Casey House has one of the few remaining supervised consumption sites in Ontario. Clients can use their substances through snorting, injection, or inhalation while being monitored for adverse reactions, including overdose. The service is available on weekdays, excluding holidays, and will soon expand to include weekends. Supervised consumption services (SCS) are supported by a multidisciplinary team featuring our harm reduction workers. The SCS at Casey House is more than a room with sterile equipment, it’s a landing place for clients to find warmth, resources, and social connection.
People who live with or are at heightened risk for HIV and use substances can register as a client to access these services. Prospective clients can meet with a harm reduction worker for a tour and to answer any questions. Once registered, they can access the full suite of outpatient services in addition to the SCS like lunch, nursing, social service work, and recreational therapy groups.
When someone arrives to use the SCS, staff bring them to one of the three private booths and provide any sterile equipment they may need for their session. Take-home harm reduction kits for safer substance use and safer sex are also available. After using their substances, clients are directed to the SCS lounge, where they can relax in comfortable seats with calming music and snacks as they are monitored for adverse effects.
If adverse symptoms appear, like low breathing rate or trouble breathing, the harm reduction team is quick to engage with a humanistic response. “Sometimes all we need to do is just keep the client engaged and encourage breathing, so we don’t have to jump to naloxone or get emergency medical services involved. It’s a more compassionate approach to actually engage with somebody rather than the carceral approach of flashing lights and vigorous sternal rubs,” says one harm reduction worker. However, if symptoms escalate towards an overdose, the team stabilizes the client, brings in a nurse to deploy oxygen or naloxone, and if needed, call for paramedics.
Adverse effects from substance use are so well managed in the SCS that in 2025-26, there were 1801 visits to Casey House’s inpatient and outpatient SCS, and amongst those there were only 8 overdoses, all of them successfully and safely managed by staff without EMS support.
Overdose management isn’t the only outcome. Harm reduction workers and peers build community and develop connection with clients. Staff and peers also chat with clients outside, in the lobby, or at lunch. Services are tailored to the needs of each individual, and harm reduction workers are nimble. Staff may call central intake for emergency shelter referrals to find someone a bed for the night; contact an external health provider to help them book an appointment; offer a shower and clean clothing; or act as a confidante to the successes, happenings, or struggles that clients are experiencing.
Drug testing is a valuable SCS service. Clients can submit a sample of their substances and have it sent to the Toronto Drug Checking Service. After two business days, staff share information about the sample’s composition with the client to help them make informed decisions about their use. Substance use is a spectrum, and the harm reduction team supports people at every point, including abstinence, reducing usage, and continued usage. No matter the client’s goal, the team provides empathy, resources, and care for all.
The SCS acts as hubs of information to promote harm reduction best practices, hear about new drug toxicity concerns, share information about policies and regulations, or learn more about current trends within the community. New clients typically learn about the SCS through word-of-mouth, especially as other safer and accessible places to use substances continue to dwindle. While some people drop-in for a single session, others come multiple times in a single day, and there are even folks who have been accessing Casey House’s SCS for multiple years. One benefit of these long-term relationships between staff and clients is having the insight to know when a client is behaving differently. Clients using the SCS may be facing multiple complex issues relating to their medical status, social determinants of health, and personal life. Having the trust and history with a client makes it easier for harm reduction workers to extend care in an approach that is tailored to each person.
Misconceptions and stigma about people who use drugs persist. Substance use is frequently a coping mechanism for challenges such as trauma and poverty, that compound and create barriers to having basic needs met. Barriers faced by people who use drugs prevent them from getting equitable access to health care. Casey House believes that everyone deserves dignified health care. The harm reduction team at Casey House sees the humanity and nuance in each person, and provides care with compassion.
And no, the supervised consumption services does not provide the substances.
September 9, 2026
Inside outpatient care: Supervised consumption services
Casey House has one of the few remaining supervised consumption sites in Ontario. Clients can use their substances through snorting, injection, or inhalation while being monitored for adverse reactions, including overdose. The service is available on weekdays, excluding holidays, and will soon expand to include weekends. Supervised consumption services (SCS) are supported by a multidisciplinary team featuring our harm reduction workers. The SCS at Casey House is more than a room with sterile equipment, it’s a landing place for clients to find warmth, resources, and social connection.
People who live with or are at heightened risk for HIV and use substances can register as a client to access these services. Prospective clients can meet with a harm reduction worker for a tour and to answer any questions. Once registered, they can access the full suite of outpatient services in addition to the SCS like lunch, nursing, social service work, and recreational therapy groups.
When someone arrives to use the SCS, staff bring them to one of the three private booths and provide any sterile equipment they may need for their session. Take-home harm reduction kits for safer substance use and safer sex are also available. After using their substances, clients are directed to the SCS lounge, where they can relax in comfortable seats with calming music and snacks as they are monitored for adverse effects.
If adverse symptoms appear, like low breathing rate or trouble breathing, the harm reduction team is quick to engage with a humanistic response. “Sometimes all we need to do is just keep the client engaged and encourage breathing, so we don’t have to jump to naloxone or get emergency medical services involved. It’s a more compassionate approach to actually engage with somebody rather than the carceral approach of flashing lights and vigorous sternal rubs,” says one harm reduction worker. However, if symptoms escalate towards an overdose, the team stabilizes the client, brings in a nurse to deploy oxygen or naloxone, and if needed, call for paramedics.
Adverse effects from substance use are so well managed in the SCS that in 2025-26, there were 1801 visits to Casey House’s inpatient and outpatient SCS, and amongst those there were only 8 overdoses, all of them successfully and safely managed by staff without EMS support.
Overdose management isn’t the only outcome. Harm reduction workers and peers build community and develop connection with clients. Staff and peers also chat with clients outside, in the lobby, or at lunch. Services are tailored to the needs of each individual, and harm reduction workers are nimble. Staff may call central intake for emergency shelter referrals to find someone a bed for the night; contact an external health provider to help them book an appointment; offer a shower and clean clothing; or act as a confidante to the successes, happenings, or struggles that clients are experiencing.
Drug testing is a valuable SCS service. Clients can submit a sample of their substances and have it sent to the Toronto Drug Checking Service. After two business days, staff share information about the sample’s composition with the client to help them make informed decisions about their use. Substance use is a spectrum, and the harm reduction team supports people at every point, including abstinence, reducing usage, and continued usage. No matter the client’s goal, the team provides empathy, resources, and care for all.
The SCS acts as hubs of information to promote harm reduction best practices, hear about new drug toxicity concerns, share information about policies and regulations, or learn more about current trends within the community. New clients typically learn about the SCS through word-of-mouth, especially as other safer and accessible places to use substances continue to dwindle. While some people drop-in for a single session, others come multiple times in a single day, and there are even folks who have been accessing Casey House’s SCS for multiple years. One benefit of these long-term relationships between staff and clients is having the insight to know when a client is behaving differently. Clients using the SCS may be facing multiple complex issues relating to their medical status, social determinants of health, and personal life. Having the trust and history with a client makes it easier for harm reduction workers to extend care in an approach that is tailored to each person.
Misconceptions and stigma about people who use drugs persist. Substance use is frequently a coping mechanism for challenges such as trauma and poverty, that compound and create barriers to having basic needs met. Barriers faced by people who use drugs prevent them from getting equitable access to health care. Casey House believes that everyone deserves dignified health care. The harm reduction team at Casey House sees the humanity and nuance in each person, and provides care with compassion.
And no, the supervised consumption services does not provide the substances.
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