Consumption and Treatment Services

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

150 Duke Street building

Updates on the CTS sites

The interim site began operations on October 15, 2019 on the second floor of 150 Duke Street West, the corner of Duke and College Street in downtown Kitchener. It is open 9 a.m. to 9 p.m., seven days a week, including holidays. The full CTS site with on-site wrap-around services is currently under renovations on the main floor of the building and is expected to be open for operations in spring 2020.

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

October 15, 2019 - The interim site began operations on the second floor of 150 Duke Street West in downtown Kitchener. On this same date, the Ministry of Health announced their approval of 150 Duke Street West as a provincially funded CTS. Renovations for the full CTS site are underway on the main floor and are expected to be complete in the spring of 2020.

The second floor of 150 Duke Street West was chosen as the interim site to minimize disruption to clients and the general community while providing important overdose prevention services. Public Health worked with Sanguen Health Centre to prepare the site and apply for an exemption from the Controlled Drugs and Substances Act (CDSA). Services at the interim site include:

Safe consumption
Harm reduction supply distribution
Wound care
Sharps disposal (new containers available, used supplies accepted)
Referral pathways to social services, primary care and treatment supports

The first floor of 150 Duke Street West will become the full CTS site in Spring 2020 and will include a number of on-site wrap around services, including social services, primary care, and treatment supports.

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.

Policing and Consumption and Treatment Services

The Waterloo Regional Police Service works in partnership with the Waterloo Region Integrated Drugs Strategy in support of a comprehensive four-pillar approach. This includes Prevention, Harm Reduction, Recovery and Rehabilitation, and Enforcement and Justice. The Waterloo Region Police Service is committed to a harm reduction approach to those addicted to drugs, while focusing enforcement efforts on individuals that manufacture, import, or traffic illegal drugs. Police confirm the following in relation to Consumption and Treatment Services in Waterloo Region:

Consumption and Treatment Services requires Federal Government approval, which is granted by the federal Minister of Health for legal exemption under Section 56 of the Controlled Drugs and Substances Act. This allows for the legal operation of these services.
Across Canada, Consumption and Treatment Services have not been shown to increase drug consumption or drug trafficking in the surrounding areas. It is anticipated, however, that these services will result in a decrease in overdoses, a decrease in unsafe practices like syringe sharing, and enhanced promotion of public order by decreasing public consumption and substance use-related litter.
The Waterloo Region Police Service supports the use of the Consumption and Treatment Services by those using it for its intended purposes. However, the laws with regard to criminal activity and public disorder, including in the immediate area of the Consumption and Treatment Service, will be enforced.
There is no “buffer zone” or “free zone” in regards to a Consumption and Treatment Service and the laws surrounding illegal drug use are enforced everywhere except the exempted area inside the site building. The Police service will continue to enforce the Controlled Drugs and Substances Act by targeting those who supply drugs or otherwise profit off those challenged by addiction. The Waterloo Regional Police Service will continue to work closely with the community and community partners to understand and address crime and disorder in the downtown core and the impacts, or potential impacts, of a Consumption and Treatment Service.

For more information, contact: Waterloo Regional Police Service at 519-570-9777

This information has been adapted from the Waterloo Region Police Service’s Consumption and Treatment Services information pamphlet.

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.
September 9, 2019	The lease negotiations for 150 Duke Street were completed and the lease was signed. The work on the interim site started and Council was advised at the Community Services Council meeting.
October 15, 2019	The interim site began operations on the second floor of 150 Duke Street West. On this same date, the Ministry of Health announced their approval of 150 Duke Street West as a provincially funded CTS. Renovations on the first floor for the full CTS site with on-site wrap-around services are underway and are expected to be complete by Spring 2020.

Information about CTS 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.

Consumption and Treatment Services - A Harm Reduction Program

Community Advisory Group

Meeting Minutes

CTS Interim Advisory Committee – Meeting July 18, 2019 at Public Health

Reviewed the Terms of Reference for the interim advisory group. This group will advise on site design and planning, service planning and site operations, support the launch of the interim site and provide input on public education and community engagement
An overview of the interim CTS site and site design was provided highlighting the difference between interim site and permanent site
A review of the communication plan and community engagement plan was completed, noting this work is just beginning. The goals include public education about CTS, both interim and permanent, how to promote services to clients and service providers and how to mitigate issues/concerns

CTS Interim Advisory Committee – Meeting August 30, 2019 at Public Health

An update was given on progress for the interim site. Wrap around services are not available for the interim site, but basic referral and treatment will be offered. A review was done on the permanent site floor plan
An update on the Communication Plan was provided
A brain storming session was done to obtain input for the Community Engagement Plan with a focus on four strategies:

Public Education
Neighbourhood Relationship Building
Peer Outreach and Community Development
Feedback and Suggestions

It was discussed that this would be the last meeting for the interim advisory committee and that the next meeting would be for the Community Advisory Group – which would include some of the same participants

Community Advisory Group (CAG) – Meeting September 30, 2019 at Church of St. John the Evangelist

Welcome and introductions were done with a focus on the Drug Strategy Harm Reduction Guiding Principles
Purpose of the Community Advisory Group and Terms of Reference were reviewed
A review of the Waterloo Region Integrated Drugs Strategy was provided, along with a CTS Overview (feasibility study, site selection and application process
Standing items will be addressed at each CAG meeting which include site design, site operations, service planning, evaluation and metrics and community engagement. Each standing item was reviewed with the CAG with current updates and reports
Time was given at the end of the meeting for an open roundtable discussion, next steps and meeting schedules

Community Advisory Group (CAG) – Meeting November 25, 2019 at Downtown Community Centre

Agenda review and introductions were done
Standing items were updated including site design, operations, service planning, evaluation and metrics and community engagement. There were many questions throughout the standing items update. The CTS has been operating since October 15th and there have been no major concerns at all
We are not referring to the site as “interim” as the CTS meets the province’s requirements
Renovations for the full site are expected to be complete by Spring 2020
The staffing model was reviewed; the busiest time frame tends to be between 1 p.m. and 6 p.m.
Discussion about an Ambassador Program occurred during the Community Engagement Update
The meeting closed with a round table discussion and updates from CAG members. Overall, things have been running smoothly. There has been no increase in crime activity, needle debris and City of Kitchener staff have not had to respond to any overdoses within the area during the operating times of the CTS
There will be a small workgroup that will come together to help support the neighbourhood associations put together a “Who to Call” information handout, similar to the Discovery Team card
The next meeting of the CAG will be in January of 2020

Community Advisory Group Membership

Heather Elliott – Region of Waterloo Public Health – helliott@regionofwaterloo.ca

Grace Bermingham – Region of Waterloo Public Health – gbermingham@regionofwaterloo.ca

Violet Umanetz – Sanguen Health Centre – vumanetz@sanguen.com

Ralphy Schmidt – Sanguen Health Centre – ralphy@sanguen.com

Grant Egerdeen – City of Kitchener – grant.egerdeen@kitchener.ca

Hilary Abel – City of Kitchener – Hilary.Abel@Kitchener.ca

Shirley Hilton – Waterloo Region Police Services – Shirley.Hilton@wrps.on.ca

Stefanie Golling – Downtown Kitchener BIA – sgolling@kitchenerdowntown.com

Linda Jutzi – Downtown Kitchener BIA – ljutzi@kitchenerdowntown.com

Paul Cox – St. Louis Adult Learning and Continuing Education Centre – Paul.cox@wcdsb.ca

Lorie Guest – Blyth Academy Waterloo – lorie.guest@blytheducation.com

Ginette Lafreniere – Wilfrid Laurier University, Faculty of Social Work – Glafreniere@wlu.ca

Laura Coakley – Wilfrid Laurier University, Social Innovation Research Group, Faculty of Social Work – lcoakley@WLU.ca

Michele Kempster – YW Duke St. Childcare (City Kids) – Michele.Kempster@ywkw.ca

Stephen Pedersen – Olde Berlin Neighbourhood Association – CTS@regionofwaterloo.ca

Beth MacIntosh – Kitchener Downtown Neighbourhood Alliance – emacinto@hotmail.com

Donna Kuehl – Kitchener Downtown Neighbourhood Alliance – adeline@sympatico.ca

Preston Parsons – Church of St. John the Evangelist – rector@stjohn316.com

Simon Guthrie – Church of St. John the Evangelist – simon.guthrie@gmail.com

Penny-Lynn Fielding – Kitchener Public Library – pfielding@kpl.org

Nancy Nay – Superintendent at 156 Duke St. – rnancynay@gmail.com

Neil Koebel, CMA Realty Ltd. – neil@cmarealty.ca

Heidi Morrison – Community Member – moreheidi@gmail.com

Margo McConnell – Community Member – margomcconnell57@gmail.com

Jenny Kirby – Community Member – kirb9110@gmail.com

Kurt Padaric – Community Member – Kurt.Padaric92@gmail.com

For more information, please contact: Grace Bermingham GBermingham@regionofwaterloo.ca

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.