Evaluation of the National Anti-Drug Strategy

Executive Summary

1. Introduction

The evaluation of the National Anti-Drug Strategy (NADS) covers a five-year period from April 1, 2011 to March 31, 2016. The evaluation was conducted in accordance with the Treasury Board of Canada Policy on Evaluation (2009)Footnote 1. The main objective was to assess the relevance and performance (effectiveness and efficiency) of the Strategy.

The evaluation approach included several lines of evidence, including a document and file review, a literature review, administrative data analysis, key informant interviews, and two case studies (prescription drug abuse [PDA] and Knowledge Exchange Strategy [KES]).

2. Program Description

Led by Justice Canada, NADS is a horizontal initiative of 13 federal departments and agencies, which was launched in 2007 to improve Canada’s response to the complex issues of illicit drug use and PDA. It is organized according to three action plans: Prevention, Treatment and Enforcement.

The Strategy’s action plans were expected to contribute to a reduction in the supply of and demand for illicit drugs, in PDA, in the negative health and social impacts and crime related to illicit drug use and PDA; and ultimately to contribute to safer and healthier communities.

In December 2016, while the evaluation was being conducted, the Minister of Health announced an updated drug strategy for Canada, the Canadian Drugs and Substances Strategy (CDSS)Footnote 2, which replaced NADS effective April 1, 2017. Given that the new drug strategy will be led by Health Canada (HC) and will have an expanded mandate to include harm reduction, this evaluation provides a summary of the results and noted challenges which can be considered in  the development of the new strategy.

3. Findings - Relevance

Continued Need for the Program

Given youth prevalence rates and the impact of substance use in vulnerable sub-populations, the ongoing issues related to prescription drugs and the current opioid crisis in Canada, the evaluation found that there is a demonstrated need for a national drug/substance use strategy. Illicit drug use is associated with costly health, community and economic impacts and these negative effects represent a significant drain on Canada’s economy.

Alignment with Government Priorities

The Government of Canada has a long history in the horizontal management of illicit drug issues. All levels of government and stakeholders expect the Government of Canada to continue to show leadership and support in this area. In recent years, the misuse and non-medical use of prescription drugs and the number of opioid overdoses have emerged as a leading public health and safety concern. As a result, the NADS mandate was expanded in 2013 to support actions that address PDA, which partners have recently implemented.

Alignment with Federal Roles and Responsibilities

The horizontal character of the Strategy calls for coordination across departments and alignment with each department’s respective roles and responsibilities. Overall, the evidence indicated that the federal roles and responsibilities are well aligned with the Strategy’s various programming elements. There is limited overlap or duplication between NADS and other programming and initiatives.

4. Findings – Effectiveness

Prevention Action Plan

The Strategy has successfully increased awareness and understanding of illicit drugs, PDA and their negative consequences among Canadians, including youth, parents, professionals and at-risk populations. In general, those benefiting from projects funded by HC and those reached through awareness campaigns reported having more information about drugs and their impact.

Problematic substance use is often symptomatic of underlying psychological, social or health issues and inequities, often referred to as Social Determinants of Health. Future strategies should consider the root causes of problematic substance use, the interaction with other issues (e.g., mental health, poverty, victimization, and socioeconomic status), and gaps in the emotional and financial resources available to at-risk populations. More work is also required in the development of impact measures and comprehensive national data to assess the extent to which risk-taking behaviours related to illicit drugs and PDA have changed.

Treatment Action Plan

The Treatment Action Plan enhanced the capacity to plan and deliver a range of treatment services and programs to targeted populations. NADS investments have supported research in drug treatment services, strengthened the quality and effectiveness of the First Nations and Inuit Health Branch’s Mental Wellness Program treatment services, increased the consistency within the treatment system, and led to changes in policies and practices. These investments also increased the availability of treatment services and the responsiveness of programs for targeted populations. With the introduction of the KES, the Treatment Action Plan has also improved collaboration among partners and agencies.

Although the Strategy investments have enhanced treatment system capacity and the availability of treatment services, there remains a substantial treatment need. Furthermore, the impacts are limited to communities reached through funding, which suggests a need for additionally funded treatment services.

Enforcement Action Plan

The Enforcement Action Plan has resulted in significant progress in expanding partnerships and increasing capacity and awareness of drug enforcement stakeholders. Through the Strategy, support and valuable tools have also been provided to control and monitor controlled substances and precursor chemicals at the national and international level, and to reduce the likelihood that controlled substances will be diverted to the illicit market. By applying new technologies, forensic accounting, financial intelligence and intelligence sharing, there has been increased effectiveness in efforts related to drug enforcement and in the prosecution of drug traffickers.

Despite advancements in enforcement, the extent of the impact has been limited by the need to continually keep up with innovations in the illicit drug market. The rapid and diverse growth in the drug market requires continued improvement in the accurate detection of chemicals, the ability to identify trends and report them to law enforcement officers, and the development of new technologies and regulations to adapt to the evolving drug markets.

5. Conclusions

Given youth prevalence rates and the impact of substance use in vulnerable sub-populations, as well as ongoing issues related to prescription drugs and the current opioid crisis in Canada, the evaluation found that there is a demonstrated need for a national drug or substance use strategy. Results of the evaluation point to the continued relevance and impact of the Strategy on outcomes related to each of the three action plans: prevention, treatment and enforcement.

However, substance abuse issues do not occur in isolation. There are many systems and issues that contribute to substance abuse and have an impact on the achievement of outcomes through the Strategy. The limited harm reduction component to the Strategy also presents challenges in aligning and collaborating with some international approaches, since many of the developed countries have integrated harm reduction components in their national drug strategies. The new drug strategy led by HC will have an expanded mandate to include harm reduction.

This evaluation does not include recommendations given the replacement of NADS by the CDSS. However, key factors that contributed to or impeded the achievement of outcomes have been identified for consideration in the implementation of the CDSS.