First supervised drug inhalation service opens in Toronto

In November of last year, Toronto’s Casey House hospital added drug inhalation to the list of services it offers through its supervised consumption service. As a result, clients can now smoke substances on-site as part of its hospital-based supervised consumption services (SCS), which also makes Casey House the first site in Ontario to offer indoor supervised inhalation.

The hospital’s inhalation booth opened last month and is currently available from 10 A.M. to 4 P.M. daily to all clients registered at the Casey House.

The service was created due to a recent influx of drug smoking-related overdose deaths in Toronto. Data released by the Office of the Chief Coroner for Ontario demonstrates a significant increase in inhalation-related deaths during the COVID-19 pandemic. In 2020 in Ontario, over one-third of deaths were inhalation-related, which corresponds to an increase of 11% compared to pre-pandemic times.

According to a statement released by Casey House, these findings point to the need for the implementation of more harm reduction services designed specifically for this mode of drug use, including supervised inhalation services. “Supervised inhalation is also highly recommended by community stakeholders. Recently, inhalation was endorsed in the toolkit Twelve characteristics of client-centred supervised consumption services (SCS), developed by the Engage with Harm Reduction study that featured input from Casey House staff, peers and community members,” the report continues.

Between Dec. 5 and 11, Toronto’s health unit issued a drug alert after paramedics responded to nine suspected opioid overdose deaths involving inhaled substances. In addition, earlier in July, Toronto Public Health warned the public after 10 people died of a suspected opioid overdose, attributing deaths due to a “potential increase of smoking opioids and stimulants” since drug inhalation equipment, including pipes, were found at the scene of some of the deaths.

In her interview with CTV News, Joanne Simons, the CEO of Casey House, said her team has been working to offer supervised drug inhalation for about five years after receiving requests from patients and clients.

Casey noted that the challenge in opening the supervised inhalation site at Casey House was ensuring that the space complied with the Occupational Health and Safety Act.

“We had no clear specifications on how to operate an inhalation site from the federal or provincial government. … There were no real guidelines,” she said in her interview with

After working with engineers and consulting with organizations in Saskatchewan and Yukon that currently offer supervised inhalation sites, Casey House it constructed its booth with the highest ventilation standards available.

“We can ventilate our room in seconds if a person needs help,” Simons said, noting that it took approximately a year to get approval for the technical plan from the province after initially presenting it.

“This isn’t just about making a space in a hospital for people to smoke their substances. This is a chance to show that (supervised inhalation) can be done and it can be done safely.”


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