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Toronto Public Health TPH provides programs and services to reduce drug-related harm for people who use drugs, including preventing the spread of communicable diseases. The Works opened its doors on August 9, It plays an integral role in reducing drug use related harm in Toronto by taking leadership in the area of harm reduction. The Works, in partnership with community agencies, provides counselling and distribution of free harm reduction supplies:. We offer a harm reduction based opioid substitution program that includes methadone and suboxone. Services offered include counselling, support and referrals to housing and other community services. This is a self-directed, client-centred program that does not require abstinence. Take-home doses are not permitted. We offer a harm reduction based iOAT program for people at high risk of overdose. Our program includes injectable hydromorphone supported by a long acting oral therapy Kadian or Methadone. Clients are able to self-administer the medication in a safe environment co-located with The Works other harm reduction services. We also offer case management, counselling and referrals to a wide variety of services. Our team includes people with lived and living experience, nurses and counsellors. The POINT program provides training to opioid users, their friends and family in preventing, recognizing and responding to an overdose. Program participants are trained on how to administer naloxone. Opioid users, their friends and family are provided with a take-home naloxone kit that contains naloxone and instructions on how to use it. Located inside The Works at Victoria Street, this life-saving health service provides a safe and hygienic environment for people to inject pre-obtained drugs under the supervision of qualified staff. Samples are collected at The Works and these supervised consumption services:. Operates Monday to Friday from p. Calls to request service are taken between p. The Works is committed to provided street outreach surrounding Victoria St. If you are concerned about discarded drug-use supplies around your business or residence, please call for assistance. In order to increase harm reduction access in Toronto, The Works provides safer drug use supplies, education and program support to many community agencies across the city. Becoming a community partner is a process that requires a legally binding service agreement, adequate insurance and an on-going, genuine commitment to the harm reduction model. Keeping Toronto neighbourhoods safe is our collective responsibility. Improperly discarded needles and harm reduction supplies found in our communities have been identified as a concern. In an effort to promote community safety, Toronto Public Health, along with many City and community partners, has implemented a variety of measures to address this area. Residents can take the used needles or syringes to a Household Hazardous Waste Depot or to some local pharmacies participating in the Health Steward program. Refer to our information about Needle Safety. Toronto Public Health TPH works with people who use drugs, agencies who work with people who use drugs and others to share information about potentially toxic drugs in circulation locally that are causing reactions of concern. Drug alerts are issued when TPH becomes aware of issues related to toxic drugs circulating in the community. TPH encourages anyone who has had an unexpected reaction to street drugs, or an overdose, to inform a harm reduction worker about it. Tips can also be made by email to drugstrategy toronto. Emails will be kept confidential, and the information will be used by staff at Toronto Public Health to inform harm reduction actions. Harm reduction is an evidence-based, public health approach. It aims to reduce the negative health, social, and legal outcomes associated with substance use and substance use policy, for individuals and communities. The Works invites you to learn more about harm reduction by exploring the free resources and trainings linked below. The Works, in partnership with community agencies, provides counselling and distribution of free harm reduction supplies: Safer injection equipment needles and syringes in various sizes and brands sterile water alcohol swabs tourniquets filters acidifiers cookers Safer smoking equipment Pyrex stems brass screens chopsticks mouthpieces safer crystal meth smoking equipment glass bowl pipes Safer sex products condoms lube. Methadone Works - Opioid Substitution Clinic. Supervised Injection Services. Nursing Services Provided at The Works. General Nursing Services Wound care e. Drug Checking Service. Mobile and Street Outreach. Services provided harm reduction supplies distribution safer drug use education safer disposal of sharps education naloxone training and distribution testing, vaccinations and wound care when nursing staff is available Street Outreach The Works is committed to provided street outreach surrounding Victoria St. Outreach activities include, but are not limited to: connecting with people who use drugs increasing awareness and use of the supervised injection services throughout Toronto promoting good neighbour practices among people who use drugs, including safe disposal of drug use supplies collecting discarded harm reduction supplies found while doing outreach providing education to workers and staff at local businesses on safer needle handling and disposal practices coordinating with other outreach activities happening in the community liaising with other service providers, including Streets to Homes, mental health supports, and detox and drug treatment services providing safer drug use education, including overdose prevention and response providing safer drug use supplies and distribute naloxone encouraging safer drug use supply disposal If you are concerned about discarded drug-use supplies around your business or residence, please call for assistance. Support for Community Agencies. Discarded Needles in the Community. Toronto Public Health has issued the following drug alerts. Harm Reduction Basics What is harm reduction?

Isotonitazene identified in Toronto’s unregulated drug supply

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Isotonitazene has now presented in 2 expected fentanyl samples, alongside fentanyl, heroin, and the benzodiazepine-related drug, etizolam. The presence of isotonitazene was not expected by those who submitted these samples to be checked. One of these samples was known to be associated with an overdose. Isotonitazene is an opioid that was synthesized in the s to relieve pain. While isotonitazene was never clinically approved for market, it has, in recent years, presented in the unregulated drug supply. Isotonitazene is believed to be highly potent: some studies conducted on animals suggest isotonitazene could be 5 times stronger than fentanyl. Isotonitazene produces effects similar to other opioids like morphine and fentanyl, including euphoria, relaxation, sedation, slowing of heart rate and breathing. However, because of its strength, the chance of overdose from using isotonitazene is increased, and greater than normal doses of naloxone may be required to arouse individuals experiencing an overdose. When isotonitazene is used in combination with other opioids or other central nervous system or respiratory depressants, like benzodiazepine-related drugs, the risk of dangerous suppression of vitals is increased e. Use of isotonitazene may result in death. View more tips to reduce the harms associated with using drugs from an unregulated supply. What is the purpose of this alert? What is isotonitazene? Advice to reduce potential harms: Carry and be trained to use naloxone. Naloxone, also known by the brand name Narcan, is a drug that can temporarily reverse an opioid overdose. Naloxone can be picked up for free from your local harm reduction agency or pharmacy and free training is available online. Consider carrying multiple doses of naloxone. Get your drugs checked before using. You can also check your drugs after you have used them by submitting paraphernalia, like a cooker or a filter. Use at a supervised consumption site. Here is a list of sites that offer supervised consumption in Toronto and an interactive map of sites that offer supervised consumption across Canada. Use with someone else and take turns spotting for each other. A buddy system is safer than using alone. If you must use alone, let someone know before you use. Call someone you know and have them stay on the phone with you while you use. Tell them your address and keep your door unlocked. If you are in Ontario, you could call the Overdose Prevention Line at BeSafe is an app that can be downloaded on your phone and provides another way to let someone know before you use. Do a small test dose first. Call in an overdose situation. The Good Samaritan Drug Overdose Act provides legal protection from drug-related charges for carrying drugs for personal use and other simple possession offences. If your drugs did not contain what you were expecting, consider talking to the person you got your drugs from , or get your drugs from another source if possible.

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