ActionNews Canada s news source for the substance abuse field Winter 2013 Volume 22, No. 3 New prescription drug misuse strategy ready to launch By Paula Robeson, Knowledge Broker, CCSA With the widespread misuse of prescription opioids, sedatives, tranquilizers and stimulants in North America, the upcoming March release of Canada s first prescription drug misuse strategy couldn t be more timely, particularly as Canada has the second-highest level of prescription opioid use globally. In the area of national strategy development, this is happening very quickly, says Amy Porath-Waller, Ph.D., Senior Research and Policy Analyst at CCSA. The National Advisory Council (NAC) on Prescription Drug Misuse is overseeing the development of the strategy. NAC is co-chaired by Carolyn Davison, Director of Addiction Services with the Nova Scotia Department of Health and Wellness, Dr. Susan Ulan, Co-chair of the Alberta Coalition on Prescription Drug Misuse (CoOPDM), and Michel Perron, Chief Executive Officer, Canadian Centre on Substance Abuse (CCSA). The strategy sets out an action plan for Canada that encompasses prevention, education, treatment, enforcement, monitoring and surveillance. NAC members include representatives from federal, provincial and territorial governments, and First Nations, health officials, pain and addiction specialists, pharmacists, dentists, nurses, researchers, regulators, military, enforcement officials and patient advocacy groups. It s not just a public health and safety issue, it s a human issue, says Ms. Porath-Waller. While it involves the manufacturers who make the drugs, and the physicians who prescribe them, it s important to also have patient and community voices at the table. For more information or to be notified when the strategy is released, please contact Robert Eves, Director of Partnerships, at reves@ccsa.ca. New alcohol screening web resource for physicians and health professionals By Carolyn Franklin, National Priority Advisor, CCSA The College of Family Physicians of Canada (CFPC), in partnership with the CCSA, recently announced the new Screening, Brief Intervention and Referral (SBIR) resource to help family physicians and other health professionals detect and address harmful alcohol consumption among their patients. This web-based guide is the first of its kind to incorporate Canada s Low-Risk Alcohol Drinking Guidelines. The site provides a wealth of resources and information, including a three-step screening, intervention and referral process, a clinical guide, a patient workbook and training videos to support motivational interviewing techniques. We re pleased to work with the physician community to build this first-of-its-kind resource to help address drinking issues before they become problematic, says Michel Continued on page 2
Perron, Chief Executive Officer of CCSA. Together with Canada s Low-Risk Alcohol Drinking Guidelines, this resource is designed to promote a culture of moderation, and represents another recommendation fulfilled under the National Alcohol Strategy. The SBIR resource is intended for use with all patients not just high-risk drinkers. For more information, please visit www.sbir-diba.ca. A brand new year and look for CCSA By Jennifer Lavoie, Director of Communications, CCSA In celebration of our 25 th anniversary, and to build upon the tremendous work undertaken by CCSA and our partners in the substance abuse field, we are pleased to unveil our refreshed brand identity. we are making positive change throughout the system, across the country, in our own communities, and even in other countries. In the coming weeks, you will see more materials and tools displaying our new logo and the special 25th anniversary icon. A new, user-friendly website is set to launch in the fall. Thank you to all the people involved in the brand refresh project members of our Board, staff, external stakeholders and the brand focus group. Your generous gifts of time, and your insights and opinions have helped shape our new direction and are greatly appreciated. Our new logo is a stylized representation of four people with arms raised to convey the importance of collaboration and represents people from all corners of Canada working together to make a collective impact. Our new tagline reads Partnership. Knowledge. Change. By bringing people and knowledge together, Like our new look? Want to join our web focus group? Please let us know what you think: jlavoie@ccsa.ca. We invite you to follow us on Twitter @CCSAcanada and @CCLTcanada Managing Editor: Tina Barton Production: John Thurston, Patricia-Anne Croteau, David Venn, Yasmina Pepa Contributors: Karine Diedrich, Carolyn Franklin, Rebecca Jesseman, Jennifer Lavoie, Paula Robeson, Michael Stephens 75 Albert Street, Suite 500, Ottawa, Ontario K1P 5E7 www.ccsa.ca Charitable #: 122328750RR0001 ISSN 1701-4522 The Canadian Centre on Substance Abuse changes lives by bringing people and knowledge together to reduce the harm of alcohol and other drugs on society. We partner with public, private and non-governmental organizations to improve the health and safety of Canadians. 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 the Government of Canada. 2
Save the date for Issues of Substance 2013 We re excited to let you know that Canada s premier national professional development event to address substance use is returning! Issues of Substance (IOS) is the must attend knowledge exchange, research and networking opportunity for professionals in the substance use field. The theme for IOS 2013 is From Knowledge to Know-how: Learn. Inspire. Change. With a focus on practical, interactive workshops and concurrent sessions showcasing new research and evidenceinformed practices, IOS participants will receive skills and knowledge to inform their policy and program development, and enhance the professionalism of Canada s substance abuse field. Early Bird registration prices will be offered. Visit www.issuesofsubstance.ca Interested in sponsoring this high-profile event? For more information, please contact Rob Eves, Director of Partnerships, at IOSpartnership@ccsa.ca. Canada s National Alcohol Strategy five years of impact By Carolyn Franklin, National Priority Advisor, CCSA Next to tobacco use, alcohol is the substance that causes the greatest health, social and economic harm in Canada. Since 2007, the National Alcohol Strategy has been in place to address this problem, guided by the report, Reducing Alcohol-Related Harm in Canada: Toward a Culture of Moderation Recommendations for a National Alcohol Strategy 2007. An impressive 34 of the 41 recommendations are underway, spearheaded by members of the National Alcohol Strategy Advisory Committee (NASAC), co-chaired by Carolyn Davison, Director of Addictions Services, Nova Scotia Department of Health and Wellness, Andrew Murie, Chief Executive Officer, MADD Canada, and Michel Perron, Chief Executive Officer, Canadian Centre on Substance Abuse. As Canada develops more strategies to reduce alcoholand drug-related harm, the development of the National Alcohol Strategy can be held up as a successful approach for encouraging collaboration between sectors. NASAC includes representatives from the provinces and territories, federal departments, non-governmental organizations, research institutes, addictions agencies and the alcohol beverage and hospitality industries, working together to create positive change for Canadians. NAS recommendations underway in Canada include: Promote Canada s Low-Risk Alcohol Drinking Guidelines Continued on page 4 3
Develop culturally sensitive screening, brief intervention and referral resources, and improve access to addiction services for isolated or vulnerable populations Adopt and review minimum alcohol prices and index prices to the Consumer Price Index Introduce incentives to promote beers and coolers with lower alcohol content Introduce volumetric pricing activities Regulate standard drink labelling Develop and evaluate programs and policies in schools, colleges and universities Promote awareness of fetal alcohol spectrum disorder Ensure systems of control over alcohol sales (social responsibilities, staff training, alcohol availability) Develop municipal alcohol policy Implement violence prevention programs in licensed establishments Endorse the Canadian Strategy to Reduce Impaired Driving Address drunk driving with a short-term suspension model Re-invigorate law enforcement around drinking and driving Focus on high-risk drivers via technology-based solutions, education, assessment protocols and improved treatment Adopt graduated driver-license programs, and zero tolerance provisions for drivers until age 21 Learn more about the National Alcohol Strategy. Listen to Gerald Thomas, Senior Research and Policy Advisor, CCSA, describe the alcohol price policy papers, released in November 2012. Download your copy of Canada s Low-Risk Alcohol Drinking Guidelines. Watch this fun video tour of the drinking guidelines, created by the Middlesex-London Health Unit. Learn how the Liquor Control Board of Ontario (LCBO) is promoting the drinking guidelines by viewing CCSA s annual report and clicking on the profile of Elizabeth Kruzel-D Cunha, Senior Policy Advisor/Coordinator, Social Responsibility, Policy and Government Relations, LCBO. The value of investing in youth substance abuse prevention By Karine Diedrich, National Priority Advisor, CCSA Why should we invest in youth substance abuse prevention? The short answer: Because prevention works! Here s what we know. More than half of young Canadians between the ages of 15 and 24 years have used drugs at some point in their life, according to Health Canada s 2011 Canadian Alcohol and Drug Use Monitoring Survey (CADUMS). CADUMS findings also show that in the past year, almost 50 per cent of high school students have reported binge drinking. Young people use substances more than adults and tend to use them unsafely, which can be harmful. We also know that substance abuse has a significant economic impact on Canadians more than $40 billion as a result of direct and indirect health, enforcement and lost productivity costs. On the other hand, analysis of many prevention programs shows that prevention can have significant savings, ranging from $15 to $18 on every dollar spent. Investing in prevention can be challenging, especially when there is an immediate need to help people seeking treatment today. However, if we don t invest in evidenceinformed prevention, the number of people seeking treatment will not decline. Effective prevention does not mean working harder, but rather focusing on what has been shown to work. For example, positive youth outcomes are most likely when prevention efforts are integrated and sustained, which means collaboration across sectors and settings. There are many great examples of programs that are working across Canada, from Campbell River s Seeds of Resilience program to Guelph and Wellington County s Strengthening Families program to the Richmond Addiction Services Society s Peer 2 Peer program. To help decision makers in developing and implementing the most appropriate youth substance abuse prevention initiatives for their communities, CCSA and a team of Continued on page 5 4
Canadian prevention professionals developed the Canadian Standards for Youth Substance Abuse Prevention. CCSA has developed new resources to support uptake of the Standards and to help you make the case for investing in youth substance abuse prevention: NEW! Toolkit to Apply the Standards to Prevention Initiatives: A collection of new worksheets, planning tools, self-assessments and video presentations to strengthen youth substance abuse prevention initiatives. NEW! A Case for Investing in Youth Substance Abuse Prevention: An evidence-informed resource to assist professionals in the prevention field to make an economic case for investing in youth substance abuse prevention. To learn more, please visit our youth drug prevention tools and resources web page. Prevention through improved youth resilience in Campbell River, BC By Michael Stephens, Knowledge Broker, CCSA Seeds of Resilience is one of the most successful resiliency initiatives of the Campbell River Alcohol and Drug Action Committee (CADAC). Recently, the CADAC assessed this initiative using CCSA s Canadian Standards for Community-based Youth Substance Abuse Prevention to help ensure it reflects an evidence-based design. positive, strengths-based approach one of the four guiding principles of the Standards. Seeds of Resilience doesn t focus directly on substance use; instead it teaches youth coping mechanisms, such as self-efficacy and emotional awareness, to make healthy and positive life choices. Seeds of Resilience is a result of cross-sectoral collaboration between police, Aboriginal elders, public health workers, community volunteers, government departments and youth addictions counsellors. It focuses on youth making the transition from middle school to high school. Erin Dusdal, the program s coordinator, led a small group of Grade 10, 11 and 12 students in a workshop to develop activities based on qualities, such as belonging, emotional awareness and self-efficacy an illustration of protective factors outlined in the Standards. The students then implemented those activities with every Grade 8 and 9 class in Campbell River, BC. Activities included helping students understand how stereotypes often blur the connections they have with each other. At the end of the activity, they were able to acknowledge that their commonalities help create a sense of belonging and can give them places to turn for support. To learn about more activities, view the Seeds of Resilience Curriculum. The results of the program have been encouraging. Ms. Dusdal attributes the school s enthusiasm to the program s Campbell River artist Jill Banting captures ideas from youth about resilience. For Ms. Dusdal, the Standards confirmed everything they had done well. The biggest takeaway was that it was nice to have some standards to compare what we were doing against and to know that we were on the right track. CADAC s next step is to focus on training youth service providers to deliver the program across Vancouver Island. Learn more about Seeds of Resilience and other prevention programs. 5
Partners across Canada taking a Systems Approach to addictions and mental health By Rebecca Jesseman, Research and Policy Analyst, CCSA CCSA is highlighting the excellent work that partners across Canada are doing with the Systems Approach report and recommendations through video case studies on the Systems Approach website. In one case study, Silvia Vajushi, Executive Director, Community Health, Alberta Health and Wellness, describes how Alberta used the Systems Approach tiered model as a framework for developing the Creating Connections strategy, providing a common language and approach for addictions and mental health. In another case study, Heather Bullock, Director of Knowledge Exchange with the Centre for Addiction and Mental Health (CAMH), highlights the Silvia Vajushi value of using the Systems Approach knowledge exchange model as a way to illustrate the knowledge exchange components and process. Ms. Bullock also describes how Ontario adapted the tiered model to fit the provincial context. CAMH has applied the adapted model to support new Service Collaboratives across the province. These Collaboratives bring together stakeholders across Heather Bullock sectors, including mental health, addictions, enforcement and education, to improve the accessibility and coordination of services that meet a broad range of needs. The tiered model provided a framework for CAMH to clearly demonstrate how its province-wide initiatives complement the 21 other initiatives moving forward under Ontario s 10 Year Mental Health and Addictions Strategy. CCSA will continue to add case studies to the website over the coming months. If you have a Systems Approach story to share, we would like to hear from you! Email systems@ccsa.ca. New resources added to Systems Approach website The Systems Approach Workbook, an online web resource for leaders and decision makers in the substance use field, continues to evolve with new resources, case studies and learning modules. Here s what s new: A recorded webinar providing a guided tour of the Systems Approach web resource A new change management module, with strategies and troubleshooting tips for Working with Teams to Support Change Our first report in the Topics to Consider section: System Thinking and Complexity in Substance Use Systems The first in a series of case studies featuring Silvia Vajushi, Executive Director, Addiction and Mental Health Branch, Alberta Health The Systems Approach was recently featured in a scan of knowledge mobilization efforts in Canada, organized by the Public Health Agency of Canada. CCSA was pleased to contribute to this dialogue on how to advance knowledge to action. Stay tuned, more Systems Approach content will be added to the website in the coming months. Have questions? Email systems@ccsa.ca. 6
Meeka Manuals now available in Inuktitut Sharing information in traditional languages supports Indigenous knowledge and culture, and a shared dialogue among community members all important factors in improving individual and community health. Since the initial release of the Meeka Manuals in English in 2010, CCSA has worked with Meeka Arnakaq, an Elder and champion of healthy Inuit communities, and Tungasuvvigat Inuit, an Ottawa-based community counselling and resource centre, to publish the Meeka Manuals in the Inuktitut dialect in which they were originally written. The Government of Nunavut s Department of Culture and Heritage has helped fund this project. One of the best ways we can support the wellness and personal growth of the Inuit is to work with our Inuit partners and Elders to offer health resources in local languages, grounded in Inuit traditional knowledge, explains Rachel Dutton-Gowryluk, National Priority Advisor at CCSA. By sharing the traditional knowledge of Elders, family and community in Inuktitut, the Meeka series effectively provides health information to a significant group of Inuit and non-inuit who may not otherwise have access to such resources. It also bridges the gap between Elders and youth, and Inuit and non-inuit service providers. The Meeka Manuals, a four-part series of culturally specific Inuit wellness resources, are designed to enhance the understanding of Inuit traditional knowledge among social workers, wellness counsellors, midwives, and other health and social service professionals, working in Inuit communities. Through traditional knowledge and storytelling, the resources help to preserve Inuit culture and language, work to build healthy Inuit communities, and support treatment and wellness services for those impacted by trauma and substance abuse. To download or order copies of the Meeka series in Inuktitut or English, visit CCSA s web page on the Meeka Project. 7
Announcements Michel Perron re-appointed as CEO For more than a decade, Michel Perron has passionately championed a pan-canadian and collaborative approach to prevent and address the impacts of substance abuse. We are therefore proud to announce the renewed appointment of Mr. Perron as Chief Executive Officer of the Canadian Centre on Substance Abuse. Mr. Perron was reappointed CEO for a fourth, five-year term by the Governor in Council of Canada in November 2012. CCSA Board Alumni member receives Order of Canada Congratulations to Dr. Harold Kalant! Dr. Kalant was recently appointed Member of the Order of Canada, one of Canada s highest civilian honours, for his accomplishments as a pioneering researcher and expert on substance abuse. The Order of Canada recognizes a lifetime of outstanding achievement, dedication to community and service to the nation. Dr. Kalant served on the CCSA Board from April 1989 May 1993. View more information about the CCSA Board Cross-Canada engagement for collective action Building on a series of successful meetings in British Columbia and Alberta, CCSA continues to push east with pan-canadian discussions to engage provincial and territorial leaders and decision makers in the substance abuse field. Our goal with these talks is to inform partners about our resources, listen to their priority issues, and learn about innovative approaches they are taking to address issues related to substance abuse. Already we have developed new partnerships and identified opportunities for further engagement and collective action. In 2013, our cross-canada dialogue will carry on across the Prairies, followed by discussions in Central, Atlantic and Northern Canada. Do you have a priority issue or innovative approach you d like to share? Please contact Rob Eves, reves@ccsa.ca. Events 2012 Research Transfer Network of Alberta (RTNA) Annual Conference February 27 28, 2013 Vancouver, British Columbia Promoting psychological health is essential to building workplaces that thrive-but how do we get there? CMHA s 10th annual Bottom Line Conference will host 300 executives, managers, union leaders, as well as HR and health professionals from workplaces, large and small, to learn steps everyone can take towards building a psychologically healthy workplace for your employees, members and yourselves. www.cmha.bc.ca/bl The 5th International Conference on Fetal Alcohol Spectrum Disorder February 27 March 2, 2013 Vancouver, British Columbia This conference brings together experts from many disciplines to share international research, to discuss the Continued on page 9 8
implications of this research, and to promote scientific/ community collaboration. It provides an opportunity to expand our understanding of the relationships between knowledge and research, and how this can apply to critical actions needed to address FASD prevention, intervention and research. For the past ten years, the conference has brought together people who are passionate about this area of work and have provided a stimulating environment for them to make new connections and partnerships. www.interprofessional.ubc.ca/fasd/registration.asp Addictions Treatment for Individuals Living with Fetal Alcohol Spectrum Disorders March 18 19, 2013 Calgary, Alberta This two-day workshop will focus on FASD sensitive treatment considerations, effective intervention strategies and intervention techniques for professionals involved in addictions prevention, treatment, counseling and aftercare. The goals of this seminar are to: Update clinical therapists and addictions specialists with current medical, physical, cognitive, sensory integration and executive functioning issues within this patient population. Provide participants with evaluation tools to determine the best course of individualized treatment plan for the individual by evaluating medical disposition of whole body disorder, social history, cultural factors and learning abilities. Discuss variables in treatment modalities and establish strengthbased, consistent provision of patient specific care and service delivery. www.obdtriage.com 9th Annual Pacific Forensic Psychiatry Conference March 20 22, 2013 Vancouver, British Columbia Call for Abstracts - Mental Health and the Justic System: Implications and Applications of Treatment, Research, Policy and Law. http://www.bcmhas.ca/education/conferences.htm Alcohol Policy 16 : Alcohol Policy Conference Series April 3 5, 2013 Washington, DC This conference is a forum for researchers, community practitioners, and public officials to meet and exchange findings, explore evidence-based solutions, and consider adoption of policies aimed at minimizing risks associated with alcohol use. www.silvergategroup.com/ap16/index.htm Lost in Translation 2013 March 25 26, 2013 Vancouver, British Columbia There is an urgent need to address substance abuse in vulnerable, at-risk individuals; specifically new and expecting mothers. Escalating substance abuse issues within this population require new approaches in order to make a significant and well needed positive impact on their mental health and well-being. To promote solutions, this event will focus on the impact that substance use has on early human development, specifically, the influence of biological, psychological and social mechanisms in mediating the impact substance use may have on critical development periods during the early stages of the human life cycle. www.cheos.ubc.ca/events/lost-in-translation-2013 9
Background: Developing A Systems Approach to Substance Use in Canada Healthcare costs in Canada are rising. The impact of alcohol and other drug use on the Canadian economy has been estimated at $40 billion per year, with $8.8 billion in direct healthcare costs alone. Against this backdrop, people within government, the healthcare system and community care services came to the conclusion that a full review of our approach to addressing the harms associated with substance use was needed. In 2003, the Canadian Centre on Substance Abuse and Health Canada led a series of cross-canada consultations to discuss the needs, priorities and changes required to reduce the health, social and economic impact of alcohol and other drugs on Canadians. National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances The result of the consultations was a national consensus-based roadmap for change and call to action that was summarized in the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada (2005). The Framework is founded on the notion of shared responsibility and accountability, where every stakeholder has a role and is committed to working on a collective response to one or more of 15 priority areas. Improving the accessibility and quality of treatment for those with substance use problems is one of these priorities. National Treatment Strategy Working Group Action on the treatment priority area was initiated and supported by British Columbia Mental Health and Addiction Services, the Centre for Addiction and Mental Health, and the Canadian Centre on Substance Abuse. The National Treatment Strategy (NTS) Working Group was formed in 2007; composed of representatives from across jurisdictions and sectors, it included people with clinical, policy, government, community, First Nations, Inuit, client and caregiver experience and expertise. The NTS Working Group members drew on background materials representing current knowledge and best practices, as well as their own areas of expertise to develop a comprehensive, evidence-based report. Production of the Systems Approach Workbook has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. ISBN 978-1-927467-20-6 Substance Abuse Prevention Tools and Resources for Health Care Providers and Policy-Makers Alcohol Canada s Low-risk Drinking Guidelines: Evidence-informed advice to help Canadians moderate their alcohol consumption and reduce the short- and long-term harm associated with drinking alcohol. Alcohol Screening, Brief Intervention and Referral: A website for family physicians and other health care providers to detect and address problematic alcohol consumption among patients. Canada s North and First Nations, Inuit and Métis Meeka Manuals: A four-part series of culturally relevant health and wellness resources that take a holistic approach to healthy living, child rearing, teamwork and healing exercises through illustrations and traditional stories. (Available in English and Inuktitut.) Systems Approach Workbook Treatment Systems Approach Workbook: An online resource to improve the accessibility, quality and range of services for substance use in Canada, translating A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy into action. Workforce Development Competencies for Canada s Substance Abuse Workforce: A workbook to enhance the professionalism and excellence of Canada s substance abuse workforce by identifying the skills required to perform effectively in the substance abuse field. Canadian Network of Substance Abuse and Allied Professionals: The first national website developed specifically for Canada s substance abuse workforce to support the uptake of evidence-informed practice across the continuum of care. Youth Substance Abuse Prevention Canadian Standards for Youth Substance Abuse Prevention: Canada s first set of national standards for drug abuse prevention that provide health care providers with step-by-step guidance on how to effectively plan, implement and evaluate prevention initiatives. Toolkit to Apply the Standards to Prevention Initiatives: A series of worksheets, planning tools, selfassessments and practical exercises to assist health care providers strengthen prevention initiatives. www.ccsa.ca www.cclt.ca