Question Period Note: Overdose Crisis

• The COVID-19 pandemic has worsened long-standing challenges regarding substance use and the overdose crisis, with most jurisdictions reporting record high rates of overdose deaths and harms.
• In addition, people who use drugs are also facing additional barriers and risks related to the toxicity of the illegal drug supply and reduced access to health and social services, including life-saving harm reduction and treatment.

KEY MESSAGES
• Our Government recognizes that the overdose crisis is one of the most serious and unprecedented public health threats in Canada’s history.
• We continue to support efforts to improve access to treatment and harm reduction services; strengthen enforcement to help reduce the toxic illegal drug supply; increase awareness and prevention efforts; and, build the evidence base through investments in research and surveillance.
• We remain committed to working closely with our provincial, territorial, and municipal partners, and people with lived and living experience, to save lives and reverse this national public health crisis. IF PRESSED ON THE NEW NUMBERS DISCLOSED IN THE OPIOID REPORT …
• Our Government remains deeply concerned over the tragic loss of so many lives to the opioid crisis. The lack of available treatment, safer supply, and other services remains a significant challenge.
• That is why our Government remains committed to addressing the opioid crisis through tools such as naloxone access and training, supervised consumption sites and safer supply programs, which are saving lives. Without these interventions in harm reduction, the number of overdose deaths would be exponentially worse.
• Our Government remains committed to working with all our partners to achieve the results that will end this complex public health crisis.
IF PRESSED ON TREATMENT…
• Our Government recognizes that improved access to treatment services can help those struggling with substance use and save lives.
• We have approved the use of new medications to treat opioid use disorder and removed barriers to prescribing and dispensing.
• We have supported the development of clinical guidelines for injectable opioid agonist treatment.
• In addition, our Government has provided $150 million through the Emergency Treatment Fund for provinces and territories to improve access to evidence-based treatment services, which, when cost-matched by provinces and territories, will result in an investment over $300 million.
IF PRESSED ON HARM REDUCTION…
• The evidence is clear – harm reduction measures save lives.
• The Government has committed funding to innovative projects, such as providing medication as an alternative to the toxic illegal drug supply.
• We know that for those who are not yet ready to seek treatment, supervised consumption sites save lives. Since 2017, federally authorized supervised consumption sites have reversed nearly 27,000 overdoses without a single death at a site.
• Our Government has also increased access to life-saving naloxone across the country, including to remote and isolated First Nations and Inuit communities.
IF PRESSED ON AWARENESS AND PREVENTION…
• Our Government recognizes the importance of investing in prevention efforts, including awareness building.
• We have invested in prevention campaigns that include engaging youth and young adults on risks and harms of substance use and the impact of stigma on people who use drugs.
• We supported school-based approaches that enhance student well-being in order to prevent substance use related harms for this important population.
• We are also funding projects that promote changes in the health system to help enhance the pathways to care for people who use drugs.
IF PRESSED ON SAFER SUPPLY…
• Our Government is aware that the pandemic has led to a more uncertain and dangerous illegal drug supply.
• We have taken action to save lives by providing people who use drugs with safer, pharmaceutical-grade alternatives to the toxic illegal drug supply.
• For example, we have allowed pharmacists and practitioners to extend, renew and transfer prescriptions to facilitate access to medications during the pandemic.
• Our Government is funding safer supply projects in British Columbia, Ontario, Quebec, and New Brunswick and will support and scale up effective models.
IF PRESSED ON SUPERVISED CONSUMPTION SITES…
• Evidence shows that supervised consumption sites reduce harms and save lives.
• Since 2017, supervised consumption sites in Canada have received more than 2.9 million visits, reversed almost 27,000 overdoses without a single death at a site, and made over 127,000 referrals to health and social services.
• These sites also provide access to other health and social services for people who use drugs, including opportunities to access treatment.
• We will continue to work with provinces and territories, and stakeholders, to take measures so that Canadians continue to have access to these lifesaving services.
IF PRESSED ON THE EXPERT TASK FORCE ON SUBSTANCE USE …
• We are committed to a comprehensive public health approach to substance use that is focused on reducing harms, saving lives, and getting people the supports they need.
• We are studying the Expert Task Force on Substance Use recommendations on how we can better treat substance use as a health issue. These recommendations are publicly available on the Health Canada website.
IF PRESSED ON PAIN…

• In early May, the Canadian Pain Task Force published their final report, which includes recommendations on key areas to ensure people with pain are recognized and supported, and that pain is understood, prevented, and effectively treated.
• We will continue to work with our partners to explore implementing the recommendations and potential next steps.
• We have also invested over $175M in pain-related research through the Canadian Institutes for Health Research and close to $19M in funding for 12 initiatives through the Substance Use and Addictions Program focused on improving opioid prescribing practices and pain management.

Most recent national data indicates that 24,626 apparent opioid toxicity deaths occurred between January 2016 and June 2021. Fentanyl and its analogues continue to be major drivers of the crisis with as many as 87% of accidental apparent opioid toxicity deaths so far in 2021 (January to June) involving fentanyl. While Canadians of all walks of life are affected, there are striking patterns, with death most common among males and individuals aged 20 to 49 years old.
The COVID-19 pandemic is compounding the ongoing overdose crisis, and people who use drugs are experiencing higher risks related to an increasingly toxic illegal drug supply and reduced access to treatment and harm reduction services. Several jurisdictions have observed unprecedented numbers and rates in relation to the wider impacts of the COVID-19 pandemic.
Although these increases have been observed across the country, Western Canada continues to be highly impacted. In 2020, the British Columbia Coroners Service reported 1,724 illegal drug toxicity deaths, a 75% increase over the number of deaths in 2019. Additionally, the crisis in BC continues into 2021 where the number of deaths so far in 2021 (January to July 2020 - 1,204 deaths) is the highest ever recorded in first seven months of a year, and a 28% increase over the same time last year (Jan to July 2020 – 941 deaths). Tragically, overdose deaths among First Nations people in BC have also surged, increasing by 119% in 2020 compared to 2019. In 2020, Alberta also experienced a 61% increase in opioid overdose deaths among First Nations people, as compared to the same time period in 2019.
FEDERAL ACTIONS TO ADDRESS THE OVERDOSE CRISIS
Since 2017, the federal government has taken significant actions and made investments of over $700M to address the overdose crisis and substance use-related harms. Additional actions to date include: improved access to treatment and harm reduction, reduced regulatory barriers to treatment; strengthened law enforcement, developed of educational products and tools for the public and health care providers, and research and surveillance to build the evidence base.
This includes Budget 2019 investments of $106.7M over five years with $1M ongoing and $66M announced in the Fall Economic Statement (December 2020) to help support community-based organizations responding to substance use issues address the additional challenges posted by the COVID-19 pandemic. In March 2021, the government announced $20 million in funding for the distribution of naloxone kits and opioid overdose response training to support communities that have been particularly affected by the opioid overdose crisis and are experiencing challenges in improving health outcomes of their residents. Budget 2021 also committed an additional $116 million to fund projects through the Substance Use and Addictions Program (SUAP).
In addition to these investments, the Government of Canada has also taken action to make it easier for people being treated for substance use disorder to access medications and for frontline service providers to establish overdose prevention sites in temporary shelters.
The Minister of Health established an Expert Task Force on Substance Use in March 2021 that provided expert advice on Canada’s federal drug policy, including examining potential alternatives to criminal penalties for personal drug possession. The Task Force provided its final advice on alternatives to criminal penalties in May 2021, and on federal drug policy in June 2021. Both reports of the Task Force have been made publicly available and can be found online at https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-task-force-substance-use/reports.html.

KEY FACTS
• Most recent national data indicates that 22,828 apparent opioid toxicity deaths occurred between January 2016 and March 2021. Fentanyl and its analogues continue to be major drivers of the crisis with as many as 87% of accidental apparent opioid toxicity deaths so far in 2021 (January to March) involving fentanyl.
• Our commitment to this crisis has seen us invest over $700 million, including $182 million to community organizations.
• This includes $150 million through the Emergency Treatment Fund for provinces and territories to improve access to evidence-based treatment services, which, when cost-matched by provinces and territories, will result in an investment over $300 million.
• Since 2017, supervised consumption sites in Canada have received more than 2.9 million visits, reversed almost 27,000 overdoses without a single death at a site, and made over 127,000 referrals to health and social services.