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The Four Pillar Model: Community-Led Capacity Building and Priority Setting

Leadership Group: Nat Kaminsky (Ontario Network of People who Use Drugs (ONPUD)), Ashley Smoke (ONPUD), Leticia Mizon (ONPUD), Cassandra Smith (ONPUD), Pamela Leece (Public Health Ontario (PHO))


The Four Pillar Model is an evidence-based approach commonly used to guide federal and provincial planning, and addresses substance use across four principles: Harm Reduction, Prevention Treatment, and Enforcement. The engagement of People with living and lived expertise of drugs use (PWLLE) in decision making processes is critical to ensuring substance use strategies are effectively designed and implemented to address inequities and reduce harms. As such, it is important to support PWLLE communities and strengthen the knowledge and understanding of policy models such as the Four Pillars Approach, in order to reduce barriers to meaningful participation in decision making around substance use.

This PWLLE-led initiative aims to build PWLLE communities’ capacity to engage in conversations around The Four Pillar Model. Partners from across the health system, such as community health, policy, and research, will be invited to participate in a virtual meeting series consisting of four 120-minute sessions (one for each pillar), where participants will share knowledge and education and identify action priorities around each corresponding pillar. This project will be guided by a PWLLE-member committee, representing the diversity of communities and regions across Ontario and Canada. Key action priorities and analyses discussed at each meeting session will be summarized and shared through several low-barrier knowledge resources, including a four-chapter report.