Collective Impact on Substance Use: A 3-Year Snapshot

June 11, 2021 North Sydney & Sydney Mines, Systems Change

By: Megan MacLeod, Community Lead, Collaboration & Engagement, Northside Rising

Background: Through the provincial government, Inspiring Communities was funded to lead 3 collective impact projects across the province. This provided a mechanism for change to shape evidence-based community plans for collaboration on the Northside, Digby, and Dartmouth North.

Listening to the Northside about issues that matter to them

Northside residents were asked through a community survey: “What keeps you up at night?” 38% answered ‘addiction’. Northside Rising followed the survey with a community meeting, launching Substance Use as the first issue area for NSR to bring together residents to dig into.

Acronyms we use related to our work in substance use at Northside Rising

Supporting the Northside to tell its complex story of substance use

Northside Rising staff went to work conducting a literature review and consulting a wide variety of stakeholders in the substance use ecosystem. Leaders with a passion for system change were identified and recruited for the Substance Use Roundtable, with a focus on prioritizing the insights of PWLLE in substance use. Members of the roundtable began to build relationships and share their diverse perspectives with each other.

As we learned, the language we used to talk about the issue evolved too. Early conversations explored the stigma experienced by people who use drugs, agreed on inclusive ways of speaking about substance use and harm reduction, and unpacked the challenges PWUD faced in accessing services. The group also spent time mapping service providers working in the substance use and mental health sectors and assessed gaps.

Creating a safe space for the community to learn together

We hosted the Rising Tide Festival with community partners, a series of 4 events which aimed to spark dialogue around substance use in the community and created entry points for community members to take part. The festival was co-developed with residents with lived experience in substance use. At the Kick-Off Event, music, art, and poetry were used as tools to pair with more difficult topics: trauma and abuse, lack of social support, criminalization, and needed resources in the community.

Participants take in the art gallery showcasing work of PWLLE of drugs and information from various support groups.

“It Takes A Community to See Through the Fog of Drugs”, Presentation by Dr. Margaret Dechman, CBU
“Cape Fear”, Presentation by Dr. Ed Michalik, Bonfire Cape Breton
Panel discussion: “Substance Use in the Community: How to Move Forward”
Video Recordings of Rising Tide Festival Events

Creative approaches needed when facilitating urgent dialogue

Each member brought their own experiences and view of the issues connected to drug use: PWLLE in drug use, youth leaders, those with backgrounds in law, and Nova Scotia Health employees from various front line & policy-level positions. As membership of the table evolved, a common hurdle of facilitating collective work became a challenge: onboarding new members to a group with months of trust and relationship building behind us. We borrowed tools & tricks from a number of playbooks: the Tamarack Institute, the Collective Impact Forum, GovLab, and of course tapped into the wealth of facilitation knowledge housed within the Inspiring Communities Network.

Roundtable aligns around an initial action plan

Throughout 2019, roundtable members collaboratively developed goals and actions using Innoweave’s ‘Intended Impacts’ process to clarify the changes we wanted to see in the community. By the time we reached our action phase, the group had expanded its collective knowledge of harm reduction approaches, including safe supply. We set our sights on long-term goals like:

Reducing stigma of people who use drugs
Creating supportive communities for people who use drugs
Increasing a sense of community pride

Through a lot of deep conversations, voting, and ranking, the roundtable agreed that the logic model was ‘roughly right’ and then, we were ready to move into action.

New pathways to mobilize the community in building conditions for change

In 2020, we expanded our activities beyond convening the Substance Use Roundtable. We:

Convened a small group of residents to develop plans to engage the business community around Naloxone training.
Focused on building capacity of people who use drugs through a user advocacy group, CAPED – Cape Breton Association of People Empowering Drug Users.
Carried out research through ‘Invictus: Measuring Hope and Agency on the Northside’ to bring legitimacy to community conditions and experiences related to substance use.

Covid-19 creates challenges & opportunities

As the rest of the world moved online with the onset of Covid-19 restrictions, the work facilitated by Northside Rising did too. We got way more familiar with tools like Zoom, Jamboard, Mentimeter, and Facebook Live. This shift drove us to take on new forms of collaborative community engagement. NSR artist, Suzi Oram-Aylward, worked with CAPED to create an art installation for Lumiere, CBRM’s art at night festival. In a North Sydney storefront, a chandelier made entirely of empty pill bottles brought light (literally and figuratively) to the impacts of substance use, with each lit pill bottle representing a lost life due to opioid overdose or tainted drug supply. View video of the installation:

We also brought substance use to the conversations in our Virtual Coffeehouses, hosted live on NSR’s Facebook page. Themes of inclusion, hope, and mental health emerged at all 21 interactive events, which started as a response to the social isolation that came with Covid-19. In our Community Health Series, we planned events that supported the goals of the roundtable: we fielded misconceptions about Naloxone and built awareness of the Ally Center of Cape Breton’s Mobile Health Clinic, a bus offering non-stigmatizing care for people across CBRM.

Growing first voice leadership capacity

CAPED continued to meet regularly as a small core team throughout 2020. The group published an annual report and the first issue of the CAPED Zine which included survey results from local PWUD capturing how a safe supply of opioids would change their lives. CAPED also hosted an online knowledge exchange about a harm-reduction approach to safe supply currently being practiced by doctors in Halifax and elsewhere across the country. Seeing how Covid-19 shifted federal prescribing policy changes that removed barriers to carrying out this method of healthcare, CAPED strategically connected local prescribers with healthcare practitioners across Nova Scotia to learn the best practices of prescribing a safe opioid supply, specifically for folks for whom Methadone and Suboxone have not been a successful solution.

Review & reset – taking stock of how the community landscape has evolved

The roundtable began an in-depth evaluation process in February 2021 to determine where we go from here. The review process has given the group space to celebrate successes, discuss challenges and reflect on lessons learned. Potentially pivoting in scope from the original goals of the Substance Action Plan, co-creating a Theory of Change in this work will be the next step, commencing in the fall when we plan to bring together past, present, and emerging stakeholders. An example of a Theory of Change, developed by Inspiring Communities, can be found here. A Theory of Change will help us collectively articulate and visualize what we are going to do next, how we expect change to happen in our context, and the impacts we are working towards.

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