised as a rural family physician in my home province of Newfoundland and Labrador, and, as such, a health-centred approach is the lens that I instinctively default to, and it will be the framework for my remarks today.

I want to first thank Senator Boniface for her exceptional efforts in advocating on this issue and for sharing her experiences and wisdom. As the former commissioner of the Ontario Provincial Police and with her strong international perspective, she, more than most, knows first-hand the often tragic consequences of substance use and recognizes the inequities that too often result from treating those requiring health care as criminals.

Honourable senators, there is ample evidence to show us that criminalizing addiction and illegal substances does not remedy the harm for individuals or for society. As Senator Boniface has so thoroughly explained, despite ongoing efforts to criminalize personal use, the use of illegal drugs persists and grows. The number of people charged with possession of prohibited non-cocaine or heroin-based drugs in Canada has tripled in the past decade, while the number of people charged with heroin possession has quintupled.

Every single one of these thousands of charges represents a cost. They each represent an allocation of time and money for police and Crown prosecutors and for the judicial system — time that could be devoted to other pressing needs. These charges represent a cost in lives and families and communities disrupted, and they represent a cost in the necessary medical treatment deferred.

Indeed, the harsh reality is that all these costs are not buying solutions. Incarcerating individuals does not improve their health or treat their addiction. The use of illegal drugs continues. Canadians are dying from preventable drug overdoses every single day. The increase in overdose deaths amid the pandemic, particularly in British Columbia and Ontario, can no longer be ignored.

The time has come for this country to recognize the lessons of history and to stop trying to treat a public health crisis with the coercive tools of criminal law. Make no mistake, honourable senators, this is a public health crisis.

While we have been understandably consumed by the current pandemic, as former Senator Hugh Segal pointed out recently in an op-ed in OrilliaMatters, “There have been days when deaths from drug overdoses exceeded deaths from COVID and traffic accidents combined.” Every life lost is a tragedy and a reminder that we can do better.

In the most practical sense, we need an alternative approach that seeks to maintain and improve the health of populations based on the principles of evidence-based policy and practice, social justice, attention to human rights and equity, and addressing the underlying determinants of health.

Honourable senators, there is a wide-ranging continuum of substance abuse and substance use disorders. Some patients can be prescribed controlled drugs for illness and injury or to cope with the stress of trauma. Some individuals can also access a dangerous, unregulated supply of drugs through illegal channels. Some individuals can also experience negative consequences from their substance use and become physically or psychologically dependent on drugs, as I know only too well.

The reasons people develop substance use problems are complex and can include genetic, biological and social factors, including experiences of trauma. However, statistics demonstrate that marginalized groups, including Indigenous and racial minorities, disproportionately experience these negative health and social outcomes typically associated with the use of drugs. Structural factors force these people to use in unsafe environments and create barriers to accessing health care and social services.

For example, it is recognized in the medical field that criminalization contributes to the promotion and acceleration of infections such as HIV and hepatitis C, as the legal consequences and stigmatization may drive unsafe injection practices such as the sharing and reuse of syringes in unsafe locations. Having managed patients with these conditions, let me assure you that it is an incredible burden not only on the patient and the families but on society as a whole. The evidence demonstrates that decriminalization typically encourages drug users to use in safer spaces where they can access medical care and clean supplies.

Honourable senators, there are existing efforts by different levels of government that help mitigate the risks and harms associated with substance use. For example, in Newfoundland and Labrador, we have a Prescription Monitoring Program that is aimed at addressing the growing opioid crisis. This program helps prescribers and dispensers make the most informed decisions when choosing a monitored drug to treat a patient. Using the provincial Electronic Health Record, prescribers and dispensers have access to up-to-date and accurate patient medication profiles to help inform and support the needs of their patients. The benefits of this program include increased quality of patient care, greater confidence when prescribing and dispensing drugs and greater efficiency and coordination of care. It prevents the phenomenon of double doctoring. The program is designed to lead to a decrease in drug misuse and prevent or reduce hospitalizations and deaths related to drug misuse. Every province, with the exception of Quebec, has some type of prescription monitoring program.

Looking to our West Coast, as British Columbia recently marked the five-year anniversary of declaring a public health emergency due to opioid deaths, the provincial government announced that it will be making an official request to become the first province in the country to decriminalize the possession of small amounts of illegal drugs. This would be achieved by a province-wide exemption from the Controlled Drugs and Substances Act to eliminate criminal penalties for people who possess small amounts of drugs for personal use. The government also announced $45 million over the next three years to expand overdose prevention services like supervised consumption sites, Naloxone supply and integrated response teams.

Local health authorities, including Toronto, Montreal and Vancouver, have also implemented public health principles into their strategies. A few weeks ago, the federal government gave $7.7 million to help fight the opioid crisis in Toronto, with funds allocated for three projects that will increase access to safer supply and provide a new harm reduction and treatment option for people living with opioid use disorder in the city.

Honourable senators, Bill S-229 could further enhance these measures and stitch together the existing patchwork by creating a national strategy based on health, equity and harm reduction principles.

Across Canada, there have been several institutions that have taken a strong stance in favour of decriminalization and of treating substance use as a health and human rights issue, and the list is long. It includes the Canadian Public Health Association, the Canadian Mental Health Association, the Canadian Nurses Association, the Canadian Drug Policy Coalition and others.

More recently, institutions that have historically not supported decriminalization, including the Public Prosecution Service of Canada and the Canadian Association of Chiefs of Police, have acknowledged the futility of criminalizing drug use.

This change is dramatic and has been echoed by several public health agencies and authorities and local, provincial and national groups.

If we look outside our own borders, we will note that several countries, including Switzerland, Norway, Austria and Portugal, as well as the state of Oregon, have integrated one or more of the cornerstones of a public health approach to substance use disorders. These policy changes have proven to be effective.

Honourable colleagues, with the pandemic exacerbating existing inequities, this is a critical time for Canada to further investigate what an alternative model could look like. There remain several outstanding questions that are beyond the scope of this bill: Is decriminalization a viable option for Canada? Can the different levels of government and relevant stakeholders reach a consensus on what should be included in the national strategy? How will objectives be measured and monitored?

However, putting all that aside, Bill S-229 simply compels all levels of government to study how best to provide a health-centred approach to substance abuse. The federal government would have two years to repeal the criminality of possession for personal use of drugs. Simple possession of certain classes of drugs would result in fines, mandatory treatment orders and other remedial measures.

Colleagues, we need to take an evidence-based approach to addressing this public health crisis. This bill is a first step in the right direction toward creating a comprehensive, equitable and, most importantly, effective national strategy to help mitigate the complex harms associated with substance use.

Simply put, criminalization is not an appropriate prescription.

Thank you, meegwetch.

Your Honour, I’m wondering whether Senator Busson would take a question?

Senator Busson, would you take a question?

Thank you and thank you for your speech. I have actually two questions. I’m trying to get my mind around some of the rationale here, and I didn’t have time to ask Senator Boniface a question. But there are two things that you talked about that I’m trying to figure out how this bill will prevent that. At the beginning of your speech you talked at length about the number of deaths and that we want to prevent deaths, and I think we all agree with that. But I just can’t get my mind around how making drugs more available will prevent overdoses. It has nothing to do with the legality of it. I have been in your province and in your city and I’ve walked through some of the horrible areas. I cannot understand how decriminalizing will prevent deaths. Could you give me the Reader’s Digest version of that?

I will ask my other question right away for the sake of time. You also talked about the demoralizing stigma of addiction. Addiction is addiction is addiction whether it’s illegal or decriminalized or legal. If you are an addict, you are an addict. So how does Bill S-229 prevent the demoralizing stigma of addiction? Two questions there, Senator Busson. Thank you very much.

Thank you, Senator Busson. Your time has expired.