Canadian Centre on Substance Use and Addiction

Opening Remarks Before the House of Commons Standing Committee on Health By Dr. Alexander Caudarella, Chief Executive Officer Canadian Centre on Substance Use and Addictions

“Mr. Chair, Vice-Chairs and Committee members, thank you for inviting the Canadian Centre on Substance Use and Addiction — or CCSA — today.

It was the late Brian Mulroney who created CCSA through an act of Parliament 35 years ago as a non-governmental, not-for-profit organization mandated to provide leadership on substance use health in Canada and to advance evidence-based solutions.
As CCSA’s new CEO, I have spent my first year listening to diverse voices on how we need to act to achieve the most impact. As well, I’m a family doctor who has worked extensively in three provinces and a territory.

My patients have told me: when someone goes to an emergency department anywhere in Canada with an opioid issue, they are likely to be offered nothing. In a recent study co-led by CCSA, less than 1% of people surveyed said they would go to their family physician for help with a substance use issue. We need wide access to treatment, but people are facing closed doors across Canada. We have a responsibility to open doors to treatment and make the access way as wide as possible.

No Canadian jurisdiction has resolved these challenges. These challenges — which are rooted in pain and tragedy, coupled with a deep sense of urgency — have sent people and organizations off in all directions. Countries that have successfully tackled past drug crises have done so, not in silos, but with humility and collective whole-of-health, whole-of-government and whole-of-community approaches.
A spectrum of care that not only includes treatment, recovery and harm reduction but that also arcs toward improved health is required. This spectrum must also include prevention. In 2011, CCSA published some of the world’s first evidence-based prevention standards. With the first emergency declaration on opioids eight years ago, we must think of the lives we could have saved if we had invested more in prevention. It is why CCSA is building community prevention coalitions.

Every community deserves to feel safe, and every person deserves access to the care they need where and when they need it. People want to help each other, and we need to create opportunities for them to do so. CCSA has been working with people with lived experience, their families, physicians, law enforcement officers and community members to move this forward. The real solutions will come from them, and CCSA is committed to using its resources to support their collaborations. We are hosting a series of community-level summits, on the ground where the issues are felt, on strategies to end the substance use crise. One immediate outcome has been the establishment of knowledge and skill competencies for prescribers of all levels.

Our failure to collaborate more effectively among sectors strains the broader healthcare systems. Harms from substance use cost the country $49 billion in 2020, equivalent to $1,300 per person in Canada.

I’ll never forget working in the emergency department and seeing a man lying in pain for four days with a broken hip, his granddaughter always by his side. He didn’t have a hospital bed because we had three people in our intensive care unit recovering from a toxic drug event that should never have happened. He didn’t have a hospital bed because we had two patients waiting for heart surgeries for drug-related infections that should have been caught earlier.

There is no turning back. We now live in an era of powerful synthetic drugs that are cheap to make and buy, and where data and clinical practices are evolving rapidly.

In 2005, CCSA redirected resources to partner with providers in provinces, territories, municipalities, First Nations, Métis and Inuit, with law enforcement agencies and key federal departments to drive everything we did toward supporting what our communities needed most. The National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada was relevant, real and impactful.

We collaborated across divides then, and it is now time for the leaders in our field, me included, to set the tone and work together. The solutions are in communities; we must support them with the science and resources that they can use.
Thank you for your time and for your study of these important issues.”

About CCSA
CCSA was created by Parliament to provide national leadership to address substance use in Canada. A trusted counsel, we provide national guidance to decision makers by harnessing the power of research, curating knowledge and bringing together diverse perspectives.
CCSA activities and products are made possible through a financial contribution from Health Canada. The views of CCSA do not necessarily represent the views of Health Canada.

Media contact
Mélissa Joseph
Communications Advisor
Canadian Centre on Substance Use and Addiction
Tel.: 613-235-4048 x 364 I Email:






We use cookies to ensure that we give you the best experience possible on our website. 

You can change your cookie settings in your web browser at any time. If you continue without changing your settings, we’ll assume that you are happy to receive cookies from our website. Review our Privacy Notice for more information.