An asset and gap analysis of existing services in our community was conducted to identify specific needs of Windsor and Essex County (WEC). The Windsor-Essex Community Substance Use Programs and Services Survey (Appendix A) was developed and administered to gain a better understanding about demands, gaps, and barriers to accessing these services, as well as to gather information on how the current system could be improved.
A four pillar approach was utilized to collect and organize responses related to the types of programs offered, whether organizations felt they were able to meet the overall needs of their clients, and challenges or barriers faced by organizations as they related to the opioid use and overdose prevention. It should be noted that the responses were organized in the pillar in which they were provided by the respondent organization, in this sense some comments may apply to more than one pillar.
The survey was disseminated to 53 organizations with a reasonable response rate of 51% (27 organizations) with representation from across each of the four pillars. Organizations which responded to the survey were also asked if they would be interested in collaborating to support the work of developing and implementing a community opioid strategy. The majority (91%) indicated that this was something they would support.
Responding organizations were asked to identify priority strategies to better address the issues that relate to substance use in Windsor-Essex County. A list of options was provided or respondents could express additional ideas. The top areas identified to be included in a community opioid strategy and ranked in order of importance can be found below:
- Increasing access to treatment services.
- Increasing public awareness of opioid misuse, diversion, and overdose prevention.
- Increasing access to Naloxone/overdose prevention, education, and training.
- Increasing provider and patient education on managing pain and the risks associated with opioids.
In addition to these priorities responding organizations provided an overview of programs and services, as well as challenges/barriers, and opportunities to address gaps in the opioid/overdose prevention system. A summary of the findings are as follows:
Prevention and Education
Twenty-one of the 27 organizations that responded indicated that they undertook some type of prevention and education activities or services. The most frequent type of program or services offered under this pillar was educational programming (e.g., presentations to schools and community groups) (70%) as well as community events. More than half of the organizations said that funding and resources, such as staffing (52 %) were key challenges they faced in implementing these types of programs. Organizations reported that there are several gaps or needs in Windsor-Essex for prevention and education resources or programming, including lack of early intervention programs, and lack of public awareness of the issues surrounding substance use.
Nineteen organizations indicated that they offered programs or services under this pillar. Education about harm reduction approaches was identified as a key programming activity under the harm reduction pillar (47%), as well as programs for methadone and naloxone. Lack of access to harm reduction services (35%, n=6), supplies (e.g., clean needles), and wait times for services (e.g., for residential treatment programs that accept clients on methadone, or other opioid substitution therapies) were some of the main challenges identified with implementing harm reduction programs and services.
Responding organizations also reported that there are several gaps or needs in Windsor-Essex for harm reduction resources or programming. Two of the main gaps related to the need for improved access to these types of services (58%) and increased awareness of what harm reduction is and the need to reduce the stigma related to this treatment approach (58%). Another key area of concern was access to harm reduction supplies, especially for those living in the county.
Treatment and Recovery
Seventeen organizations reported offering treatment and recovery services and programs. These types of programs or services offered locally aligned with three general categories - counselling services (65%, n=11), life skills education (29%, n=5), and referrals to other community resources (e.g., dental care or primary health care providers, 12 step meetings, or housing supports). Responding organizations reported that there were several significant challenges with implementing these types of services, including an overall lack of treatment and recovery options (69%, n=10), low staffing and capacity due to funding (62%, n=8).
Service gaps identified in Windsor-Essex for treatment and recovery resources included: lack of non-abstinence based programs (46%), the length of wait times to access services, and insufficient support for clients and their families (e.g., lack of outpatient services).
Enforcement and Justice
Nine organizations indicated they provide some form of programming, support, or enforcement activities. Programs and services under this pillar include education programs and outreach (44%), system navigation and referral to other services, such as court-ordered treatment programs (56%), and criminal investigations. One of the main challenges for these organizations outlined, is simply the need to increase awareness of substance use services and programs in this region (50%). Responding organizations reported that they lacked knowledge about what services are available, especially which services are offered outside of the City of Windsor.