Harm reduction includes a set of strategies that address the harms caused by the criminalization of people who use drugs. GRCHC engages in harm reduction action in our community, and strives to provide high-quality, non-judgmental support and care for people who use drugs.

Harm Reduction Resources

Free Naloxone Kits

Naloxone is a life saving medication that can be used to reverse an Opioid overdose.

There are several locations around Brantford where you can pick up a Naloxone Kit and receive training to use it. Grand River Community Health Centre has Naloxone available at our Outreach Station during designated hours

Additional locations: 

  • St. Leonard's Community Services (133 Elgin St. and 225 Fairview Dr., Unit 1)
  • Towards Recovery Clinic (95 Darling St.)
  • Colborne Street Clinic (349 Colborne St.)
  • Rosewood House (42 Nelson St.)
  • Salvation Army Booth Centre (187 Dalhousie St.)
Harm Reduction Supplies
To pick up sterile harm reduction equipment and to drop off used equipment, the below services are available: 
  • The Van: Call or text at 289-440-4912. A mobile harm reduction service available in the Haldimand, Norfolk, and Brantford/ Brant regions. Visit the Aids Network Webpage for more info on the Van schedule.

  • St. Leonard’s Community Services Exchange Program: 133 Elgin Street, Brantford. Call 519-759-8830 for more information.  
 Peer Resources

If you have lived or living experience of drug use, or you care about someone who does, there are resources available to you: 

The National Overdose Response Service (NORS)
Never use alone! Call the NORS line at 1-888-688-NORS(6677) before you use to connect with someone and stay safe. 

Consumption and Treatment Services (CTS)

Consumption and Treatment Services (CTS) are locations where people can use pre-obtained drugs indoors in a safe, clean facility, and overdoses can be reversed by professional healthcare providers. At these sites, people who use drugs can access other services like primary care, mental health services, housing support and drug treatment.

Data has shown CTS sites do not encourage or increase drug use. A CTS site will allow the drug use that is already happening in our community to move indoors, where people can receive the medical support that they need. CTS sites prevent overdose deaths and harms, and reduce public drug use and related litter (ex. needles) in the surrounding area. 

♦ In Ontario, Supervised Consumption Sites (SCS) are referred to as Consumption and Treatment Services (CTS) sites. These terms refer to the same services.

Safer for everyone: Brantford's need for a consumption and treatment services (CTS) site

Thousands of people who access CTS locations in Canada also receive referrals to treatment and housing supports. Currently, there are 16 CTS locations in Ontario, in communities like Hamilton, Peterborough, Guelph, St. Catharine's, and Toronto.

Why does Brantford need a CTS site?

In 2022, an average of 21 people overdosed each month in Brant, and each month, an average of 4 people died. Overdose rates are consistently above the provincial average within our jurisdiction. According to the Office of the Chief Coroner, three-quarters of overdose deaths in Brant between 2019 and 2021 (the most recent period for which data is available) occurred when an individual was using drugs alone, with no one with them to administer naloxone. These deaths are preventable: when people overdose in the presence of trained overdose responders at a CTS site, there is someone present to reverse the overdose.

suspected opioid related deaths in brant and ontario by year graph

Police reporting, REDCap, January 2022 to December 2022, Extracted January 5, 2022.

In 2022, Brant’s rate of emergency department visits for opioid overdose was 2.3 times the provincial average. CTS sites can help reduce this strain on our emergency responders and free up capacity for them to address other issues by reducing the need for first responder involvement in overdose response. One analysis of a CTS site in Calgary estimated that for each overdose that occurred at the CTS site rather than in the community, the site produced approximately $1600 in emergency medical cost savings, with estimated savings of over $2.3 million for the lifetime of the program. The authors found that the average CTS site visit cost just $52, compared to $1061 for an emergency department visit for overdose treatment.

rates of emergency department visits for opioid overdoses in brant and ontario by year graph

National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health (CIHI) 2017 to January 6, 2023. Extracted January 11, 2023.

CTS sites can help make the whole community safer. People in Brantford are using drugs in fast food restaurant bathrooms, parks and parking garages because they don’t have better options. In other cities, CTS sites have helped to reduce drug use in public spacesOne study found that 71% of a CTS site’s users reported less outdoor injecting than prior to the opening of the site. CTS sites can also reduce discarded syringes and other drug use supplies, since people who use drugs at a CTS site are easily able to safely dispose of used supplies.

Between 2017 and 2019, Canadian CTS sites made around 70,000 referrals to substance use treatment, medical care, mental health support, housing services and other health and social services. For many people, CTS sites are the first place that they connect with community supports.

Brantford’s CTS site will provide access to primary care services including foot care and wound care, addictions counselling, mental health support, outreach support, peer support and links to other services provided at the community health centre and in the community. These resources will ensure that people accessing the site are provided with wraparound care. CTS sites have had demonstrated success reducing HIV and hepatitis C infection, as well as reducing other injection-related infection - another way that they reduce the burden on emergency departments and other healthcare care providers.

CTS Roadmap

In October 2023, the Ministry of Health announced that they have paused applications for new CTS sites to allow for updates to the application process. Consequently, as of the time of this Action Plan’s publication, the CTS Working Group has paused actively exploring potential locations. The working group, led by GRCHC, will continue public education work and other planning in 2024 while waiting for applications to reopen. Once applications are reopened, the working group will restart its work to identify an appropriate site. Once GRCHC identifies a site to propose to the community, there will be an extensive public engagement process.

steps of CTS application

For more detailed information on the process for opening a CTS site, see “What are the steps in the process?” below.

Frequently Asked Questions

Who is leading this work?
Opening a CTS site in Brantford is a priority for the Brantford-Brant Community Drug Strategy. Grand River Community Health Centre is leading this effort and will be the operator of a future site. We are working in partnership with the Brant County Health Unit, St. Leonard’s Community Services, the AIDS Network and the Brantford Substance Users Network.

Who supports CTS?

CTS have been endorsed by multiple professional associations in Canada, including the Ontario Association of Chiefs of Police, Canadian Nurses Association, Registered Nurses Association of Ontario, Canadian Medical Association, Canadian Association of Family Physicians, Canadian Public Health Association, and more.

If you support opening a CTS site in Brantford and want to hear about future opportunities to help move this work forward, please fill out this form. This information will be kept confidential, and your support will not be made public without your explicit consent at a later date. We will be in touch about opportunities to support this work as they arise.

What are the steps in the process?

To operate a CTS, GRCHC must apply for permission from Health Canada. Before an application can be submitted, a site needs to be identified. Currently, GRCHC and its partners are working to identify an appropriate site in Brantford, where the greatest need has been identified. Some of the characteristics of an ideal CTS location include proximity to areas where a lot of overdoses take place, correct zoning for operating a healthcare facility and a physical space (size and layout) that allows for the provision of a variety of onsite services.

In October 2023, the Ministry of Health announced that they have paused applications for new CTS sites to allow for updates to the application process. Consequently, as of the time of this Action Plan’s publication, the CTS Working Group has paused actively exploring potential locations. The working group, led by GRCHC, will continue public education work and other planning in 2024 while waiting for applications to reopen. Once applications are reopened, the working group will restart its work to identify an appropriate site. Once GRCHC identifies a site to propose to the community, there will be an extensive public engagement process.

Health Canada also requires organizations to provide information about how the site will operate (proposed services, hours of operation, site floor plan, policies and procedures etc.), information about local drug-related overdoses and deaths, and the site’s anticipated impact. Organizations must provide information to the community about the proposed site and seek input from a range of individuals and groups. Health Canada also requires that organizations demonstrate that they have taken steps to address community concerns. Stay tuned for opportunities to formally participate in the consultation process in the future, but in the meantime see “I have more questions. Who can I talk to?” for information on how to share your thoughts right away. We welcome hearing from community members!

Once permission from Health Canada is granted, a CTS site may operate legally, but to receive funding from the Ontario Ministry of Health and Long-Term Care, GRCHC will complete an additional application process. This second application requires similar information to the Health Canada application, although the processes are separate. To receive funding, the Ministry of Health requires that CTS sites offer defined pathways to addiction treatment, mental health, primary care and social services. CTS sites must also have a plan in place to regularly collect and safely dispose of drug use equipment discarded in the area around the site.

How do these services work?
Clients of a CTS program arrive at the site with drugs that they have purchased themselves from elsewhere – no drugs are provided on-site. An intake worker confirms a client is eligible to use the service and provides harm reduction supplies and information on safer use practices. Once an intake is completed, the client takes a seat at a booth to use their drugs under medical supervision. Medical personnel in the room can respond to any emergencies. All drug use supplies are disposed of on-site. After the client has finished taking their drugs, they are directed to a waiting room where they are observed and can receive medical attention in the case of negative effects. CTS staff are available to assist people with accessing treatment or other wraparound services both on-site and through referrals.
What do people who use drugs think of CTS sites?
Qualitative studies on existing CTS sites make it clear that these sites are profoundly important to the people who use them. Below are some examples of people sharing their experiences using CTS sites. They report that the services have helped them improve their own health and their community’s health.
  • "I have never felt like I can talk with health professionals so openly about my drug use. I am able to talk about other issues in my life. […] The other day they helped me by connecting me with mental health support. All around they’ve been very helpful."

 

  • “I've been talking to staff, ‘cause I've been wanting to stop, and they kind of pushed me in that direction, to seek help.”

 

  • “So many people in the community won’t even give eye contact but here it’s different. You hear me. I feel I matter and what I have to say matters. I feel like I’m a person here.”

 

  • “I’ve started practicing a lot safer and cleaner… for sure. Now I stop and think, right? It’s like, ‘Well, I don’t have to rush.’… In the alley, you just don’t have time to do that.”

 

  • “I can turn around, I can look in the mirror, I can see the nurse. They’re watching, right? If anything goes wrong, I mean… you could yell. But if you are by yourself… you could yell if anything happened, nobody answers.”

 

  • “I seen a couple people OD. And [the staff] know what they're doing, and they bring them around… Where they could have died, and they didn't, because they were here.”

 

  • “I was one of those people that you would walk around and feel unsafe from—you would see me sitting in a corner and doing drugs, and you would bump into my garbage in the streets. Because of the [CTS], I am not one of them any longer…I think that’s a very, very much a win-win situation, because I’m sure nobody wants to walk with a kid and see needles and people in the streets injecting or ODing.”

 

  • “It’s one of the places that keeps me connected to the world.”

 

GRCHC is working in partnership with the Brantford Substance Users Network to ensure that our CTS site meets the needs of the people that use drugs in our community.

What impact will a CTS have on crime and public safety?
Research of existing CTS sites does not indicate that they drive an increase in crime in surrounding areas, and CTS sites can be part of the solution to the problem of public drug use. We have met with both CTS operators and law enforcement in other communities to learn how they have successfully ensured that their CTS sites do not negatively impact public safety. We are committed to proactively mitigating any public safety risk through careful planning. Staff will conduct daily sweeps for discarded needles outside the CTS location, ensure that people are prevented from gathering outside of the CTS, and will maintain ongoing communication with the surrounding community to address concerns promptly.

The optimal site will be located in an area where people who use drugs already congregate and where drug-related activity is already frequent. The site will bring people who are currently using drugs in outdoor public areas into an indoor, medically supervised space. This approach is safer for everyone: it keeps people who use drugs safer, it reduces the frequency of public drug use, and it reduces the amount of syringe litter in areas where this is already a concern. One study found that 71% of a CTS site’s users reported less outdoor injecting than prior to the opening of the site.

In June 2022, Peterborough opened a CTS site and since then their community has seen significant improvements in public drug use and discarded needles in and around their downtown. Below you can read quotes from Peterborough’s Downtown Business Improvement Association, Public Library, City of Peterborough Transit, Wild Rock Outfitters (an outdoors gear shop) and GreenUP (an environmental non-profit based in the downtown), describing the positive effect that the CTS has had on their business and their neighbourhood.

 

quotes from cts clients

Image source

Has a site been chosen yet?
A site for the CTS in Brantford has not been chosen yet. When a site is chosen there will be extensive consultation with the surrounding community and operational planning tailored to the specifics of that particular site. This website will be updated when a location is selected, but please feel free to reach out at any time (see “I have more questions. Who do I talk to?” below) if you would like an update on this process.
Why don’t we just add more treatment services?

While treatment services are an important component of our community’s response to drug use, they are not enough by themselves. Harm reduction programs like CTS sites are also an important part of the continuum of care for people who use drugs: they ensure that people are able to stay alive long enough to get treatment, or to remain as healthy as possible before they are ready to stop their drug use. CTS staff are able to build trust with people who use drugs by meeting them where they are at, and this trust can form the basis for expanded engagement with services and improved social connections.

 

GRCHC is working closely with St. Leonard’s Community Services, who provide an extensive array of withdrawal management and treatment services, to ensure that CTS clients are able to access withdrawal management and/or treatment services promptly and smoothly through the CTS site. We also want to be sure that anyone struggling to maintain abstinence during treatment is able to connect with the CTS site to ensure that relapse or a return to use does not end up being fatal. By building trusting, judgement-free relationships with clients who may not access other services, for some people CTS sites are able to serve as a gateway to treatment. 

How will I know if the CTS is working? 
The GRCHC and its community partners will consistently monitor data and community feedback on the CTS site once it opens to ensure the site is working as intended and that it is not negatively impacting the surrounding community. Communication and community engagement will be ongoing, and there will always be someone you can reach out to, to share concerns or get an update on the impact of the site. Regular evaluation reports will be shared with the community.
I have more questions. Who can I talk to?
If you have questions about CTS sites in general or the work that is taking place in Brantford, please reach out to Alyssa Stryker, Brantford-Brant Community Drugs Strategy Coordinator, at alyssa.stryker@bchu.org.