Modernization Recommendations: Summary Report

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.
  • 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.
• 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.

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:
• Guide for Co-chairs/meeting template and goals.

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.

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.

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).

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.

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.

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.

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.