Background: Opioid overdoses have killed almost 20,000 Canadians since 2016. To address this, Canada has established supervised consumption sites where people can use drugs in the presence of trained staff and get access to pharmacological treatments such as methadone. However, there is very little research on whether supervised consumption clients use methadone, or whether their use of methadone prevents opioid overdose. Methods: A secondary data analysis of information collected from one supervised consumption site was undertaken in order to explore relationships between client self-reported methadone dosage and subsequent observed same-day opioid overdose. Results: Statistical analysis showed no correlation between methadone usage and reduced chance of opioid overdose. However, the most common dosage of methadone reported (30mg/day) was far below the minimum therapeutic dose of methadone. Conclusion: Clients of supervised consumption sites often report being prescribed methadone, but not at a dose high enough to reduce opioid overdose.

YWCA Hamilton’s Safer Drug Use Space (SUS) is one of only two gender-specific safe consumption spaces in Canada, and the only one integrated into an emergency drop-in program. It is widely acknowledged in both the scholarly literature and by social service and healthcare providers that women and non-binary people are vulnerable to violence and coercion when using substances around men. They also have different needs from harm reduction programs that are not always met in all-gender safe consumption sites. Furthermore, the integration of safe consumption sites in emergency shelters and drop-ins has been found to lower the number of drug poisonings in the area. This study sought to build upon this existing body of literature by speaking with service users from SUS about how they have been supported by the program in its first year of operation, and how it could be improved. Five service users were engaged in individual, qualitative interviews conducted by one of the front-line staff at SUS who is also a student at McMaster University. The “in-between” position of the researcher and previously established rapport with the participants generated nuanced insights to come out of these conversations. Four themes came out of the data: (1) the importance of positive service user/staff relationships; (2) staff knowledge and expertise; (3) SUS being considered a “safe” place and like a “home” to service users; and (4) accessibility of the space for service users being a contributor to why people return to SUS. This study revealed that aligning their harm reduction framework to include safe consumption onsite has meant SUS staff and service users develop more trusting relationships with each other. This allows them cooperate in unique ways to keep the community safe and connect service users to necessary social and healthcare supports. / Thesis / Master of Social Work (MSW)