The overdose and toxic drug crisis is wreaking havoc everywhere, including in Quebec. The opioids circulating on the streets are sometimes 25 times more powerful than fentanyl. Last year, 536 people died from drug-related poisoning, more than the number of road deaths in the province. The duty takes stock with the Minister responsible for Social Services, Lionel Carmant. Comments collected by our collaborator Simon Coutu.
We are facing a serious public health crisis. Is this a priority for the government?
This is a major concern. We invested $6.1 million last year, including $1.6 million for Montreal, to combat the crisis. In particular, to increase the capacity of organizations to test drugs. There are now mobile units that visit festivals. We ran a major advertising campaign on social media and television to raise awareness. It is important to get the message across that this does not only affect the homeless population. The majority of deaths occur in private residences.
But even today, the province’s supervised consumption centres are not open 24 hours a day, even though this is a need expressed by community organizations.
It’s a possibility that we’re considering. But before that, the most important thing was to open a supervised inhalation site, which raised quite a bit of controversy. It didn’t exist in Quebec. We also want to make sure that we don’t concentrate all the coverage in the Quartier des spectacles and the east end of the island. We extended the opening hours in existing services and we revived the mobile service in Montreal. We’re going to continue in that direction.
Is there a plan to open other inhalation centres after the experience of the Maison Benoît Labre in the Saint-Henri district?
We are looking at this. We will follow the recommendations of the Montreal Regional Public Health Department to assess where to implement others so that it is as effective as possible.
British Columbia is in its second year of a pilot project to decriminalize simple drug possession. Is this an avenue for Quebec?
No, it’s not in the pipeline. We’re watching how it’s evolving in other cities, like Portland, which are going backwards. I think we need to first and foremost establish solid and impeccable services across Quebec before we can think about that.
In Alberta, the Conservative government has opted for a model based on addiction treatment. They want to offer drug addiction therapy without waiting and for free. Is it possible to offer the same services in Quebec?
Absolutely. We are in the process of setting up a system where liaison nurses in our emergency rooms work in mental health and addiction. We want the CISSS and CIUSSS to develop links with addiction rehabilitation centres and to be able to refer their patients there, and for this to be paid for by the RAMQ. Because we generally catch this population in the emergency room in cases of overdose or psychotic episode. That is when we must intervene.
We’re even considering revising the regulations that currently limit patient transfers. Because, strangely enough, when there’s a certain level of intoxication, we can send them home, but we can’t send them to a rehabilitation center.
The saturation level of dependency accommodation resources is around 80%. There is room, but this service needs to be made more accessible. The reference framework should be released this fall.
Black market drugs are increasingly contaminated with fentanyl or its derivatives. In Quebec, some doctors are prescribing safer opioid supplies to their patients struggling with addiction. This is being done as part of a federal government pilot project. Is this an approach you would like to deploy on a larger scale?
I still have some concerns about this. I am interested, but it has to go through a small group of doctors. When we broaden the scope a little too much, we hear stories of doctors who prescribe safe drugs that then end up on the street, on the black market. So we rely on specialists to manage this issue. We are trying to encourage some family doctors to specialize in drug addiction. And it would be this group of doctors who could make recommendations to us.
The overdose crisis is closely linked to the housing crisis. How do we ensure that health, political and community stakeholders coordinate their efforts?
We are in the process of consolidating mental health, addiction and homelessness programs. This has already been done at the ministry, and it is currently being done in the various institutions.
But you have to go for a walk downtown and you see that the situation with drug use and homelessness is not getting better. It’s looking more and more like the situation we see in the west of the country.
We are working very hard to avoid this. That is why we will continue to invest. To ensure that as many people as possible are taken care of. And above all, to raise awareness among the population as much as possible about this issue. Because it can happen to anyone.