Communities across Canada are facing significant challenges as they respond to an ever-changing and rapidly evolving substance use crisis. Adding to the complexity are the intersections between substance use and other public health and social crises, including mental health, chronic pain and housing instability. Too often, responses have relied on top-down, one-size-fits-all approaches that overlook the power and impact that communities themselves can have (Canadian Centre on Substance Use and Addiction, 2024). Every community is unique in the challenges it faces. One community may be experiencing high rates of overdose due to the toxic drug supply. Another may be seeing elevated rates of substance use among young people and above-average emergency department visits and hospitalizations. Working directly with small municipalities across Canada, the Canadian Centre on Substance Use and Addiction (CCSA) developed the Playbook for Action: Practical Interventions Small Cities Can Use to Tackle Canada’s Substance Use Crisis. The playbook is a practical resource that outlines evidence-based and evidence-informed interventions (including strategies, policies, programs and services) that municipalities can draw on to meet their communities’ needs. It is not intended to replace existing strategies, but to complement them and strengthen local action to improve health and well-being.

This guide was created as a companion to the playbook. It walks communities through a process that combines local data, community insights and other forms of knowledge to identify the most suitable interventions to consider for implementation. The process described in this guide was informed by discussions with municipal leaders, service providers and community members, and draws on research from implementation science, public health and related fields. It is unlikely that those leading this process will be able to implement any of the interventions in the playbook on their own. Most interventions require collaboration across sectors and orders of government. Instead, this process is intended to generate recommendations that can be shared with relevant service, government and community leaders to support implementation efforts and improve community well-being. This guide does not provide instructions for implementing specific interventions from the playbook.

Who Is It For? This guide is designed for anyone working to improve substance use health and well-being in their community. It may be used by municipal leaders, local service leaders, social service providers, law enforcement personnel, harm reduction and treatment providers, community coalitions, policy makers, people with lived and living experience, and others working to improve community health and well-being.