Four Pillar Approach
We serve Haliburton County, City of Kawartha Lakes, and Northumberland County, including Alderville First Nation.
Steering Committee Duties
Considering emerging and complex substance use trends, the current Canadian Drugs and Substances Strategy was developed using a multi-faceted 'Four Pillar' approach, which is grounded in public health principles.
The four pillars approach integrates prevention, treatment, enforcement, and harm reduction in a complementary manner to address the health, safety, and societal issues associated with substance use.
The four pillar approach includes foundational principles of trauma-informed care, anti-stigma, anti-oppression, and is inclusive of health equity, social justice, and evidence-based methods. The approach is common to other regional and municipal drug strategies that have been developed across Ontario in response to the harms associated with alcohol and other substances. This approach acknowledges that the prohibition (ban) of illicit substances may not actually eliminate the availability and use of illicit substances, but in fact have negative implications for the people who use substances and the larger society. Thus, the four pillars model promotes a collaborative approach to reduce the harms associated with substance use, and address the impact that is felt locally by individuals, families, and the community.
Four Pillars Approach:
Harm Reduction
We seek to reduce substance use-related harms to individuals and communities, without discontinuing substance use itself.
Treatment
We encourage the improvement of quality of life through treatment, reduce barriers to treatment, and build community capacity to provide addiction services.
Prevention and Education
We reduce harms associated with substance use by preventing them by happening through education in early childhood and adolescence.
Justice and Enforcement
We seek to strengthen community safety by responding to criminal activity and safety issues associated with drugs.
Harm Reduction
The philosophy and practice of harm reduction is considered a pragmatic, evidence-based approach to drug use, which seeks to reduce substance use-related harms to individuals and communities, without discontinuing substance use itself. Harm Reduction remains an important pillar to many drug strategies across Ontario with shared goals of:
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Advocating for the uptake and increase in harm reduction services
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Increasing awareness and understanding of harm reduction
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Preventing and reducing the incidence of opioid-related harms and opioid overdoses
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Improving the management and response to overdose events through education and naloxone distribution; and
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Reducing the stigma and discrimination associated with substance use
Within the harm reduction approach, the main goal is to meet a person where they are at in terms of their substance use, at a given time. Harm reduction programming comes in many forms, including street outreach (literally meeting people where they are at), safer injection and inhalation programs, prescription maintenance programs (i.e., methadone maintenance therapy and access to Suboxone), supervised consumption sites and overdose prevention sites, drug testing services, and access to naloxone, counselling, and referrals.
Harm reduction does not enable drug use, but instead recognizes that substance use is a part of life and attempts to reduce the harms associated with the behaviour. For example, safe injection sites have shown significant success throughout North America, especially in terms of reducing public disorder, infectious disease transmission, and overdoses, as well as an increasing number of clients seeking treatment facilities.
Prevention and Education
One of the most cost effective and long-lasting ways to reduce harms associated with substance use is to prevent them from happening through education and attention paid to efforts in early childhood and adolescence. It is well known through research that children are more resilient and develop healthy coping behaviours when they have what they need growing up. When they don’t have a stable and loving home environment, they may develop unhealthy behaviours. This is often termed Adverse Childhood Experiences, or ACEs. Childhood experiences, both positive and negative, have far-reaching outcomes in terms of future violence victimization and perpetration, and lifelong health and opportunities. Adverse Childhood Experiences have been linked to risky health behaviors, chronic health conditions, low life potential, and early death.
One local prevention strategy in CKL is the “Medication Take Back Campaign”. Trends indicate rising rates of recreational prescription medication use among youth, the majority of whom obtain these drugs from family medicine cabinets and from friends. In an effort to reduce diversion of prescription medications and contribute to increased community safety, the HKPR District Health Unit, in partnership with police, pharmacies and other agencies, participates in prescription drug drop-off events. These events offer a safe, convenient way to dispose of unused medications and promote the pharmacy take back programs for any other time. To learn more, contact the HKPR District Health Unit at 1-866-888-4577, or visit http://www.healthsteward.ca/
Peer-led programs have been successful prevention efforts to reduce the harms associated with substance use. For example, the Parent Action on Drugs’ Challenges, Beliefs and Changes (CBC) Program is a peer-based prevention education program for senior secondary students to present on the harms associated with substance use to their younger peers at the grade eight/nine level. The program attempts to empower school-aged youth to make effective decisions about the use of alcohol and other drugs.
Treatment
Treatment is an important pillar to many drug strategies across Ontario with shared goals of:
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Improving the physical, emotional, mental, and spiritual health of people who use or have used substances
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Improving the quality of life of families, neighbourhoods, and communities affected by substance use
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Reducing the barriers that prevent people from becoming engaged in care
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Increasing the number of people who access treatment
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Expanding treatment programs; and
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Building community capacity to provide addiction services- working with FHTs, physicians, pharmacists
There are many kinds of treatment available for people wanting to address their substance use.
Fourcast (Four Counties Addiction Services Team) is the main service provider this three-county region and offers many types of services. Community-based withdrawal management allows for a person to stay at home and go through withdrawal in a managed and safe way. They also offer Hospital to Home services and have specific opioid case management services, as well as group supports. Other supportive services in the region include Narcotics Anonymous and Alcoholics Anonymous.
To learn more about the treatment and substance use services nearest you, click here.
Justice and Enforcement
The pillars of Justice and Enforcement encompass interventions that seek to strengthen community safety by responding to criminal activity and safety issues associated with the use, manufacturing, and sale of legal and illegal substances. Justice and Enforcement remain important pillars to many drug strategies across Ontario with shared goals of:
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Addressing the criminal behaviour that most affects the safety of community members
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Increasing community safety
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Ensuring access to addictions supports in the court system
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Developing effective pathways to support community members with substance use issues transitioning out of the justice system
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Promoting alternative healing and recovery options for court-ordered programming (supporting individuals whose addiction has resulted in criminal activities)
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Exploring evidence-based strategies to address social justice and enforcement efforts in addressing substance use and those struggling with addictions
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Encouraging working partnerships between police, justice, and social/health service providers to address shared challenges
Decriminalization offers a range of policies and practices to reduce the harms associated with the criminalization of illicit drugs by removing mandatory criminal sanctions, often replacing them with opportunities for education, harm reduction, and treatment services. The HKLN Drug Strategy is not taking a position on decriminalization at this time, but would like to draw attention to provincial and municipal police forces that have been promoting non-criminal justice alternatives to drug offences. These “de facto” enforcement approaches can be implemented relatively quickly compared to changes to formal legislation, and they can be tailored to respond to local issues. Such programs seen in the three counties include:
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Mental Health and Police Programs (see Support page)
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Police Diversion Programs
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Prison-Based Harm Reduction Programming
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Within the four pillars approach, the Justice and Enforcement Pillars have the opportunity to intersect with other pillars to consider strategic approaches explore the role of the legal context of substance use.
