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As the City of Cambridge prepares to consider two locations for a Consumption and Treatment Services (CTS) site this fall, Region of Waterloo Public Health has completed its first review of the CTS site in Kitchener.
The report, to be presented during the region's Aug. 10 committee of the whole meeting, concludes that not only has the Kitchener CTS been “well received”, but it has achieved its goals of “supporting clients to use substances safely, and reversing potentially fatal overdoses, while increasing access to multiple support services.”
In an emailed response to CambridgeToday, Cambridge Mayor Kathryn McGarry said the report includes many "positive signals" and offers a "hyper local" "look at the realities of operating a CTS in our region."
"It’s helpful to have local metrics with true human impact, rather than focusing on the experiences of other jurisdictions," she wrote.
"We know what we’re doing in Cambridge right now isn’t working – people continue to die due to a toxic drug supply. They are using drugs alone and using drugs in our streets.
"I look forward to learning more through engaging with our service providers and community on what a CTS could or should look like in Cambridge.”
The CTS program was established by the Ontario Ministry of Health in response to growing public health concerns related to opioid use and overdose.
It allows people to use their own substances under the supervision of medically trained workers who also provide sterile consumption supplies, education on safer consumption, overdose prevention and intervention, medical counselling, and referrals to drug treatment, housing, income support and other services.
The review of the Duke Street CTS site, which has been operating since October 2019, used key service delivery data and “stakeholder feedback" to highlight "site successes, challenges, and the impact of the COVID-19 pandemic.”
It involved interviews with 33 CTS clients, 13 staff members, 10 members of a community advisory group, and six community safety partners, including the Waterloo Region Police Service, the City of Kitchener, and site security.
Region of Waterloo Public Health staff analyzed data for the first full year of operations (January to December 2020), noting the impact the pandemic has had on access to services.
Some of the key findings:
- There were a total of 5,797 visits to the CTS in 2020, averaging at 15.8 visits per day.
- Sixty per cent of the 858 different individuals that accessed the site were between the ages of 20 and 39, and only one per cent of the clients were younger than 20.
- Most clients used crystal meth (45 per cent) or fentanyl (37 per cent) and nearly all chose to inject their substance over ingesting or snorting.
- Most, more than 60 per cent, identified as male, while 24 per cent identified as female. One per cent identified as trans or other gender, and 13 per cent chose not to identify their gender.
- Nearly half of all visits occurred in the afternoon.
- The impact of having wrap-around services at the site resulted in 640 referrals to social services, 506 referrals to primary care, 2,060 referrals to mental health care and 138 referrals to addiction treatment.
Some things clients said they would like improved at the site include expanding hours of service to 24 hours a day, allowing substances to be smoked at the site and making the entrance more private to lessen concerns about community stigma.
“Although there were concerns the site would have a negative impact on the community, feedback and data has shown concerns related to the site have been minimal and the site has not required significant policing or security staff attention,” reads the report.
Cambridge residents who gathered at a recent protest at one of the proposed CTS locations, 8 Oxford St., expressed many of the same concerns brought up in Kitchener prior to selection of the Duke Street site.
Worries about increases in crime and proximity to nearby daycares and schools were top of mind for many opposed to a Cambridge CTS, along with the feeling the service does nothing to address the problem of addiction.
But when asked if the CTS has negatively impacted the community in Kitchener, 70 per cent of respondents from the community advisory group disagreed or strongly disagreed, 80 per cent agreed the CTS “feels like part of the community” and 90 per cent agreed the CTS and its partners are responsive to their concerns.
The 10-member advisory group, composed of immediate neighbours of the Kitchener CTS, including schools, childcare centres, neighbourhood associations, faith organizations, and the Downtown Kitchener BIA, was surveyed about the first year of the site.
The advisory group commented that more CTS locations and more rehabilitation services are needed in Waterloo Region to support people who use substances.
The report also outlines how the pandemic played a role in the number of people accessing the service.
Among the impacts of COVID-19 was the fact that protocols required fewer people in the building at one time and reduced the number of consumption booths by half.
People experiencing homelessness were also relocated to shelter spaces in other areas, making the trip to the CTS a challenge, while changes to community response to the pandemic made it difficult for clients to access services.
Opioid-related deaths rose substantially in 2020, with 102 suspected overdose deaths compared to 62 in 2019.
Pre-pandemic, the average monthly visits between January and March of last year was 764.
Starting in April of 2020, the average monthly visits dropped by half to 389 monthly visits through the end of December.
A report released in May by the Ontario Drug Policy Research Network and the Office of the Chief Coroner for Ontario said the province experienced a 79 per cent increase in opioid related deaths driven largely by “an increasingly volatile unregulated drug supply during the pandemic.”
There were 2,050 opioid-related deaths in Ontario between March 16 and December 31, 2020, more than half of which occurred among people who were unemployed at the time of their death.
There were no overdose related deaths in the Kitchener CTS, but staff responded to 188 overdoses last year. Only one required a call to 9-1-1. CTS staff called 9-1-1 a total of 11 times for other medical emergencies such as cardiac arrest, seizures and mental health emergencies.
Staff at the facility called in security to intervene during 12 incidents in or outside the site.
