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Women’s access to supervised consumption services: a study

As many Canadians continue to lose their lives to opioid poisonings, understanding how to prevent these tragic and preventable deaths is essential. The opioid poisoning crisis has been called a “men’s health crisis”. Policy, research and the media have not focused on women’s needs, even though women who use drugs are exposed to greater risks and harms compared to men, including gender-based discrimination, aggression and violence.

That is why CMHA undertook research to better understand how – and if – services and supports for women who use drugs are working. To do this, we asked women who use these services as well as the staff members who provide them.

Our community-based research project, Access to and Safety for Women at Supervised Consumption Services, asked women who use drugs (WWUD) in Southern Ontario to describe which factors impact their access to supervised consumption services (SCS) and overdose prevention sites (OPS).

The researchers in this study hosted focus groups with 30 women at three SCS/OPS and one drop-in centre and interviewed 7 staff members to better understand what factors impact women’s access to the services. We asked about topics such as the site design and layout, site rules, staff characteristics and approaches, sex work, mothering and pregnancy.

The women in the study described how SCS help prevent violence, discrimination, and coercion, but also noted that they were sometimes exposed to unwanted attention or advances at sites where men are also served. The SCS staff also supported women to get on wait lists for housing, connected them with health care, and linked them to many other services and supports in the community, including mental health services, peer support, sexual health services and sexual assault supports. The women reported that SCS are inclusive spaces that challenge marginalization and reduce power imbalances between staff and women.

Our findings showed that staff tried to ensure safety for women, including women who are pregnant or parenting, but that women were sometimes reluctant to use the SCS for fear of being reported to child protective services. And although the staff agreed that understanding the impact of trauma and oppression on women is key, they noted that training to ensure this approach was not always available.

The women participants suggested that safety and access to supervised consumption services and overdose prevention sites would improve with extended hours and overnight services, women-only services, more private spaces for injection, the option to receive assisted injections, and staff who have drug use experience.

CMHA is pleased to present this valuable research, which offers important insights for improving women’s access to important harm reduction and health services. CMHA thanks the Women’s College Hospital for the grant that made it possible.

Read the study here.