The toxic drug crisis is gripping every part of our country. While it seems very different from town to town, and from coast to coast to coast, one thing is consistent: We are ill-equipped to truly tackle the issue at the community level.

Small cities in Canada know this all too well. Fraught with the same issues as big cities but plagued by fewer resources, communities are trying hard to take action based on what they know to support their constituents.

Much like our communities, there is nothing homogeneous about the toxic drug crisis in Canada. Rates of opioid toxicity deaths are highest in British Columbia, Alberta, Manitoba and Yukon. These rates are declining in most areas, but in Manitoba, they continue to rise. And while Newfoundland and Labrador and Nova Scotia have some of the lowest rates of deaths due to opioid toxicity, the data show that rates are rising there. Layer on the vast differences in economies, cultures, and proximity to larger cities, and it’s clear: There is no one-size-fits-all approach.

So, instead of approaching these issues at a national level, the Canadian Centre on Substance Use and Addiction is trying something new. Working first with Timmins Mayor Michelle Boileau, we co-hosted a summit to examine the impact of the substance use crisis on small cities across Canada. In a first-of-its-kind initiative, the Timmins Summit brought together elected municipal leaders, public health officials, drug policy experts, Indigenous leaders, first responders, local service providers, resource industry leaders, and people with lived and living experience with substance use.

Now, just a few short months later, the momentum is growing with the Municipal Leaders Table. We are working with an expanded group of mayors and colleagues from across Canada, representing:

Together, we are developing the first municipally led, integrated standards for treatment, harm reduction, recovery, prevention and policing services, policies, and strategies.

So far, we’ve learned that for many people, accessing services when they want help is challenging. That silos and other pressures prevent communities from sharing best practices among each other, and that they want to be better equipped to advocate for themselves within their own provincial or territorial healthcare systems. That regions are at different stages of readiness to tackle the crisis and need options they can easily implement at low cost. And finally, that there is real power in numbers and networks.

We’re creating a menu of options for small cities to explore with their communities. Based on their needs, resources, and values, they will be able to quickly consult on and implement evidence-based solutions to the toxic drug crisis in their own regions and receive focused yet vital government support. Our whole-of-community approach, where community leaders engage in thoughtful dialogue with all parts of their city to define the problem together and identify the solutions that work for them, will also reduce the growing polarization concerning this crisis.

The results of our work together through the Municipal Leaders Table — which we expect shortly after we gather in Lethbridge, Alta., in April — will be available to all municipalities in Canada at no cost. We are prepared to provide guidance and equip them with a road map to implement this new, collaborative but regionally sensitive approach.

The toxic drug crisis isn’t just a big city issue, it’s a whole-of-Canada issue that’s disproportionally affecting smaller cities. But community is powerful and building a network of communities even more so.

Dr. Alexander Caudarella, MDCM CCFP AM ABAM(d),
Chief Executive Officer,
Canadian Centre on Substance Use and Addiction