The province's decision to close 10 sites offering supervised consumption services (SCS) across Ontario, including five in Toronto, will have "far-reaching detrimental impacts on our communities," says the chair of the city's Board of Health.
"Last year, there were 524 opiate intoxicity deaths in Toronto. It's clear that more action is needed from all orders of government to address this crisis," said Toronto Centre Coun. Chris Moise, who added that these sites provide "critical services to people who use drugs and have saved countless lives in Toronto and across the province."
"Research indicates that SCS are successful in reducing drug related harms. They provide immediate response to overdoses, which significantly reduces death rates. They also reduce public drug use and associate issues such as discarded needles."
Moise said that prior to becoming a municipal politician he worked as an addictions counselor at a local hospital and said that supervised drug consumption and harm reduction are both healthcare and they work.
"We have saved lives over the years and I've seen it firsthand. We must understand that the closure of supervised consumption services will affect not only the people who use their services, but our entire communities," he said.
"Closing supervised consumption services will not stop people from using drugs. If sites are forced to close, we will see more public drug use in our parks and in our laneways. We will see more discarded needles on our streets. We will see increased risk of transmission of infectious diseases due to shared needles such as HIV and Hep C and we will see more overdoses and deaths."
Moise added that emergency responders and emergency departments are "simply not equipped to support the influx of drug related calls that will result from a drastic loss of supervised consumption services," adding that the city is waiting for more details from the province about what the planned restrictions will entail. He noted that the city was not consulted by the province about this plan.
In a joint statement with Moise, Mayor Olivia Chow said "any change to evidence-based harm reduction programs should be in consultation with Toronto Public Health."
"We are concerned that the provincial closure of existing harm reduction services will have significant consequences -- such as more overdose deaths, more strain on police, fire and paramedics, more crowded emergency rooms, and more public drug consumption," Chow wrote on X.
On Tuesday, the Ontario government announced that 10 SCS sites, nine of which are provincially-funded, have been banned from operating as they're within 200 metres of a school or child care centre.
In Toronto, they include Parkdale Queen West Community Health Centre’s Bathurst site at 168 Bathurst St., Regent Park Community Health Centre at 465 Dundas St. E., South Riverdale Community Health Centre’s Queen site at 955 Queen St. E., Toronto Public Health’s The Works at 277 Victoria St., and the Neighbourhood Group’s Kensington Market Overdose Prevention Site at 260 Augusta Ave, which is a self-funded location.
Elsewhere in the province, SCSs will be shutting down at Guelph Community Health Centre, 176 Wyndham St. N.; Hamilton Urban Core Community Health Centre, 70 James St. S.; Thunder Bay’s NorWest Community Health Centre, 525 Simpson St.; Region of Waterloo Public Health and Emergency Services, 150 Duke St. W., and Ottawa’s Somerset West Community Health Centre, 55 Eccles St.
These locations must close by no later than March 31, 2025.
Sylvia Jones, Ontario’s deputy premier and minister of health, shared more details about the plan in an address during the Association of Municipalities of Ontario conference in Ottawa on Tuesday afternoon.
In her remarks, she said that the changes come as the “status quo of drug consumption sites is not working.”
“Parents are worried about discarded needles that their children could pick up. Some parents no longer feel comfortable sending their children to the local elementary school, or have pulled them out of their local daycare,” Jones said.
“Businesses and communities are concerned about disruptive behavior that increases crime around drug consumption sites that impact their communities.”
Jones went on to say that assaults, violent crime and even homicides are up significantly in the vicinity of a number of supervised consumption sites in the province.
“We also know that the cycle of addiction is not being broken by using drug consumption sites. We need to do more to support a journey into treatment and recovery, to keep communities safe and to address the tragic impact of substance abuse drug overdoses and opioid related deaths have in our communities. It feels like every day we turn on the news and learn more about the tragic outcome of an approach that accepts and promotes the use of illegal drugs over treatment and recovery,” she said, noting that access to supportive housing is also part of that equation.
“Individuals deserve support resources and the opportunity to recover and thrive. Most of all, they deserve our compassion and our unrelenting commitment to help them in their journey to recovery.”
Province mandates new requirements for remaining SCS sites
In an Aug. 20 news release, the province said it would also implementing new "protections to better protect community safety in the vicinity of remaining sites," including new requirements for safety and security plans and new policies to "discourage loitering and promote conflict de-escalation and community engagement."
This will entail requiring Consumption and Treatment Services (CTS), as provincially-funded sites are called by the province, to work with local police on a crime prevention through environmental design assessment every three years and to update their safety and security policies and procedures.
Among other things, the province is also requiring them to create new complaints and serious incident policies for discouraging loitering, de-escalation, and service restriction, as well as enhanced reporting for greater ministry oversight of any safety and security concerns. A full list of requirements can be found online.
New law aims to prohibit new SCS sites, safer supply, decrim
Aside from shutting down supervised consumption sites near schools and child care centres and mandating additional safety and security measures at the remaining ones, the Ontario government also said that it would be introducing new legislation this fall that aims to prohibit municipalities or any organization from "standing up new consumpton sites or participating in safer supply programs."
This soon-to-be proposed legislation also calls for the prohibition of municipalities from applying for drug decriminalization examptions from the federal government.
Province to create new 'HART Hubs'
Instead of funding SCSs, the provincial government said it would be investing $378 million to open 19 new Homelessness and Addiction Recovery Treatment (HART) Hubs in partnership with the Ministry of Health, the Ministry of Municipal Affairs and Housing, the Ministry of Children, Community and Social Services, and the Ministry of Labour, Immigration, Training and Skills Development.
The province says these hubs, which will not be allowed to deliver needle exchange programs, but may be permitted to offer needle return or collection services, would be similar to existing models "that have successfully provided people with care" and would "reflect regional priorities by connecting people with complex needs to comprehensive treatment and preventative services."
Jones, however, indicated on Tuesday that these hubs would not be permitted to offer safe supply, supervised drug consumption, or needle exchange programs.
The province said that the services that would be offered at them could include primary care, mental health services. addiction care and support, social services and employment support, shelter and transition beds, supportive housing, and other supplies and services like naloxone, onsite showers, and food, it said.
Ontario said its plan for these hubs to add 375 "highly supportive" housing units along with addiction recovery and treatment beds.
The provincial goverment is encouraging its nine provincially-funded supervised consumption services sites slated for closure to submit proposals to transition to HART Hubs, noting that they may be eligible for up to four times more funding than they previously received and would be priorotized in the application process.
"This is part of our commitment to avoid gaps in care," Jones said.
Harm reduction advocates, meanwhile, have long championed supervised consumption sites as a way to help mitigate opioid-related deaths, which have surged in recent years as the unregulated drug supply has become increasingly toxic and unpredictable.
Supervised consumption sites allow people to bring their own substances to be consumed within a clinical space under the supervision of trained healthcare professionals who can provide treatment immediately if an overdosei occurs. Staff are also able to connect clinets with health and social services.
The first SCS site opened in Toronto in 2017. Currently, 10 sites in Toronto provide these services. Six of them are funded by the province.
Scrutiny of these sites intensified following the shooting death of Caroline Huebner-Makurat, a 44-year-old mother who was struck by a stray bullet near a supervised consumption site near Queen Street and Carlaw Avenue in Leslieville, last summer.
Police have said there was an altercation between three males which escalated into violence. Two suspects have since been charged in the shooting, while police believe a third fled the country. A fourth person – an employee of the consumption site – was also charged with accessory to an indictable offence after the fact and one count of obstructing justice in connection with the shooting. However police have not said exactly how she is connected to the shooting.
Some area residents voiced concern about visible drug use, aggressive behaviour, and drug paraphernalia around the site.
Advocates for the sites, however, say that housing and mental health crises have overwhelmed available services.
Closures could lead to rising death toll: Advocate
Diana Chan McNally, a community and crisis worker in downtown Toronto, called today's news "devastating" and said it will result in more harm.
"If you close down a number of these sites, we're going to see a death toll rising out on our streets," she said.
"And for people who are concerned about people using drugs, it will be much more visible out everywhere."
Chan McNally said dealing with the additional health impacts of closing the sites will also be costlier than keeping them open.
"From a policy perspective, it's also going to be costly because if we don't have these services and people are overdosing on the street, overdosing in public, you're going to have to send EMS. You're going to have to take people to ERs, and you're going to see an extreme expense attached to that as well," she said.
Asked about the development at an unrelated news conference Tuesday, Toronto Police Chief Myron Demkiw said it would be "premature" to comment before he's seen the details.