This is what the NWT’s new alcohol strategy will try to do

The Northwest Territories has a new alcohol strategy designed to reduce alcohol-related harm, primarily by letting communities choose from a range of measures that can help.

Bree Denning, hired as a specialist advisor after four years at the Yellowknife Women’s Society, spent almost three years leading work on the strategy, which was launched on Wednesday.

The NWT government has spent years building up to this moment, having sought to create a strategy partly in response to a damning independent report in 2019.

For example, in March 2021, health minister Julie Green told MLAs: “Our current efforts are really all focused around the alcohol strategy.” A year later, Green characterized alcohol as a much more significant problem than illegal drugs in the territory and one the strategy would address.

Green has said she wants the strategy to ultimately “produce better health … people not falling into the poor health outcomes of excessive alcohol use, and also not falling into the personal despair of excessive alcohol use.”

So what’s in the strategy?

The 24-page main document sets out 15 actions the territory can take, what each action will achieve, and what evidence supports each recommendation.

Denning said the strategy is the product of years of reviewing other jurisdictions’ approaches, then listening to people with first-hand experience of alcohol and addictions, service providers, Indigenous governments and, she particularly highlighted, youth.

“Youth today are very interested in what they can do to improve their communities. They are, frankly, smarter than I feel like I was at that age, and they want to be engaged,” Denning said.

“The changes that we make with our youth can influence the adults around them [and] change the health outcomes we’re seeing down the road. So the fact that there was this youth engagement, and youth are interested in asking for more, was really encouraging.”

Funding for everything in the strategy will be an “ongoing conversation,” Denning said. The strategy does not contain dollar amounts, but an accompanying work plan does assign responsibility for actions to various departments and agencies, with some rough timelines.

Here’s a guide to what’s in the strategy – you can read it here – and how Denning and others hope it can make a difference.

What are the key points?

The strategy promises better, more joined-up communication about alcohol, alongside changes that encourage people to make healthier choices and make access to services easier, without trying to simply get people to stop drinking entirely.

Communication about alcohol from the GNWT has been in silos up till now, Denning said: Health and Social Services does the health messaging, the liquor commission does social responsibility and so on. She wants information to be “coordinated and community-specific.”

Community is a big word in this strategy – almost the entire thing revolves around talking to individual communities about the help they need, then putting that in place.

“What we’re trying to do is provide a menu of options to choose from and work from there,” said Denning. “It’s not something where we can lay out a clear map because there is so much possible variation in how we approach it. It’s a matter of keeping the conversation open and providing support wherever we are welcome to do so.”

Example supports on that menu are managed alcohol and detox programs, developing some sort of helpline people can call for public safety that isn’t the RCMP (“what this looks like might vary drastically by community,” Denning said), incentivizing sober gatherings and non-alcoholic drinks, offering childcare so people can get to addictions recovery services, or creating extra support positions to take some heat off clinicians and plug gaps in access to services.

The strategy also looks at changes to how liquor is sold.

For example, it recommends a new minimum price per standard drink, removing the idea of “door-crasher specials” and other products that Denning says tend to be attractive primarily to youth and heavy drinkers, two of the demographics most at risk of alcohol-related harm.

There’s also the suggestion that new liquor stores could be built to combat bootlegging.

The alcohol strategy calls for more liquor stores?

At the moment, bootlegging is a big problem in many smaller NWT communities. People bring in alcohol and illegally sell it, usually at a significant premium. Almost invariably, the product being sold is hard liquor.

One of the reasons bootleggers are so popular is the complete lack of anywhere else to legally buy alcohol without driving for hundreds of kilometres.

If you create a liquor store, the strategy argues, now there is legal access to liquor at cheaper prices and, just as importantly, access to alternatives to hard liquor.

“Bootleggers don’t particularly care whether someone is intoxicated or whether someone’s too young to purchase alcohol,” said Denning. “Stores are mandated to do so, and so we want to enter into discussions if communities are interested about … beer and wine or liquor stores within those communities.

“Liquor is in communities anyway. It’s generally hard liquor, there is not much of a beer and wine culture. There are safer things than hard liquor that you can be drinking. Generally, with beer and wine you drink more slowly.”

Lynn White, a liquor legislation senior advisor at the Department of Finance, said the kind of liquor store that might help isn’t necessarily the “big bricks-and-mortar store that sells all types of liquor” that Yellowknife residents would imagine.

“Maybe there’s another model that might be able to be added on,” White said, “that would be more appropriate for a community to try – maybe a beer-only store or something like that. That can be done through our liquor legislation.”

So the hope is that people ditch vodka for beer?

Essentially, yes, because the expectation is that even a shift like that improves some health outcomes. The strategy includes a few measures that will attempt to move people from hard liquor to options with a lower alcohol percentage.

An as example, the territory will look at making drinks with a lower alcohol percentage cheaper to buy.

“If you look at purchasing a Radler,” said Denning, referring to a three-percent alcohol drink that usually blends lager with lemonade or grapefruit juice, “it’s one of the most expensive alcohol drink products. Maybe if we change that pricing, more people would choose that compared to a 16-percent cabernet sauvignon.”

Again, this measure targets youth – defined by Denning as people aged roughly 15 to 25 – and people who drink heavily. She says those are the two groups who “look for the highest bang-for-buck alcohol” and who could be persuaded to pick drinks with a lower alcohol content if those are the cheaper options.

Where is cultural safety in this?

The strategy has guiding principles at its start. Denning says one of those principles is understanding the impacts of colonization and intergenerational trauma on northern alcohol issues and alcohol use patterns.

“We wanted to make sure that we were centring communities and individuals with lived experience as experts,” she said of the strategy’s creation.

An Indigenous advisory body reviewed the strategy and provided feedback as it was drafted, and the final 15-action strategy was the result of feedback following a presentation that put 35 draft recommendations to a group of Indigenous leaders representing 20 organizations.

One of the 15 actions specifically tackles whether the concept of screening and brief intervention can be delivered in a culturally safe way.

Screening and brief intervention is a tool where healthcare workers ask you about your alcohol use, regardless of why you’re coming into the health centre, just to start a conversation and check in. “Even when that might not be a concern yet, it’s a prevention tool,” Denning said.

“However, looking at the history of alcohol and how Indigenous people have been treated in clinical settings around stereotypes around alcohol, that might not be a safe thing to do – and that might actually make people feel uncomfortable in those healthcare settings and less likely to access healthcare.

“Just because it’s a universal best practice, doesn’t mean that it works in translation here. And so we need to talk about: can we do this in a way that’s culturally safe?”

How will we know if the strategy works?

Denning says annual reports will be made available, evaluating success through metrics like whether the number of hospital visits, injuries and RCMP calls related to alcohol declines.

Anecdotal evidence will also be part of that assessment. “Are people telling us that there are changes, that things are better or worse?” Denning said. An addictions recovery survey is also being repurposed in part to help ongoing evaluation of the strategy’s performance.

A full evaluation and monitoring plan is still being finalized. In the meantime, the territorial government’s first step based on the strategy will be to increase funding for youth-oriented activities this summer.

“One of the number-one reasons that youth gave for drinking or using drugs was that they were bored, and they didn’t have enough to do. And that was another one of the reasons that adults gave for drinking, as well,” said Denning.

“Every community is different, and every community is going to have different needs in terms of how we move forward. There are some activities that the government can take, sort-of unilaterally put out there, such as … supporting more youth activities, but there are others that are going to be quite community-specific.

“Those are the ones where we really need to do a bit more discussion and exploration at the community level or at the Indigenous government level, to really get what, exactly, that needs to look like.”