Nathaniel Erskine-Smith

Your member of parliament for

Beaches-East York

Nathaniel Erskine-Smith

Your member of parliament for

Beaches-East York


C-37 Will Save Lives

Read/watch Nate's thoughts on Bill C-37 in the House during Second Reading.

To save lives, our government fast-tracked Bill C-37. Among other things, it simplifies the process for organizations to apply for and open supervised consumption sites.

Here is my speech in support of Bill C-37:

We can and should treat drug use and abuse as a health issue, and not as a crime.

Our government has committed to a sensible and evidence-based approach to drug policy. That approach is emphasized by the recent task force report on cannabis regulation.

And it is emphasized by our Health Minister’s actions. Those include restoring harm reduction as a key pillar of Canada’s drug strategy, permitting physicians to prescribe heroin to severe drug addicts, and introducing Bill C-37, effectively repealing the previous Conservative government’s attack on evidence and supervised consumption sites.

The story of that attack, and how we have ultimately come to Bill C-37, it begins with Insite, and the former Conservative Health Minister’s refusal to renew its exemption from the Controlled Drugs and Substances Act.

Insite is a supervised injection clinic in Vancouver. It is North America’s first government-sanctioned such facility, having received a conditional exemption in September 2003.

Since that time, it has been open 7 days a week. Users are provided with clean injection equipment to use. They are monitored by staff during injection, and health professionals provide treatment and support in the event of overdoses. Users are provided with health care information, counselling and referrals to health authorities and service providers. In the fall of 2007, a detox centre opened above Insite – named “Onsite” – to provide detox on demand. It’s a drug free environment supported by addiction specialists, physicians, nurses, and peers.

Since opening, Insite has saved lives and improved health outcomes with the support of the local police, as well as municipal and provincial governments. The benefits of Insite and supervised injection facilities, and the lack of any related negative impacts, have been well documented in leading scientific journals, including the New England Journal of Medicine, The Lancet, and the British Medical Journal.

An expert advisory committee’s report to the former Conservative Health Minister concluded that there was no evidence of increases in drug-related loitering, drug dealing, or petty crime around Insite, there was no evidence that Insite increased the relapse rate among injection drug users, the police data showed no changes in rates of crime recorded in the area, and the cost/benefit analysis was favourable.

Despite all of this, that Minister refused to grant a continued exemption and stated that Insite “represents a failure of public policy.”

Now, in determining the successes and failures of public policy, we must be guided by evidence.

Contrary to the claims of that Conservative Minister, Insite did not represent a failure of public policy. But the Conservative Minister’s actions did represent a failure of decision-making in the public interest.

In fact, it was such a failure that the Supreme Court of Canada, in a unanimous 9-0 decision in 2011, ordered the Minister to grant an exemption to Insite and stated as follows at paragraph 133:

“Insite saves lives. Its benefits have been proven. There has been no discernable negative impact on the public safety and health objectives of Canada during its eight years of operation. The effect of denying the services to the population it serves is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.”

At paragraph 153, the Supreme Court held that a Minister must consider a number of factors in exercising discretion to grant an exemption from the CDSA, including 1) evidence, if any on the impact of such a facility on crime rates, 2) the local conditions indicating a need for such a supervised injection site, 3) the regulatory structure in place to support the facility, 4) the resources available to support its maintenance, and 5) expressions of community support or opposition.

In the face of that landmark decision, the previous Conservative administration remained wilfully blind to the evidence, and continued to attack safe injection facilities.

With the introduction of then Bill C-2, the previous government ignored our Supreme Court, and in the words of the Canadian Nurses Association, created “unnecessary and excessive barriers to establishing supervised injection facilities.”

Bill C-37 removes those unnecessary and excessive barriers. Bill C-37 simplifies the process of applying for an exemption from the CDSA for supervised consumption sites, as well as the process for subsequent exemptions.

Specifically, Bill C-37 replaces the excessive 26 criteria imposed by the Conservatives with the 5 factors set out by our Supreme Court. It simplifies documentation, requires reasons for a Minister’s decision, and removes the moralizing principles regarding illicit substances.

Bill C-37 will save lives. And one need not condone drug use to want to save lives.

Now, this is a good beginning to a modern drug policy, with public health and harm reduction front and centre. In addressing the United Nations last year on April 20, our Health Minister said: “I am proud to stand up for drug policy that is informed by solid scientific evidence and uses a lens of public health to maximize education and minimize harm.”

That commitment to evidence is important. But it also demands that we go further.

Fentanyl and illicit drug overdoses killed hundreds of Canadians in 2016. B.C. health officials and medical experts have called it a public health emergency. It is so serious that the B.C. government opened two new supervised consumption sites without waiting for federal approval. We need new solutions. The current approach, the so-called war on drugs of criminal sanctions and preaching abstinence is not working.

We need new solutions.

The current approach – the so-called war on drugs of criminal sanctions and preaching abstinence – it isn’t working. In 2011, the Global Commission on Drug Policy called for an end to drug prohibition, stating that “government expenditures on futile supply reduction strategies and incarceration displace cost-effective and evidence-based investments in demand and harm reduction. That Commission included former presidents and prime ministers of Brazil, Colombia, Greece, Mexico, Switzerland, former UN Secretary General Kofi Annan, and former Supreme Court of Canada judge and UN High Commissioner for Human Rights Louise Arbour.

Prohibition has failed to effectively curtail the supply or consumption of illicit drugs. And its unintended consequences can be devastating, creating a lucrative and violent black market, and shifting resources to public health to law enforcement, instead. Those enforcement efforts only serve to divert problems to new geographic areas or to inadvertently promote the use of alternative drugs, and the use of the criminal justice system marginalizes those who are already often at society’s margins, diminishing the likelihood that they seek treatment.

Prohibition treats the very people we want to help – the victims, the users, the addicts – as criminals.

Looking outside of Canada, we know there is a better path.

In 2001, Portugal decriminalized low-level possession and use of all drugs. Those caught with drugs are sent before dissuasion commissions, which include representatives from law, medicine, and social work. More than 80 percent of cases are dismissed without sanction, and the number of people arrested and sent to criminal courts declined by more than 60 percent. There’s been no major increase in drug use (the level of drug use is below the European average), adolescent and problematic drug use has decreased, and the number of deaths from drug overdoses has dropped significantly.

As Donna May – a woman who lost her daughter to overdose on August 21, 2012 has said: “We have to get ahead of this crisis and the fastest and most effective way of successfully accomplishing this may well be done by taking away the profit from the black market and dangerously produced counterfeit opioids by legalizing and regulating all substance use. At the very least, following the lead of other countries who have decriminalized drugs and substituted criminalization with a health protocol, needs to be seriously considered.”

I’m not suggesting I have all of the answers. But I am asking our government and this House to consider additional public health and harm reduction measures. I am asking us to work together to save lives.