So SASSY
Casey House’s Vending Machines Dispense Everything A Drug User Needs - Except The Drugs
SAVING LIVES :: Harm reduction is pretty much what it sounds like. Assuming that all people - and that includes drug users - deserve safety and dignity, harm reduction aims to reduce the injuriousness associated with drug use, through a variety of public health interventions. Information on how to use drugs safely, safe drug consumption sites, clean needle programs, overdose prevention, and drug testing (for toxic / deadly ingredients) are all examples of harm reduction.
So too is SASSY (safely access services and supplies for you) the cleverly and cheekily named twin dispensing machines installed this past summer outside Casey House. The renowned specialty hospital in Toronto, founded in 1988 by volunteers led by the late journalist / activist June Callwood (and named in honour of her late son) is located at the corner of Isabella and Huntley streets, and offers care for people living with and at risk of HIV.
Casey House has evolved mightily from its beginning days as a hospice with just 13 beds for people dying of AIDS at the height of the epidemic, one made internationally famous thanks to a visit from the late Princess Diana in 1991. Her time there, a pre-Internet moment, went “viral” globally after she held hands with patients, helping destigmatize public hysteria and aiding in quashing the myth AIDS is spread by casual contact.
But back to SASSY, who lives on the Huntley side of the hospital, under a shed-like structure to protect it from the elements. From it (why do I want to humanize SASSY and say “her?”) you can get free sexual health supplies like condoms and lube, and drug use supplies like clean needles, glass pipes, naloxone (used to reverse opioid overdoses) and other paraphernalia for safer drug use.
Safer supply kits are most popular, according to early observations. Glass bowl pipes used for smoking crystal meth are most popular, accounting for over 50% of what SASSY serves. Stem kits (for smoking crack) and shorts kits (containing syringes, alcohol swabs, tourniquettes and other must-haves for safer drug injection) are the most requested supplies after that.
Whatever you need, placing your order is done by a huge touch screen, like when you order at a McDonald’s (not that I ever eat McDonald’s.) Simply tap the menu item you want, and then, like a soft drink vending machine, out pops your request through a slot at the bottom. And voila, you’re on your way, supplied and safer.
And while countless people do drugs, it’s still a small community, and one prone to gossip.
Low-barrier and anonymous, Sassy is a bold, necessary move in today’s panicky, judgemental, righteous “close the safe consumption sites!” world. (At least the world of Ontario, under the ill-informed, hypocritical and prejudicial rule of its premier, Doug Ford, who has, in an embarrassing and dangerous move, shuttered 10 of the province’s 23 safe consumption sites.)
But Casey House is known for bold moves. I’d love to see it on a dance floor. The institution, whose logo is a welcoming red heart peeking out of a door, has a longstanding commitment to harm reduction. The hospital has been putting together safer inhalation and safer injection kits and giving them to community members since 2014, for example; in fiscal 2023-204, 62,394 harm reduction kits were distributed.
Over 62,000 in a year. Clearly there’s a need.
Until SASSY, Casey House’s distribution of kits was simple, yet sometimes problematic: supplies sat in buckets in the front entrance of Casey House, which meant they were exposed to the weather and the surroundings got messy; pedestrians complained numerous times over the years.
And while countless people do drugs, it’s still a small community, and one prone to gossip. Despite the tens of thousands of kits given out in the most recent fiscal year, I know many people who would never go into the hospital entrance, for fear of being spotted by a Casey House staffer they knew, or of running into an acquaintance while sifting through the buckets for what they need. It’s just not a cute look.
But they will go around the corner to the far less obtrusive, secluded SASSY, where it’s much harder to be spotted, affording a greater measure of privacy plus quick convenience: you can get what you want 24/7, instead of just when staff are available, and be gone in seconds. In this way, SASSY helps more clients be reached, reducing more potential harm.
That said, clients are also welcome to enter Casey House to use their on-site supervised consumption services (SCS). There they can consume drugs while trained staff supervise, enjoy clean supplies, and learn about safer use. Drug equipment is disposed of on site, not left in alleys, on sidewalks, or in playgrounds.
SCS as harm reduction are vital, especially right now. Much of the current drug supply is toxic, some of it laced with deadly fentanyl. Fentanyl is 100 times more potent than morphine, and 50 times more potent than heroin; an amount the size of 5-7 grains of salt can kill you. Casey House’s SCS have reversed 20 overdoses: twenty lives saved.
People from all walks of life use drugs. And they are going to do them regardless of what others think, what the law says, and do them for a cornucopia of reasons, the common denominator being they are all looking to feel better than they do in any red hot moment. Therefore, make things as safe as possible for them to do so. Because look at the alternative. Who wants that for someone they love? Who wants that for anyone?
“Harm reduction is one of the foundational components underpinning our hospital’s approach to care,” Joanne Simons, CEO of Casey House, responded when I asked why Casey House even cares to make the effort; why not leave it to another organization?
Simons also added, “In addition to reducing the risk of HIV transmission, Casey House believes that reducing risks of drug use through harm reduction in a judgement-free environment is an essential health service.”
Concur. Harm reduction is in fact urgent, to address, according to research from the chief coroner’s office, the significant pandemic-induced change in opioid-related harms and deaths in Ontario. It’s also a comprehensive continuation of mental health and addictions care that can work hand in hand with treatment and recovery.
SASSY’s been a hit so far, though because it’s only been a half a year, there’s no data to report yet. “People have been receptive to the machines and appreciate what is offered,” says Simons. “The need to replenish supplies daily suggests they are being well used.”
SASSY isn’t perfect. Tech glitches have happened. And, unsurprisingly, not all the neighbours were happy and some have complained, but that I guess is to be expected. Stigma around drug use causes some people to actually believe people who use don’t deserve support in a dignified, safe, clean way.
But more often than not, most people have been curious. (Some have asked if SASSY dispensed drugs - can you imagine?)
When I first spotted SASSY out walking my dog last summer, I felt so pleased and proud of Casey House, that the beloved hospital had executed this initiative, outdoing themselves again. They’ve been on the leading edge of modern ideas about caring for people for years. It’s wonderful and hopeful to see that the very good work they do on the inside of that gorgeous Hariri Pontarini-designed building continues on, outside, quietly and privately, even after everyone working there has gone home, helping those who need and deserve it.
Shaun Proulx is the host of The Shaun Proulx Show, heard every weekend on SiriusXM Canada Talks 167, and publishes TheGayGuideNetwork.com. He has written and broadcast about the subject of recreational drug use, especially crystal meth use within the cis gay male community, since 2005.