Small Cities Lead National Action on Alcohol and Other Substance Use
Mayors and city leaders from across Canada met in Lethbridge, Alberta, from April 14 to 16, 2025, to confront the growing crisis of harm from addictive substances in their communities.
The substance use crisis is not just a big city issue.”
Dr. Alexander Caudarella, CEO, CCSA
As reported by the Canadian Centre on Substance Use and Addiction (CCSA), the gathering brought together representatives from 30 municipalities to shape Canada’s first municipally led playbook on substance use policy.
The focus included evidence-based approaches to prevention and treatment of harm due to alcohol and other addictive substances, as well as recovery, and policing services.
Dr. Alexander Caudarella, CCSA’s CEO and a family physician specialising in substance use health, stated that “the substance use crisis is not just a big city issue.” He emphasised that smaller municipalities face disproportionate harm due to substance use, and that municipal leaders are key to designing effective, sustainable, and localised solutions.
The substance use crisis is not just a big city issue — it’s a whole-of-Canada issue that’s disproportionally affecting smaller cities and towns.
We have the expertise in substance use health, but the mayors and municipal representatives here are the real experts on what their communities need. For the first time, we are bringing the two together to build effective and sustainable localised solutions.”
Dr. Alexander Caudarella, CCSA’s CEO and a family physician specialising in substance use health
Municipal Collaboration Drives Local Solutions
The Lethbridge meeting builds on momentum from the Timmins Summit, part of CCSA’s Small Cities Initiative, reports CCSA. Senator Sharon Burey, known for her advocacy in children’s mental health and social justice, delivered the keynote address, reinforcing the importance of local-level collaboration in protecting communities from the harms caused by alcohol and other addictive substances.
Lethbridge Mayor Blaine Hyggen, who hosted the event, underlined that many municipalities share similar challenges and must work across jurisdictions. For example, small cities are increasingly reporting proliferating addictive substance use in public spaces, rising hospitalisations, and preventable deaths. Many also face serious housing shortages, further complicating their community response.
We are all facing very similar challenges, and being able to have honest conversations was very constructive,” said Lethbridge Mayor Blaine Hyggen, as per CCSA.
A community’s response to a drug crisis is often polarising, it crosses many jurisdictions and can have very different impacts. I think everyone in attendance looks forward to reviewing the draft playbook CCSA creates, based on this feedback, and seeing how that can be used to support local government leaders moving forward”
Blaine Hyggen, Mayor of Lethbridge
Scott Christian, Mayor of Queens, Nova Scotia, highlighted the urgency of action. He acknowledged service provider fatigue caused by repeated discussions with little implementation. He committed to advancing local measures even before the official playbook release, expected this fall during CCSA’s Issues of Substance 2025 conference in Halifax.
We already knew the municipality needs to play more of a role in community health. This event has crystalized my understanding of what is needed for that,” said mayor of Queens, Scott Christian, according to the CCSA press release.
We need to look at what collective impact we’re seeking to have and how elected officials, municipal staff and community leaders fit into that. We also know there is fatigue in our service provider community, from so many meetings but no action. My big action going back to Queens, even before the playbook is available, is to be really intentional to break through that inertia.”
Scott Christian, Mayor of the region of Queens, Nova Scotia.
Playbook to Guide Evidence-Based Local Policy
The forthcoming playbook will include a practical table of contents shaped by feedback from municipal leaders. It will serve as a tool to guide local governments in selecting and adapting evidence-based options suitable for their communities. The initiative also aims to reduce the growing polarisation around how communities respond to harm from substance use.
For instance, attendees explored diverse policy areas, including public health, education, bylaws, community safety, and workplace prevention programs. Timmins Mayor Michelle Boileau will promote this collaborative work at the upcoming Federation of Canadian Municipalities’ Annual Conference and Trade Show in Ottawa later this spring.
Next Steps and Community Engagement
The CCSA invites other municipalities to join the initiative or stay informed. Over the summer, the organisation will expand community engagement, training, and education. This is vital, as many communities are grappling with the worsening effects of alcohol use, unstable housing, and limited support systems.
Canadian municipal leaders are stepping up to drive change. Their focus on prevention, community health, and coordinated policy marks a turning point in how local governments respond to the substance use crisis. With robust national support and access to global knowledge, cities and towns are better equipped to protect people’s health and build safer, more resilient communities.