General

Recommendation 1

That the Government of Canada declare the opioid overdose crisis a national public health emergency.

Recommendation 2

That the Government of Canada create a national multi-sectoral taskforce on the opioid crisis.

Recommendation 3

That the Government of Canada work with provincial and territorial counterparts to immediately develop an ongoing and fully coordinated pan-Canadian surveillance system for drug overdoses.

Harm Reduction

Recommendation 4

That the Government of Canada reinstate “harm reduction” as a  core pillar of the National Anti-Drug Strategy, and also define “harm reduction.”.

Recommendation 5

That the Government of Canada work with the provinces and territories to establish a network of harm reduction facilities.

Recommendation 6

That the Government of Canada work with the provinces and territories, and first responders’ regulatory authorities, to ensure that first responders, individuals who use drugs and others have access to naloxone and appropriate training on how to use it.

Recommendation 7

That the First Nations and Inuit Health Branch of Health Canada ensure that adequate supplies of naloxone and appropriate training on its use are available in reserve communities. Naloxone should be included in the safer injection kits provided on reserve by Health Canada nurses in First Nations, Inuit and Métis communities.

Recommendation 8

That the Government of Canada repeal or significantly amend the Controlled Drugs and Substances Act where it creates barriers to communities in establishing supervised consumption sites, and in the interim, work with communities and organizations to overcome administrative hurdles in relation to seeking exemptions under the Controlled Drugs and Substances Act in relation to supervised consumption sites.

Recommendation 9

That the Government of Canada grant exemptions under the Controlled Drugs and Substances Act for the purposes of drug testing at supervised consumption sites.

Prevention – Prescribing

Recommendation 10

That all medical regulatory agencies in Canada work with their respective memberships to develop information and training tools relating to recognizing addiction (including evaluating a patient’s history of prescription drug use), making appropriate referrals to evidence-based treatment programs, and treating individuals who have substance abuse issues in a respectful and compassionate manner.

Recommendation 11

That appropriate regulatory agencies develop a review system in relation to prescribing practices of physicians and pharmacists.

Recommendation 12

That the new opioid prescribing guidelines be expedited, and that the Government of Canada work with the provinces and territories to encourage provincial licensing bodies to mandate their adoption.

Recommendation 13

That the Government of Canada work with the provinces and territories to facilitate a broader approach to reducing opiate prescribing and integrate alternatives for pain management.

Recommendation 14

That Health Canada review and revise if necessary its approved indications for opioids to reflect peer-reviewed data.

Recommendation 15

That the Government of Canada work with the provinces and territories to establish a comprehensive, real-time, national electronic prescription monitoring system.

Prevention – Education

Recommendation 16

That the Government of Canada, through either Health Canada or the Public Health Agency of Canada, work with the provinces and territories to develop public awareness tools in relation to the risks associated with opioid use, and how to respond to overdoses. Public awareness tools should include materials targeted at youth.

Treatment

Recommendation 17

That the Government of Canada invest significant new funding to expand treatment for addictions.

Recommendation 18

That the Government of Canada work with the provinces and territories to significantly increase the availability of community-based, publicly funded substance abuse treatment programs.

Recommendation 19

That the Government of Canada work with the provinces and territories to strengthen existing detoxification treatment programs and create new ones.

Recommendation 20

That the Government of Canada work with the provinces and territories and their medical regulatory authorities to develop effective clinical practice guidelines relating to addiction treatment.

Recommendation 21

That the Government of Canada improve access to medications for opioid addiction treatment such as ‎‎Suboxone^® and other effective medications not currently available in Canada, especially for people at high risk of complication and death.

First Nations communities

Recommendation 22

That the First Nations and Inuit Health Branch of Health Canada consult with First Nations and Inuit communities to ensure that culturally appropriate care and assistance for addictions are available on reserve, and

Recommendation 23

That the Government of Canada work with the provinces and territories to ensure that culturally appropriate care and assistance for addictions is available to Indigenous individuals off reserve.

Recommendation 24

That the Government of Canada ensure that working with Indigenous communities to address the opioid crisis is carried out in the context of addressing the recommendations made by the Truth and Reconciliation Commission of Canada and the social determinants of health such as adequate housing, education, and access to health services including mental health services.

Recommendation 25

That the Government of Canada increase funding to First Nations communities to allow for multi-year health and social service provider contracts and appropriate accountability and transparency measures.

Recommendation 26

That the Government of Canada commit to providing stable needs-based funding for First Nations in order for them to implement the First Nations Mental Wellness Continuum Framework.

Recommendation 27

That Health Canada eliminate its current time restrictions on the scopes of practice of nurses relating to treating addiction on reserve.

Recommendation 28

That the Government of Canada provide a full and adequately funded continuum of services for Indigenous Canadians that includes long-term funding for community-based prescription drug abuse programs, such as opioid substitution therapy with ‎Suboxone^®, along with land-based treatment and other cultural therapies.

Mental Health Supports

Recommendation 29

That the Government of Canada work with the provinces and territories to ensure treatment for active drug users is available to address the underlying mental health issues that may contribute to or exacerbate drug addiction.

Recommendation 30

That the Government of Canada work with the provinces and territories to develop a national strategy to provide better training and mental health services for front-line workers and first responders.

Data, National Leadership

Recommendation 31

That the Government of Canada work with the provinces and territories to compile information relating to fatal and non-fatal overdoses due to opioid use and that this information be reported by the Public Health Agency of Canada in a timely manner.

Recommendation 32

That the Government of Canada work with the provinces, territories to establish provincial/territorial and municipal support services that will allow for the monitoring and surveillance of drug use patterns to better facilitate treatment strategies on a national scale.

Law Enforcement and Border Security

Recommendation 33

That the Government of Canada take measures to grant authority and lawful privilege to Canada Border Services Agency officials to search and/or test suspect packages that weigh under 30 grams.

Recommendation 34

That the Government of Canada develop a federal enforcement and interdiction strategy around the importation of illicit opioids.

Recommendation 35

That the Government of Canada adopt measures to regulate commercial pill presses to limit their possession to pharmacists and others who hold an appropriate licence.

Recommendation 36

That stronger criminal penalties for having a production machine be established.

Recommendation 37

That the Government of Canada provide more resources for drug testing packages and other shipments.

Recommendation 38

That the Standing Committee on Public Safety and National Security undertake a study into the primary source for illicit opioids in Canada to determine the risk to public safety and evaluate the current methods and relationships to determine if Canada can be more successful at stemming the flow of illicit opioids into Canada.