Considering emerging and complex substance use trends, the current Canadian Drugs & 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.
Substance use is a complex issue that cannot be resolved by any single change in policy or practice. Therefore, the four pillars of prevention, treatment, enforcement, and harm reduction collectively provide a framework to combine resources and coordinate efforts to address the concerns and harms related to substance use. Each pillar provides a nuanced perspective to substance use and working with people who use substances, and comprises a number of strategies that can be used to reduce the harms associated with substance use that can be implemented in various ways and contexts.
The constantly shifting nature of substance use trends and drug markets requires timely, innovative, and adaptive responses. The best solution for any given jurisdiction will be determined by a thorough consideration of contextual factors, including resources and readiness for change among community members, service providers, and key decision makers. Therefore, the many individuals and organizations that make up the HKLN Drug Strategy will work within a four pillars model to collectively determine whether adaptations to existing models are required to better reflect their own context and objectives for reducing the harms associated with substance use in each of the three counties.
1 Haden, M. (2006). The evolution of the four pillars: Acknowledging the harms of drug prohibition. International Journal of Drug Policy, 17(2), 124-126.
2 Peterborough Drug Strategy. (n.d.). Why a Drug Strategy? Retrieved from http://peterboroughdrugstrategy.com/get-to-know-us/about/
3 Piscitelli, A. (2017). Practice Guidelines: Learning from Ontario’s municipal drug strategies: an implementation framework for reducing harm through coordinated prevention, enforcement, treatment, and housing. Journal of Community Safety & Well-being, 2(2)