Ottawa’s Plan to Promote Wellbeing and Reduce Harms from Substance Use

What is Ottawa's Plan?


Ottawa’s plan to prevent and respond effectively to overdose, while enhancing  substance use health and wellbeing is multifaceted.  

The foundation of the  plan  has been built using a public health approach, with an overarching protective factor of access to safe, supportive, and affordable housing. As a community we are utilizing innovative and comprehensive approaches to promote substance use health though these foundational pieces, the overarching protective factors and a seven-pillar framework.

The framework is intended to help prevent overdose related mortality, while also improving the lives of people living with substance use health related challenges.

Actions within  the framework have been co-designed with partners, including people with lived and living experience. Aa number of guiding principles have been established in the creation of Ottawa’s plan:

  • Designing and implementing initiatives using best practices;
  • Ensuring people with lived experience are involved in all phases of the strategy;
  • Leveraging the expertise and experience of all partners in the co-design;
  • Adopting an evidence-based approach to continuously learn and improve;
  • Planning for sustainability from the start;
  • Ensuring that all aspects of the seven pillars are carried out.

Together,  these elements have helped and will continue to help  guide our actions to prevent overdoses and advance wellness and the substance use health needs of our community.  

The image below outlines how we are approaching this complex situation to make tangible contributions to Overdose Prevention and Response:

 Image of Ottawa's Overdose Response Strategy. Visual is shaped like a house that is yellow and black and includes seven separate watercolour images to highlight the different components of the strategy, including prevention across the lifespan, stigma reduction, harm reduction, coordinated access to treatment and services, data and surveillance, community safety and wellbeing and cluster and response strategy. It also includes the 4 components of a public health approach to substance use health

Who is Involved?


To ensure a collective and impactful approach, OPH and other agencies are working closely with the Overdose Prevention Task Force (ODPTF), the Ottawa Community Action Plan (OCAP), mental health, addictions, substance use health and social services advisory groups, and key partners.

Ottawa’s plan is intended to be inclusive and includes partnerships with a broad range of individuals, agencies and existing networks representing people with living experience and expertise, Indigenous Peoples, newcomers, visible minorities, women, 2SLGBTQI++ and equity deserving populations.

Collaboration between these networks allows us to monitor trends through data collection, surveillance, and qualitive input, as we try to meet the ever-evolving substance use health needs of the community.  

We are in this together,  it takes a community of partners and individuals with living experience to improve, promote and protect the health and wellness of our community.

What is OPH's Role?


OPH is an active member at many community led networks and is the convenor and backbone support to the Overdose Prevention and response Task Force (ODRTF) and  the Ottawa Community Action Plan (OCAP). See some examples of OPH’s immediate and ongoing actions.

How Did We Get Here?


The section below provides a timeline of some key milestones. The list is not comprehensive, and as we continue to build through the years, it is important to note that initiatives listed from previous years continue to evolve.

2015

Establishment of the Overdose Prevention and Response Task Force (ODRTF). This group brings together local and regional stakeholders to increase communication and collaboration to reduce unintended overdoses related to alcohol and drug use in Ottawa. The purpose of this group is to:

  • Share expertise and best practices in the field of prevention and harm reduction
  • Share information related to available programs and services
  • Collaborate on collection and dissemination of up-to-date surveillance data
  • Outreach to service providers
  • Collaborate on local initiatives

2017

In addition to the purposes listed above, the ODRTF developed the Opioid Cluster Response Protocol, which led to:

  • enhanced local surveillance and monitoring of overdose data,
  • guidance on enhancing Naloxone distribution in the community,
  • creating a communications sub-group to further coordinate public messaging related to overdoses and to allow for rapid coordinated emergency communications · the creation of the StopOverdoseOttawa.ca campaign to increase awareness and align messages.

2018

OPH, in collaboration with partners and stakeholders, was in the process of developing a Comprehensive Substance Use and Mental Health – Focus on Opioids strategy.

As input to the strategy, a consultation was undertaken by OPH and The Strategic Counsel (TSC), a professional market research firm, seeking feedback from various stakeholders, including partners, agencies and individuals with living experience. The findings, based on input from over 70 stakeholders, are summarized in the Comprehensive Mental Health and Substance Use – Focus on Opioids Strategy: Findings from Consultation report. A consensus emerged among stakeholders regarding several areas which were viewed as key to moving forward and achieving further progress. These became the three areas for discussion at the 2019 Ottawa Summit.

2019

On February 7, 2019, the Ottawa Summit on Opioids, Substance Use and Mental Health was convened as a joint initiative between OPH, The Royal and CAPSA.  The day-long Summit brought together, in-person, more than 200 community members.  Using a workshop approach, table discussions and expert panel discussions, participants shared ideas and identified priorities for action and a series of comprehensive next steps under each of the three key goal topic areas.

The following reports were produced subsequent to the 2019 Summit, outlining areas for improvements, actions and next steps. 

Post-Summit Summary Report (2019) and a Post-Summit Executive Summary (2019) outline the discussions and the key takeaways from the 2019 Summit. The report was used as a foundation for the development of the OCAP.

In September 2019, the Ottawa Community Action Plan (2019) was released. It outlines how tangible improvements could be made within the community to reduce harms related to substance use and mental health.

2020

Diverse community and national partners have continued to lead on the actions outlined in the plan. The Ottawa Community Action Plan Highlights Report (2020) outlines some of the steps that have been taken.

To continue to move the OCAP forward, the 2020 Virtual Summit was hosted by Ottawa Public Health (OPH), Community Addictions Peer Support Association (CAPSA), The Royal, Canadian Centre on Substance Use and Addiction (CCSA) and the Canadian Public Health Association (CPHA). This event brought together more than 160 attendees with varying perspectives and expertise to discuss issues and ideas for further action.

The discussions and the key takeaways from the 2020 Summit are outlined in the Post-Summit Summary Report (2020) and the Post-Summit Executive Summary (2020).

2021

On September 20, 2021, the Ottawa Board of Health approved the Ottawa Public Health’s 2019-2022 Strategic Plan: Strategic Priority Relating to Mental Health and Substance Use Health

The strategy includes recommendations to improve access to and quality of mental health care, for increased capacity for special intensive mental health services in the community and recommends the implementation of a municipal dashboard to monitor and report on mental health and substance use health services within the city.

The Board received a presentation from OPH’s Harm Reduction and School and Mental Health and Substance Use Program Managers, as well as from eight public delegations, all of whom expressed support for the report and recommendations, as well as for OPH’s work and partnerships in this area. The Board then voted to approve the report recommendations. 

2022

OPH submitted a consultation response to the Ministry of Labour, Training and Skills Development (MLTSD) on naloxone in the workplace.  With the construction industry being disproportionally represented in the overdose crisis, in collaboration with RespectRX pharmacy engaged the industry to provide information on Bill 88 (Working for Workers Act,2022), how to identify and respond to an overdose and access to naloxone.

OPH expanded the Have THAT talk series and launched the have THAT Talk about Substance Use Health website and co-developed Tips for Talking to Someone about Substance Use in collaboration with Families for Addiction Recovery.    

Developed and delivered virtual Naloxone trainings to school administrative staff, and with the reopening of many community spaces, OPH leveraged existing relationship to ensure Overdose Prevention and Party Safer support was provided for local events and festivals.  Staff also established Neighbourhood Wellness Hubs in 5th quintile neighbourhood.

2023, and ongoing

OPH continues to monitor for emerging issues and is continually advancing evidence-based interventions.

Most recently, Ottawa Public Health’s collaborative efforts to inform system and service planning through the Ottawa Mental Health, Addictions and Substance Use Health (MHASUH) have resulted in the launch of the community dashboard. This Mental Health, Addictions and Substance Use Health in the Community dashboard allows our community to improve timely surveillance of the drug toxicity crisis through the overdose reporting tool.

OPH has also expanded our community reach by developing and launched the Party Safer virtual course. This self-directed course allows the learner to access overdose identification and prevention information, provides them with an option to order no-cost naloxone that can be delivered directly to their home, and party safer tips and strategies.

This platform allows our community to access information at any time and allows OPH to continue to have one-to-one interactions, deliver in person workshops on these topic areas for those citizens that do not have access or the means to access this information virtually.

In September 2023, Ottawa’s Board of Health unanimously passed the Substance use and Overdose motion.

Additional examples of work currently being done to address substance use health and wellbeing includes, but is not limited to:

  • Advancing emerging harm reduction initiatives that can reduce harms associated with substance use, for example:
    • Serving as naloxone distribution leads, supporting eligible community agencies in the planning and implementation of take-naloxone kit programing, and supporting allied service partners in the development of tailored overdose prevention and response policies and procedures.
    • Provide training on overdose prevention and response training (including naloxone administration) to facilities/service providers serving those at increased risk of overdose.
    • Supporting eligible organizations that do not have capacity to take on naloxone distribution programming and reporting to facilitate and establish clear referral pathways to ensure low barrier naloxone access for their clients.  
    • Supporting the implementation of the Ontario Naloxone Program - Expanded Access (ONP-EA) initiative, onboarding identified organizations who were not previously eligible for participation in the provincially funded naloxone kit distribution program. 
    • Providing front line harm reduction services and supervised consumption services. This program offers front-line service provision of harm reduction materials and health teaching; clinical services including naloxone training and distribution, and referrals through the Harm Reduction fixed site, mobile van and targeted outreach activities, such as, sexually transmitted and blood borne infections (STBBI) testing and treatment; contraception; vaccines for hepatitis and influenza. The program also supports the provision of medically supervised consumption services through OPH’s fixed location at 179 Clarence. The team works to connect clients to other needed health, social, addictions and community services through the provision of onsite wrap-around services as well as providing support to remove accesses barriers such as appointment accompaniment, providing transportation, developing referral pathways. The team builds community partnerships and referral pathways to ensure coordination and timely access to harm reduction and wrap around services.  
    • Delivering the Needle Syringe program. This program aims to reduce the risk of bloodborne infections, overdoses and other drug related harms among people who use drugs and the broader community. Through the distribution of sterile needles/syringes and other safer drug and other drug use supplies, the program reduces the risk of sharing and re-use of supplies and reduces discarded needles in the community. The program also provides a point of access into health and social services for clients who may not otherwise have access to such services, as well as opportunities for education on safer drug use and overdose prevention practices.
    • Implements the core Needle & Syringe Program (NSP) in Ottawa, and supports over 40 partner agencies across the city coordinating accessible, evidenced based services.  Service utilization data collected by the team and epidemiology, is routinely monitored to guide interventions and assess any required response to emerging trends. Furthermore, the team provides education, training and support to allied service providers and community groups to facilitate the integration of harm reduction philosophy and practice, increase capacity in overdose prevention and response, and foster an understanding of the need for local evidence based best services.  
    • Provides education and awareness about safe disposal of needles, including through online web communications and community engagement events in collaboration with City and community partners.
    • Continuing to collaborate with community pharmacies to dispense Naloxone directly to equity deserving populations.
    • Increasing knowledge and resources for identifying and preventing overdose related deaths through collaboration with local pharmacists to the construction industry
    • Ensuring the risk of harms and problems occurring due to substance use at events is reduced by providing Party Safer and naloxone training to organizers of events, and in collaboration with pharmacy partners, and Event Central’s, Special Events Advisory Committee (SEAT). 
  • Preventing stigma, promoting Substance Use Health and the Spectrum of Substance Use in the community by providing such interventions as:
    • In-person workshops and online training related to Substance Use Health, Person First language resources, and Stigma (for access, click here: Stigma: The Power of Language in Supporting your Community)
    • Online resources, such as the have THAT talk About Substance Use Health webpage
    • Promoting Canada’s new guidance on Alcohol and Health  
    • Collaborations with CAPSA and other organizations of People with Lived and Living Experience and Expertise (PWLLEE) to bring substance use health messaging and training to the Ottawa community. 
    • Capacity building of the African, Caribbean, Black (ACB) and other racialized communities by increasing intermediaries understanding and knowledge around SUH and stigmatizing language through trainings. 
  • Collaborating and integrating across the health and social systems to centralize access to comprehensive addictions, substance use health mental health and social services leading to increased access and uptake of services and improved care. For instance:
    • In collaboration with city and community partners, offering free drop-in services to all residents of Ottawa at our accessible Neighbourhood Health and Wellness Hubs. Residents can come and speak to Ottawa Public Health staff and obtain information related to addictions, substance use health, mental health, overdose prevention, and more. OPH staff can also dispense naloxone kits and link clients to short term counselling. Other city services are also present to offer additional supports and services.  
    • Ensuring access to a comprehensive listing, and active promotion of where community supports and services are available for mental health, addictions and substance use health.
  • Working collaboratively with federal, provincial and municipal governments, other public health units and community partners to help reduce harms related to substance use. For instance:
    • Maintain a comprehensive early warning surveillance system that which includes real-time qualitative and quantitative indicators and complementary information on local illicit synthetic opioid risk to allow for the sharing of information in a timely manner among health system and community partners and people who use drugs to respond to local needs in a timely fashion.
    • Ensure maintenance of an “Ottawa Interagency Opioid Overdose Cluster Response Plan” which outlines the operational responses of all partner organizations to a cluster of opioid overdoses in the city. This plan, which complements existing municipal emergency plans, clarifies the roles and responsibilities of internal and external partners who would be pulled into such a response.
  • Utilizing online platforms to increase reach of harm reduction knowledge, information and resources (i.e. where help can be found) to Ottawa residents, for example:
    • The StopOverdoseOttawa.ca website. This website is a collaboration multiple partners and provides information on the following: 
      • Substances such as opioids (fentanyl, and carfentanil), benzodiazepines, stimulants, and more. 
      • Accessing Naloxone and local Harm Reduction services. 
      • Substance use and overdose statistics. 
      • Substance Use Health support for youth and parents. 
      • OPH also uses this platform to issue alerts aimed at raising public awareness on trends in the unregulated drug supply including increased overdose activity and risk of toxicity. 
  • Advancing wellness in youth and young adults by working to decrease harms related to addictions, substance use and mental health challenges, through development and implementation of targeted interventions.  
    • OPH’s Mental Health, Addictions and Substance use Health teams, together with Ottawa school boards and community partners have developed Youth Connections Ottawa (YCO), a peer-to-peer program which aims to contribute to positive mental health, addictions and substance use health of Ottawa youth. YCO uses a peer-to-peer approach, where peer leaders are supported by adult allies to learn about mental health, addictions and substance use health, and then encouraged to develop activities, events and initiatives for their peers. This program recognizes that youth are often more receptive to messaging that comes from their peers and is delivered in a way they can relate to.
  • Maintaining the Mental Health, Addictions and Substance Use Health (MHASUH) regional dashboard in collaboration with internal and external partners.
    • Having data and surveillance at a local level through a regional dashboard is one way we are showing what the current picture related to mental health, addictions and substance use health looks like in Ottawa. This dashboard allows our community to understand and respond to growing and changing needs, identify needs, inform systems and service planning, and contribute to building long-term promotion and prevention strategies in the community. 

If you require additional information, please visit our StopoverdoseOttawa.ca website or contact us via email at Substancehealthsante@ottawa.ca

We are in this together

Image of all the partners involved in overdose prevention in Ottawa

 

Reports

 

StopOverdoseOttawa.ca
StopOverdoseOttawa.ca

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