A Harm Reduction Program for People Who Use Drugs

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, 1989. 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:

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

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.

For more information, please see the iOAT External Referral package.

If you are interested in starting your own iOAT program, please email iOATworks@toronto.ca.

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.

To schedule training for clients at your agency, see the Overdose Training & Resources page.

Toronto Public Health opened the city’s first permanent supervised injection service on November 8, 2017. Located inside The Works at 277 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.

The Works provides the following nursing services to people who use drugs:

Testing

  • HIV (anonymous and Rapid testing available)
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Gonorrhea
  • Chlamydia
  • Syphilis

Free Vaccination

  • Hepatitis A
  • Hepatitis B
  • Tetanus
  • Diphtheria
  • Pertussis
  • Pneumococcal
  • Influenza

General Nursing Services

  • Wound care (e.g. injection-related abscesses)
  • Counselling
  • Pregnancy testing and supportive decision-making
  • Referrals to internal and external services

Have your drugs checked to find out what’s in them. Knowing what’s in the drugs you use is a harm reduction strategy that can help you make educated choices about your drug use. Please see information at Toronto’s Drug Checking Service. Samples are collected at The Works and these supervised consumption services:

image showing types of samples accepted by drug checking services: crushed bit of pill, blotter, small amount of powder, small amount of liquid, liquid from a syringe, used cooker, used filter

The Works Van

Operates Monday to Friday from 6:30 p.m. to 10 p.m. Calls to request service are taken between 4:30 p.m. and 6:30 p.m. on our main line at 416-392-0520.

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. and Dundas St., as well as in other areas as needed.

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 311 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. Please see Become a Harm Reduction Partner Agency for details.

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.

Toronto Public Health has issued the following drug alerts.

2024:

2023:

2022:

2021:

2020:

2019:

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.ca. 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 one of the central components of the Toronto Drug Strategy, and a mandatory public health program under Ontario’s Health Protection and Promotion Act. 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.

Harm Reduction Basics

Harm Reduction in Practice

Harm Reduction During COVID-19:

Understanding Substance Use and Stigma

Videos

Safer Sharps Handling and Needle Safety

Harm Reduction Communities and Websites

Free Trainings: