Overview

Supervised injection services (SCS) have been demonstrated to reduce overdose fatalities and infectious disease risks among people who use drugs (PWUD), while facilitating access to substance use treatment. In response to Canada’s opioid overdose crisis, SCS are expanding across the country. In Ontario, recently-opened SCS are integrated within existing healthcare agencies, with the goal of promoting access to services that address the health and social needs of people who use drugs.

While the evidence base for stand-alone SCS models is strong, research on the effectiveness of integrated models such as those being implemented in Ontario is underdeveloped.

It is believed that the integration of SCS within community health agencies can facilitate engagement of people who use drugs with the continuum of services they offer, including primary care, counselling, mental health, health promotion, and employment and housing supports. Further, feasibility research has suggested these models are preferable to standalone models in settings like Toronto where drug use is relatively geographically dispersed.

Drawing on a longitudinal cohort of people who use drugs (including SCS users and non-users) and administrative data linkages, T-DOT evaluates a variety of harm reduction services in community health spaces with and without integrated SCS, and services along the substance use care spectrum. The study is being conducted in partnership with the integrated SCS and peer advisors/research associates.

This research will generate information on the effectiveness of integrated SCS, ongoing barriers to access, and opportunities to optimize health services and outcomes for people who use drugs.

Impacts of toxic drug crisis and over representation

The T-DOT study continues to work towards intentionally gathering data on communities who are overrepresented and disproportionately impacted by the toxic drug supply such as Indigenous communities, and African, Caribbean and Black communities. We only collect such data in partnership with organizations and leaders in the Indigenous and ACB communities in Toronto. We aim to uphold OCAP and EGAP principles when working with all data collected. These principles are grounded in community based data sovereignty and ownership rights.

HIV/HCV Testing

As of January 2026 we are excited to announce that we are offering HIV and Hepatitis C point of care testing for T-DOT study participants! This expansion is funded by the Ontario HIV Treatment Network, CanHepC and is in partnership with Toronto Community Hepatitis C Program. This study expansion aims to identify ways to improve testing, testing accessibility and access to care including treatment. Data will be collected on clinical accessibility and outcomes for individuals accessing care in community organizations.

We will be rolling out this project in phases. The first phase will include HIV and Hep C testing available at South Riverdale Community Health Centre weekly on Thursdays from 10am to 3pm starting at the beginning of January 2026.

The second phase will include two additional testing locations where we currently have T-DOT interviews taking place. We will provide updates on locations and times when we are closer to this phase!

Participants will be offered $30 for participating in HIV and Hep C tests in addition to $30 for the T-DOT survey. If individuals receive a reactive test and would like to be connected to treatment, we will facilitate this referral and connections to on going supports in the community that are clinically and culturally appropriate.

This expansion would not be possible without our funders the Ontario HIV Treatment Network (OHTN), CanHepC (via CHUM: Centre hospitalier de l’Université de Montréal), the CTN+ (The CIHR Pan-Canadian Network for HIV and STBBI), Cepheid and our partners at Toronto Community Hepatitis C Program. We look forward to being able to gather this data while Ontario faces Supervised Consumption Site closures and reduced harm reduction programming. Prevention and treatment of blood borne illnesses is an important aspects that harm reduction programs support. We are thankful to be working with our community partners and participants on this timely project.

Stay updated with our schedule!

Financial Supporters

Canadian Institutes of Health Research
St. Michael’s Hospital Foundation
New Frontiers in Research Fund

Partners

Black Coalition for Aids Prevention | Parkdale Queen West Community Health Centre | Regent Park Community Health Centre | South Riverdale Community Health Centre | Street Health | The Works | Toronto Indigenous Harm Reduction

Project Contact

Jolene Eeuwes
Jolene.Eeuwes@unityhealth.to