More than a year and a half after its opening, a site in a Kingston prison, Ontario, where inmates can consume smuggling drugs under medical supervision has only had one user.
The overdose prevention service (PAHO) in the institution of Collins Bay was established as a place where prisoners could inject, inject or swallow substances, all with a nurse waiting.
It opened on November 28, 2023, becoming the first of its kind in Ontario and only the third in Canada. (Two more OPS sites have been opened since then).
So far they have learned five people who requested to use the site, but only one has done so, and that inmate has only used a handful of times, as of April, CBC has learned.
“There will always be a level of distrust, especially with a novel program like this and a fundamental change on how we are supporting someone who lives with addictions,” said Matthew Secord, health and rehabilitation manager at Collins Bay.
Sedord described the first visit as a “a surreal moment”, adding that “a little courage and courage” is needed to try something new, especially within a prison.
As of March 31, 2025, the cost of administering the site, which includes salaries more operational and maintenance costs, has reached $ 517,000, according to a Canada Correctional Service Spokesman (CSC).
The inmate says that visits attract unwanted attention
A man who spent more than a year imprisoned in the Minimum Security Section of Collins Bay said he is not surprised that the site has seen so little use because it means exposing and potentially to his supplier.
CBC has agreed not to identify the inmate, who fulfilled his time before the consumption site was opened, because he believes that speaking could cause problems with his job.
“If you are a drug trafficker in prison, you are not going to sell drugs to a guy who will go to the guards because … they will know who you are, and they will pay attention to you,” explained the man.
That can lead to cell searches or be labeled as a member of a gang, he said, describing some correctional officers such as “pure enemies” who wish to punish inmates beyond their prayers.
The objective for almost all the requirements after bars is to leave, said the former prisoner, so an inmate would be nonsense to do anything that can risk delaying its probation possibilities, especially the open drug use.
Less needles found in cells
There is an “amnesty zone” around the consumer site, which means that approved inmates can go to the prison medical care wing and if drugs are found in them, they cannot be charged, SECORD explained, the Head of Health Services.
Once a prisoner arrives, they are provided with clean supplies and they are given 10 minutes to consume their substance. They are then required to stay for 30 minutes under observation in case of negative effects.
The sites are an initiative backed by both the defenders of damage reduction and by the union that represents the correctional officers, which sees it as a way of limiting the number of needles within the cells and ensuring that medical personnel, not their members, are those who respond to overdose.
CSC said that visits to a consumer site, such as all the other medical information, are confidential and will only be shared in limited circumstances, as a potentially deadly situation.
“The participants … will not be disciplined to use the service, which includes questions about potential impacts on the conditional release of a criminal, but can face disciplinary measures if they are trapped with illicit drugs outside of it,” wrote spokesman Mike What in an email.
Hours of operation of a problem
Even with that security, the concern persists among the prisoners, according to Lynne Leonard, who recently retired as a professor at the School of Epidemiology and Public Health at the University of Ottawa.
Between 2019 and March 2025, he visited four of the five operations sites throughout the country, including Collins Bay, spending hours in each one speaking confidentially with all, from the director to the inmates, before writing recommendations as part of an independent evaluation.
Leonard said that one of the most stubborn obstacles he found was the fear among the inmates that visiting an OPS would inform the probation board. While that was a requirement in the past, it is no longer, said the evaluator, and added that he asked CSC to make clear that distinction for inmates in their 2020 and 2025 reports.
Another common complaint is hours of operation for sites. While they are open during the day, Leonard said the prisoners do not want to be under the influence of narcotics during programming, work or meetings with probation officers. Instead, they would prefer to take drugs during their free time after dinner.
The evaluator said that CSC staff has told him that the hours are reduced to finance and staff, explaining that it can be difficult enough to find nurses to work in a prison, much less someone willing to work until 10 pm.
A movement towards glass methamphetamine
There has also been a change in the drug choice of inmates. While the fentanil was popular when PAHO sites opened for the first time, that is no longer the case.
“Now he has moved to glass methamphetamine … resulting in the fact that you can get fentanil for a caramel bar now because nobody wants it, because it is associated with overdose,” Leonard said.
Methaphetamine is usually smoked, a method of drug use that is not allowed in PAHO locations. The drug can also come with “terrifying psychotic episodes,” he explained.
Even so, the most obvious and lasting barrier is the pressure that comes from walking through a prison to visit one of the sites.
Leonard said that beyond concerns about probation or repression by correctional officers, inmates who use an operation face a more immediate risk, being “muscular” for others anxious for their drugs and willing to use violence to obtain them.
“It is not confidential in any way, and that is part of the subject,” he said about visiting the site. “Confidentiality is a big problem.”
Trying to attract inmates
Twenty -three overdose or suspicious overdose were reported in Collins Bay between 2022 and 2023, according to CSC.
Since the PAHO opened, that number had fallen to zero, said Sedord, to explain that the tendency towards glass methamphetamine has probably been an important factor.
Like Leonard, he identified the hours of operation, the attention that attracts a visit to the site and the change in the drug of choice as barriers for use.
If there is a recommendation to allow smoking substances, including methamphetamine in PAHO, that option could be discussed in the future, he added.
Meanwhile, Sedord said Collins Bay staff will continue working with their health and health links committee to highlight what the site has to offer.
Leonard said everyone wants the OPS model to work, but some problems will be easier to solve than others. During its evaluations, it has heard suggestions that the sites must leave the Health Services section of the prisons, or that they must be placed in a variety of cells specifically for inmates that are using substances.
The former inmate said that the approach should be in rehabilitation, not in drug use, and argued that CSC will always have difficulty convincing prisoners that using an OPS will not harm their hopes to release.
“I think inmates must be sure that he is genuine for their own health, their own life,” he explained. “You have to attract them and make them feel that this is not going to harm me.”
