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Canadian Urban Substance Use Surveillance (CUSSP)

Funded by the Public Health Agency of Canada (PHAC)

Canada is currently experiencing the worst substance use crisis on record. The aim of the project is to assess the feasibility of and develop and implement an integrated pan-Canadian substance use surveillance system via consolidated and expanded substance use data indicators on supply, use, determinants, interventions, and outcomes to inform policy and practice and to reduce substance use-related harms in cities across the country.

Program Phases

The CUSSP project is being carried out in two phases. 

Phase 1

Phase 1 of the project focuses on a feasibility study. The specific objectives include:

a) Compile a comprehensive list of data sources and indicators relating to substance use that are currently being collected and used by different local systems across Canada.

b) Identify key stakeholders, experts, institutions actively engaged in substance use surveillance locally.

c) Design and propose an integrated public health surveillance system for substance use in urban communities across Canada.

Phase 2

The second phase will aim to pilot the surveillance system model developed by the project in one or two local centres.

To date, we have accomplished objectives a and b through an environmental scan that included a grey literature search of existing surveillance systems, stakeholder holder interviews, and a stakeholder survey. Findings were presented during UPHN member annual gathering in Halifax in June 2023, and at a UPHN member meeting Montreal in October 2023.

Through the literature search, stakeholder interviews, and survey, we have identified:

  • 32 independent substances use surveillance systems across 9 provinces including Alberta, British Columbia, New Brunswick, Nova Scotia, Manitoba, Ontario, Prince Edward Island, Saskatchewan, and Quebec.
  • Over 17 substances including (Fentanyl, Fentanyl analogue, Hydromorphone, morphine, codeine, oxycodone, heroin, methadone, methamphetamine, cocaine, benzodiazepines, benzodiazepine analogues, 3,4-Methylenedioxymethamphetamine (MDMA), Tramadol, Ketamine, Alcohol, Other sedatives, Cannabis, Nitazene, Carfentanyl, and Xylazine) are actively being monitored across Canadian jurisdictions. Two-third of these substances are currently monitored by all 9 jurisdictions surveyed.
  • 16 different data sources are currently in use to provide data on substance use. These data sources span provincial and local public health jurisdictions.
  • Majority of current data sources provide substance use outcome-related indicators.
  • There are limited socio-demographic data being collected or accessible across these systems.
  • There are innovative data sources like wastewater being integrated in some jurisdictions.
  • There are multiple stakeholder collaborative platforms at local and provincial jurisdictions.

Next steps in this project

  • Continue stakeholder consultations to guide framing and implementation of phase 2 of the project.
  • Continue the engagement with the advisory council to provide the necessary expertise, support, and network required for this project.
  • Assess the level of data comparability across stakeholders engaged in substance use surveillance.
  • Examine existing data sharing agreements for substance use surveillance.
  • Propose possible pathways towards a pan Canadian substance use surveillance system.
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