Annual Report 2021

WINDSOR-ESSEX COMMUNITY OPIOID AND SUBSTANCE STRATEGY ANNUAL REPORT 2021

MESSAGE FROM THE CO-CHAIRS OF WECOSS

In its fourth year of implementation, the collective effort of WECOSS partners has continued in the face of the COVID-19 pandemic, and addressing substance use harms has continued to be a priority area for action. Building on previous successes, in 2021 the WECOSS foregrounded its commitment to a collective impact model in order to support the implementation of bold actions to help reduce stigma associated with substance use, save lives, and create a healthier and safer community for residents of Windsor and Essex County.

Nicole Dupuis
Chief Executive Officer
Windsor-Essex County Health Unit

The challenges related to substance use in our region have been magnified and also brought into focus throughout the pandemic. In 2021, there were a record number of opioid-related overdoses and drug-related alerts in our region, highlighting the unique impacts of the COVID-19 pandemic on people who use substances. The community partners and peers that comprise the WECOSS have continued to move forward with a shared vision to address and mitigate the challenges faced by people who use substances.

Bruce Krauter
Chief
Essex-Windsor Emergency Medical Services

Introduction

The Windsor-Essex Community Opioid and Substance Strategy (WECOSS) was developed in response to the opioid crisis with the vision of creating a local response plan relevant to the issues in Windsor-Essex County. The Strategy aims to address substance use at the local level through a set of community-driven actions and activities. It is a multi-year strategy led by a diverse network of community organizations and people with lived experience (PWLE) using substances. 

The fourth annual report provides an overview of the activities undertaken throughout the Strategy in its fourth year of implementation (2021). The report describes the community impacts of substance use, the original WECOSS Action Plan (2018), the recent WECOSS Modernization Recommendations (2021), activities identified for implementation in year four, progress made on these activities, and future direction of the Strategy. The report will also highlight the continued efforts that have been made by the WECOSS to respond to and mitigate the ongoing impacts of the COVID-19 pandemic on people who use substances in the community.

Strategy Implementation

The fourth year of the Strategy has demonstrated the WECOSS’ continued commitment to developing innovative and responsive strategies to address the unique needs of people who use substances during the ongoing COVID-19 pandemic (Figure 1).

In 2021, a comprehensive evaluation of the WECOSS was conducted to assess the level of awareness and early impact of the WECOSS in the community to date (2018 – 2021), to evaluate the WECOSS’ strategy design, and to identify areas for strategy improvement. In response to the alarming rise in the number of community alerts issued through the WECOSS’ Opioid and Substance Notification System in 2021, the WECOSS Leadership Committee also organized an Emergency COVID-19 Response Meeting in May of 2021 to review the specific impacts of the COVID-19 pandemic and to discuss a response and recovery plan tailored to the immediate needs of people who use substances in the region. The results collected through these activities were used to generate a set of recommendations designed to strengthen and modernize the foundation of the WECOSS using a collective impact approach. The report also identified priority areas of focus for the Strategy in 2022 and beyond.

The WECOSS Modernization Recommendations supported the establishment of a WECOSS Data-Sub Group in order to foster shared measurements across the Strategy and to support future evaluation efforts. Stakeholders who participated in the WECOSS Evaluation (2021) also reinforced the critical need to create additional spaces to meaningfully engage people with lived experience across the Strategy by developing a formal Peer Advisory Committee. These activities will be prioritized as the WECOSS strives to implement the Modernization Recommendations in 2022 and in subsequent years (Figure 2).

Figure 1 - WECOSS STRATEGY IMPLEMENTATION FOR 2021

Leadership Committee

Prevention & Education
Working Group
Youth Engagement for Substance Use Prevention Sub-Committee

PROJECTS

  • Youth Engagement for Substance Use Prevention
  • Label Me Person: Anti-Stigma Campaign
  • Healthcare Provider Education
Harm Reduction
Working Group

PROJECTS

  • Consumption and Treatment Services: Consultation and Application
  • Needle Syringe Program
  • Needle Drop Boxes: Locations & Education
  • Naloxone Program Promotion & Expansion
Treatment & Recovery
Working Group

PROJECTS

  • Pathways: System Navigation
  • Increased Access and Coordination of Treatment and Recovery Services
  • Breaking Free: Computer Assisted Treatment
Enforcement & Justice
Working Group

PROJECTS

  • Strengthen Community Safety Through Partnership
  • Enforcement Agencies as “Community Resources” - Awareness & Education

Figure 2 - WECOSS STRATEGY IMPLEMENTATION FOR 2022

Leadership Committee

WECOSS Data Sub-Group

Prevention & Education
Working Group
Youth Engagement for Substance Use Prevention Sub-Committee

PROJECTS

  • Healthcare Provider (HCP) Engagement & Education 2022
Harm Reduction
Working Group
Peer Advisory Committee

PROJECTS

  • Community Engagement for Urgent Public Health Need Site Services/Consumption and Treatment Services and Harm Reduction Education
Treatment & Recovery
Working Group
Providers of Addiction Treatment Sub-Committee

PROJECTS

  • Enhancing PATHWAYS to Substance Use Treatment and Recovery, Mental Health, and Supportive Services
Enforcement & Justice
Working Group

PROJECTS

  • Addressing Substance Use in Corrections Reintegration Supports

Strategy Improvements and Sustainability

The WECOSS Modernization (2021) identified a set of five Structural and Capacity-Building Recommendations and six Priority Action Areas to build upon the initial eight recommendations outlined within the WECOSS Action Plan (2018). These recommendations will be used to help guide the pathway forward for the WECOSS in years to come and include the following:

Structural and Capacity Building Recommendations

The framework offered by a collective impact approach closely aligns with the findings from the WECOSS Modernization (2021), for ways to improve the Strategy and to facilitate a mechanism allowing the many partners involved in the WECOSS to work better together. A collective impact approach requires five conditions for collective success – i) a common agenda, ii) a set of shared measurements, iii) mutually reinforcing activities, iv) continuous communication, and v) a strong backbone organization (Kania & Kramer, 2011).

Pathway #1: Shared Vision. The vision and actions were outlined in the original Action Plan and WECOSS – Leadership Committee Terms of Reference; however “modernization” of this shared vision for the entire collective needs to be addressed at the Leadership Committee level to ensure all members agree to the primary goals of WECOSS as a collective impact initiative. Suggested outputs for modernization would include:

  • Revised WECOSS Terms of Reference detailing a “shared vision”.

Pathway # 2: Shared Measurements. The Strategy, along with its short and long-term goals, must be well-understood and agreed upon by the Leadership Committee. There are several ways to move forward with this recommendation:

  • Create a WECOSS data subgroup and an evaluation subgroup to identify key indicators to monitor and evaluation priorities, as well as to oversee this work.
  • Establish a community scorecard, a tool for tracking a shared set of measurements.
  • Construct a web-based dashboard, that includes relevant data on substance use (e.g., ED visits, EMS calls, crime data) to support clarity around the local issues.

Pathway # 3: Collective Leadership. Ensuring a shared vision and set of measures are important, but there are core functions of leadership that will require attention to support a collective leadership approach. Outputs to support this include:

  • Structures & resources to improve collective leadership, by developing a set of supportive documents:
    • WECOSS Terms of Reference identifying responsibilities and tenure of Leadership and Working Group members, as well as decision-making criteria for taking on WECOSS- initiated projects.
    • Guide for Co-chairs/meeting template and goals

Pathway # 4: Capacity Building and Sustainability. Advocacy work or specialized projects could be led by relevant members of the WECOSS Leadership Committee. This can be accomplished by collaboratively engaging in the following:

  • Create a system and establish a process for discussing and supporting advocacy work at the Leadership Committee level for capacity building and sustainability, regardless of the focus of advocacy – whether it be for funding or specialized projects.
  • Detailing the backbone agency and WECOSS partners’ concrete roles and responsibilities should be another vehicle used to ensure accountability, with authentic power to call partners to action, when needed.

Pathway # 5: Continuous Communication.  Consistent and structured public communication across different channels can support trust, and commitment to a common agenda (Kania & Kramer, 2011). The following outputs can support this recommendation:

  • Social Marketing Communication Plan so that every resident is aware of the main messaging of the WECOSS, specifically its vision, principles and goals.
  • Quarterly WECOSS Newsletter/Social Media Accounts & Strategy could include regular updates from each of the pillar working groups and core WECOSS messaging.
  • WECOSS.ca, promoted as the centralized hub for information on substance use to be expanded to include sections specific for healthcare providers and a dashboard that includes the shared measurements and tracking related to WECOSS and its member organizations.

Recommendations for Priority Action and Focus

The structural pathways outlined above will better support recommendations in the existing WECOSS Action Plan and will build a firm foundation as we take on emerging priorities. As part of the evaluation process, the following priority areas were identified and may be considered for the modernization of the strategy to ensure it is addressing pressing community issues.

Priority # 1: Foster inclusion as a core value starting with a WECOSS peer advisory committee. Create and support spaces to meaningfully engage People with Lived and Living Experience by establishing a local peer advisory committee, centering diversity, equity, and inclusiveness.

The goal of these committees is to provide people with lived/living experience with opportunities to use their experiences and voice to help inform local programs, policies, and initiatives. These committees also provide opportunities for agencies to gather formalized feedback about their ongoing services and activities and to adapt them to better meet the needs of people with lived experience with substance use.

Priority # 2: Formalize healthcare provider engagement and education as key drivers in addressing substance use. Formal efforts should be made to engage healthcare providers, as their role in addressing the opioid crisis is critical. These recommendations may include:

  • Building access to safer supply programming, which has received support from the federal health leaders (2020), as these pharmaceutical-grade alternatives to the unregulated drug supply have been recognized as a life-saving and critical part of addressing the drug-poisoning crisis.
  • Specialized education for key healthcare provider groups on Opioid Agonist Treatments (OAT), as well as safer supply clinical practices.
  • Emergency departments (ED) must also be part of a community effort to support those who use substances, so that a crisis in the ED can potentially become an opportunity for treatment and recovery, including access to a safer opioid supply (META:PHI, 2021).

Priority # 3: No Wrong Door: Enhancing Access to Services and Supports. Clear entry points for services and supports (e.g., harm reduction, treatment, and mental health service options) for clients with substance use disorders must be established.  Once established, concerted efforts are required to ensure all stakeholders are aware of these entry points.

Priority # 4: Augment harm reduction services and supplies through coordinated agency involvement and policy supports. In addition to the current work towards establishing a local Consumption and Treatment Services (CTS) Site, community-based overdose prevention approaches should be explored to provide information to businesses about naloxone, how to access it, and how to use it as a potentially life saving action (Toronto Public Health, 2021).

Formalized, coordinated outreach services, and harm reduction/overdose prevention resources in shelters should be enhanced. Harm reduction approaches, may be further supported by policy development and memorandums of understanding (MOU) with agencies that provide harm reduction supplies. A policy template may be developed and shared with organizations in the community or an MOU, as elements to help organizations adopt more of a harm reduction philosophical approach.

Priority # 5: Address the social determinants of health that impact substance use and community well-being. Enhance counselling services to support people who use substances as well as for service providers, especially for grief and loss associated with increased deaths related to overdoses. Allocating additional resources and providing further support to shelter and housing partners must also be considered as a priority in modernization of the WECOSS.

Efforts to enhance health literacy as it relates to substance use across the life-span should be prioritized to increase the understanding individuals have about their health and how to access health services or health information related to substance use or harm reduction approaches.

Priority # 6: Build a shared understanding of community safety and well-being by strengthening public safety and public health partnerships that support vulnerable and marginalized populations. Regional police services remain committed to disrupting the supply of harmful substances by targeting drug trafficking and illegal production and importation (CACP, 2020). However, future action should be tempered with a willingness to explore decriminalization. If decriminalization was adopted, the time previously used to process criminal charges could instead be used to support those with substance use disorders to access pathways of care for substance use treatment or harm reduction programming (CACP, 2020).

Those pathways would need to be established through partnerships with the health and social systems for law enforcement and other first responders to better link people to the appropriate services. Recent developments in the community, such as the Mental Health and Addictions Response Teams (MHART) model, can be seen as supporting these pathways to care.

An initial step at the local level for WECOSS partners would be to begin reviewing the local implementation of the Good Samaritan Drug Overdose Act and consider a policy that does not make it mandatory for police to attend overdose calls, unless there is a threat to public safety or if the overdose is fatal.


Foundational Activities Summary for 2021

Opioid and Substance Use Notification System

Ongoing implementation of the communication and emergency response systems between public health, emergency and health services, and other community stakeholders remains critical to the WECOSS. In 2021, there were thirteen (13) community alerts issued as a result the Opioid and Substance Use Notification System (OSUNS), which represents the highest annual number of community alerts issued through the OSUNS since reporting began in 2019. These alerts are issued when there are elevated rates of opioid-related emergency department visits and overdoses in the region. Alerts are used to mobilize community organizations that serve people who use substances in order to heighten awareness about these increases across the community, while also seeking to improve and strengthen local overdose prevention and harm reduction activities. With that said, the alerts only capture the opioid-related overdoses in the community that result in an emergency department visit and therefore, the numbers that are reported are likely only a fraction of the opioid-related overdoses that occur in our community.

To learn more about the specific initiatives that were undertaken across the WECOSS to respond to these increases, please see the Project Summaries for each of the four Pillar Working Groups.

Prevention & Education Working Group

PROJECT
1

Youth Prevention and Education Engagement Strategy

WECOSS Action Plan Guiding Recommendation Three: Provide early education and prevention about opioids and other substance use.

Goal: To engage youth in the development of health promotion programming related to substance use, starting with the creation of messaging, identification of youth-relevant dissemination channels, and finally to the delivery of education strategies in the school setting.

Summary of Activities: In 2021, the Youth Engagement Subcommittee continued Phase 2 of its implementation of the Higher Education campaign. Phases 1 and 2 of the social media campaigns were run consecutively on SnapChat from November 2019 through September 2021. Messages were organized into three themes: The “dark side of drugs”, which focused on negative aspects of drug use with students (e.g., addiction can affect anyone); “See the signs”, which focused on identification of substance use issues; and “How you doin?” which focused on checking in on your friends and knowing where to access help for substance use. A new wecoss.ca webpage, Your Voice Speaking for You, was created. The most popular images from Phase 1 and 2 of this social media campaign were used to develop a toolkit for local educators, which was distributed to school boards and community agencies. An evaluation of campaigns will be completed in 2022 and will inform future approaches undertaken to address substance use.

Measurable Outputs:

  • More than 2,000,000 SnapChat impressions occurred in 2021. Impressions resulted in 10,252 swipe ups for the reader to find out more information and connect youth to supports. Since 2019 there have been more than 6,500,000 views and 30,000 swipe ups.
  • Instagram reach from the campaign was 28,000.
  • Toolkits have been distributed to School Boards
  • A survey was developed to evaluate the effectiveness of the social media campaigns.
    • The social media campaign was reported to increase respondents knowledge of substances with 63% of participants (n=32) indicating they learned something new from the social media messages
    • 35% of respondents looked for more information about substances after seeing these messages, 71% of respondents said they know of resources they can reach out to for substance use support or help.
    • Nearly 60% of respondents reported that campaign messages made them think twice about using substances.

PROJECT
2

Healthcare Provider Education

WECOSS Action Plan Guiding Recommendation: Support healthcare providers to play a key role through appropriate prescribing practices, patient education about opioids and overdose prevention, and other pain management options.

Goal: To determine best practice for physician and patient education related to prescribing opioids to treat acute and chronic pain.

Summary of Activities: Two educational opportunities for local healthcare providers were promoted as part of this ongoing work to support healthcare providers. The target audiences were local nurse practitioners and members of the Essex County Medical Society (ECMS). The first educational opportunity was Safer Opioid Prescribing (University of Toronto) and the second was Chronic Pain and Opioid Stewardship (Project ECHO). Education sessions were held in Winter and Spring of 2021. Project partners are currently working to identify data on prescribing practices by healthcare provider (HCP) groups with the support of WECHU’s Epidemiology & Evaluation department. This information is needed to determine which healthcare providers to plan targeted education. Work is also ongoing to engage with the Essex County Dental Society regarding opioid prescribing practices education, as well as with local primary care healthcare providers on identified topics related to care for patients experiencing complex substance use issues.

Measurable Outputs:

  • More than 450 local healthcare providers were provided opportunities to engage in continuing education for opioid prescribing and pain management.

Next Steps: In 2022, a survey will be administered to local primary care healthcare professionals to identify key substance use topics and resource types for continuing education, and educational materials will be prepared and disseminated based on identified needs.


PROJECT
3

Medicine Cabinet Clean Out (MCCO) Campaign

WECOSS Action Plan Guiding Recommendation Three: Provide early education and prevention about opioids and other substance use.

Goal: To raise awareness of the importance of proper storage and disposal of medications in the home – including the importance of returning expired prescriptions for safe disposal to a local pharmacy.

Summary of Activities: Medicine Cabinet Clean Out posters to raise awareness about proper medication disposal and storage were prepared. Key messages included the importance of returning expired medications to the pharmacy because this practice can save lives and reduce harm from improper medication use. Printed posters were mailed alongside a letter of introduction to local medical clinics, and were also provided to the Essex County Pharmacists Association, the GECDSB, and Windsor Police Service shared posters throughout the community. A wecoss.ca webpage for the Medicine Cabinet Clean Out campaign was developed for launch in early 2022 to provide information and downloadable campaign materials in English and French, as well as to share key messages and link out to additional external resources. The MCCO campaign will continue through 2022.

Measurable Outputs:

  • 75 Medical Clinics across Windsor-Essex received a Medicine Cabinet Clean Out Campaign poster for their practice.

Harm Reduction Working Group

PROJECT
1

Label Me Person (LMP) Anti-Stigma Campaign

WECOSS Action Plan Guiding Recommendation: Addressing stigma associated with problematic substance use through the development of supportive policies and education of healthcare professionals, community organizations, and the public.

Goals: To bring attention to the opioid, substance, and overdose crisis in the community.

Summary of Activities: Pozitive Pathways Community Services (PPCS), in collaboration with the WECOSS Harm Reduction Working Group, launched a 14-Week Summer Awareness Campaign that was designed to increase awareness about the stigma associated with substance use and to humanize the opioid, substance, and overdose crisis in the community. Campaign activities included the launch and/or promotion of an LMP Anti-Stigma Campaign website, 13 videos and 5 podcasts that shared the unique perspectives of diverse community stakeholders on the crisis and/or heightened awareness about the campaign, and a series of online and in-person vigils and memorial events designed to honour those whose lives have been lost to the overdose crisis. Five LMP-specific webinars were also offered over the course of 2021 on the topics of Consumption and Treatment Services, Introduction to Harm Reduction, Opioids and Naloxone, and Drug Decriminalization and Legalization.

Measurable Outputs:

  • 1,789 page views on the LMP website between July 5th and October 14th of 2021.
  • 31 content posts were created to promote the Summer Campaign events, activities, and resources, with a total of 85,042 people reached on Facebook, 2,398 accounts reached on Instagram, 40,342 impressions on Twitter, 3,822 views on Linked-In, and 6,220 impressions on YouTube.
  • 234 community members participated in the LMP webinars.

Next Steps: The LMP Anti-Stigma Campaign has concluded as of 2021. An evaluator has been hired to complete the final evaluation of the campaign, with a report to be produced in 2022. The LMP Anti-Stigma Campaign website will also continue to serve as an ongoing resource for the community.


PROJECT
2

Community Engagement for Consumption and Treatment Services

WECOSS Action Plan Guiding Recommendation: Increase access to a variety of harm reduction options, such as non-abstinence based programs that accept clients using medication-assisted therapies, safer drug use equipment, and mobile outreach activities, for people who use opioids and those affected by people who use opioids.

Goals

  • To engage the community in selecting a suitable and accessible location for a Consumption and Treatment Services (CTS) site in the City of Windsor.
  • To apply for and to establish a local CTS site that meets the needs of people who use drugs in the community.

Summary of Activities: The Windsor-Essex County Health Unit (WECHU), in partnership with the WECOSS Harm Reduction Working Group and the CTS Stakeholder Advisory Committee, continued in its search for a suitable and accessible location to host a local CTS site. A site assessment of over 30 potential sites that met the mandatory criteria set in the provincial and federal CTS/Supervised Consumption Services (SCS) applications (as well as locally established eligibility criteria) was conducted. This site assessment was used to rank and condense the list of potential site options to two candidate sites – 101 Wyandotte Street East and 628 Goyeau Street. Crime Prevention through Environmental Design Audits conducted by the Windsor Police Service found that both of the candidate sites would lend themselves sufficiently to establishing manageable “Safe Consumption Zones”, whereby public safety can be maintained with any identified risks to be mitigated. As such, the WECOSS launched a site-specific community consultation on June 17th of 2021 to assess community perceptions about the feasibility and acceptability of establishing a potential CTS at either of the candidate sites. A new CTS page on the WECOSS website was also developed to launch the consultation.

Measurable Outputs:

  • A community survey with a total of 448 survey responses
  • 13 key informant interviews with business and agency stakeholders operating within a defined radius from the sites
  • 7 focus groups with area stakeholder groups
  • 3 Virtual Town Hall meetings that allowed community members to ask questions and voice concerns to a panel of expert speakers, with a total of 53 registrants.
  • Results yielded local support for the creation of a potential CTS at either of the candidate sites.

Next Steps: In 2022, the results collected through the site-specific community consultation will be used to guide the selection of one candidate CTS location to submit for approval through the provincial and federal application documents. While these applications are in the process of being fulfilled and approved, the WECHU will complete and submit an application to Health Canada to establish and operate a temporary Urgent Public Health Need Site at the selected location until it can be transitioned into a longer-term CTS.


PROJECT
3

Needle Syringe Programming

WECOSS Action Plan Guiding Recommendation: Increase access to a variety of harm reduction options, such as non-abstinence based programs that accept clients using medication-assisted therapies, safer drug use equipment, and mobile outreach activities, for people who use opioids and those affected by people who use opioids.

Goal: To support a local system of Needle Syringe Programs (NSP) in order to improve the lives of people who use drugs by providing improved access to harm reduction supplies and health and social services.

Summary of Activities: In the midst of the COVID-19 pandemic, Pozitive Pathways Community Services (PPCS) continued to support the harm reduction needs of the community through the provision of NSP services and supplies. Supplies were distributed at three in-person locations in the City of Windsor and through two mobile delivery programs. In early 2021, PPCS also received a Second Harvest Food Grant that allowed the organization to provide food packages to clients on the last Wednesday of each month. By December of 2021, the in-centre food packaging service had increased its offerings from monthly, to bi-weekly, to weekly due to ongoing demands for the service. In response to local needs identified by residents in the Glengarry area of the City of Windsor, a street outreach partnership was also developed between the PPCS NSP and CommUnity Partnership in order to provide harm reduction supplies and one-on-one education to people who use substances in the areas surrounding the Housing and Homelessness Help Hub.

Measurable Outputs:

  • 14,266 client transactions were recorded by local NSP sites and mobile delivery programs.
  • 3,723,831 harm reduction supplies were distributed (excluding condoms, dental dams, and lube), including 720,771 sterile needles.
  • As of December 2021, approximately 200 food packages were distributed monthly to clients through the in-centre food packaging service.  

PROJECT
4

Needle Disposal Bins: Systematized Data Collection

WECOSS Action Plan Guiding Recommendation: Increase access to a variety of harm reduction options, such as non-abstinence based programs that accept clients using medication-assisted therapies, safer drug use equipment, and mobile outreach activities, for people who use opioids and those affected by people who use opioids.

Goal: To track the number of needles collected from the needle disposal bins installed across the region.

Summary of Activities: Systematized data collection for needles collected through the needle bins installed across the region continues to be incorporated into the work of the WECOSS. Data about the usage of these bins can be used to inform local needs and programming.

Measurable Outputs:

Next Steps: Moving into 2022, this systematized data collection process will become one of the activities centred under the WECOSS Data Sub-Group.


PROJECT
5

Overdose Prevention – Naloxone Program Promotion and Expansion

WECOSS Action Plan Guiding Recommendation: Increase access to a variety of harm reduction options, such as non-abstinence based programs that accept clients using medication-assisted therapies, safer drug use equipment, and mobile outreach activities, for people who use opioids and those affected by people who use opioids.

Goals:

  • To recruit organizations to the Ontario Naloxone Program (ONP) and train organizational champions how to operate the program.
  • To increase community literacy around how to respond to an overdose.

Summary of Activities: As part of the Windsor-Essex County Health Unit’s (WECHU) commitment to increasing access to local harm reduction services, naloxone kits and training continued to be provided to eligible organizations through the delivery of the ONP and the ONP – Expanded Access Program (ONP-EA). Given that COVID-19 restrictions and other resource demands disrupted the traditional delivery of the ONP in 2021, the WECHU created a series of asynchronous training videos that could be accessed by various program leads for the purposes of educating their staff about naloxone administration. The WECHU also continued to work with various community agencies to recruit other partners into the ONP over the course of 2021.

Measurable Outputs:

  • 18 community organizations were actively involved with the ONP, 4 of which were on-boarded or re-trained during the ongoing COVID-19 pandemic.
  • 1,065 nasal spray naloxone kits were distributed by community partners involved with the ONP.
  • 2,820 individuals were trained on naloxone administration by participating community partner organizations.
  • 557 injectable and 3,395 nasal spray naloxone kits were distributed by pharmacies across the region, for a total of 3,952 kits distributed.

Activity – Official Position Statement on Safe Supply

WECOSS Action Plan Guiding Recommendation: Increase access to a variety of harm reduction options, such as non-abstinence based programs that accept clients using medication-assisted therapies, safer drug use equipment, and mobile outreach activities, for people who use opioids and those affected by people who use opioids.

Goals:

  • Develop an Official Position Statement on Safe Supply that outlines the WECOSS’ shared vision and position on safe supply initiatives.
  • Use the Official Position Statement on Safe Supply to advocate for increased funding and access to safe supply initiatives at the municipal, provincial, and federal levels.

Summary of Activities: Safe supply initiatives significantly improve health outcomes by transitioning people who use drugs from the toxic unregulated drug market to legally prescribed pharmaceutical-grade substances within a regulated healthcare context. In 2021, the WECOSS Harm Reduction Working Group discussed that the development of an Official Position Statement on Safe Supply for the WECOSS could be marked as a foundation for incorporating future safe supply projects and advocacy initiatives throughout the Strategy. As such, a position statement was drafted by this working group in 2021 for the review and approval of the WECOSS Leadership Committee (WECOSS-LC).

Measurable Outputs:

  • 1 Official Position Statement on Safe Supply was drafted for the review and approval of the WECOSS-LC.

Next Steps: The WECOSS-LC will be asked to review the position statement in early of 2022 and to provide their endorsement to move forward with the statement as a declaration of the WECOSS’ support of safe supply initiatives.

Treatment & Recovery Working Group

PROJECT
1

Increased Access and Coordination of Treatment and Recovery Services

WECOSS Action Plan Guiding Recommendation: Work with provincial partners to advocate for increased funding to expand the capacity of the local substance use treatment system.

Goals:

  • To optimize processes used to assess and screen clients for treatment and recovery services.
  • To support streamlined access to treatment and recovery services.

Summary of Activities: As part of a sustainment strategy, Hôtel-Dieu Grace Healthcare, in collaboration with the Centre for Addictions and Mental Health and the WECOSS Treatment and Recovery Working Group, continued to deliver virtual training sessions to local service providers on how to administer the Global Appraisal of Individual Needs Short Screener (GAIN-SS). The GAIN-SS is a tool that can assist in the referral process by assessing the client’s most pressing psychological, behavioural, and personal needs. The tool can then be used to support clients in navigating and accessing relevant resources, services, and treatment, as well as to assess client change over time. Use of the tool by service providers allows for more streamlined access to appropriate care options.

Measurable Outputs:

  • 6 virtual GAIN-SS training sessions were held in 2021, with 55 individuals taking the training for the first time and 23 taking it as a refresher class
  • 19 GAIN-SS training sessions have been held to date as of March 17th, 2022, with 197 individuals taking the class for the first time and 24 taking it as a refresher class

PROJECT
2

PATHWAYS – System Navigation for Treatment and Recovery Services

WECOSS Action Plan Guiding Recommendation: Work with provincial partners to advocate for increased funding to expand the capacity of the local substance use treatment system.

Goal: To promote treatment and recovery options to key target groups, including people who use substances, their loved ones, and other health and social service professionals.

Summary of Activities: The Windsor-Essex County Health Unit (WECHU), in collaboration with the WECOSS Treatment and Recovery Working Group, assessed options for embedding Connex Ontario’s provincial database of publicly-funded substance use, mental health, and gambling/gaming services directly onto the WECOSS website, as per the data agreement established between the WECHU and Connex Ontario in 2020. The vision for this activity was to leverage the Connex Ontario database in order to create and maintain an accessible inventory of local treatment and recovery services on the WECOSS website. After further investigation of the digital methods available for transferring and organizing the data onto the website, it was decided that other strategies should be assessed for creating and maintaining a local program and service inventory.

Next Steps: Other strategies for creating, maintaining, and promoting a sustainable inventory of treatment/recovery and supportive service options on the WECOSS website were discussed with the working group in late 2021. As per consultation with the group, the proposed direction forward for this project in 2022 was to:

  • Continue to link to Connex Ontario’s service inventory on the WECOSS website
  • Complete a comprehensive review of the local “Get Help with Drug, Alcohol, and Other Addictions” inventory on the WECHU website and update its contents
  • Transfer and post the updated inventory directly onto the WECOSS website
  • Determine a method and time interval to monitor/review the inventory for ongoing updates
  • Promote the WECOSS inventory through various promotional and networking channels

These activities will be a priority for the WECOSS Treatment and Recovery Working Group in 2022.


PROJECT
3

Breaking Free Online – Community Implementation

WECOSS Action Plan Guiding Recommendation: Work with provincial partners to advocate for increased funding to expand the capacity of the local substance use treatment system.

Goal: To implement the Breaking Free Online (BFO) program across relevant, publicly funded community organizations in Windsor and Essex County.

 

Summary of Activities: BFO is an e-learning software that helps clients to achieve and maintain abstinence from substances. In 2021, Hôtel-Dieu Grace Healthcare (HDGH), in collaboration with the WECOSS Treatment and Recovery Working Group, facilitated a community roll-out project aimed at implementing BFO across eligible organizations in Windsor-Essex County. Interested organizations were trained on the implementation and use of BFO at the agency-level and were subsequently provided with service codes, a BFO toolkit, and tablets (as needed) to begin registering clients with the program. During the implementation phases, a Community of Practice was developed with clinical leads from each of the participating organizations in order to provide a shared platform for service providers to ask questions and to discuss barriers and facilitators related to the program’s success. As part of the project’s conclusion, HDGH also secured the resource support of the Homewood Research Institute to conduct a third party evaluation of the initiative.

 

Measurable Outputs:

Evaluation Findings (April, 2019 – December, 2021)

  • 390 clients from 16 community organizations activated an account with BFO.
  • The retention rate for clients who started with BFO was 95.6%.
  • 86% of clients who were actively engaged with BFO interventions and were abstinent at baseline assessment had maintained abstinence at the time of their most recent “progress check”.
  • 64.7% of clients who were actively engaged with interventions on BFO demonstrated clinical improvement in their level of substance dependence, as measured by the Severity of Dependence Scale.

Enforcement & Justice Working Group

PROJECT
1

Strengthen Community Safety Through Partnership

WECOSS Action Plan Guiding Recommendation Eight: Redefine the role for enforcement agencies and other first responders to build “public safety-public health” partnerships for a safer and healthier community.

Goal: To strengthen community safety and address substance use-related crime by taking a coordinated approach among neighborhood groups, police, municipal and peer leaders, and other community stakeholders.

Summary of Activities: Progress on this project has been impacted by the ongoing response to the COVID-19 pandemic. For most of 2020 and 2021, the Windsor Police Services’ Community Service Officers were reassigned to the Patrol Division due to COVID-19. During this time, other project activities continued. Community Safety Handbooks, designed for residents to use to assess their own property for safety concerns, were distributed during Crime Prevention Week at Devonshire Mall and are available for Windsor residents. In addition, local crime data continued to be shared to inform the WECOSS surveillance and monitoring system. Data sharing is useful to community stakeholders and is used for program planning and local responses to crime patterns within neighbourhoods.

Measurable Outputs:

  • 500+ Community Safety Handbooks were handed out during Crime Prevention Week November 7th- 13th 2021 at Devonshire Mall.

PROJECT
2

Enforcement Agencies as “Community Resources” - Community Communication Strategy

WECOSS Action Plan Guiding Recommendation Eight: Redefine the role for enforcement agencies and other first responders to build “public safety-public health” partnerships for a safer and healthier community.

Goal: To raise the profile of local enforcement agencies as a “community resource” by increasing public awareness of the community outreach role of law enforcement, with a key focus to educate and raise awareness among at-risk populations.

Summary of Activities: The Working Group developed a social media communication plan and campaign to promote awareness of Crime Stoppers, the Good Samaritan Drug Overdose Act (GSDOA), and the important role of naloxone in harm reduction in the local community. The GSDOA offers legal protections for people who seek the help of emergency services during an overdose, and is designed to help reduce fear associated with police attending overdose events to encourage people who witness an overdose to use emergency services. GSDOA posters were updated and disseminated by WPS Community Services at events and at community centres. A letter was sent to local municipalities to assess interest in promoting the WECOSS on their websites. This promotional work will continue in collaboration with the Prevention & Education Working Group in 2022.

Measurable Outputs:

  • 100 GSDOA posters distributed by Windsor Police Service Community Officers
  • 20,199 reach for 8 organic Facebook posts to raise awareness of the GSODA, naloxone, and Crime Stoppers