Toronto hospital becomes first in Ontario to provide supervised consumption services

Casey House in Toronto, Canada’s first and only hospice for people living with HIV, is now the first in Ontario to offer on-site supervised consumption as part of its health care.

“We see a supervised consumption service as a critical health care necessity,” said Casey House CEO, Joanne Simons.

Casey House’s supervised consumption services are open to registered clients 24-hours a day for the inpatient unit and 10 a.m.-4 p.m. for outpatients.

“There is a tremendously toxic drug supply on the streets right now, and so to provide a safe space for people who use substances is really critical to their health and their care,” added Simons.

“People are able to currently eat, snort or inject substances at these booths,” described Casey Schapel, harm reduction coordinator at Casey House, as he brought Global News on a tour of the new space.

More than a third of Ontario overdose deaths in 2020 were attributed to inhaling substances, so Casey House also built one booth for inhalation and the team is working towards offering the service.

“At least 50 percent of our clients would prefer to use the inhalation site as opposed to injecting drugs. Right now, there’s legislation actually preventing us from opening up the inhalation site. Smoke Free Ontario doesn’t allow smoking, certainly within hospitals, within public spaces,” she explained.

Casey House created an environment where the smoke is immediately evacuated out of the building.

“We’re going to work with our government partners to understand how we can actually move the legislation so that we can provide people this lifesaving experience,” said Simons.

Schapel is hopeful the new space and services will save lives.

“I think given the current toxic drug supply or the drug poisoning crisis, we know that there has been an increase in the number of deaths associated with overdose in the community so just by having the supervised consumption site means that people are able to consume in a safe manner and overdoses are able to be reversed in a timely and safe and supportive model,” he said.

Simons credits the work of the harm reduction community across Canada for laying the groundwork for hospital-based supervised consumption to become a reality.

“We think that all hospitals, all health care institutions really need to think about how they work with people who use substances because this is actually not a moral issue. This is a health issue,” she said.

“They know that there are people there that are coming in for health care, but also are using drugs, and this is just a recognition of that fact to stop judging people for that,” said Nick Boyce, director of Ontario Harm Reduction Network.

“It’s opening up a conversation with people around their drug use and just being able to connect with them and being open and honest with what’s happening. So it’s great to see this happening,” he added.

Boyce said supervised consumption sites should have started a long time ago in Ontario.

“The first one in Canada was almost 20 years ago in B.C., the first ones in Ontario didn’t start legally happening until about five years ago. And then the last few years we haven’t had any scaling up of those … and in terms of the hospitals, there’s just an extra layer of stigma around drug use in hospital settings, in health care settings that makes it harder for those institutions to think about this,” he said.

Boyce said there is a future for other healthcare institutions to follow Casey House’s lead in combining supervised consumption services with other health services.