Skip to main content

Assessing need and feasibility of supervised drug consumption sites in Toronto and Ottawa

The Story and Impact

Map of Ontario showing Toronto and OttawaSupervised consumption sites are legally sanctioned spaces where people can inject illegal drugs, typically heroin or cocaine, under the supervision of trained health staff and without fear of prosecution. The sites are associated with fewer overdoses, safer needle use, more drug treatment referrals and better public order. However, implementation remains controversial.

ICES was a research partner in the 2012 Toronto and Ottawa Supervised Consumption Assessment (TOSCA) study, which used multiple research methods to produce a report that recommended opening safe injection sites in Toronto and Ottawa, home to roughly 50% of all people who inject drugs in Ontario.

ICES conducted a 2015 follow-up study, published in the journal Addiction, which determined that establishing up to three supervised injection facilities in Toronto and up to two in Ottawa would be cost-effective.


  • Briefings about the 2012 report were held with public health agencies, police officials, senior civil servants, municipal government officials and community groups.
  • The report received national and international attention, including extensive coverage by major Canadian and international news outlets and an invited commentary in The Lancet.
  • Conducted public opinion polling and qualitative research to determine that Ontarians’ support for supervised injection services has increased, with 90% of respondents indicating support if evidence shows that these sites improve the health of people who use drugs and reduces neighbourhood problems.
  • Based on the TOSCA report, Toronto’s Chief Medical Officer recommended that Toronto create three safe injection sites. Toronto City Council voted overwhelmingly to support this plan, and Ottawa’s Board of Health is moving forward with a modified plan.

The Scientist


  • Toronto Public Health
  • Ottawa Public Health
  • Ministry of Health and Long-Term Care
  • Several community health agencies in Toronto and Ottawa
  • Communities of people who use drugs

Published in the 2015-16 ICES Annual Report

Download the PDF

Read more impact stories