Consumption and Treatment Services

Consumption and Treatment Services (CTS) sites are part of a range of proven strategies to address the harms of substance use. CTS sites offer comprehensive, compassionate, and evidence-based services that support prevention, harm reduction, and treatment for people who use drugs.

Applying for a CTS site is one example of the collaborative community response that is underway to address opioid use and related harms in Peterborough. Find a timeline of past and ongoing community efforts here.

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Information about CTS in Peterborough

About Consumption and Treatment Services

Supervised Consumption Sites (SCS) are health services that provide a safe, clean space for people to consume pre-obtained drugs under the supervision of health professionals. Staff are present at all times to respond to medical emergencies. Individuals are also provided with sterile injection supplies, education on safer consumption practices, basic medical services, and referrals to drug treatment, housing, and other social services.

Consumption and Treatment Services
Provincially, supervised consumption services are called Consumption and Treatment Services (CTS). As with SCS, Consumption and Treatment Services sites provide a safe, clean space for a person to use pre-obtained substances under the supervision of a health care professional and to engage in treatment, healthcare and social services.

How do these services work?

Supervised consumption sites do not provide drugs. Clients come to the program with their own supply of drugs. An intake worker greets each person and completes an assessment to confirm they are eligible to use the service and that they understand how it works.

The client is given sterile injection equipment and instruction on safer injection practices. In a neighbouring room, a nurse supervises their injection and responds in the case of any medical emergencies.

Once the individual has finished their injection they are directed to a waiting room for ongoing observation and to receive information and referrals about other health and social services.

What are the benefits of these services?

Canadian and International research shows that supervised injections services provide many benefits both for individuals using the services and for the community, including:

  • Reduced drug overdoses, poisonings, and deaths
  • Reduced risk factors leading to infectious diseases such as HIV and hepatitis
  • Increased use of detox and drug treatment services
  • Connection and referral to other health and social services
  • Reduced public drug use and less publicly discarded needles
  • Cost-effectiveness
  • No impact on crime or increased drug use in the local community

For more information about the evidence and benefits of SCS, visit our CTS Facts page.

Are these services legal?

Yes. In Canada, legal operation of a supervised consumption site requires an exemption under Section 56.1 of the Controlled Drugs and Substances Act (CDSA). Exemptions are granted by the federal Minister of Health.

Will this service increase crime in our neighbourhood?

Supervised consumption sites do not increase crime in the surrounding area. They are located in areas where drug use is already having an impact on the community.

In the neighbourhood around InSite in Vancouver, research has shown there has been no increase in crime, and actual decreases in vehicle break-ins and thefts. Australian studies have also found decreases in drug-related crime, public drug use and loitering.

For more information about the evidence and benefits of SCS, visit our CTS Facts page.

Won’t these services just encourage more drug use?

People do not start injecting drugs because of supervised consumption services. There is no evidence that harm reduction services of any kind promote drug use. Supervised consumption services are used mainly by people with a long history of injection drug use. Research has also found that supervised consumption services do not cause people to relapse (e.g., start using drugs after a period of not using) or prevent people from stopping drug use altogether.

For more information about the evidence and benefits of SCS, visit our CTS Facts page.

Has a site been chosen in Peterborough?

No. A site selection committee has been established to investigate all potential sites to ensure compliance with Federal and Provincial guidelines. In the meantime, Community partners are inviting community members to participate in consultations to learn about the benefits of a site and respond to any concerns.

Why don't we just add more treatment services?

Harm reduction programs like consumption and treatment services are important parts of a comprehensive strategy to improve community outcomes related to substance use. Harm reduction services aim to link people who use drugs to services and supports to improve their health. Treatment services are needed for people who want to reduce or stop using drugs. A range of supports are needed because people may fall in and out of treatment and recovery or may not be ready to stop using drugs.

Health Canada and the provincial Ministry of Health and Long-Term Care recognize the need for both harm reduction and treatment. Funding for treatment services are supported through different health services and provincial branches. Locally, harm reduction service providers and treatment service providers work together through the Peterborough Drug Strategy to ensure our approaches are coordinated and resources are used efficiently and effectively.

 

Do we need this service in Peterborough?

There is an urgent need in Peterborough to rapidly mobilize and expand on existing harm reduction services to address the growing opioid crisis. Recent statistics show that Peterborough is one of the top-ranking communities in Ontario for highest per capita rate of opioid-related deaths, and has seen drastic increases in calls for emergency services and emergency room visits.

  • Peterborough County/City Paramedics (PCCP) call volume data indicates that Opioid Overdose type calls have increased steadily over the past several years. From January 1 to June 28, 2019, PCCP reported a 31% increase in Opioid Overdose type calls compared to the same timeframe in 2018. In 2017, PCCP reported a 65% increase in Overdose/Intoxication type calls, compared to an average yearly increase of 15% between 2014-2016.
  • Between July 2017 and June 2018, Peterborough Public Health (PPH) ranked 3rd highest in the province for average opioid-related deaths per 100,000 population, at a rate of 15.4 per 100,000, which is nearly double the provincial average of 8.4 per 100,000 for the same time period [ODPRN 1]. A previous analysis covering the period between July 2013 to June 2016 ranked PPH 4th highest [ODPRN 2].
  • Opioid-related deaths in the PPH area have increased steadily over the past 3 years. There were 10 opioid-related deaths in 2016, 16 in 2017, and 26 in 2018 [PHO]. In the first 9 months of 2019, there were 26 deaths due to opioid poisoning (combination of confirmed and suspected) [personal communication with Peterborough Police Service].
  • In 2017, Peterborough ranked as the 3rd highest central metropolitan area in Ontario in the number of opioid poisoning Emergency Department visits with an age-adjusted rate of 108.9/100,000 [CIHI].
  • Visits to Peterborough’s Emergency Department for opioid poisoning increased 214% between 2014 & 2018. ED visits for poisoning by heroin increased almost four-fold between 2016 and 2017, and then increased by a further 44% in 2018. Additionally, “poisoning by other synthetic narcotics” increased 52% in 2018 over the previous year and in 2018 approximately three quarters (76%) of this category were specifically attributed to “poisoning by fentanyl and derivatives” [IntelliHealth].
  • The 2017 rate of Hepatitis C in the PPH area (65.3) was approximately double that of the province (33). PPH’s rate has been increasing since 2015, while Ontario’s rate has stayed relatively the same. [PHO 2]
  • In 2018, 1022 naloxone kits were distributed by community sites and there were 761 interactions where training was provided. In 2017, community sites distributed 599 naloxone kits and there were 529 training interactions [PPH]. Peterborough area pharmacies distributed 1666 kits in 2018, compared with 1135 kits in 2017 [ODPRN 3].

Sources:

[ODPRN 1] – https://www.publichealthontario.ca/-/media/documents/opioid-mortality-surveillance-report.pdf?la=en
[ODPRN 2] – http://odprn.ca/research/publications/opioid-prescribing-in-ontario-august-2017/
[PHO] – https://www.publichealthontario.ca/en/data-and-analysis/substance-use/interactive-opioid-tool; Date Extracted: Jun 25, 2019
[PHO 2] – https://www.publichealthontario.ca/data-and-analysis/infectious-disease/reportable-disease-trends-annually#/27; Date Extracted: Jun 28, 2019
**[CIHI] – Reviewed 15 communities in Ontario, with a population greater than 100,000 https://www.cihi.ca/sites/default/files/document/opioid-related-harms-report-2018-en-web.pdf
[ODPRN 3] – https://odprn.ca/ontario-opioid-drug-observatory/ontario-prescription-opioid-tool/?ct=t(OPOT_Revision_April_2019); Date Extracted: Jun 28, 2019  
[IntelliHealth] – National Ambulatory Care Reporting System (NACRS), IntelliHealth, Ministry of Health & Long Term Care, extracted July 2, 2019.

What else is being done to address drug issues in Peterborough?

Many organizations across the City and County of Peterborough deliver a broad range of services to reduce the harms of drug use. These services include prevention programs, harm reduction services, and treatment programs.

Since 2009, our community has supported a comprehensive four pillar approach to drug and substance misuse through the Peterborough Drug Strategy. This includes:

  • Prevention– e.g. Addressing root causes of drug use, supporting parents and youth with information about the dangers of substance use.
  • Harm Reduction– e.g. Increasing needle recovery and disposal options.
  • Treatment – e.g. Rapid Access Addiction Medical Clinics.
  • Enforcement– e.g. Enforcement focus on drug trafficking; Good Samaritan Drug Overdose Act.

For more information, visit the Peterborough Drug Strategy website at http://www.peterboroughdrugstrategy.com. For a timeline of current and ongoing initiatives to address the harms of opioid use, visit our opioid response timeline

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If you are struggling with opioid use or another substance-related concern, help is available now.

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For general inquiries regarding CTS, please contact:
705-749-9110 ext 208
cts@peterboroughdrugstrategy.com