Consumption and Treatment Services

Home/Health and Wellness/Alcohol and Drugs/Consumption and Treatment Services

150 Duke Street building

Updates on the CTS sites

An interim site is currently being established at 150 Duke Street West, the corner of Duke and College Street in downtown Kitchener.

Community engagement continues to be an important component of Consumption and Treatment Services implementation. Staff will be working with community stakeholders to increase awareness and understanding of the services offered on site, ensure mechanisms are in place to respond to any issues should they arise, and continue to proactively connect with stakeholders in proximity to the site to answer questions and prevent issues from occurring.

150 Duke Street West, Kitchener

The second floor of 150 Duke Street West was chosen as the interim site to minimize disruption to clients and the general community. Public Health worked with Sanguen Health Centre to prepare for implementation of the interim service model to receive a time-limited class exemption from the Controlled Drugs and Substances Act (CDSA) to operate this urgent public health need site. Public Health and Sanguen Health Centre have been working with Region of Waterloo Facilities and architects to design both the interim and permanent sites. The interim site is expected to open in September 2019.

Health Canada has also provided an exemption from the CDSA for Public Health and Sanguen Health Centre to operate a permanent CTS at 150 Duke Street West. Construction is expected to occur on the first floor while the interim site is operating on the second floor. The permanent CTS site is expected to be operational in February 2020.

CTS in Cambridge

On June 19, 2019, Cambridge Council passed a resolution in support of proceeding with the identification of candidate sites for Consumption and Treatment Services with wrap around services in Cambridge, outside of the core areas; and in an area of need as per the requirements of the provincial Consumption and Treatment Services Program.

As well, the Council directed the development of a community consultation approach be developed in consultation with the proposed Community Wellbeing Advisory Committee to support the sited identification. This work will be supported by a professional facilitator contracted to assist with the design and implementation of the community consultation for a site to be identified as a potential location for Consumption and Treatment Services in Cambridge.

Public Health staff continues to work with Cambridge staff on this process to identify candidate sites.

CTS Chronology

Date	Information
October 2017-August 2018	Research identifies the need for Consumption and Treatment Services and where they should be located and 150 Duke Street West is one Kitchener possibility that meets all the criteria
August 14, 2018	150 Duke Street West is first approved by Regional Council as a possible Kitchener location
January 8, 2019	150 Duke Street West community consultation is approved by Regional Council
March 2019	Community consultation report shows strong support for 150 Duke Street West compared to other Kitchener locations
April 9, 2019	150 Duke Street West is recommended because of: Large size – space for: wrap around supports, daytime rest spaces, possible expansion Commercial appeal: can use service anonymously Downtown core location Community and Implementation Working Group support
April 9, 2019	Board of Health approves recommendation of submitting a Federal and Provincial application to have Consumption and Treatment Services at 150 Duke Street West
April 15, 2019	Kitchener City Council approves moving forward with a Federal and Provincial application for Consumption and Treatment Services at 150 Duke Street West
April 17, 2019	Board of Health ratifies decision to move forward with Consumption and Treatment Services at 150 Duke Street West in Kitchener. Public Health to proceed with applying for an exemption under the Controlled Drugs and Substances Act through Health Canada, and to the Ministry of Health and Long-term Care for funding.
June 5, 2019	Board of Health approves recommendation for the interim site to be located at 150 Duke Street West, and agreed to revise the 2019 budget to fund the one-time capital and ongoing operating costs for the interim site.

Information about the CTS process in Waterloo Region

About Consumption and Treatment Services

Consumption and Treatment Services are part of a range of evidence-based services that support prevention, harm reduction, and treatment for people living with substance use challenges.

In 2017, 86 people died of opioid related drug overdoses in Waterloo Region. It is suspected that a further 53 people died in 2018. As of August 2, 2019, it is estimated that 46 people have died of opioid related drug overdoses in Waterloo Region this year already.

Overdose death is a serious concern and with our partners we are working hard to reduce the harm from substance use.

Problematic substance use is a complex issue faced by many people, and requires a multifaceted approach that includes prevention, treatment, harm reduction, and justice and enforcement.

CTS are a compassionate, comprehensive, and collaborative form of evidence-based care and provide options when clients are ready for change. CTS are a place where people can use drugs in a monitored, hygienic environment to reduce harm from substance use while offering integrated, wrap-around services such as counselling, primary care, opioid-dependency treatment, and other health and social services. CTS provide a safe environment for people who use drugs. They reduce:

Overdose deaths
Transmission of diseases and infections, including HIV, Hepatitis C, and bacterial infections
Public substance use and discarded needles

The program also includes requirements to address community concerns, and ensure ongoing community engagement and liaison where Consumption and Treatment Services are established.

A literature review of Supervised Consumption Services was completed by Public Health in November 2016.

Consumption and Treatment Services (referred to as CTS) will provide integrated, wrap-around services that connect clients who use drugs to primary care, treatment, and other health and social services. The program also includes requirements to address community concerns, and ensure ongoing community engagement and liaison where Consumption and Treatment Services are established.

Identifying Consumption and Treatment Services Sites in Waterloo Region

In 2017, the need for Consumption and Treatment Services in Waterloo Region was established through Phase 1 of the Supervised Injection Services Feasibility study reported to Regional Council in February 2018. Check here to see the full report, or the infographic.

In August 2018, Regional Council directed Public Health to explore a prototype for a “Made in Waterloo Region” model for
Consumption and Treatment Services. This work was to be done during a pause in moving ahead with public consultations on candidate sites. To explore this model, a two-day visioning session was held. Click here to view the summary report of the visioning session.

In 2018, the focus has been on finding viable locations to house Consumption and Treatment Services in Central Kitchener and South Galt.

For detailed information about our process, please see our Community Services Committee Council reports below. As evidenced in the timeline, 150 Duke Street West in Kitchener was chosen as the preferred CTS site due to its large size, commercial appeal, location, and community and Implementation Working Group support.

Date	Key decisions by Regional Council (Board of Health)
June 6, 2017	Endorsement to move forward with Supervised Injection Services Feasibility Study
October 24, 2017	Endorsement of methodology for Supervised Injection Services Feasibility Study In person interviews with people who inject drugs Key informant interviews with harm reduction service providers Information and consultation sessions with interest groups Online public survey
February 28, 2018	Endorsement of Receipt of Supervised Injection Services Feasibility Study Phase 1 report for information Scheduling special council meetings for public input on recommendations from Phase 1 Arrangement of Supervised Injection Services tours for Regional Councillors
April 10, 2018	Endorsement to move forward with Phase 2a of the Supervised Consumption Services Feasibility Study - identification of candidate locations
June 19, 2018	Endorsement of the following identified candidate locations 150 Main Street, Cambridge 149 Ainslie Street North, Cambridge 115 Water Street North, Kitchener Endorsement to move forward with Phase 2b of the Supervised Consumption Services Feasibility Study Decision to direct staff to provide community members the opportunity to suggest additional candidate location options for consideration
August 14, 2018	Endorsement of additional candidate locations 150 Duke Street West, Kitchener 105 Victoria Street North, Kitchener (vacant lot at corner of Weber and Victoria) Decision to put community consultations for candidate locations of Consumption and Treatment Services (Phase 2b of the study) on hold until further direction is received from provincial government
December 11, 2018	Public Health provided Community Services Committee of Regional Council with an update on the work that has been completed regarding Consumption and Treatment Services during the fall of 2018. Specifically, Public Health shared: The new provincial program “Consumption and Treatment Services” released by the Ministry of Health and Long-term Care in October 2018 The Made in Waterloo region model of service for Consumption and Treatment Services developed by community partners through a visioning exercise Work is continuing on developing floor plans and costing estimates for the five candidate locations in Waterloo Region
January 8, 2019	Approval to remove 149 Ainslie Street North, Cambridge as a candidate location for Consumption and Treatment Services. Endorsement to move forward with community consultation on the following candidate locations: 150 Main Street, Cambridge 115 Water Street North, Kitchener 150 Duke Street West, Kitchener 105 Victoria Street North, Kitchener Endorsement to submit a Letter of Intent to the Ministry of Health and Long-term Care describing the need for Consumption and Treatment Services in Waterloo Region, the local process to date and describe the next steps, including, pending Regional Council endorsement, the community’s intent to apply for exemption under the Controlled Drugs and Substances act through Health Canada to operate a site and to the provincial government for funding should a site be approved by Community Services Committee of Regional Council.
April 9, 2019	Public Health shared the results of the community consultations on the four candidate locations in Waterloo Region: 115 Water Street North, Kitchener 150 Duke Street West, Kitchener 105 Victoria Street North, Kitchener 150 Main Street, Cambridge Strong community support was identified for 150 Duke Street West in Kitchener. Minimal engagement/support was found for 105 Victoria Street North in Kitchener. Strong community opposition to operate Consumption and Treatment Services at 115 Water Street North in Kitchener. Community Services Committee of Regional Council unanimously endorsed proceeding with an application to Health Canada to operate Consumption and Treatment Services at 150 Duke Street West pending City of Kitchener approval. Community Services Committee of Regional Council unanimously endorsed Public Health staff returning to Community Services Committee on April 30, 2019 with a location, plan, and costs to have a temporary site open within two months of approval with appropriate partners in place. Community Services Committee of Regional Council unanimously endorsed that Public Health continue to work with City of Cambridge staff and council to identify an alternative site that meets provincial and federal program criteria for Consumption and Treatment Services in as timely a manner as possible, and remove 150 Main Street as a candidate location. Community Services Committee of Regional Council unanimously endorsed proceeding with consultation on an alternative location in Cambridge once it has been identified.
April 30, 2019	Public Health provided an update on the Interim CTS site including the process to identify the site location, the model of service, and the temporary federal exemption.
June 5, 2019	Endorsement of 150 Duke Street West as the interim site location. Endorsement for the Regional Municipality of Waterloo to amend the 2019 budget to include an estimated $530,000 for the provision of Consumption and Treatment Services at 150 Duke Street West. Endorsement of all one-time capital and ongoing operating costs associated with the site preparation and operations for the provision of interim Consumption and Treatment Services at 150 Duke Street West, Kitchener be funded from the Tax Stabilization Reserve.

Public Consultation Sessions

The public consultation sessions for Consumption and Treatment Services in Waterloo Region are now complete and the corresponding online survey is closed.

The consultant hired to complete this work (ICA: The Institute for Cultural Affairs) has prepared the Consumption and Treatment Services Site Exploration report of the findings.

We thank all consultation session participants and survey respondents for their input into this important work.

Frequently Asked Questions

If you want to learn more about consumption and treatment services, please check the Frequently Asked Questions document.

A number of questions were asked at the community consultation sessions that took place between January 29th and February 13th in Kitchener and Cambridge. The following link provides responses to questions asked – Community Consultation Questions and Answers.

Contact

To contact us regarding Consumption and Treatment Services, please email cts@regionofwaterloo.ca or leave a message at 519-575-4400 ext.5613.