Overdoses are increasing in the province of Ontario, Canada; however, they are not evenly distributed. Northern communities such as Sudbury, Ontario have experienced a disproportionately elevated rate of drug-use related harms, with opioid-related deaths doubling that of the provincial average. To address this issue, governments have implemented supervised consumption services (SCS) where people who use drugs (PWUD) can use their pre-obtained substances onsite under supervision. In 2022, the City of Sudbury was granted approval to operate a SCS, entitled ‘The Spot’. However, the site’s sustainability remains uncertain due to issues securing long-term funding, which is contingent on the site demonstrating benefit to PWUD and the neighboring community. To examine the impact of the site on PWUD and the community, we undertook an initial evaluation of the consumption service at ‘The Spot’.
The study employed a non-interventional multi-methods design involving a brief five-minute survey to collect demographic and substance use profiles of 20 individuals who utilized the consumption room at the site, followed by a semi-structured one-on-one qualitative interview. Interviews were also conducted with nine site staff.
The cross-sectional site utilization data highlighted an overall increase in consumption service uptake. A total of 256 unique clients had visited the site, representing 706 total consumptions between September 28th, 2022, and March 31st, 2023. Nine overdoses were treated, two of which required naloxone. The site distributed various harm reduction supplies to PWUD, including syringes, alcohol swabs, and sterile water.
Qualitative results were organized into four main categories: 1) Site impacts on substance use, including perceptions of overdose risk and frequency of use; 2) Site impacts on stigma, including impacts on community-level stigma; 3) Site operational impacts, such as policies related to lack of inhalation services, drug checking services, and rules regarding splitting and sharing substances in the consumption room, the impact of site staff and peer harm reduction staff involvement, hours of operation, geographic location, and impacts of funding; and 4) Site functionality, including physical infrastructure.
Participants and staff described the importance of the site in preventing and responding to overdoses and providing a safe and comfortable environment to consume drugs; increased feelings of safety when utilizing the site was the most common benefit reported by participants. Participants also described the site’s ability to reduce public drug use, which they suggested can reduce stigmatization within the community. However, participants suggested a number of challenges, including negative attitudes in the community regarding the site, and issues regarding site operational policies that hindered site uptake by PWUD. Suggestions made by participants to improve site uptake and sustainability included educating the community about the site’s benefits (e.g., the potential for reduced public drug consumption), relocating ‘The Spot’ to downtown Sudbury where PWUD commonly congregate, improving the site’s infrastructure, incorporating inhalation services, and extending operational hours.
Sudbury Consumption Site Evaluation Report