What's the difference between a supervised consumption site and an overdose prevention site?

Some communities across Canada are applying for a supervised consumption site or an overdose prevention site in light of the opioid and fentanyl crisis. But it turns out, there is quite a difference between them.

Permanency and services offered at these sites is what sets them apart from one another

Permanency and services offered at a a supervised consumption site or an overdose prevention site is what separates them from one another and applying for them can be a long an complex process. (Jonathan Hayward/Canadian Press)

In light of the opioid and fentanyl crisis, supervised consumption sites (SCS) and overdose prevention sites (OPS) continue to be the topic of discussion in many communities across the country. 

However, permanency and services offered at these sites is what separates them from one another.

To get a SCS or an OPS within a community, the facility looking to get one implemented — from public health agencies to organizations that work in addictions and harm reduction — needs to apply for an exemption to the Controlled Drugs and Substances Act, which allows them to operate freely with out any repercussions from police. 

Municipalities all over Ontario are looking to get supervised consumption sites or overdose prevention sites. But what is the difference? CBC Kitchener-Waterloo's Carmen Ponciano explains with a look at how cities like London, Toronto and Guelph have approached the growing drug overdose problem in this province. 7:50

Supervised consumption sites

A SCS is tailored to be a permanent site. Health Canada's website has a list of cities in Canada that have a SCS, as well as cities in the process of getting one.

But the application process to Health Canada can be long, complex and take several years. The facility looking to set an SCS needs to conduct community surveys, consultations with community partners and have a location selected, among other steps. 

Once that application is completed, Health Canada grants a one year exemption to the Controlled Drugs and Substances Act, which allows staff to operate the site freely with out repercussions from the police.

When the exemption expires, Health Canada reviews the facility's renewal application and can grant it another year or more, in some cases.

SCS are not limited to one type of consumption under their roof. Some sites will allow injection, oral or intranasal forms of consumption.

A SCS is required to have a network of support services at their sites for individuals, such as addiction treatment programs, counselling and support for permanent housing. 

Supervised injection site

Waterloo region is in the process of implementing a supervised injection site (SIS), which is very similar to a SCS.

Waterloo region public health wants the SIS to be a permanent facility that also offers a network of support services. The only difference is that the region's SIS will only allow injection as the form of consumption.

"These locations become a place for people who tend to be marginalized in our society and it's a place for people to go and feel like they are not being judged," Grace Bermingham, manager of harm reduction for public health told CBC News.

"This integrated, wrap-around service is so crucial to the success of these programs in not just saving lives but actually helping people move to a healthier place in their life."

An estimated 4,000 people in Waterloo region inject drugs, almost half do it on a daily basis. 

Bermingham said Central Kitchener and South Cambridge are being looked at as ideal spots for a SIS because there were more incidents of opioid related overdose in those areas. 

Waterloo region has not sent in their application to Health Canada, but is now taking the next steps to do so. 

Two community feedback sessions are scheduled for March 21 at regional headquarters on Frederick Street in Kitchener and April 4 at Cambridge City Hall.

Overdose prevention sites

Health Canada announced in December 2017 it would grant exemptions to the province of Ontario to allow temporary overdose prevention sites (OPS) to be operated.

An OPS facility is meant to address an immediate need in the community and can be set up in a matter of weeks because they don't require community surveys or consultations and are not required to have support services like a SCS. 

As a result, many communities have been using them as stepping stones to get a permanent SCS site.

London, for example, was the first city to have a sanctioned OPS in Ontario, which has been in operation since February. 

"We needed something right away," said Shaya Dhinsa with Middlesex-London Health Unit. "At least now we are hopefully saving lives and decreasing the spread of infection in the interim."

However, London's OPS goes above the minimum requirements as they have nurses and EMS on site and offer support services.

One of the biggest differences of an OPS is its lack of permanency. According to the Controlled Drugs and Substances Act, they are granted three to six month exemptions. 

This process is also done through the province's Ministry of Health. 

London recently picked 372 York St. as the city's permanent permanent SCS.

The City of Guelph is following in the same footsteps. They hope to open an OPS in early April with the goal to set up a permanent SCS in the future.

About the Author

Carmen Ponciano

Associate Producer

Carmen Ponciano is an associate producer and web writer for CBC K-W.