local context

Background & Local Context

Drug Overdose Crisis in Middlesex-London:

Our community of Middlesex-London, like many Canadian communities, has been significantly impacted by opioid-related deaths.

  • 62 deaths due to opioid overdoses in 2018 
  • 60 deaths due to opioid overdoses in 2019
  • 25 deaths in the first quarter of 2020

The rates of emergency department visits, and opioid related hospitalizations had also increased during the 2018-2019 timeframe representing a large burden on the health care system.

For the latest data on Opioid related morbidity and mortality in Middlesex-London region, visit Public Health Ontario’s Interactive Opioid Tool: interactive-opioid-tool

In response to this intensifying crisis, multiple community and government agencies have joined in local efforts to save lives, and address harms associated with opioid use.

– One such effort was the establishment of a temporary overdose prevention site (TOPS).

– In February 2018, Ontario’s first legally sanctioned temporary overdose prevention site opened its doors in London.

– It was a collaboration between its founding partners, the Middlesex-London Health Unit and Regional HIV/AIDS Connection.

– In April 2019, TOPS began to transition to the new provincially-funded Consumption and Treatment Services (CTS) program, named CarePoint Consumption and Treatment Services.


Drug poisonings are killing people who use drugs in London and in cities across the country. We acknowledge and mourn lives lost to drug overdoses, including any of those who have passed since participating in our research. We hope that sharing their stories is one small way we can honour their valuable lives and contributions.

About CarePoint

The site provides a safe place for people to consume substances under the supervision and care of health professionals (Registered Nurse or Emergency Medical Services) and harm reduction workers.

The staff are situated in the drug consumption room to support clients and provide education about substance use practices, as well as potential health concerns from injection drug use [e.g. soft tissue injuries, cellulitis, abscesses,
Invasive Group A Streptococcal Infections (iGAS), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV)].

The site is supported by several community partner agencies that provide wrap-around services on a rotational basis at the site. Among these are the

  • Southwestern Ontario Aboriginal Health Access Centre (SOAHAC),
  • London Cares Homeless Response Services (LCHRS)
  • Addiction Services Thames Valley (ADSTV)
  • London Intercommunity Health Centre (LIHC)
  • Canadian Mental Health Association (CMHA)
  • Middlesex-London Health Unit (MLHU)

When first established, the site operated six hours per day. However, with enhanced provincial funding to the interim site in the summer of 2019, the hours expanded.

Currently, the site is open seven days per week, including Statutory holidays, from 9:30 am to 9:00 pm.


After 2 years of operation, the site had provided








The authors would like to acknowledge the staff and leadership from Carepoint Consumption and Treatment Service and Regional HIV/AIDS Connection for their constant support and dedication to this research project.

The team at Carepoint provided access to their facility, introduced us to their clients and worked with us every step of the way to make this research possible. Sonja Burke, Director of Harm Reduction, worked with us to ensure we could successfully integrate our research principles into their environment.

When we encountered challenges completing second interviews because of photo development delays, Sonja suggested we work with Kailey Anderson, their Peer Support Worker to accompany participants as they took photographs on a digital camera. Without the support of Sonja, Kailey and all the Carepoint staff, this project would not have been possible.

In addition, we would like to thank the community stakeholders and people with lived experiences who guided us on our Advisory Committee. Finally, we want to thank our participants who took the time to share their stories and photos with us, so we could share with others. Your honesty and trust in us is truly appreciated.

Thank you.

For more information about CarePoint:

To find out more about CarePoint Consumption and Treatment Services, visit: