[Recorded by Electronic Apparatus]
Tuesday, October 22, 1996
.1038 
[English]
The Chairman: As part of our study of Canada's drug policy, we're pleased to welcome, from the Canadian Foundation for Drug Policy, Mr. Eugene Oscapella. We assume you may have an opening statement. We hope it's real brief so we can ask you some questions.
Mr. Eugene Oscapella (Founding Member, Canadian Foundation for Drug Policy): Thank you, Mr. Chairman. I will try to make my comments very brief at the outset.
First of all, I would like to say that the foundation is appearing here in a non-partisan mode. We are not a partisan organization. That said, it is this government that has passed legislation that has caused a great deal of difficulty. So our remarks may appear partisan, but I assure you they are not. We would be critical of any measure that had these consequences, no matter which government passed it.
We are an association that was formed in 1993 by 11 of what we believe to be the most experienced drug policy researchers in this country. We have pharmacologists, criminologists, lawyers and public policy researchers. Collectively, we have, I believe, about 175 years of experience in the field of drug policy. So I would encourage the members of this committee to treat our remarks with that in mind.
To be polite, we were extremely dismayed that the Controlled Drugs and Substances Act received royal assent in June. It's clear that there's a great deal of misinformation about drug policy in this country and the effect of prohibitionist drug laws like this.
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We're very concerned about what we can only see as - I don't like to say it's deliberate, but it's very hard to say anything else - deliberate attempts by the government proposing this legislation to describe it as something it is certainly not. It is not a compassionate piece of legislation; it is a very inhumane piece of legislation. It is going to do tremendous harm to this country. That is the point we'd like to address today.
I think perhaps you can see graphically how we have a problem with our drug laws by looking at the front page of The Gazette in Montreal from Sunday. I have a copy of it here. On this page you'll see an article called ``Gang Revenge Expected''. The gang revenge they're speaking of is by the motorcycle gangs in Montreal that have been fighting each other over the drug turf there. This is a drug turf created by the criminal prohibition of drugs, the Controlled Drugs and Substances Act and the present Narcotic Control Act.
Here you will see an article dealing with police corruption. It's an inquiry into the Sûreté du Québec that's looking at possible links to drug traffickers.
Down here you'll see a human rights issue dealing with drug testing. President Clinton now wants to introduce drug testing for young drivers of cars.
These are three of the consequences of the criminal prohibition of drugs.
There are other consequences, too. We stop about 10% of the illegal drugs destined for this country from coming in. Our drug laws do not work. They do not stop the flow of drugs into this country. They do not stop the production of drugs within the country. In fact, they encourage the flow of drugs into the country. They encourage the production of drugs within Canada. They encourage the use of drugs.
Our basic point is that our drug laws haven't worked, are not working, and - this is more of the same - will not work.
This is a health committee, Mr. Chairman, so I would like to very briefly mention some of the health consequences of this type of legislation. You are concerned about the health of Canadians. Let me explain how this legislation is going to do tremendous harm to the health of Canadians.
In 1993, 331 people died in British Columbia from drug overdoses. They get drugs of unknown purity and adulterated drugs. They don't know what they are taking. This is a product of prohibition, just as much as illegal moonshine was a product of the prohibition of alcohol in the 1920s.
We would argue that many of these overdose deaths are entirely preventable if people had a clean, safe supply of the drug on which they're dependent.
We know our drug laws are responsible for the conditions that lead to the spread of HIV infection and hepatitis C infection. In one Canadian prison, the Prison for Women, the rate of hepatitis C infection is approaching 40% of the inmate population. That is a terrifying figure. This is largely, or at least in part, because we're imprisoning people with drug problems. We're not treating them; we're imprisoning them. We're putting them into high-risk prison environments, and they're getting infected.
We know our drug laws are creating conditions that are leading to the spread of AIDS and hepatitis around the world. This isn't something that's going to kill a few people; this is going to kill millions of people over the next decades around the world.
We are encouraging the production of more potent forms of drugs. Just as during prohibition in the 1920s, very potent forms of alcohol became available, we are now encouraging the production of more potent forms of drugs because they have to be hidden and easily transported. The more potent you make a drug, the less of it you have to carry across our borders.
We're driving away people from treatment, which is really what dependent people need. We're driving them away from treatment and their support communities and we're criminalizing their behaviour. We're pushing them to the margins of society.
We're drawing resources away from our health and social programs. We're inhibiting honest educational messages about drugs. We're distorting messages about the legal drugs by focusing on illegal drugs. We're creating the perception that some drugs are more harmful than others because of their legal classification, again, leading to considerable harm. In some ways, we may be shifting the consumption patterns of drugs from drugs that are less harmful to drugs that are more harmful.
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I would argue, for example, there's a tremendous amount of violence associated with the consumption of alcohol. I think that's quite clear to us. Cannabis is not a drug that engenders violence by its use, and yet we discourage the use of cannabis and encourage the use of alcohol in this society. Some of the women's groups in this country might be concerned about the effect of the laws on violence.
These are just some of the problems that flow from a reliance on the criminal prohibition of drugs. I hope this committee will reconsider the very foundations of Canadian drug policies. Our drug policies at present are not harm-reduction policies. It is extremely misleading to characterize them as harm-reduction policies. They are punitive, brutal policies that do not serve Canadian society. Your own party acknowledged that in resolutions at its biennial convention in 1994. Another resolution is going to be put before the biennial convention this weekend, dealing with the need for an independent inquiry into the foundations of Canada's drug problems.
Finally, I would say that over the past two and a half years, many, many witnesses have appeared before both the Commons subcommittee that looked into Bill C-7 and the Senate Standing Committee on Legal and Constitutional Affairs. Their recommendations were almost entirely ignored by this government.
I know there have been people within the government attempting to amend the severity of these laws, and to those people we extend our thanks. But we also know this government has passed very Draconian legislation. It has ignored the considered views of the vast majority of witnesses who appeared before it. This is leading to a profound degree of cynicism about the process of parliamentary reform.
Thank you, Mr. Chairman.
The Chairman: Pierre, then Paul.
[Translation]
Mr. de Savoye (Portneuf): Mr. Oscapella, welcome back to the Standing Committee on Health. I remember that you had made similar observations similar to the ones you made this morning at our hearings on Bill C-7. Bill C-7 has now been passed and it is in all likelihood because of your comments and similar comments by many witnesses that the Standing Committee on Health has asked the House for a mandate to examine the Canadian drug strategy. The spirit that guides our work today is quite different from the one which prevailed when we studied Bill C-7, since our mandate is different.
That being said, in my opinion, the members of the House of Commons are very well aware of the ravages caused by drugs, both to the health and social climate of families and to various environments. We want to find useful and effective means of intervention to reduce the problems related to drug use.
That being said, I know, as do the other members as well no doubt, that any legislation we introduce has to respect the population's perceptions. Even if they are not reality-based, we must legislate in a way that respects those perceptions because the population would not understand anything else.
The purpose of the exercise we have undertaken is not only to inform us, as members, on the situation; we also want to determine what to do in order to inform the population.
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Our visits to many cities will give the population an excellent opportunity of better understanding the drug problem, its causes, and to become aware of possible effective solutions.
This morning, I would like to ask you to tell us about solutions, if possible, which have been attempted here or elsewhere in the form of pilot projects or which have been successful, and which we should examine with particular attention in our travels throughout the country.
I know that you are particularly well informed on all of these questions and have been for a number of years and that you are thus a precious source of information for us this morning.
Mr. Oscapella: Thank you, Mr. de Savoye. I would like to answer in English because that is easier for me.
[English]
First of all, I would like to thank you, because our foundation realizes you have been one of the most profound thinkers in the House of Commons on this issue. We do sincerely thank you for your consideration of these issues. It has been of great assistance to us.
One of the things you mentioned was the perception of the public. One of the things we have to deal with is people in public office who occasionally make irresponsible statements - because the public listens to those statements. I'll give you one example. In the House of Commons on October 30, 1995, an MP stood up and said the marijuana that's available today is 15 times as potent as it was 10 years ago, and as potent today as cocaine was 10 years ago.
This statement was utter nonsense. It was not scientifically valid. It made no sense. Marijuana and cocaine cannot even be compared as drugs. They have completely different properties, completely different characteristics. This statement was made in the House of Commons and went onto the public record.
It is these types of irresponsible and uninformed statements that cause tremendous damage to the process of intelligent drug policy reform in this country. We cannot have a debate on drug policy in this country if people continue to make misleading statements like that.
So I urge the members of this committee and other members of Parliament to be careful when they speak of these issues, because they can do a great deal of damage to an intelligent discussion on this topic by making a misleading statement.
As to the solutions, there are methadone programs. We have some methadone programs in Canada. Methadone is basically a synthetic opium, a substitute for heroin. We know they can help. There are heroin maintenance programs in the United Kingdom and in the Netherlands. Germany is looking at heroin maintenance programs. Switzerland has started heroin maintenance programs, both in prison and out. Australia is looking at heroin maintenance programs.
These would be programs that would supply a clean, safe supply of heroin to dependent users. The initial results - and perhaps Dr. Riley can speak to this later, because I know she's appearing - from my understanding, particularly with the Swiss experiment, have been very good, as they were with the English experiment.
The Dutch effectively decriminalized the possession of cannabis 20 years ago, in 1976. Eleven American states have decriminalized possession of cannabis. The rates of consumption of cannabis did not explode, as some MPs have alleged. The rates of consumption did not in fact explode after they decriminalized the possession of these drugs. In fact, the rates of consumption have generally been lower or about the same as rates of consumption in states or countries that have very severe penalties for the possession of marijuana.
So there's one option. We could get the law enforcement business out of going after drug users. We could certainly reduce much of the harm associated with the tremendous cost of law enforcement, the civil liberties implications of going after people, the human rights aspects, and the criminalization of people unnecessarily. Those are some of the programs that have been tried elsewhere in the world, that are being considered by several countries, and that Canada should be looking at. We don't need to follow this punitive McCarthyist model that is the American model.
[Translation]
Mr. de Savoye: On the matter of prevention, I remember that when we were studying Bill C-7 several witnesses talked about the virtues of education, especially where young people are concerned.
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Do you have any statistics or experiences you would like to share with us in this regard?
[English]
Mr. Oscapella: All I can say about education is that we have to have honest education. You can imagine a 16-year-old child who uses marijuana for the first time after being told that it's an extremely dangerous drug that's going to cause tremendous harm, and that child finds out in fact that marijuana doesn't cause tremendous harm. As the British Medical Journal states, and as many medical organizations will tell you, this drug doesn't cause harm. They are not going to believe other drug-related messages.
What we need is honest education about the harms associated with all drugs: alcohol, tobacco, heroin, cocaine, marijuana, and ecstasy. We need an across-the-board, honest approach to education. This vilification of some drugs and the deification of other drugs leads to very distorted educational messages. That causes much of the harm we see.
[Translation]
Mr. de Savoye: Thank you. Thank you, Mr. Chairman.
[English]
The Chairman: Paul, and then Bonnie.
Mr. Szabo (Mississauga South): Thank you, Mr. Chair.
It's nice to see you again. Having been the chair for Bill C-7 and gone through it, members will realize that Bill C-7, which became Bill C-8 in the new Parliament, was not a bill dealing with Canada's drug strategy. It dealt with consolidating parts of the Food and Drugs Act and the Narcotic Control Act, but one of our recommendations was that we do this process.
I'd like to just provide you with some information. Are you familiar with the document prepared by the Canadian Centre on Substance Abuse? It contains the latest available data on drugs, including alcohol, tobacco, and illicit drugs.
Mr. Oscapella: I've seen parts of it, sir, yes.
Mr. Szabo: This is the best information that Canada has. It just came out on June 20, 1996, and despite your figures about how jillions of people are going to be dying, the latest figures are that732 people died from drug-related deaths in 1992. That's the most available data it has. The total cost of that to Canadian society health care was $88 million - direct health care costs.
I don't understand how you can accuse everybody else of putting out misinformation when you come here before the committee and claim that the current drug laws are killing numbers of Canadians far in excess of what independent experts have advised the Government of Canada. I think you should reconcile your numbers with that.
I would also like you to comment on the whole aspect of harm reduction versus supply reduction in terms of an approach, because I think it's important for this committee to ultimately deal with. It would appear to me from your comments that you're basically saying that all of this is happening anyway, so let's stop trying to stop it. Let's just let it go. How is that going to affect the vast majority of Canadians, who have absolutely no interest or participation in the illicit drug use, distribution, etc.? How do you think stopping this battle against illicit drugs would affect the rest of Canadians?
Mr. Oscapella: I'll be pleased to respond to all those things.
First of all, what I said was that our present drug laws will foster the conditions that will lead to thousands of deaths from HIV infection and from hepatitis C over the coming years.
If you look at tab 3 of the materials I sent you, there's a fairly extensive document outlining just how our drug laws do in fact contribute to the spread of HIV infection and hepatitis C. There are multiple ways in which these drug laws contribute to that. Overdose deaths are not the only form of drug-related death in this country. There's death related to HIV infection acquired through the use of injection equipment.
We have argued, and I think the evidence is quite clear, that our drug laws encourage people to use drugs in more efficient manners because of the excessive cost of these drugs. In other words, instead of snorting heroin or cocaine, because these drugs are so expensive to buy, you have to use it in the most efficient manner possible. So what do you do? You inject.
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I'll give you another example of how our drug laws contribute to the spread of HIV and hepatitis C. If you're a drug user, you don't want to be caught on the street in possession of drugs or syringes, because you know the police will either arrest you or harass you. So what do you do? You go to a shooting gallery where they supply the drugs, possibly adulterated. You don't know the quality of the drugs you're getting there. They'll also supply the injection equipment and the other works you need to inject these drugs. You don't know whether you're getting a clean syringe. So our drug laws are directly responsible for fostering the conditions that lead to people becoming infected.
We're putting drug users in prisons, where we are not giving them treatment and where they will continue to want or need to use drugs, and we're not giving them the means to prevent HIV infection. You cannot get clean syringes in Canadian prisons. The rate of hepatitis C infection in the Prison for Women in Kingston, as I said, is about 40%, according to a 1994-95 study. That is an appalling figure. We know that a lot of the hepatitis C infections and HIV infections among women are coming as a result of injection drug use. We have to look at how our drug laws create the conditions that lead to the infection of people.
As to my figure of jillions, it was millions. I'm serious about that figure, because we also know that the prohibition tends to encourage the production of more concentrated forms of drugs. In Thailand, for example, it appears they've had some success in eliminating some of the heroin production labs from Bangkok. So heroin production has moved up into the hills of Thailand, where traditionally people smoked opium. Opium did not pose a risk of HIV infection. Heroin does, because people are starting to inject it. What we're seeing is a swath of HIV infection going through Southeast Asia into India that will kill millions of people over the coming years. That is what I'm speaking about.
I'll now deal with your third point. I've forgotten what your second point is. The impact on the rest of this country of decriminalizing or moving to a harm reduction approach would be quite dramatic. There would be significantly less acquisitive crime related to the need for heroin and cocaine addicts, for example, to have to pay the exorbitant black market price of drugs.
These gang fights in Montreal that have killed 55 people over the past three years.... Incidentally, they found a truck loaded with 90 kilograms of explosives in Montreal. You can read the same article here. This was going to be used as part of the ongoing turf war amongst drug dealers. It would probably make our society safer, because we wouldn't have organized criminals fighting over the drug turf that we now have. Criminal prohibition fosters an enormously profitable, lucrative, corrupting, violent black market in drugs. It's time we realized this, and it's time we tried to deal with it. You cannot stop the black market through law enforcement. It will not work. We stop less than 10% of the drugs coming into this country. Law enforcement does not work.
We have to look at other means to discourage these groups. One of the means is making a clean, safe supply of a drug available to a heroin addict so that he doesn't need to turn to crime. He can stay with his family, he can stay employed, and he can function in society. That's what we need to do. That is our approach. It's not a punitive approach.
The Chairman: We're running out of time. Bonnie, very quickly, and Harb, very quickly.
Mrs. Hickey (St. John's East): I just wanted to talk about the youths for a moment, because everything you read today shows that youths in the environment today are using more marijuana. It's on the increase instead of decrease. I guess that's where education comes in. When do we start educating these people so that they don't get into heroin and so on.
There's also an increase in tobacco and alcohol consumption. Is there a reason you may have studied or know of that youth are being targeted this way? Why are they on the increase more so than, say, adults?
Mr. Oscapella: Let's take smoking, for example. We know that the reason some girls smoke is that nicotine is an anorexic; it keeps you thin. Smoking in young women can be directly related to the need to stay thin. There's peer pressure, obviously. That's another issue.
Why do people use drugs? What are the social circumstances? We know that street kids use a lot of drugs. Maybe they're doing it to escape the misery of their existence. We don't know. There are ebbs and flows in patterns of drug use. If you look at drug use over the years, drug use will go up and down with the same laws in place. There are ebbs and flows within society. What we really should be looking at are the social conditions that are leading to these changes in the patterns of drug use, not the laws, because the laws aren't really having any effect.
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Mrs. Hickey: What about that statement you made earlier? You said drugs such as marijuana and that level of drugs aren't really as dangerous as we think they are, or as we tell people they are. Is that message getting to the youth, that it's okay to do those drugs because they're not dangerous? Would that be a reason for the increase?
Mr. Oscapella: I would have to ask this question. If a drug isn't dangerous, why should people resist other people using it? That's the first point.
But we don't want people driving while they're under the influence of cannabis, because that can be bad. We know if you smoke too much cannabis it can be bad for your lungs. But of course people don't smoke cannabis to the same extent they smoke cigarettes. You don't smoke 20 cannabis joints a day, as you do with nicotine. The average nicotine smoker uses 19 cigarettes a day.
What you want to do is discourage the harmful consumption of substances. You have to honestly educate people on the possible consequences if they use cannabis and the possible consequences if they use cocaine. You have to tell them they might become dependent on cocaine and it could cause them tremendous physical harm.
Let's be honest about these messages. We have to be honest, because if we keep lying and distorting the messages to kids, they find out. They're smart.
The Chairman: Mr. Dhaliwal, very quickly, please.
Mr. Dhaliwal (Vancouver South): Thank you very much, Mr. Chairman.
I want to thank you for your presentation. I agree with you that we need a new solution to deal with the drug problem. When I toured some of the prisons, one of the prison wardens said 75% to 80% of all crime is the result of drugs and alcohol. We need to address the issue.
We understand the problem, but the solution is very difficult. It's not that easy for one to say ``let's decriminalize''. We have to sell to the public that we have to have new solutions and do it on a step-by-step basis.
Going back to India, I witnessed a village where everybody knows the local village addict, but he doesn't have to steal to get his drugs. It grows wild, so he can go out and pick it and smoke it. Everybody knows he's a drug addict, but there's no crime element involved in it.
We need solutions where we can provide it in a controlled environment, and that's where the problem is. If someone wants to register himself and say he has a problem, we should be able to deal with him in a controlled environment, registered for a medical reason. That can be accomplished. But you have civil libertarians and other people who then object to those types of solutions.
I agree with you that we need to approach this with a different approach, where those people who are drug addicts can register and it can be provided on a basis of trying to cure the problem. We're not just saying ``You're a drug addict. Here you go. Thank you very much.'' We're saying ``You have a medical problem, and therefore, in a controlled environment under a doctor's supervision, we're going to try to deal with your problem.'' We should do this on a step-by-step basis.
This needs to be debated. It needs to involve the public. We need to get all the facts out. I agree very much.
Thank you for your excellent presentation.
Mr. Oscapella: We will support any attempt to bring a sense of rationality to Canada's drug laws. We will speak in favour of intelligent government actions. We've been very critical in the past because we've felt these actions have done a lot of harm. We will support you. One of our goals is public education. We will help to the extent we can.
We realize there is a series of intermediate solutions between both polar extremes. We're happy to talk about them. We will meet with people. We will support parliamentarians who have the courage to speak on this issue. We know it's a difficult issue politically. We will support you; I can promise you that.
Mr. Dhaliwal: Thank you.
The Chairman: Thank you very much.
Mr. Oscapella: Thank you, Mr. Chairman.
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The Chairman: We'll continue now. In a moment I'll welcome our next witness. Before doing so, just let me say that we are losing some of our people because of the length of this meeting. We began at 9 a.m. and others have other commitments. Harb certainly has a commitment. Andy has a commitment to chair another committee at 11 a.m. But we have enough here to hear the witnesses.
The problem is that I have another commitment very shortly as well, and I've invited my colleague and friend, John Murphy, to take the chair in a minute for the balance of this session.
Let me welcome Professor Beauchesne from the University of Ottawa. We assume you have a brief opening statement because we want some time to ask you some questions.
[Translation]
Ms Line Beauchesne (Professor, Department of Criminology, University of Ottawa): Thank you for inviting me to take part in this reflection on a Canadian policy. You already have my brief, and I will simply give you a broad overview of the perspectives that formed the basis of the brief.
In reviewing Canada's drug policy, the first question to ask is the following: What objective do we want to attain? Prevention is not an objective as such, but a means; reducing the ravages caused by drugs is not an objective, but a means. In my opinion, the various statements one hears at this time in Canada do not contain any overall policy because prevention, if it is not guided by a very clear objective, can take all kinds of forms.
For instance, if I want to prevent my children from being hit by a car, I can lock them up in their room all day: that is prevention. I may also decide that my objective is to make them independent, and teach them how to cross the street. If I lock them up in their room, they will not know how to cross the street when they go out without my permission.
And so I asked myself: What do we want to do? I quickly became aware that Canada's health policy already has an excellent objective which is to promote health and teach people to be independent and to make choices, and that Canada's drug policy could very well be articulated around the Canadian health promotion policy.
I realized that in certain documents there was confusion between harm reduction and demand reduction. For instance, after various campaigns, the habits of those who do not consume drugs were assessed. In several programs, it was noted that people who had a moderate consumption no longer consumed drugs and people who had a problem consumption were not touched by the campaign. Let's be clear: we must define our objective. Is it to reach a point where people will no longer take any drugs, legal or illegal, nor medication nor alcohol, or do we want them to consume drugs in a moderate, i.e. non problematic way? Harm reduction means that consumption has become non problematic.
There are already two examples one can point to involving alcohol, one of them being Operation Red Nose. What is that? It is a harm reduction program which recognizes that people having fun will consume alcohol. We want to reduce the harm caused on our roads by people driving a car under the influence of alcohol. That is a harm reduction strategy.
Designated drivers are another example. Worried fathers can ask their children to arrange for a designated driver who will not drink any alcohol, while the other members of the group will. That is harm reduction. It involves recognizing that there is a situation where people will consume alcohol and reducing the risks involved.
On the basis of those two elements, the framework and the means, I have identified four focuses which you will find in the summary and which are inseparable: Improving quality of life - drug consumption differs according to your social class and milieu - ; improving information - we mentioned it earlier, and I wrote a book on programs to prevent drug abuse among young people; improving legislation and regulations, which in my opinion, not only have a bearing on illegal drugs, but also on the promotion of legal drugs. I am just as worried about Prozac and its frenetic promotion as a cure for everything that ails us. On the one hand, we allow certain drugs to be promoted without any restrictions, and on the other, we act as though certain drugs, if they were to be legalized, would be nothing but ticking time-bombs; finally, improving access to health care - and I think that Professor Riley will be discussing this later - that is all of the treatments that can improve the quality of life of people who have developed problems.
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And that is the end of my presentation.
[English]
The Chairman: Thank you.
Pierre, and then Paul, please.
[Translation]
Mr. de Savoye: Madam Beauchesne, it is a pleasure to see you here again today. We had the good fortune of enjoying your significant and timely co-operation during our previous work on Bill C-7. You are without a doubt one of those who have the most articulated thoughts on the matter, and we can see that in the four focuses you have defined.
Before you mentioned it, it was not at all obvious, but as soon as you defined the problem using those four focuses, the directions we must head in to implement solutions became more evident. I would like you to elaborate a bit more on those four axes. Why did you identify them? How could we use them to guide our reflection and our actions?
Ms Beauchesne: I was responsible for drafting an action framework for the Association des intervenants en toxicomanie du Québec (association of drug addiction workers of Quebec), and in the course of that work, we drafted a harm reduction policy. That is when we identified the four focuses with the drug addiction workers from various environments.
Why are those four focuses grouped together? When you do prevention work, you have to wonder why people take substances. For instance, if my daughter suddenly starts to eat huge quantities of chocolate on a daily basis, my first reaction will not be to forbid chocolate, but to wonder what is wrong with my daughter? So, the first reaction of drug addiction workers is not to say that we have to prohibit drugs, but to wonder what is wrong with those people. Their first questions were about the quality of life of a large number of those persons.
The second area of investigation was information. I reviewed the 375 programs that have been evaluated throughout Canada and the United States to determine the characteristics of good prevention programs.
There were three. The first was the multiplicity of approaches. Just providing information on products is a way of making young people curious without having a very long-term effect. I'm sure we all can recall the little briefcase that is opened up to display various drugs in any drug presentation. When the presentation is given by a policeman, we must not forget that the message is the messenger, not the content.
When I say multiple approaches, I also mean that we mustn't simply say that people take drugs because they have problems. The first time we consumed alcohol, we did not do so because we were unhappy. There are all kinds of other reasons to drink alcohol. The same thing is true of drugs. An effective program has to talk about publicity, the way one feels, one's body, a whole range of things, and finally the environment. To talk about the environment, you have to be able to talk about the full range of drugs to young people. So, the first characteristic was to have a multiplicity of approaches.
The second was that you had to broach the topic very early. In a good drug program, the presenter didn't say: "All right, today, kids, we are going to talk about drugs". You have to talk about health and introduce the topic gradually. In a good program, youngsters cannot say when the topic first came up; it was introduced imperceptibly in presentations about personal training, health, etc.
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The third characteristic is that adults who are important in the youngsters' life must be convening the same messages. That is the difficult part: how to reach parents and teachers. We are beginning at the present time to prepare training programs for parents and teachers to modify the message conveyed by the school. I must admit that this is the most difficult part, because the parents tell us that they don't want to read any documents; they're just not interested. They simply want us to tell young people that they should not take drugs. So I can understand your concern about citizens.
I won't go back to the third focus, improving legislation and regulations, because Gene has developed that topic sufficiently. I will let Diane Riley illustrate the importance of the last focus. When the person decides to take steps to get out of a problematic situation, he must have easy access to resources.
Mr. de Savoye: Thank you, Miss. That was extremely instructive.
[English]
The Chairman: Paul.
Mr. Szabo: Thank you, Mr. Chair. I'm almost afraid to ask a question. It might trigger another speech.
Very simply, Madam, I want you to know as a preamble that I do not understand why Mr. Oscapella and yourself, and I assume Ms Riley, will try to tug at the heart strings of people by claiming health, poor prisoners, poor people who get HIV, and poor this, that and all the other things, and fail to have the guts to stand up and say exactly what you stand for. What you stand for is to make drugs legal so everybody can have access to drugs. That's what you stand for.
I would like to ask you a very simple question. If drugs were made legal so you could get safe cocaine, safe marijuana, all the drugs you wanted, what signal do you think that would give to Canadians who respect the laws of Canada today, and what impact do you think it might have in terms of the number of users of currently illicit drugs?
[Translation]
Ms Beauchesne: You are asking me to stand up for what I believe. I say that legalizing, decriminalizing and harm reduction are not objectives as such, but means to an end. We have to ask ourselves which means will best allow us to reach our health promotion objective. In my opinion, Mr. Oscapella and Ms. Riley are not fighting for legalization, but for health promotion and to improve the quality of life of a certain number of persons who have problems. We must take care not to confuse means and objectives.
Secondly, what message do we want to transmit to our citizens? If I were to say that criminalizing people who drink and drive is not the best way of preventing drinking and driving, would that mean that I am for drinking and driving or that criminalizing people who drive after having consumed alcohol is not the best way of preventing those people from drinking and driving? What I have said, quite simply, and what the other speakers will be saying, is that the means currently being used are not the best means to prevent the problem consumption of drugs. We are not saying that we are in favour of problem consumption. We are looking for the best way of preventing it, and that is what we can say to our citizens.
[English]
The Acting Chairman (Mr. Murphy): Joe.
Mr. Volpe (Eglinton - Lawrence): I guess the professor would probably be in agreement with me that the best way to deal with this as a health issue, if we're really concerned about the best way to prevent use, is just to stop it. If you can prevent people from using this or you can encourage people not to misuse drugs, then you don't have to deal with any of the consequences. Is that too simplistic a view?
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[Translation]
Ms Beauchesne: My answer will be twofold. Do you think it is possible that we will one day have a world where no drugs, legal or illegal, are consumed? People use Valium to sleep, to manage their day. They use wake-ups or take a glass of alcohol when they come home from work. We use legal drugs to facilitate dinners. Do you think a world without drugs would be possible?
In the same way, I don't think a world without cars is possible. Since my daughter will some day be crossing the street, I had better show her how to cross the street. I can't keep her in her room forever.
Let me draw the following parallel: In Quebec, for a long time, people believed that the best way to prevent pregnancy was to never say anything about sex. In spite of that, there were many pregnancies and everyone hid them, until people realized that we had to accept that some young people would make love before being married and perhaps they should be told about contraception.
The same thing applies to AIDS. Schools are beginning to understand that they are going to have to accept and talk about the fact that young people do make love and that condoms do exist. Avoiding the topic is not a solution.
So, to manage our daily lives, we all on occasion take drugs, legal or illegal, medication or other drugs, and it is a better approach to teach people to be intelligent in the choices they make and to avoid problem consumption insofar as possible.
[English]
Mr. Volpe: Madam, since you have focused on human weakness and the frailty of the human experience, is it perhaps a little bit too much to expect, as you call it, an intelligent decision to be made?
[Translation]
Ms Beauchesne: Here, I am talking as a mother. When I drink wine with meals, my children of five and three-and-a-half see me. I'm not worried about explaining my consumption to them; through my behaviour, I am already showing them what they must not do.
Statistics on the problem consumption of alcohol show clearly that the majority of problem consumers are from families where the topic was taboo or where the consumption of alcohol was already a problem. Thus, the example of moderation in our behaviour is the best form of education.
[English]
Mr. Volpe: I think in the examples you've given me, Madam, with respect to love-making, pregnancy, and drinking, whether the drinking be with meals or without meals, you've underscored a value system, and a value system stripped of its religious or metaphysical allusions is not all that different from what I think you're espousing right now. But the value system I see in your four indications replace those you objected to in your own examples.
I'm wondering whether we should be addressing the reimposition, as you suggest, of a value system, which would permeate society by a series of techniques, none of which have been proven, that would have to somehow bring those new value systems into fruition so that there is no abuse. To have no abuse, one has to think logically or within the parameters of a widely accepted value system or there has to be a strengthening of the individual's ability to think logically through every single decision.
The examples you used make a direct reference to the inability of the individual to make decisions. You talked about unwanted pregnancy and drinking to excess as two clear examples. If in your family you had wine at the table with your meals, I'm sure that was one of the techniques by which a certain value system was projected in the household.
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By the way, I used to have wine with my meals, as well. I didn't think it was alcohol abuse until I walked out of the house.
[Translation]
Ms Beauchesne: I am not saying that you are going to eliminate drug abuse. I'll go back to the previous example. You are still going to see unfortunate love affairs and pregnant 16 year-old girls, but they should find support and the situation will be much less dramatic. There will also be young women who will manage to take the necessary precautions and others who will manage their pregnancies.
But we have to be careful to not put the emphasis on the products. In order to be able to say that there is no more drug abuse, I would have to be able to say that there are no more unhappy people, that the world is perfect and that there is no reason left to want to numb one's feelings in one way or another.
Let's go back to the example of drinking and driving. The idea is to find better ways of managing the problem, and the problem is linked to the quality of life of certain people and to personal conditions, but that approach is a means. We are looking for the best means of reaching people. Tomorrow, there will still be low income groups and unhappy people, just as there will still be people who will try to settle their problems by turning to alcohol or other substances.
Mr. Volpe: The problem is not drinking and driving. It is the way in which the person driving the car handles it. One of the conditions that lead to
[English]
misadministration or use of that particular vehicle...if you want to speak to me about eliminating all the factors that lead to bad driving, I think this might be a different discussion.
I guess, Madam, what I have yet to grasp is the connection between the approaches you propose and what some experts in the field tell me is a serious problem, drug abuse. They tell me that notwithstanding all the other techniques, which Mr. Oscapella alluded to - and I think one of his phrases was that the breakdown of a personal value structure or a societal value structure is the greatest impediment to rehabilitating the individual or giving the individual the appropriate footing to solidly replace substance abuse with quality of life. I think that was one of your first points.
I'm wondering how one does that when, at the same time, one puts forward ideas that suggest the individual has singular responsibility for making a decision that's not necessarily supported by all the information available to the individual making the life-altering decision.
The Acting Chairman (Mr. Murphy): We'll ask for your response and then we'll have to close.
[Translation]
Ms Beauchesne: I will answer your question briefly. Whatever the behaviour involved, be it driving a car, making love or taking drugs, there are risks. You can take one of two positions. You can prevent people from driving a car; that way, no one will be injured in car accidents. You can prevent people from making love; by curtailing one of the ways in which it is spread, you will reduce the spread of AIDS. You can prevent people from taking drugs. You could reduce the problems in these ways. But studies show that 80 to 85 per cent of people do manage their consumption of drugs, be they legal or illegal, and 10 to 15 per cent of people have problems. Should we concentrate on eliminating the risk and the product or should we acknowledge that 80 to 85 per cent of people manage their consumption quite well and wonder, rather, how to help, understand or reach those who have problems?
[English]
The Acting Chairman (Mr. Murphy): Thank you, Ms Beauchesne.
We'll bring it to a close now. Thank you very much for appearing before us.
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We'll now ask Diane Riley to join us.
Dr. Diane Riley (Chair, Harm Reduction Network): In the interest of time I will keep my opening statement brief. As you know, I have provided the committee with both a summary statement and a background paper on harm reduction, which is one of the main issues I'd like to address today, in questions as well, if you're interested in that.
I would like to say by way of preamble, though, something I think is fundamental to the proceedings of this committee and also addresses one of the questions raised already by Mr. Szabo, and that is what I stand for.
I feel very strongly about this, because I've worked in this area now for 24 years in various countries around the world.
One of the reasons I became interested in drug policy reform, although originally I was what you might call a fairly pure researcher doing brain research into drug-related effects.... During the 1980s I became interested in the fact that some of the patients I was treating were undergoing various disorders that we'd never seen before. Of course, these were the things we came to call AIDS and the effects related to hepatitis. During that time I realized that the work I was doing, which was so pure, had to become more applied and that I had to take political action in order to realize the kinds of effects I'd like to see. I realized that no longer were we able to keep drug users alive. We had to work out much better ways of protecting their health and insuring their life and their functioning ability.
I'd like to say that I stand for reduction of drug-related harm, just as I feel we all stand for reduction of pain, reduction of misery, reduction of human suffering. Over the last decade or so, since I've been very much involved in the HIV pandemic...I think it's also a way of dealing with the fact that the pandemic we see with HIV and with hepatitis B, C, D, E and F has to do with the fact that there are primarily two epidemics going on. One of them is sexual and the other is drug related, and I think we have to deal with them head-on. Those are the things that are going to be at the very heart of how we deal with our society in the future, because those are the things that are fundamental to the costs we will see in health care and so on.
I would also like to say, in addition to the comments I've presented to you in my summary, that it's important to look at the differences between legalization of drugs, decriminalization of drugs, and medicalization of drugs - the whole spectrum.
I certainly don't stand for legalization of drugs, and one of the things I'd like the committee to address is the fact that the drugs we do have that are legal or licit, such as alcohol and nicotine, and especially nicotine, are so poorly regulated. This division between licit and illicit is a false one, which says to children, for example, that you can use alcohol with little damage but you can't use marijuana because...and then we tell them the lies. I think the lying has to stop, not just with the illicit drugs but with the licit ones as well.
Dr. Beauchesne mentioned the issue of Prozac. This is something I'm considerably concerned about myself. I think these drugs are being pushed by the legal dealers in our society, and there is a great deal of money to be made in this.
One of the things we don't realize with Prozac is how poorly tested it is. The relationship between Prozac and other anti-depressants and cancer, especially breast cancer...as a woman I'm very concerned about this, and I think these are things we need to look into.
The other thing I think we need to look at very closely is who's benefiting from prohibition. Just before alcohol prohibition came to an end, when the Wickersham commission was held in the United States, one of the commissioners professed that prohibition was a dismal failure - soon after it came to an end. Yet why is it that a prohibition system that was a dismal failure has now become the heart of our international as well as our national approach to drugs? I think this is one of the issues we have to examine very closely.
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I would like to comment on that by giving a quote from Joseph McNamara, the chief of police in Kansas City and San Jose, California, now one of the most outspoken people against prohibition in the United States. He said:
- ``It's the money, stupid,''.... After 35 years as a police officer in three of the country's largest
cities, that is my message to the righteous politicians who obstinately proclaim that a War on
Drugs will lead to a drug-free America. About $500 worth of heroin or cocaine in a source
country will bring in as much as $100,000 on the streets of an American city. All the cops,
armies, prisons, and executions in the world cannot impede a market with that kind of tax-free
profit margin. It is the illegality that permits the obscene markup enriching drug traffickers,
distributors, dealers, crooked cops, lawyers, judges, politicians, bankers, businessmen.
It's the same with the shape of the curve with respect to the increase of infections of HIV, hepatitis B, C and so on, in injection drug users. It's an exponential. These are the things that concern me. It's what we're looking to in the future. I know you as politicians want to look to this as well.
We also have to look at what that means for our prisons. Many of the people we have in prison are there for drug- or sex-related offences. I think we have to look at that whole system, at alternatives in the form of what's called ``restorative'' justice, some of which is being practised out west, based on native models and so on. Those are good alternatives to look to.
But here we're interested in looking at solutions. I would suggest, as I did in the paper I submitted to you, that we look at harm reduction around the world. Many countries now have turned to harm reduction, including countries such as Australia, where it is the national policy. Australia was able to reduce its level of HIV infection in drug users from more than 6% to less than 1% over a few years.
In Canada now, in some of our cities, such as Montreal, we have a level of 20%. In Ottawa the level is 10.2%. The World Health Organization has cautioned that if one does not keep the country's level of HIV infection in injection drug users below 10%, then one faces an explosive epidemic. We are already facing that in many of our urban centres. I think we need to look at the solutions Australia took. How was it able to get its level back down again and maintain it?
Look at some of the other examples that are in the paper and in the binder we provided you from the foundation. Look at Merseyside, England, where HIV infection in drug users, despite the fact that they have the highest level of registered users in the U.K., is statistically zero. How have they been able to do that? Through harm-reduction programming. So that's one of the things I'd like to suggest.
I'd also like to suggest that we re-examine our strategy in prisons. Last year the drug-testing budget in prisons was $1,200,000. We know drug testing leads to the ingestion of more powerful drugs, such as heroin, because they're less likely to be detected by the drug-testing approach than are less harmful drugs, such as marijuana. In addition to that $1,200,000, CSC spent $1 million on its drug strategy last year, yet its AIDS budget in total was $175,000. Something is clearly out of order here.
As well, remember that in all of this our drug strategy is winding down. It started to wind down seriously last April, when I and several others were laid off from the Canadian Centre for Substance Abuse and also from the secretariat. It's due to close completely next March. I'd ask all of you to revisit that issue, because clearly we do need an effective strategy no matter what it is you decide it should be.
One of the things to bear in mind is that there's a lot of stuff being done around the world to go to that, and to be open to solutions. I'd also suggest that it be borne in mind that in a number of countries, especially Australia, prisoners and drug users are now taking cases to court of not just civil negligence but also criminal negligence around failure to provide prevention of HIV and hepatitis, and for failure to provide adequate treatment for drug-related problems.
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Of course, that brings us to a whole other issue, which I don't have time to address - the terrible lack of treatment and services in Canada for people who are drug dependent or who are beginning to have a problem. I think we have to revisit that issue as well.
Finally, on the one hand, it's all very well to say that this is a moral responsibility. Obviously, we all feel that. But to put on a different hat for a moment, I would like to make the comment that I was on the board of directors for the Hemophilia Society for more than eight years. In my experience with that and the tainted blood scandal, of course, one of the things that was brought home to us was the fact that a terrible disaster could have been prevented and that now many people were facing both the issue of negligence and the issue that went along with the fact that people at the time said - and I was present at those meetings - that it would only be some hemophiliacs who would die.
The issue here is, will it only be some drug users who die? Well, these drug users are our children and our partners. They're people who get out of prison and have relationships with your children and grandchildren. All of us are affected by this and are brutalized by prohibition.
I think the only thing we can do is recognize that the war on drugs is a crusade, and nobody wins in a crusade. It's a religious issue. We have to step back and take another perspective on this, take a scientific and public health perspective. I suggest the only response then will be a humane one, where we weigh the pros and cons. We see what works, what doesn't work, and what causes the least damage.
I would suggest that the solution is indeed a very easy one if we take that approach, but what's needed is courage and humanity. Those are difficult things to come by in this day and age.
Thank you.
The Acting Chairman (Mr. Murphy): Thank you, Ms Riley.
Pierre.
[Translation]
M. de Savoye: Ms. Riley, welcome to the committee. We had the opportunity of meeting you over a year-and-a-half ago on Bill C-7. Your comments at that time were every bit as interesting as the ones you have made today.
Because of your training, your approach is mostly medical. You talked about the medicalization of drugs. You compared it to decriminalization and legalization, as an opposing or complementary element. Could you tell us a bit more about your perspective on those three terms?
[English]
Dr. Riley: The way the three terms are generally used, in my circles, at least, is that ``legalization'' is a process that occurs when the manufacture and/or selling and/or possession of drugs is totally legal. In very few countries of the world does such a system exist. Some in South America do this.
``Decriminalization'' pertains to the fact that there may still be some penalties associated with possession or selling or manufacture, but it is no longer a criminal penalty.
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The medicalization, or what is sometimes called the ``prescriptive approach'' - prescribing of drugs - is regarded as sort of a stepping-stone to a different approach. Some people say there's the final solution, and you'd hand it over completely to the medics. I have trouble with that as a final solution because I see that only as putting one false controller over another. It would become a medical problem, a disease, and I don't think it is a disease in that sense. But I think it's a good interim step and it's working very well to reduce harms in a number of countries, including Switzerland, the Netherlands, Australia, and of course the U.K., which is the most famous example of this. So there are different fine shades that need to be looked at as well.
[Translation]
Mr. de Savoye: You also talked about detoxification and you indicated that in Canada too little is being done in this regard, and what is being done is not necessarily top-notch. There are detoxification centres in my riding; some new ones are opening up, and some have shut down. They are generally located in buildings that are not necessarily very comfortable.
Although staff is well meaning they do not seem to have to comply with any specific training or qualifications criteria in order to be able to take care of the clientele. The clients themselves come to the centre on a voluntary basis and may leave on the same terms; there is no government, legislative or regulatory framework that seems to apply. These centres spring up like mushrooms and operate by the seat of their pants. What are your thoughts on all that and what should be put in place with regard to detoxification?
[English]
Dr. Riley: Yes, I think that's one of the most serious problems we face, and one that I hope this committee will be able to address in its deliberations of the next months; that we have so little in place. I think partly that's because we've inherited the mentality that alcoholics and other drug users are sinners - the moral mentality. Although organizations such as the Salvation Army and so on are able to do a very good job, they have very limited resources, and also they are using one perspective to treat a problem, when in fact these are problems that need many different kinds of approaches, from abstinence all the way to harm reduction approaches, with maintenance. We have inherited that.
We also still tend to have this approach where we're judging drug users and alcohol users in a very pejorative way. We're not necessarily giving the resources unless it is in a private way where people are paying to hush something up or whatever. We have to tackle that head on.
We have to face up to the fact that drugs are with us and drug use is with us, and to a certain extent drug abuse is with us. In the realities of this and the next century and the next millennium, it's going to get a damned sight worse. People use drugs for recreation, yes, but they also use them as a way of coping with pain, with unemployment, boredom, and so forth. Of course, that is really going to seriously get worse.
One of the reasons Prozac is so widely used is to deal with the malaise of the modern era. It is the soma of our time. I think we have to face that head on, not just look at chemical ``solutions'' - whether solutions or not, it's what human beings and other primates use - but look at other alternatives to ways in which these voids can be filled.
Our society is very poor at that. It's poor at doing services. I think one of the gaps we're going to see with the end of the drug strategy, if it's allowed to end, is that we will have no force nationally to bring this to the fore. That's one thing that must be on the agenda. Provincially, I think there are only three provinces left that have a provincial addictions agency. Ontario's is very much under threat at the moment; there is talk of closing it down. What happens when that goes? What are we left with? Just general services for things that in fact need very specific solutions.
I think that federally as well as provincially we must take that on as a priority, because things can be done. There are models around the world for effective treatment. It's not as though we're looking at something and saying there is nowhere in the world with a solution. There are places with solutions. We should look at those.
The Acting Chairman (Mr. Murphy): Paul.
Mr. Szabo: Welcome, Professor. I found it interesting, and I'm sorry I didn't get a chance to study your stuff more, but I want to ask you one specific question that's quite relevant.
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The information that you gave us deals in part with labels on the containers of alcoholic beverages. As a principle - leaving aside methods, I would simply like your response to the approach - do you feel that educational information on labels of alcoholic beverages would affect either awareness and/or behaviour, and what authoritative reference or source would you have for coming to that conclusion?
Dr. Riley: That's a very good question, because I think in the alcohol area we're able to deal with issues that we can use as illustrations for what we might want to do with other drugs. Quite a lot of work has been done on the labelling issue in Australia. They've started labelling there and they've started labelling giving ``warnings''. They're actually trying this out in the U.K. as well, so I can give you some references on this. But I can certainly say the Stockwell work from Perth in Western Australia is the best place to start, and I can give you some stuff on this.
They have looked at different kinds of labelling and found that one of the things that really helps to cut down is to put down what's contained by way of alcohol per standard serving in that particular container. They found that by doing extensive focus testing, it was amazing just how poor people were at guessing, unless they were a trained bartender, how much alcohol they were imbibing. They almost always, of course, erred in the error of judging that they were giving themselves less than they were. So there's been some very interesting work.
That was one of the reasons they decided to do the labelling, and also the public response was tremendous. This was what the public wanted. They wanted to know because they were so confused by the different alcohol-per-volume signs and so forth. They needed to know that.
The other issue, of course, that was raised around labelling was the issue of liability of the company, and also to send the message clearly to children that alcohol is a drug, nicotine is a drug, and so on, and to get them into that kind of thinking. Australia has moved quite a way along that general harm reduction strategy, and I think it's one of the countries you really must look at. They have some very good approaches.
The Acting Chairman (Mr. Murphy): Thank you very much, Ms Riley, for your fine presentation.
That brings us to a close. Our next meeting is next Tuesday. Thank you.