Consumption and Treatment Services

Drug and substance use is an important community health issue that has significant impact on people who use drugs, their families, and the broader community. These impacts include death and disability from overdose, the spread of infectious diseases, injection drug litter and injection in public spaces.

Substance Use in Hamilton

Substance use remains a top cause of avoidable deaths in Hamilton. The rate of opioid-related deaths in Hamilton has been consistently higher than the provincial rate, and Hamilton continues to see increasing opioid overdose deaths, 9-1-1 calls for opioid overdose, and emergency department visits for suspected overdose.

For example, in 2018, 123 people died due to opioid-related overdose in Hamilton (109% higher – more than double – the provincial rate). Among health units in Ontario, Hamilton has the third highest opioid-related mortality rate (2018) in the province, behind Thunder Bay District Health Unit and Algoma Public Health. Hamilton has the highest opioid-related mortality rate among southern Ontario health units (2018).

Learn more about Hamilton’s Opioid Information System

Consumption and Treatment Services

Consumption and Treatment Services (CTS) are locations where people consume pre-obtained drugs in a safe, hygienic environment under the supervision of trained and authorized harm reduction staff. These services reduce the harm caused from substance use (e.g. overdose, infection), while offering additional services such as counselling, primary care, addiction treatment, and connection to critical social supports such as housing. Currently there are 17 approved CTS sites in Ontario, including Toronto, Guelph, Kitchener, London, St. Catharines and Hamilton.

In 2017, Hamilton’s Supervised Injection Site Needs Assessment and Feasibility Study(PDF, 3.92 MB) found that Hamilton would benefit from one or more of these services due to annual increases in opioid-related overdose deaths, high rates of infectious disease, and community support demonstrated during community and stakeholder consultation.

Photo of Insite PHS Community Services Society in Vancouver

Photo Credit: Insite, PHS Community Services Society, Vancouver

Benefits, Model & Approach

Milestones

Timeline

Inspections

Benefits

Supervised consumption services have been studied in Canada and worldwide. Research has demonstrated benefits of supervised consumption services for both people who use drugs and for their communities. The addition of permanent, comprehensive Consumption and Treatment Services in the community has the potential to:

Save lives by reducing the number of fatal and non-fatal drug overdoses
Reduce the spread of infectious diseases like HIV and hepatitis C amongst people who inject drugs by promoting safe injection practices
Connect people who use drugs with primary health care, addictions treatment, and social services like housing
Create a safer community by reducing drug use in public spaces and publicly discarded needles and debris

There is no evidence that consumption services result in increased drug use, shifting drug use to different neighbourhoods, or increased drug trafficking or crime in the surrounding area.

Location

For any agency looking to operate a CTS site arrangements must first be put in place that will allow the site to be made public and to initiate community consultations. The selected site will be located near an area with a high concentration of opioid-related emergency department visits and suspected opioid overdose paramedics calls.

There is currently one CTS site in Hamilton, Hamilton Urban Core Community Health Centre operates Consumption and Treatment Services at 70 James St. S.

The AIDS network is currently submitting an application to the Ministry for a second location at 746 Barton St. E. More information can be found here: https://aidsnetwork.ca/cts/

Funding

Consumption and Treatment Services are funded by the Ministry of Health as part of a provincial response to the opioid crisis, in a model that provides harm reduction services and connects people with addiction treatment and other health and social services.

There are many steps to complete prior to opening a Consumption and Treatment Services (CTS) program. Major milestones are listed below:

Identify - Identify potential sites for Consumption and Treatment Services (CTS) program and initiate site assessment and finalize location details.
Announcement - Announce proposed site location of CTS program
Local Partnerships - Work with local partners and community to assemble a committee for planning and implementing a CTS program and liaising with the local community
Consultation - Conduct community information and consultation sessions.
Provincial Application - Submit a complete application, including results of community consultation, to provincial Ministry of Health for funding and approval to operate a CTS program.
Federal Application - Submit a complete application to Health Canada for an exemption to the Controlled Drugs and Substances Act to permit the operation of a CTS program.
Approvals - Obtain all required permissions and approvals to proceed
Sign Lease - Sign lease with landlord of proposed CTS site
Renovations - Complete building renovations.
Site Launch - Launch Consumption and Treatment Services.

October 2021 - The AIDS network TAN receives support from council to open a CTS site in Ward 3
December 2019 - Public health identifies possible CTS site.
April to November 2019 - Public health staff reviews 29 different sites as possible CTS locations, but none meet the requirements.
March 27, 2019 - Hamilton City Council supports proposal for Public Health to seek government approvals and funding for a Consumption and Treatment Service in Hamilton.
January 11, 2019 - Hamilton Urban Core Community Health Centre submits an application to Health Canada proposing a Consumption and Treatment Site at the interim site of 71 Rebecca Street.
December 19, 2018 - Board of Health supports the Hamilton Urban Core Community Health Centre to submit an application moving from a temporary overdose prevention site to the provincially approved Consumption and Treatment Service model.
December 12, 2018 - Public Health Services convened the first Consumption and Treatment Site Working Group to consult on application process and potential CTS site locations within the City of Hamilton.
October 22, 2018 - The MOHLTC announces a new, enhanced approach to services provided under the new Consumption and Treatment Services model.
June 5, 2018 - Urban Core Community Health Centre and Shelter Health Network open a temporary Overdose Prevention Site at 71 Rebecca St, Hamilton.
May 2018 - Ministry of Health and Long-Term Care announces funding for OPS in Hamilton awarded to applicants Urban Core Community Health Centre and Shelter Health Network.
December 2017 - Health Canada issued an exemption to Ontario to establish temporary overdose prevention sites across the province.
December 2017 - Public Health Services SIS needs assessment and feasibility study recommendations are endorsed by City Council (BOH 17004(b)).
May 2017 - Health Canada simplifies application process for Supervised Consumption Sites (Bill C-37).
December 2016 - City Council approves funds for 2017 Supervised Injection Site (SIS) Needs Assessment and Feasibility Study.

CTS in the City of Hamilton are inspected annually as well as when a complaint is received by the health unit. The inspections are limited to those settings with a Transfer Payment Agreement with the Ministry of Health. Learn more about CTS inspections in Hamilton.

Inspections and their postings are in accordance with the Health Protection and Promotion Act (HPPA) and the Ontario Public Health Standards, and the following Protocols:

Date modified

March 08, 2023