Report of the Issues Table

of the

Ottawa Integrated Drugs and Addictions Strategy

 

 

 

 

 

 

 

 

 

 

Submitted to

 

 

The Steering Committee

of the Ottawa Integrated Drugs & Addictions Strategy

 

May 28, 2007

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Executive Summary

 

On May 11, 2005 Council directed that an Integrated Drug Strategy for Ottawa be developed in response to the need to address the most critical drug-related issues in an integrated way across the whole population.  Based on service provider and community consultations, it was recommended that issue planning tables be established to seek solutions related to:

 

a)     The co-ordination between City services, other service providers and key community stakeholders enabling neighbourhoods to deal with drug-related problems; and

 

b)     Balancing the need to address the HIV and Hepatitis C rate among the drug using population in Ottawa while addressing the concerns of the community and the safety of front line workers.

 

The complexity of this task is best summarized in the following statement from an interview with Wolfgang Götz, Director of European Monitoring Centre for Drugs and Addiction:

 

Local authorities have to deal with an apparent conflict.  On the one hand, they are expected to help drug users, guiding them into treatment and making sure they have a certain quality of life.  On the other hand, they need to protect the wider community against crime and public nuisance.  From this perspective, local authorities always have to find the best compromise between law enforcement and social and healthcare interventions (http://www.eukn.org/eukn/news/2007/04/interview-mr-gotz-emcdda_1011.html)

 

Based on the experience of over 30 cities in various countries in the European Union and beyond, an international criminal justice forum concluded that “the complexity of the problem requires a multi-faceted response developed and implemented in partnership between relevant agencies and stakeholders” (“Responding to open drug scenes and drug-related crime and public nuisance- towards a partnership approach,” John Connoly, Pompidou Group, Strasbourg, August 2006). 

 

For this reason, the Issues Table was comprised of a diversity of stakeholders, including community representatives, consumers, police, public health, addiction and social service agencies.  Over several months, the group met to identify key issues of concern surrounding drug use, including its impact on HIV/HCV rates and its impact on public disorder, as well as solutions which incorporate a 4-pillar coordinated and integrated approach.  Although the Issues Committee came up with 20 recommendations, only 14 recommendations received majority support, indicating the diversity of viewpoints and the importance of on-going dialogue.

 

PUBLIC DISORDER RECOMMENDATIONS

 

One-Year Pilot

1.      We recommend a one-year pilot initiative, with an evaluation component (report card), that coordinates existing internal city services (police, public health, bylaw services, fire, paramedics and employment and financial assistance), the drug court, private security, community services (eg. outreach, mental health & addiction), people who use substances and other stakeholders to respond proactively to non-crisis public disorder incidents and problematic drug use (eg. police address illegal drug use while a community outreach worker engages the person who is using drugs in motivational counselling).  This would not replace 9-1-1 calls in the case of life-threatening emergencies and/or crime in progress. There would be a centralized telephone number for the general public to use to access this integrated response, although the integrated service response would be proactive and not wait for the community to call.  The feasibility of offering this pilot in French as well as English would be explored.

 

The Issues Planning Committee supports the motion accepted by the Community Protective Services Committee and brought forward by Councillor Bédard that is aimed at integrating a coordinated response to problematic addresses in Rideau-Vanier.  The feasibility of integrating or coordinating these two initiatives, as well as the City of Ottawa initiative, “No Community Left Behind,” would be explored.

 

Outreach

  1. We recommend that organizations involved in outreach adopt a common understanding of addiction, in particular the “Stages of Change” model that is supported by evidenced-based practice in the addictions field.

 

  1. While we acknowledge the existing outreach efforts of numerous organizations in affected communities, we recommend a greater level of coordination and integration of services in order to increase the participation of people with a substance use problem in treatment.

 

  1. We recommend that all solutions are integrated with the four pillars, are informed both by evidence-based research and the impact on the individual with a substance use problem, the front-line worker  and the community ( e.g. Arrest Referral Program, methadone maintenance).

 

Legislation

  1. We recommend the city advocate other levels of government for new or revised legislation in order to support efforts to address public disorder concerns. An example of new legislation would be enacting legislation similar to Manitoba’s Safer Communities and Neighborhoods Act. Another example of revised legislation would be expanding the mandate of the drug court.

 

HEALTH RECOMMENDATIONS

 

Treatment

  1. We recommend an increase in treatment capacity and the further development of the continuum of services in Ottawa to include options for people using substances eg. substitution therapy for crack and cocaine addiction. Any increase in services will address community concerns regarding location and proximity of new services to existing services.

 

  1. We recommend the establishment of a sustainable peer-driven intervention plan for people who use substances.

 

Harm Reduction

  1. We recommend that the Site Development Consultative Group be expanded and be used as a vehicle to bring various stakeholders together including Public Health, Police, Crime Prevention Ottawa, BIAs, community representatives, Services Providers and Service Users to provide on-going guidance to harm reduction programming in the City.

 

  1. We recommend an independent operational review of the safer inhalation program (i.e. policies, procedures and practices) its effectiveness and impact on the community. Public Health would have the responsibility to oversee this independent operational review and would also require access to appropriate funding to do this review.

 

 

Determinants of Health

  1. We recommend that the availability of safe, affordable, supervised and/or supportive housing, as well as adequate income levels and/or employment opportunities for people with substance use and/or mental health problems be increased in the city.  There are already promising examples that can be used as templates eg. CMHA’s Housing First model and the Rideau BIA youth employment initiative in partnership with Operation Go Home. It is important that these services be available for both Francophones and Anglophones.

 

  1. We recommend that the City find ways to increase primary care and support services for people using substances and liaising with the Champlain Local Health Integration Network (LHIN) and other health and social service funders.

 

Communication

12. We recommend that the IDAS task force continue to establish and develop their relationship and partnerships with those involved in the Steering Committee and the Working Group such as the Ottawa Police Service, Crime Prevention Ottawa, the Centre for Addiction and Mental Health (CAMH), Ottawa Public Health, BIA and, community representatives within affected communities in order to share information and develop a strong internal communications strategy.

 

  1. We recommend that there be joint education and training sessions with key stakeholders from enforcement, treatment, harm reduction and prevention in order to create an integrated approach.

 

  1. We recommend that there be public information materials and sessions with all concerned stakeholders, to dialogue with affected communities about addictions, harm reduction policies, practices and procedures and the immediate and long-term impact of problematic drug use on the individual and neighborhood.

 

Issues Table Membership:

ü      Alfred Cormier, CAMH (Co-Chair)

ü      Niki Economo, United Way (Co-Chair)

ü      Public Health

ü      Ottawa Police

ü      Rideau-Vanier BIA

ü      Dalhousie Safety Committee

ü      Sandy Hill CHC- OASIS

ü      Salvation Army

ü      CMHA

ü      Maison Fraternité

ü      Crime Prevention Ottawa

ü      Youth Services Bureau

ü      Consumers (youth & adult)

ü      Robert Smart

ü      Carleton University School of Journalism & Mass Communication

Writer:  Peter Williams, CAMH