The Works, Toronto Public Health is currently operating a a harm reduction based Injectable Opioid Agonist Treatment (iOAT) program for people at high risk of overdose.

iOAT is part of a continuum of programs that replace the need for people who use opioids to purchase drugs from the unpredictable and toxic drug supply.  iOAT programs have been proven to:

  • Reduce or discontinue use of the toxic illicit opioid supply
  • Reduce risk of overdose
  • Provide a regular connection to care and access to resources and other services like housing, mental health supports, primary care
  • Improve mental and physical health and wellbeing for participants

The iOAT program includes injectable hydromorphone supported by a long acting oral therapy (Kadian or Methadone). Clients are able to self-administer the medication in a safe environment co-located with other harm reduction services provided by The Works. The iOAT program also offers case management, counselling and referrals to a wide variety of services.  Our team includes people with lived and living experience, nurses and counsellors.

iOAT is not a “carry” program, all doses have to be observed.

The program currently has capacity for 35 people and is targeted towards people who are:

  • Regularly injecting opioids or who have others regularly injecting opioids for them
  • At risk of overdose
  • Wish to reduce their use of street opioids
  • Are able to attend the clinic 2 or 3 times daily

(People are not required to have tried more traditional oral replacement therapies).

Step 1: Complete the Eligibility Assessment

  • Referrals to the iOAT program are made by completing the Eligibility Assessment form with your client and faxing it to us at The Works for review.
  • The Assessment captures key demographic information and a brief history of drug use, OAT prescriptions if any, and overdoses.
  • We also ask about client ability to meet enrolment considerations such as:
  • The program requires multiple daily visits to the clinic
  • Clients must have the ability to self-inject, or be willing to accept support, or have the PHN administer the injection IM

Step 2: Fax completed Eligibility Assessment to The Works

  • Once completed, fax the assessment to The Works iOAT Program Intake, attention
  • Samira Walji or Chris Langford
  • Fax number: 416 392 0810
  • Include contact information for both the client and yourself

Step 3: Client is Appropriate for Program, UDS and Doctors Consult Needed

  • Once the assessment has been reviewed, we will let you know whether or not the client has been approved for the program.
  • If client is approved, we will need to do a UDS (Urine Drug Screen) and arrange a consult with our prescribing physician.

Step 4: Client Approved to Start iOAT

  • If the prescribing physician decides the client is eligible, we will be able to start them on the program. Most clients will be able to start right away, however, if there is a wait list, we will inform you.
  • Client will be informed and arrangements will be made for them to start titration.
  • New starts are done Monday to Wednesday to allow time for the completion of the titration process.

For more information call 416-392-0520.

To request a copy of the Eligibility Assessment, please send an email to