Evaluation of overdose prevention sites in Toronto: An urgent public health response to the opioid crisis

In Progress

Substance Use and Harm Reduction

Overdose prevention sites provide a safe space for people to use pre-obtained drugs under the supervision of trained staff who can respond in the event of a medical emergency. They are a low-barrier, community-led response to the opioid crisis that offer more flexibility than other models of supervised consumption.

There are five overdose prevention sites in Toronto. So far, they’ve demonstrated a high volume of use and a significant and positive impact in the community.

Canada is facing a national, public-health crisis with respect to opioid-related overdoses and death. Urgent measures are needed to advance harm-reduction efforts, treatment and prevention. The decision of the Ontario government in early 2019 to cut funding to existing Overdose Prevention Sites highlights the need to evaluate and build the evidence to support the innovative overdose prevention site model.

How do Toronto’s overdose prevention sites work – and how well are they working – to meet the needs of diverse populations?

We’re speaking with people who use overdose prevention sites and staff members to find out:

  1. Who is using these sites
  2. What is working about them
  3. What could be working better

Alongside overdose prevention site staff, we have constructed a logic model that shows how the sites work. Next, we will conduct individual interviews with staff, and focus groups with clients. This will allow us to see how the mechanisms described in the logic model are implemented on the ground. Together, these data will tell us how exactly overdose prevention sites save lives, and what unique strategies would be useful to incorporate into other models of overdose prevention.

The project findings could be used to inform ongoing adoption and improvement of the overdose prevention site model and related harm-reduction services in Canada and across the globe.

Our goal is to help propel movement towards a robust complement of adequately funded harm reduction services in Canada that are responsive to community needs.

Substance Use and Harm Reduction

Dr. Michelle Firestone

Dr. Michelle Firestone has dedicated her career to unmasking Indigenous health inequities, and to the collaborative development of strategies and solutions to address mental health, substance use and healing among diverse Indigenous populations.


  • Dr. Jason Altenberg (South Riverdale Community Health Centre)
  • Dr. Nicole Greenspan (Toronto Public Health)
  • Jessica Hales (Street Health)
  • Dr. Michele Health (Regent Park Community Health Centre)
  • Dr. Kathleen Kenny (University of Manitoba)
  • Jen Ko (Moss Park OPS)
  • Vivian Recollet (Parkdale Queen West Community Health Centre)
  • Lori Steer (St. Stephen’s Community House)
  • Dr. Carol Strike (University of Toronto)
  • Kelly White (Street Health)


  • Marie Laing, Research Coordinator


  • Canadian Institutes of Health Research


  • Moss Park OPS
  • Street Health OPS
  • Regent Park Community Health Centre OPS
  • St. Stephen’s OPS
  • Parkdale OPS

Contact Info

Marie Laing

Research Coordinator