Consumption and Treatment Service – keepSIX

keepSIX logo



Monday 8:00am-8:30pm (last call at 7:30pm)
Tuesday 8:00am-8:30pm (last call at 7:30pm)

Wednesday 8:00am-4:30pm (last call at 4:00pm)
Thursday 8:00am-8:30pm (last call at 7:30pm)
Friday 8:00am-4:30pm (last call at 4:00pm)

After years of research, consultations, community engagement, planning, exemption and funding applications, advocacy, and dedicated work by staff and our community, South Riverdale Community Health Centre (SRCHC)’s “keepSIX” Supervised Consumption Site (SCS), now known as Consumption and Treatment Service (CTS), opened its doors on November 27, 2017.

KeepSIX assists service users to connect to the wide variety of programs and services offered at South Riverdale CHC. There is a Sharing Circle, Women’s Circle, Women’s only drop ins, a HepC clinic, Nurse Practitioner, and Social Workers. KeepSIX provides outreach and harm reduction education to the broader community, and provides harm reduction kits for distribution, as well as harm reduction supplies such as naloxone kits, safe disposal supplies and clean syringes and pipes. keepSIX also provides a drug checking service and naloxone training in the community.

A CTS is a health service where people inject, snort or orally consume pre-obtained drugs in a safe, hygienic and welcoming environment under the supervision of trained staff. More than 100 CTSs are operating worldwide, including several cities across Canada. An extension of our comprehensive health and harm reduction programs and services for people who use drugs, keepSIX is Toronto’s second Health Canada-approved and Canada’s first community health centre-embedded CTS.

In March 2016, Toronto’s then Medical Officer of Health, Dr. David McKeown made a presentation to the Board of Health about the need for CTS in Toronto. A variety of community consultation activities about CTS took place over April & May of 2016. For SRCHC, consultations regarding the addition of CTS at SRCHC included an online survey, Open House events, focus groups, presentations to schools and other community groups, individual meetings and tours of the Centre. We heard from nearly 600 people. Overall, the vast majority of people consulted saw the benefits of such a service to our community. Since this process began, the overdose crisis has become a public health emergency and many of our community members have died–underscoring the need for this vital space.

For SRCHC, providing a safe, supportive, nonjudgmental space where people can use drugs, is a natural extension of the harm reduction work the agency has been doing for twenty years. The criminalization of drug use-together with historical and ongoing structural oppressions and the subsequent stigma and neglect of people who use drugs by health and social service systems-creates multiple barriers to health and well-being that KeepSIX will help address.

keepSIX-the name of our CTS, meaning “got your back” is an homage to Raffi Balian, founder of SRCHC’s COUNTERfit Harm Reduction Program and lifelong advocate for people who use drugs.

Consumption and Treatment Services: Impact [Queen St]

  • In June 2023, our Queen St E CTS location saw 57 unique individuals used this CTS which has up to 100 visits per day. The number of service users per day can fluctuate greatly each day.  The illicit drug supply is unpredictable in its toxicity and composition.  If overdoses are frequent or prolonged then the capacity of the service may be reduced.
  • The Queen St E CTS had over 10,000 visits for drug consumption in 2022 and there have been over 5,000 visits in the first six months of 2023.
  • Queen St CTS staff reversed 124 overdoses in 2022. Over 900 overdoses have been reversed since the service began in November 2017.
  • CTS is a health care service. CTS staff also make referrals to health and social services and provide primary care to service users directly
  • In 2022, Queen St CTS staff made the following referrals to health and social services:
    • 65 to substance use services (detox, treatment program, methadone, safer supply)
    • 11 referrals to mental health services (case management, treatment program)
    • 124 referrals to primary care and hospital services
    • 101 referrals to social services (Indigenous health promoter, shelter, group programs, ID replacement, legal support, social assistance support, housing)

Service Evaluation:

  • Preliminary data by researchers at Unity Health who are conducting the evaluation of supervised consumption services in Toronto found that the proportion of service users who participated in a drug/alcohol treatment or detox program in the last six months was significantly greater than the proportion of non-service users:
    • 53% of recent SCS service users vs. 43% of non-service users recently participated in a drug/alcohol treatment or detox program
    • 38% of recent SCS service users vs. 25% of non-service users participated in a methadone maintenance program in the last 6 months
  • The evaluation has found that SCS service users were more likely to:
    • Participate in a drug/alcohol treatment or detox program in the past 6 months
    • Participate in a methadone maintenance program in the past 6 months
    • Receive medication to manage drug or alcohol use
  • The evaluation has also found that people in Toronto who use SCS experience multiple forms of social and structural vulnerability and are at high-risk for overdose death:
    • The vast majority of SCS service users were homeless or unstably housed (91%)
    • One-third were Indigenous
    • Approximately half (48%) reported fentanyl as their most frequently injected drug. (Note: Fentanyl was found in 94% of those who died from opioids during the pandemic. Toronto’s Drug Checking Service continues to find that opioids are significantly more contaminated than other drug types)

References and for more information:

  1. Centre on Drug Policy Evaluation, SCS evaluation:
  2. Drug Checking Project:

KeepSIX infographic with statistics of program use and impact.

Program Details

Organization Contact
  • South Riverdale CHC

  • 955 Queen Street East
  • Toronto, ON    M4M 3P3
  • [email protected]
  • 416-461-1925
Program Location

South Riverdale Community Health Centre, 955 Queen Street East

955 Queen Street East, Toronto, Ontario

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