Normalizing Conversation, Not Consumption

Transcription

1 Normalizing Conversation, Not Consumption A Public Health Approach to Cannabis Canadian Public Health Association

2 A Public Health Approach to Cannabis Project Overview A public health approach emphasizes evidence-based, pragmatic initiatives, and takes into consideration social justice, equity, respect for human rights, efficiency, and sustainability It also recognizes that problematic substance use is often symptomatic of underlying psychological, social, or health issues and inequities

3 A Public Health Approach to Cannabis The goal of this project is to improve the capacity of the health and social service sector to respond to cannabis use (and other substances) Project Overview

4 A Public Health Approach to Cannabis Project Audience This project seeks to engage service providers and allied health professionals including: Public health practitioners and professionals Social workers, addictions and mental health counsellors, psychologists, psychiatrists, frontline workers, community workers Nurses and physicians

5 A Public Health Approach to Cannabis Project Outcomes The aim is that health and social service providers will have the knowledge and capacity to: measure the use of cannabis and other substances in their communities to inform local programming decisions make informed decisions about the provision of harm reduction and health promotion services for cannabis use in their communities engage target populations in health promotion and harm reduction messaging for cannabis use measure the influence of harm reduction initiatives and interventions in their communities

6 A Public Health Approach to Cannabis Authorization for Medicinal Purposes Consumption (project focus) Retail Project Context Illegal Personal Growing

7 A Public Health Approach to Cannabis Community Consultation Model CPHA will partner with community organizations who can: engage target audiences as well as those who regularly work with target populations provide resources for community consultations identify local capacity building needs and ensure that project resources are reflective of the needs of target audiences and health needs of people who use substances (or are at risk of using substances)

8 Project Context Community Engagement Model

9 A Public Health Approach to Cannabis Project Research Questions 1. What data and surveillance metrics are currently being collected regarding cannabis consumption and it s health effects? 2. What information should be collected to inform programming? 3. What harm reduction and health promotion materials are currently available for cannabis? 4. What should harm reduction and health promotion look like for cannabis? 5. What is the current capacity of organizations and providers to respond to cannabis use? 6. What are the needs at the local level to: collect and use data and surveillance measures for cannabis use to inform programming; create and/or implement harm reduction and health promotion services and messaging; integrate care and services for people who consume cannabis? 7. What resources or tools can CPHA develop to respond to those needs?

10 A Public Health Approach to Cannabis Project Work to Date To inform the design of capacity building resources related to cannabis use for health and social service providers the project is mobilizing the following: 1. Environmental scanning 2. Key informant interviews 3. Community consultations 4. An Expert Reference Group

11 Gaps and Opportunities Post-Legalization To-date from the key informant interviews and environmental scanning we have heard the following concerns regarding legalization: 1. Varied response as to whether cannabis use will increase or decrease 2. In the absence of evidence to guide safer use of cannabis, providers may default to a strict, abstinence-based approach to cannabis 3. There is some debate on if public health should concentrate on reducing use, or just harmful use

12 Harm Reduction Health Promotion Metrics and Surveillance Data 04. Gaps and Opportunities

13 Gaps and Opportunities Lack of research impacts clarity of effects and harms of cannabis use Varied perspectives on harm reduction based on field of practice We all have biases and values that shape our perspectives Harm Reduction

14 There are currently no guidelines for health promotion messaging related to cannabis Gaps and Opportunities Health Promotion Experts identify the need for an approach to cannabis related health promotion messaging that (CPHA, 2017; Rottach et al., 2009): Includes harms, but does not exaggerate or fixate on them Focuses on the place of cannabis in a person s life and their goals with use

15 Gaps and Opportunities Metrics and Surveillance Data Several standardized data collection tools; however, most are limited in their ability to capture data for local program use: Adults: Canadian Community Health Survey (CCHS) Canadian Tobacco Alcohol and Drugs Survey (CTADS) CAMH Monitor Students: Canadian Student Tobacco Alcohol and Drugs Survey (CSTADS) Ontario Student Drug and Health Use Survey (OSDUHS) BC Adolescent Health Survey National College Health Assessment Survey (post-secondary institutions) Screening tools: Cannabis Use Disorder Identification Test (CUDIT) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Research studies Roadside surveys Statscan crime surveys / databases

16 Gaps and Opportunities There is a need for local data to be captured at an early stage on different populations (regions, socio-economic status, cultures, age groups), social context for use (peers), personal context for use, emerging methods of use) Metrics and Surveillance Data

17 Gaps and Opportunities Community Consultations Organizations are excited that CPHA will allow them this opportunity to discuss cannabis in their community Low capacity to increase surveillance and metrics at the community level Concerns around age groups and legality for programming purposes Residential treatment concerns (using cannabis while in treatment for problematic substance use of another substance) Acknowledge that less harmful methods of use are often more expensive Many organizations claim they are working from a harm reduction approach

18 Gaps and Opportunities What do you perceive as the key public health and social service priorities post-legalization of cannabis? Large Group Discussion

19 Gaps and Opportunities In an ideal world, what processes, tools, or supports would be made available to communities as they respond to cannabis use? Discussion

20 Gaps and Opportunities What do you think service providers need to effectively engage the community in dialogue about cannabis? Discussion

21 Thank you! CPHA Project Team: Greg Penney: Polly Leonard: Sarah Vannice: Thomas Ferrao: