Early Warning in Canada: Focus on the Canadian Community - - PowerPoint PPT Presentation

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Early Warning in Canada: Focus on the Canadian Community - - PowerPoint PPT Presentation

Oct 16, 2023 141 likes •516 views

www.ccsa.ca www.ccdus.ca Early Warning in Canada: Focus on the Canadian Community Epidemiology Network on Drug Use (CCENDU) Matthew Young and Zachary Patterson Canadian Centre on Substance Use and Addiction Presentation overview

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www.ccsa.ca • www.ccdus.ca

Early Warning in Canada: Focus on the Canadian Community Epidemiology Network on Drug Use (CCENDU)

Matthew Young and Zachary Patterson Canadian Centre on Substance Use and Addiction

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Presentation overview

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  • About the Canadian Centre on Substance Use and Addiction (CCSA)
  • About Canada
  • Monitoring New Drug Trends in Canada
  • Sentinel Surveillance in Canada
  • The Canadian Community Epidemiology Network on Drug Use

(CCENDU)

  • What it is and how it works
  • Alerts and Bulletins that have been issued
  • Impact
  • Current initiatives
  • Advantages and disadvantages of this model
  • Lessons learned

www.ccsa.ca • www.ccdus.ca

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Acknowledgement

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This work is made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

www.ccsa.ca • www.ccdus.ca

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About CCSA

  • Visi

sion: A healthier Canadian society where evidence transforms approaches to substance use.

  • Missi

ssion: To address issues of substance use in Canada by providing national leadership and harnessing the power of

  • f evidence to generate coordinated action.
  • Val

alue Prop

  • pos
  • sition
  • n:

: CCSA was created by Parliament to provide national leadership to address substance use in Canada. A A trusted counsel, we provide national guidance to decision decision makers by harnessing the power of research, curating curating knowledge and bringing together diverse perspectives. perspectives.

4 www.ccsa.ca • www.ccdus.ca

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National Priorities and Areas of Action

www.ccsa.ca • www.ccdus.ca 5

Canada’s National Framework for Action

Children & Youth Problematic Substance use & Co-

  • ccurring

Issues Canada’s Indigenous People Monitoring & Surveillance Workforce Development Treatment & Recovery Impaired Driving Alcohol Prescription Drugs Cannabis

National Framework for Action (2005): Collective action for collective impact

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35 million

  • ne of the highest per-

capita immigration rates in the world 59.7 % English 23.2 % French 6.6 % other 2nd largest country in the world six different time zones

  • ne land border

About Canada

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About Canada (cont.)

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13 provinces and territories large differences in data collection on drug use across provinces provincial police forces, as well as one national police force health care administered by province

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Dru rug g use e Alcohol – about 1 in 4 report report > 3-4 drinks at one time in past year Cannabis very popular – 1 in in 10 report past year use, 1 1 in 4 among young adults Opioid pain relievers – 14.9 % 14.9 % report past year use.

  • use. ~0.3% report past year

year non-medical use Drug use trends more common north– south than than east-west

About Canada (cont.)

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Monitoring New Drug Trends in Canada

  • Self-report surveys (Health Canada)
  • Enforcement data (Health Canada)
  • Internet monitoring (Health Canada)
  • Opioid overdose surveillance (Public Health Agency of

Canada and Canadian Institute for Health Information)

  • Poison Centre Exposures [regional Poison Control Centres

and the Canadian Surveillance System for Poison Information (CSSPI)]

  • Sentinel surveillance (CCSA)

www.ccsa.ca • www.cclat.ca 9

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Sentinel Surveillance in Canada

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11 British Columbia

BC Centre for Disease Control

Alberta

Alberta Health

Manitoba

Addictions Foundation of Manitoba

Toronto

Toronto Public Health

Nova Scotia

Nova Scotia Health Authority

Newfoundland and Labrador

Memorial University of Newfoundland

Saskatchewan

College of Physicians and Surgeons of Saskatchewan

Montreal

Agence de la santé et des services sociaux de Montréal

Quebec

Institut National de Santé Publique du Québec

Ottawa

Sandy Hill Community Health Centre

CCENDU is a sentinel surveillance network made up of representatives across Canada. Each site coordinator collects quantitative and qualitative information on drug harms from:

  • Local data sources (e.g., poison control centres,

coroners);

  • Anecdotal reports from those directly

working with drug-using populations (e.g., law enforcement, harm reduction programs) and people who use drugs. This information is then collated and assessed for risk at the national level. If warranted, CCENDU issues alerts to:

  • Law enforcement
  • First responders
  • Healthcare practitioners
  • Treatment providers
  • People who use drugs
  • Others

These bulletins and alerts provide information about new drug trends and advise what can be done to prevent and reduce harms. Yukon

Government of Yukon

Northwest Territories

Government of Northwest Territories

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www.ccsa.ca • www.ccdus.ca

Alerts and Bulletins

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CCSA sends request for information to SCs across Canada SCs distribute request to local network SCs respond within 5 working days Non- responsive sites are excluded from the Alert/ Bulletin CCSA collates unstructured information provided by each SC CCSA distributes summary to each respective site coordinato r for review/app roval. SC reviews summary and provides feedback within 5 working days Non- responsive cities are excluded from the Alert/ Bulletin CCSA makes necessary revisions, and distributes draft of complete Bulletin to SCs for approval SCs review draft of complete Bulletin provide approval within 5 working days. Failure to respond to this request within the designated timeframe will be perceived as [passive] approval CCSA posts final CCENDU Bulletin on CCSA website

Agreed upon operating procedure for handling information and contributions between CCENDU site coordinators and CCSA

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The rise of overdose deaths involving fentanyl and the value of early warning

**Reproduced with permission from the Canadian Society of Addiction Medicine.

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CCENDU’s Impact

www.ccsa.ca • www.ccdus.ca 26

193 234 260 296 349 421 463 508 579 615 687 741 786 836 878 926 980 1012 1091 1111 1131 1151 1171 1191 1223 1341 1390 1410 1430 1453 1464 1475 1486 1497 1508

Number of people who have subscribed to receive CCENDU Alerts and Bulletins

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CCENDU’s Impact (cont.)

www.ccsa.ca • www.ccdus.ca 27

Law Enforcement 5% Public Health 20% Federal Government 2% Provincial Government 4% Municiple Government 1% Universities/Colleage s/Researchers/Stud… Business 2% Social Work 3% NGO 6% Media 1% Pharmacy 20% Aboriginal 1% Addictions Agency 17% Community Group 5% Canadian Border Serives 1%

CCENDU Subscription by Sector

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CCENDU’s Impact (cont.)

www.ccsa.ca • www.ccdus.ca 28

Since 2012

  • Over 850 media stories published that referred to

CCENDU alerts or bulletins

  • Alerts and bulletins downloaded > 125,000 times from

CCSA’s website

  • Alerts and bulletins cited in domestic and international

reports and releases including those by:

  • Government of Canada
  • International Narcotics Control Board
  • Royal Canadian Mounted Police
  • Canadian Harm Reduction Policy Project
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www.ccsa.ca • www.ccdus.ca

Current Initiatives

Network growth and capacity building

  • Ensuring the network is appropriately represented nationally;
  • Establishing connections and relationships with stakeholders at

the community level, along with key organizations in Canada

  • Working with CCENDU site coordinators to increase capacity to

monitor and report substance use trends within their jurisdictions

– Sharing contacts – Building relationships – Networking and network development – Terms of Reference – In-kind support

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www.ccsa.ca • www.ccdus.ca

Current Initiatives (cont.)

Updating Bulletin on Deaths Involving Fentanyl in Canada, 2009–2014

  • Canada is facing an epidemic of opioid
  • verdose deaths, with fentanyl playing a

large role in this trend;

  • Currently no formal quantification of the

number

  • f fentanyl-related deaths;
  • 2015: High impact bulletin which garnered

>44,000 downloads, 650+ media stories, and international recognition;

  • Working with colleagues at Public Health

Agency

  • f Canada, Health Canada, and Canadian

Institute for Health Information to enhance monitoring of fentanyl-related deaths.

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Advantages of Sentinel Surveillance

  • Relatively inexpensive
  • Sensitive
  • Flexible
  • In-depth, meaningful qualitative data
  • Partnerships at the community, provincial/territorial

and national level

www.ccsa.ca • www.ccdus.ca 31

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Disadvantages of Sentinel Surveillance

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  • Specificity is not as strong as sensitivity
  • Capacity for local level monitoring is

heterogeneous

  • Volunteer network
  • Sensitivities around data and information

sharing

  • Barriers accessing non-public information
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Lessons Learned

www.ccsa.ca • www.ccdus.ca 33

  • Don’t release “hurry up and panic” bulletins
  • Quantum mechanics of surveillance
  • Potentially negative impact when “story” comes

across as comparing jurisdictions to one another, instead of looking at bigger picture

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List of Resources

  • The Canadian Community Epidemiology Network on Drug Use (CCENDU)

(video)

  • CCENDU alerts and bulletins

– Substance-related Harms at Canadian Music Festivals from May to July 2017 (August 2017) – Calling 911 in Drug Poisoning Situation (March 2017) – Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs (June 2016) – The Availability of Take-Home Naloxone in Canada (March 2016) – Deaths Involving Fentanyl in Canada, 2009-2014 (August 2015)

  • The Rise of Overdose Deaths Involving Fentanyl and the Value of Early

Warning, Canadian Journal of Addiction. (2015)

  • Detecting a Signal in the Noise: Monitoring the Global Spread of Novel

Psychoactive Substances using Media and Other Open-source Information, Human Psychopharmacology (2015)

www.ccsa.ca • www.ccdus.ca 34

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Register Now / Inscrivez-vous

www.ccsa.ca • www.ccdus.ca 35

Registration Open Program Now Available L’inscription est ouverte Programme est maintenant disponible

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Research & Policy Analyst 500–75 rue Albert Street, Ottawa, ON K1P 5E7 bhall@ccsa.ca Adjunct Research Professor, Department of Psychology, Carleton University, Ottawa, ON www.carleton.ca www.ccsa.ca • www.ccdus.ca

Contact Information

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@CCSAcanada • @CCDUScanada

Senior Research & Policy Analyst 500–75 rue Albert Street, Ottawa, ON K1P 5E7 myoung@ccsa.ca

Matthew M. Young, Ph.D.

Knowledge Broker 500–75 rue Albert Street, Ottawa, ON K1P 5E7 zpatterson@ccsa.ca

Zachary Patterson, PhD Bridget Hall, MPH