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Decentralized Democracy

House Hansard - 200

44th Parl. 1st Sess.
May 18, 2023 10:00AM
  • May/18/23 10:45:44 a.m.
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Mr. Speaker, while that member is up at night cruising around the dark web, we on this side of the House are understanding that there is a crisis in crime, that there is a crisis in the fact that the Liberal government supplied hydromorphone, which is being sold to buy illicit fentanyl, because that is what addicts are wanting right now. We know that this is an untenable position and we know, on this side of the House, that we want Canadians to have a home: Our home, their home, bring it home.
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  • May/18/23 10:46:21 a.m.
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Mr. Speaker, I will be sharing my time with the member for Sherbrooke. Before I begin my speech, I want to acknowledge that I am rising today in Ottawa, which is on the traditional unceded territory of the Algonquin Anishinabe people, who have lived on this land since time immemorial. It is important that we take the time today to address this national public health crisis, but first, however, I want to talk about the wording of the motion we are debating today. The opposition is calling on us to reverse deadly policies, yet the BC Coroners Service has repeatedly said that there is no indication that the prescribed safe supply is contributing to the drug deaths from the illicit drug supply. It seems that the Conservative Party wants to take us back to the failed ideology of the Harper-era drug policies. Assez, c'est assez. Why can the opposition members not understand the harm that their narrative is causing. The member talks about zombies and talks about crazy policies. This is stigmatizing, and that is all they know how to do. Do they not hear the public outcry from people who actually have lived and living experiences with substance use, the people who have overdosed two and three times and have been revived at a safe consumption site and are now part of helping people get well? Groups like Moms Stop the Harm, who have are the loved ones of people who have lost lives to overdoses and toxic drug supply, have asked the Leader of the Opposition to meet with them in early June. Will he meet with them and hear their story? It changes people's lives and their opinions. This fight against evidence-based programs that are actually saving lives just has to stop. People are dying but not for the reasons they are giving. Canada is facing a twofold epidemic: a toxic and illegal drug supply and an overdose crisis. Every day, countless lives are shattered by the devastating consequences of the crisis and over 30,000 people have died. We must recognize that substance use and addiction are two complex problems that we cannot resolve by simply ignoring them or using outdated approaches. Families mourn the loss of their loved ones. Communities bear witness to the tragedy of addiction, and the individuals suffer often in silence because they are being stigmatized, as the opposition is doing today. It does not have to be this way. Substance use disorder, opiate use disorder, is a recognized, chronic medical condition that deserves the same respect and evidence-based care as any other illness. By implementing safer drug supply initiatives, we can save lives and provide individuals with the opportunity to break free from the cycles of addiction, because there is no recovery for people who are dead. We have to be there. When the person using drugs asks “where is the suboxone lady”, we need that absolutely real-time approach. It is by implementing safer supply that we minimize the risks of people using drugs. We can ensure that those who use drugs have access to pharmaceutical-grade substances that are tested for potency, purity and prominence. It is the poisoned drug supply that is killing people. The opposition needs to understand that this is the problem we are dealing with, this toxic drug supply. We can prevent accidental overdoses caused by drugs with unpredictable potency, contaminated substances or adulterants. We can save lives; we must save lives. However, our approach goes beyond saving lives. It is about creating the path to recovery and rebuilding shattered lives and families. When individuals have access to safer drugs, they engage with the health care professionals. They are able to seek support, healing and rehabilitation. It is like moving from Insite to Onsite in Vancouver. It provides an opportunity for connection, trust and the delivery of comprehensive care. I want to be clear that this is not about encouraging drug use or turning a blind eye to the consequences. It is about acknowledging the reality that people will continue to use drugs and that by providing a safer alternative, we can minimize the harm and pave the way toward recovery and rehabilitation. Illegal drugs being sold illegally is still illegal. Diversion is illegal. We need to recognize that, behind the statistics and the headlines, there are real people who have dreams but are struggling. They deserve our empathy, our understanding and our support. Stigmatizing people who are battling a substance use problem and criticizing the care they receive will not help them seek treatment. What is more, Canadian drug policy and international drug policy are aligned. Prevention, harm reduction, treatment and enforcement make up the four internationally recognized pillars of drug policy. We lived through 10 years of that Conservative government taking harm reduction out with its deadly war on drugs, and that has been proven to be ineffective, costly and deadly. These policies have also had a profound negative effect on Canada's most vulnerable, including indigenous people, children, young people, people living with disability, and immigrants and refugees. While the Conservatives continue to try to take us back to the days when substance users were told that their lives did not matter, our government is using every tool at its disposal to put an end to this national public health crisis. I would like to quote from the public safety and justice adviser to former prime minister Stephen Harper, Ben Perrin, who said, “Safer supply has been tested and found to be beneficial for people who have been unable to have treatment for whatever reason, and are long-term substance-abuse users. We’re talking about essentially substituting a contaminated street drug with a drug that has known contents and potency to help people stay alive, first of all, and also to be able to stabilize.” Here is what some other important experts have said. Both the College of Physicians and Surgeons of BC and the College of Physicians and Surgeons of Ontario have made statements acknowledging safer supply is a harm reduction tool to support people with opioid use disorder. I encourage the member to reread the CMAJ article from last September and see that on safe supply, the community health centre is providing the suite of health and social services reports. That is exactly what we do. It is exactly how we get them in the door so they can find a way to a better life. As I continue to say, since 2017, safe consumption sites in Canada have received more than 4.1 million visits, reversed 46,000 overdoses and made 236,000 referrals to health and social services, which the Conservatives have vowed to defund. What do we say to the families of those who would have died if this approach had not been offered to people who use drugs? If only I could say that this is the first time the Conservatives have not followed public health advice. Unfortunately, this is the pattern for the official opposition. Despite overwhelming support and effectiveness of vaccines and despite the fact that 11% of maternal deaths are from unsafe abortions, that party continues to prefer ideology over evidence. We, as a country, must and can do better. I prefer the Canadian Medical Association Journal to the National Post. More important, this is how we will save lives.
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  • May/18/23 10:55:24 a.m.
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Mr. Speaker, I represent Mission—Matsqui—Fraser Canyon, which is in the Fraser Health region. In British Columbia, the most deaths from opioids took place in the Fraser Health region. In 2022, 680 people died in the Fraser Health region. Since the implementation of the decriminalization policy of the Liberal government, those deaths have only increased. I have a very specific question today for the minister. Part of the agreement, when the government decided to decriminalize hard drugs in British Columbia, was that there would be enforcement for schools and places where children frequent and that the policies of decriminalizations would not apply. A week after the government decriminalized, my son's day care had to be shut down because people were injecting illicit substances and leaving things behind. I could not take my son to day care that day. He goes to a school in downtown Abbotsford. What policies have been put in place to enforce areas where children frequent to ensure they are not exposed to illicit drugs? We are normalizing illicit drugs in our country and I want to know what the minister is going to do to stop that.
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  • May/18/23 10:56:46 a.m.
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Mr. Speaker, I am pleased that the member recognized that, in the agreement for the section 56 exemption, it is still not okay to use drugs in playgrounds or schools. Many municipalities are looking at expanding that with their bylaws, but at the moment that is still illegal. What we are also saying to the member is that a lot of the deaths in the Fraser Canyon and all over the country are not of the people who have been using drugs for a long time. I was with the carpenters' union in Victoria, where they are handing out naloxone because they are losing loved ones on the work site due to the poison drug supply. I want the member to understand that people are using alone and dying alone. We have to have policies that will prevent those deaths.
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  • May/18/23 10:58:01 a.m.
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Mr. Speaker, I very much appreciated the approach my colleague used in her speech. It is true that this is a complex issue, a human issue. Behind the statistics and the numbers there are some very serious realities. It is a really important issue. I have experience with this problem in my family. It is hard to talk about without getting emotional. I think that we agree with my colleague on the fact that it is a public health problem and that the Conservatives' approach to this crisis is a bit dogmatic. Public health is health. Recently there were negotiations with Quebec on the matter of health transfers. Unfortunately, Quebec and the provinces, who were asking for $6 billion, barely got $1 billion. If we really want to help people, in this case addicts, on the ground, there needs to be an increase in health transfers. When will the government increase the transfers?
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  • May/18/23 10:58:58 a.m.
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Mr. Speaker, my condolences and my sympathies to the member for the truly sad situation in his family. Part of the transfers to the provinces and territories, $25 million to be precise, is for mental health and substance use. I think that the action plan will help respond to this tragic situation in the provinces and territories.
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  • May/18/23 10:59:59 a.m.
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Mr. Speaker, first we heard the Conservative from Fraser Valley rail against harm reduction when, in fact, they support harm reduction and they support treatment and recovery. There is no war between harm reduction and treatment and recovery. We need them both. Today, I am seeing the Conservatives spreading misinformation, which is costly in a health crisis. However, we also see the Liberals taking an incremental approach, which costs lives. I asked the minister repeatedly to scale up efforts. This is a national health crisis. The government is spending less than 1% of what it spent on the COVID-19 crisis and the response to that. We have lost almost as many lives. We look at the money the government spent on the AIDS crisis, on SARS and on other health crises. It goes beyond being pale in comparison. When is the government going to scale up on safe supply? When is it going to get involved in the recovery and treatment on demand? We need the government to get involved. It cannot keep downloading this to the provinces. That is where Portugal stepped up. We need the federal government to scale up with rapid investments so that, when people need help, they get it and we meet them where they are at.
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  • May/18/23 11:01:16 a.m.
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Mr. Speaker, I thank my colleague for the really important distinction, as the polarization of harm reduction versus treatment is extraordinarily unhelpful. We know people need access to treatment at the moment they are ready. However, we also know they need adequate aftercare so they do not fall back into the environment that made them sick in the first place. As we move forward, as the member well knows, over $100 million has been designated for safe supply in this last budget. We received another $144 million for the substance use and addiction programs, as well as $25 billion going to the provinces and territories, where one of the four pillars is mental health and substance use. We hope that the provinces will be able to use that on the issues of complex care, treatment beds and aftercare. I look forward to working with the member as we tackle the flawed ideology of the other side.
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  • May/18/23 11:02:44 a.m.
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Mr. Speaker, I am pleased to rise in the House today to address the motion from the member for Carleton and provide an update on our government's response to a complex challenge facing our country, the overdose crisis. This crisis is having a tragic and unrelenting toll on Canadians, their families and communities. Each one of these deaths is tragic and creates a void in the community that can never be filled. Every person who has lost their life in this crisis has left behind someone who is grieving: a friend, a partner, a parent or a child. There are four pillars recognized internationally as necessary for a successful substance use strategy: prevention, harm reduction, treatment and enforcement. Our government is committed to a comprehensive approach that implements policies and supports for all four of these essential areas. The dangerous, ideological and outdated approach proposed by the Conservative motion creates a false choice between harm reduction measures and treatment. We need both. As B.C. chief coroner Lisa Lapointe recently said, “There should not be a dichotomy between access to life-saving safer supply and access to life-saving treatment options”. The intent of this motion is simply to create fear, increase stigmatization and score political points with the Conservative base. It is dangerous, anti‑science and would cost lives if implemented. The toxic drug supply and overdose crisis is a daily worry for our government. When we think of the lives lost, the repercussions for communities, the devastating losses for families and the impact on the economy, we realize that it is a national tragedy. It has never been more important for all levels of government, partners and stakeholders to work together to turn this crisis around. To find solutions, we must first understand the many different factors that drive substance use. That must include addressing mental health. Harmful patterns of substance use are established over time. Some people can trace their substance use back to early childhood trauma. Others may be affected by poverty or housing instability. While many people in Canada struggle with mental health problems, some groups face particular challenges because of systemic racism, discrimination, socio-economic status or social exclusion. Marginalized groups are often victims of stigmatization or prejudice, which places them at higher risk. These include youth, indigenous peoples, racialized communities and LGBTQ+ people. Stigma is harmful in several ways. Stigma discourages people from seeking help and reduces their chances of getting help when they do seek it. It can also make it difficult to get the support needed to implement policies and programs to help people who use substances. That is because there is still a deep-seated misconception that addiction is a choice, and that is just not true. Addiction is a medical condition that can be treated. The fact is that people who use substances need support, not judgment. They need community, not isolation. They need empathy and understanding, not stigma. When substance use is stigmatized, it creates a very dangerous situation. It can lead to people using drugs alone and prevent them from seeking help. That is why we need to provide a continuum of care to people who use substances, one that is woven through every area of their lives. Prevention, treatment and harm reduction measures all have a role to play, as too do actions that reduce stigma and provide continued access to health and social supports for individuals. Our goal is to reduce the stigma and risks associated with substance use while providing people who use drugs with better access to health and social services. To achieve this, Canada must address the risks of substance use from a comprehensive societal perspective. Since 2017, the government has invested more than $1 billion in prevention, treatment, risk reduction and enforcement. This is in addition to the investments made by provincial governments within their jurisdictions. The Government of Canada is now working with the provinces and territories on a transformative multidisciplinary care model that integrates patient centred mental health and substance use care. From increased access to mental and substance use health through primary care to improve data and better sharing of health information between the professionals they consult, these tailor-made agreements with provinces and territories would improve access to the supports Canadians need when they need it. However, we know that we need to do more, and that includes trying innovative approaches in order to save lives. It also includes making it easier for people who use drugs to access health and social services, such as treatment for people who are ready for it. Budget 2023 sets out our plan to transfer nearly $200 billion to the provinces and territories over the next few years to improve health care, including support for mental health and substance use services. This will be done through a combination of increases to the Canada health transfer and new 10-year agreements with the provinces and territories. These investments would help us build, among other things, a resilient health workforce that provides Canadians with high-quality, effective and safe health services when they need them. That includes access to timely, equitable and quality mental health, substance use and addiction services. Through our tailored bilateral agreements, we will invest $25 billion over 10 years to work with the provinces and territories to advance shared health priorities. This approach is the most effective way to integrate mental health and substance use services throughout the health care system. This investment is in addition to the $2.4 billion over the next four years that will still be provided to the provinces and territories for mental health and addiction services as part of the 2017 common statement of principle on shared health priorities. Harm reduction services are a vital part of a comprehensive, compassionate and collaborative public health approach to problematic substance use that includes prevention, treatment and additional social and health supports. We cannot allow the Conservative Party's ideological agenda to shut down the safe consumption sites that have prevented more than 46,000 overdoses since 2017. Safe consumption sites replace contaminated street drugs with a drug of known content and potency to keep people alive. We need to keep people alive until they are ready to access treatment. We cannot allow the Conservatives to take us back to the failed ideology of the past. Together, we can create real systemic change and give every person in Canada the support they need to live long and healthy lives.
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  • May/18/23 11:10:59 a.m.
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Mr. Speaker, in her speech, the member opposite just said that we need to help keep people alive until they are ready to receive treatment. I represent the Fraser health region. We had the highest number of deaths caused by opioids last year, and we are on track to pass that number again. Under this policy, it is like death has become normalized. I agree with part of the member's speech in that we need to have a comprehensive approach. However, right now in British Columbia, there is no comprehensive approach. In fact, in the Fraser health region, there are only eight detox beds. What we have done in Canada is normalize the use of hard drugs without providing any option or capacity for people who want to receive care to get it on demand. Why has the government failed to provide detox beds in the areas of Canada where there is the highest number of deaths caused by illicit opioids?
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  • May/18/23 11:12:01 a.m.
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Mr. Speaker, my thoughts are with the people in his riding. There are several ways to help drug users, and if we want to keep people safe, supervised consumption sites and overdose prevention sites are part of the solution. They play a significant role in saving lives. Almost no one has died of illicit drug poisoning at these sites. We are there, and we will move forward with the opening of others.
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  • May/18/23 11:12:40 a.m.
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Mr. Speaker, we in the Bloc Québécois view the opioid crisis as a public health issue, and we believe in a supportive approach. Yes, there are times when these individuals must be allowed to transition to a safe place with what we call a safe supply. There is no harm in that. My concern is that the terms used in the motion are judgmental. I am also concerned about the fact that when I very calmly and politely asked my Conservative colleague a question and challenged the Conservative stance, he responded by saying, “Shame on this member”. I would therefore like to take this opportunity to ask the Liberal member a question. At least I can probably count on an answer other than, “Shame on you”. How can we reach a balance? When it comes right down to it, the Conservatives' intentions are not all bad. That is not what I mean. They want to offer more services and to offer therapy. A balance between the two remains to be found. I would like the member to share her thoughts with us. How can we balance support for drug use in public spaces against the urgent need to help these individuals break free from this vicious cycle? Ultimately, we all share the same goal.
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  • May/18/23 11:14:15 a.m.
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Mr. Speaker, I thank my colleague for that important question, and no, I will not answer him in the same way. The government's approach is built on four main pillars: harm reduction, supervised consumption sites, treatment and enforcement. This comprehensive and holistic approach provides a variety of solutions for people using drugs. It is a complex problem that affects everyone differently. We do not know why people use drugs. We do not know each person's specific reason. That is why we have to offer them a range of solutions so that they can find the one that works best for them.
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  • May/18/23 11:15:16 a.m.
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Uqaqtittiji, could I ask the member to talk in more detail about one of the four pillars and the importance of safe consumption sites? I do not know there is enough understanding about the importance of these places. Could she please provide more detail about why they are so important?
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  • May/18/23 11:15:45 a.m.
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Mr. Speaker, I am pleased to answer that question. As I was saying, the four pillars are prevention, risk reduction, treatment and enforcement. By relying on these four pillars, we can provide solutions that are better adapted to each person using drugs. The latest statistics show that 46,000 overdoses have been reversed at safe consumption sites. That clearly shows that these sites are essential and are an important part of the range of solutions that have been proposed to address this national crisis.
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  • May/18/23 11:16:34 a.m.
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Mr. Speaker, first, I would like to note that I will share my speaking time with my passionate, interesting and capable colleague from Longueuil—Saint-Hubert. Talking about drugs and their repercussions is not an easy topic for me. It is not easy because I quickly become emotional. When I do not want to be emotional, I get into data and statistics, so I distance the heart from the head. It is not easy because there are people from my past who will no longer be in my present or my future. Yes, it is a topic that is important to me. I need to find a middle ground in all this. Clearly, this morning, I did not find it, but it will be fine. A full picture of the situation is needed to be able to act properly. The purpose of pilot projects is to obtain data, among other things. The opioid crisis is not a partisan issue or an issue that should become partisan. It is not the type of issue where the terms “me” or “my party” can be used. It is the type of issue that requires phrases like: “together, we succeeded”. I will briefly recap the data reported in the media while adding a few caveats and stating the purpose of pilot projects and safe supply programs. The date included in the Conservative Party's motion are true. I will not review them all. The opioid crisis kills 20 people per day. Since 2016, over 34,000 people have died. Almost all the deaths were accidental. These are people who were supplied by the black market with products that those people did not even know contained fentanyl. In 88% of cases, the deaths involved adults aged 20 to 59, people in the prime of life. Prior to the pandemic, 10 people per day died of an opioid overdose. That increase may be the result of mental health problems that were exacerbated by the distress experienced during the pandemic. I heard my Conservative colleagues say that the pandemic has passed. Just because the pandemic has passed does not mean the distress has passed. Just because the pandemic has passed does not mean the addiction has passed. In the media, it was noted that people were taking hydromorphone to sell it and then buy fentanyl on the black market. Are all hydromorphone users doing that? The answer is no. How many are reselling hydromorphone? We still do not know. I hope it will be possible to find out through the pilot projects and the data collected. The black market exists because people cannot access something legally, no matter what it is. However, on the black market, it is impossible to control either the amount or quality of drug hits. That is the main problem. People who become addicted leave the health care system, even if they can function day-to-day. These people quietly leave the system because they will not tell their physicians that they have an addiction and need help. It is a minority who will do this. The system needs to reach these people. How can they be reached? It is by seeking them out where they get their supplies. Since these products are unfortunately addictive, one way to ensure the health of these people is to give them the opportunity to access products that are controlled in quantity and quality. When they come to pick up these products, there are people there who will listen to them, hear them and learn about their struggles, find out where they come from and quietly try to sort things out. It may take a very long time to overcome an addiction. Some never manage to do so. Unfortunately, the Conservative motion does not mention the services provided by the pilot projects. These include medical care, mental health support, medical support regarding sexually transmitted and blood-borne infections, employment assistance, and housing assistance. These projects have a holistic and broad vision of the needs of people who are addicted. Their addiction did not just happen, all of a sudden. Something happened. All these activities within the pilot projects and all these interventions must be based on understanding and openness, not judgment or punishment. We have to consider where the person is at. How did they get there? How can we help them? We need to unravel the knots in the addicted person’s mind. The Conservative motion does not refer to the fact that, so far, participants who are actually involved in these programs have had many beneficial effects, such as improved health, well-being and quality of life; a lower risk of overdose and reduced use of street drugs, which are inherently dangerous; a willingness to deal with health issues related to their situation; having more energy and being more active; and having more time in their lives. These are all important factors. They are more engaged with themselves. Lastly, these people re-engage not only in their own lives, but in their own societies. Will they be cured for life? Maybe or maybe not, but they do get on the path to recovery. Drug use is a public health and public safety issue. We must keep in mind that there is no single, simple solution. No single department is responsible. It is everyone’s business. Interventions must be based on evidence-based best practices and seek to protect the health and dignity of individuals. Dignity is one of the most important factors in the process. It is amazing how the behaviour of people with addictions can be affected by the gaze of others. It is amazing how they are affected by their own gaze, when they look in the mirror and see how much they have deteriorated, destroyed from within. They know it. They need help in dealing with that, in accepting and seeing the best in themselves. They should not be judged, not be ostracized and, above all, not be allowed to return to the black market with its uncontrolled hits. Quebec has a strategy comprising seven areas for action that intersect with the interdepartmental action plan: information and awareness; overdose prevention and harm reduction; public policy and regulation; vigilance and monitoring; evaluation, research and training; addiction treatment; and pain treatment. Those seven areas can be broken down into 15 measures that will consolidate and enhance access to naloxone as well as consolidate and expand the offer of substance use services. The goal is to protect people, even from themselves. By developing safer supply practices, drug hits can be controlled, as I said before, in terms of quantity and quality. Most importantly, stakeholders are opening the door to recovery for people with addictions by giving them access to support services that would be inaccessible without the pilot projects. Is that perfect? No. Services are overwhelmed by the magnitude of the crisis, hence the importance of better and larger health transfers. In short, the current crisis needs to be taken seriously. We must listen to stakeholders and develop a holistic vision to help people with addictions while cracking down on black market criminals. Above all, we must stop stigmatizing mental illnesses. The Conservative motion is throwing out the baby with the bathwater. I would rather keep the baby and raise it right.
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  • May/18/23 11:26:48 a.m.
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Mr. Speaker, I share my colleague's pain and emotion. To be quite honest, I prefer her emotion to the Conservatives' rigidness. She talked about how others see people who use drugs and how those people see themselves. We know that stigma has a major impact on how they react, on how they act. Does my colleague agree that working on reducing the stigma surrounding drug users could improve the current crisis?
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  • May/18/23 11:27:28 a.m.
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Mr. Speaker, when we see someone who appears to be in crisis because they have been using or because they are having mental health issues, we need to see the human being behind that behaviour, not judge them. That is another goal of these pilot projects. That is important. Sometimes people have hurts and hang-ups that explain the situation they are in now. We need to support them, help them, not judge them.
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  • May/18/23 11:28:05 a.m.
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Mr. Speaker, I want to thank my colleague for her very real, human speech. It is unfortunate, what this is turning into. I am hearing words like “rigidness” and “judgment”, and that is not at all the case. I know, here on this side, we heard one of our colleagues talk about the importance of community, connectedness and hope. We believe in the value of every single person. Dignity is so important, like the member said, absolutely. Empowerment is so important; the policies that are being put in place at every single level of government are there to empower the person. I know I did hear the member talk about services. I definitely believe in the importance of wraparound services, such as housing, counselling and psychotherapy. Could she expand on whether she believes in the importance of these services as well to help people overcome addictions?
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  • May/18/23 11:29:19 a.m.
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Yes, Mr. Speaker, those services are essential. There are functioning addicts, people who have housing but are at risk of losing it if their addiction gets worse. They need support. They may be addicted because of pain. That pain, be it physical or psychological, needs to be managed. Sometimes people need help to learn how to manage their pain and live with it. Those services are essential, and better funding is urgently needed.
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