Consumption and Treatment Services

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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.

Within the Harm Reduction pillar of the Waterloo Region Opioid Response Plan, one of the strategies being pursued is Consumption and Treatment Services (previously called Supervised Consumption Services). Consumption and Treatment Services are one service within a continuum of evidence-based services that support people living with problematic substance use. They provide a place where people can use drugs in a monitored, hygienic environment to prevent fatal overdose and other harms from substance use, while also providing a gateway to additional services such as counselling, primary care, and treatment.

What are 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.

Consumption and Treatment Services are a place where people can use drugs in a monitored, hygienic environment to reduce harm from substance use while offering additional services such as counselling, primary care, and opioid-dependency treatment.

Do we need Consumption and Treatment Services?

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 April 1, 2019, it is estimated that 20 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.

Consumption and Treatment Services, along with needle syringe programming, naloxone, and opioid dependency treatment, help reduce harms from substance use, including HIV, Hepatitis C, bacterial infections, and overdose death.

What has been the process in Waterloo Region so far?

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. The findings of the study indicated that Consumption and Treatment Services are needed in Waterloo Region to reduce overdose related death, reduce the spread of infectious diseases, connect people with health and social services, and create a safer community.

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 Supervised Consumption Services 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 to date, please see our Community Services Committee Council reports below.

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

Why provide Consumption and Treatment Services?

Consumption and Treatment Services provide a safe environment for people who use drugs, and reduce:

Overdose deaths
Transmission of diseases and infections
Public substance use and discarded needles

Consumption and Treatment Services are a compassionate, comprehensive, and collaborative form of evidence-based care and provide options when clients are ready for change.

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.

Where will Consumption and Treatment Services be located in Waterloo Region?

According to the Ministry of Health and Long-term Care (MOHLTC), Consumption and Treatment services will be located in communities in need based on ministry-defined criteria. These criteria include the following:

Number of opioid-related deaths
Rate of opioid-related deaths
Rate of opioid-related emergency department visits
Rate of opioid-related hospitalizations
Proxy measures for drug use:
- Needle distribution
- Naloxone and oxygen use to respond to an overdose

It is well established in Waterloo Region that Consumption and Treatment Services are needed in Central Kitchener and South Galt based on these criteria.

Public Health has recommended that Consumption and Treatment Services be provided at 150 Duke Street West in Kitchener.

Public Health has also recommended that 150 Main Street be removed as the candidate location in Cambridge and that through ongoing partnership with the City of Cambridge, to continue searching for an ideal location in a timely manner. Once that location has been identified, to pursue community consultation on that location.

The provincial and federal governments have specific requirements for locations and Waterloo Region has criteria for consideration. All proposed locations will be evaluated based on the provincial, federal and local criteria. A location will be brought forward to the Consumption and Treatment Services Implementation Workgroup for consideration if it meets the following:

All criteria listed below:
- The site is in an area of high need as indicated by high occurrences/rates of overdose (fatal and on-fatal) and current occurrences of public illicit drug use.
- The site is a minimum 1000 square feet and is ideally 2000 square feet to accommodate wrap-around services.
- The site has capacity for various security measures (e.g. has security on site, secure entry, cameras, etc.).
- The site is strategically located within an approximately 10-15 minute walk to areas of highest reported drug use.
- The site is easily accessible by public transit (i.e. within 450 meters of a GRT stop).
- The site is accessible or can be made accessible for people with disabilities (e.g. on a main floor).
- The site is in close proximity (i.e. 10-15 minute walk) to complementary health and social services including mental health care, primary care, palliative care, opioid withdrawal support, and social services.
- The location is accessible by first responders.
The property is available for lease; and
The property owner/landlord is on board with the intended use of the space.

To suggest a location, please email cts@regionofwaterloo.ca or call 519-575-4400 ext. 5613.

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.

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.