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Meeting Document Type: 
Minutes

Board Members Present:

Joe Bachetti, Dr. Ken Blanchette, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Gord Queen, John Scott, Ed Sleiman

Board Member Regrets:

Paul Borrelli, Mark Carrick, Richard Meloche, Dr. Carlin Miller, Hilary Payne, Michelle Watters

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Dan Sibley, Lee Anne Damphouse

Administration Regrets: 

Nicole Dupuis, Kristy McBeth

Introduction:  T. Marentette introduced and welcomed the newest WECHU Manager, Felicia Lawal, Manager of Health Families Department.

T. Marentette also advised Board of Health members that there are KI Pills (Potassium Iodide) available at the meeting and if anyone wishes to obtain to please register accordingly.

  1. Call to Order
    The meeting was called to order at 4:05 p.m.
  2. Agenda Approval
    It was moved
    That the agenda be approved - CARRIED
  3. Announcement of Conflicts of Interest – None.
  4. Approval of Minutes
    1. Regular Board Meeting: October 18, 2018
      It was moved
      That the minutes be approved - CARRIED
  5. Presentation – Topical Issues: Dr. Wajid Ahmed
    Opioid Related Morbidity and Mortality in Windsor-Essex County
    Dr. Wajid Ahmed provided information to the Board on problematic drug use in our communities, noting the sudden spike in the use of various drugs.  How did this happen?  The sudden increase stems from several factors, one being psychological, social and biological risk factors like genetics, mental health, early life experiences, trauma, poverty, lack of secure housing and other determinants of health.  Another factor is the misunderstanding of the addictive risk of prescribed opioids.  Previously, in the 1990’s, pharmaceutical companies designed opioids that reduced pain and symptoms, though lack of awareness of alternative treatments for pain led to, in some cases, over-prescribing, as well as unintended consequences such as addiction.

    The lack of access to prescribed opioids has led to theft of prescription opioids by friends and family members and illicit opioid use.  Illegal drugs are frequently laced with other substances like fentanyl leading to serious, and sometimes fatal, consequences.

    Addiction vs Dependence
    Addiction
    A chronic, relapsing disorder characterized by compulsive drug seeking and use despite harmful consequences, as well as the drug providing desired euphoric effects

    Dependence
    A condition that can occur with regular use of drugs even if prescribed and used as prescribed. Characterized by withdrawal symptoms when stopped – a person can be dependent without being addicted but dependence sometimes leads to addiction

    Public health’s role in this complex problem is leveraging our partnerships. By collaborating and coordinating with other various organizations we can all be part of the solution through harm reduction activities, i.e. clean needle distribution, naloxone distribution, SIS/Consumption sites, and the advocacy piece for more funding and more resources for our communities.  Data collection from various agencies pulled together help to paint a better picture of what is happening in our region. Short term steps are sharing data with relevant agencies and advocating for funding for treatment and rehabilitation/harm reduction services.

    What is happening here is a significant problem and it is happening across the country.  In 2016, WECHU formed the Windsor Essex Community Opioid Strategy Leadership Committee (WECOS-LC) to develop community wide response focusing on opioid related morbidity and mortality, and to ensure implementation across multiple sectors and address the following four pillars of the WECOS:
    1) Prevention/Education
    2) Harm Reduction
    3) Treatment
    4) Enforcement

    This leadership is tasked with ensuring the feasibility of suggested interventions as well as assisting in the implementation of effective, local and sustainable solutions for opioid use and overdose prevention.  Effort was made to include people with lived experience to ensure they have direct input into the high-level planning of the strategy.

    T. Marentette is currently conducting Key Stakeholder Interviews as part of the Supervised Injection Services Community Consultation study.  The purpose of this study is to:
    • Look at how the community in Windsor view supervised injection services and identify any concerns
    • Explore potential clients’ willingness to use supervised injection services
    • Identify how the services should be delivered to meet the needs of people who inject drugs

    This study will help with decisions about supervised injection services and identify any questions or concerns.

    Various discussion continued on Naloxone distribution.  EMS are equipped with Naloxone but Fire and Police Services do not. In order to save lives First Responders need to be equipped with Naloxone and we need to be able to provide services where people can safely inject drugs – Windsor is not one of those sites that have been approved.

    Rapid Action Addition Medicine Clinics (RAAM) are medical clinics for individuals who are looking for help in regards to their substance use. The doctors at these clinics have experience treating individuals struggling with alcohol or opioid use. Doctors assess each individual and develop a treatment plan accordingly, and referrals to community organizations for further support can be arranged.  These clinics have been implemented in many communities, but not in Windsor.  We need to increase our budget to cover costs within our communities, and when we do request more funding/resources we need to have a game plan and accurate data.  The Board of Health will be kept informed of any progress and if further funding from the Ministry is not forthcoming, we may need to speak with our local funders.

    In closing Dr. Ahmed noted that the Windsor-Essex region needs more treatment and rehabilitation services so people who need them can be guided to treatment.

  6. Consent Agenda:
    1. Information Reports
      The following information reports were presented to the Board.
      1. Q3 Strategic Plan Report/Q3 Strategic Plan Progress Report
      2. Q3 Planning Report
      3. BOH Education Sessions – Summer 2019
      4. Risk Management

      It was moved
      That the information reports be received. - CARRIED

  7. Business Arising – None
  8. Board Correspondence – Circulated
  9. New Business – None
  10. Board Correspondence/Other Health Unit Letters/Resolutions
    1. alPha – Update to BOH Members – For Information – October 26, 2018 – various links and items of interest
    2. Opioid Crisis – National Drug Strategy – For Support - Southwestern Public Health – Oxford, Elgin, St. Thomas – Letter to Hon. Premier Doug Ford
      It was moved
      That the above correspondence be Supported and Received - CARRIED
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 4:57 p.m. - CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:15 p.m. - CARRIED
  12. Next Meeting: At the Call of the Chair, or December 20, 2018 in Windsor, Ontario
  13. Adjournment
    The meeting adjourned at 5:20 pm.

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