A passer-by stops to look at a makeshift memorial near the South Riverdale Community Health Centre supervised consumption site in east Toronto on July 10, 2023, where Karolina Huebner-Makurat, mother of two, was killed by a stray bullet.Chris Young/The Canadian Press
The Ontario government is shutting down more than half of the supervised drug-consumption sites that it funds as it implements sweeping changes to its addictions policy that will shift the focus to treatment and recovery and away from harm reduction.
Health Minister Sylvia Jones announced Tuesday that the government is banning supervised consumption sites – called consumption and treatment services in Ontario – within 200 metres of schools and child-care centres, beginning next March. The government also intends to prevent such sites from relocating and to block new ones from opening.
There are 23 supervised drug-consumption sites in Ontario, according to Health Canada. The new policy means nine of Ontario’s 17 provincially funded sites will be forced to close, as well as one of six sites that are self-funded. At the same time, the government plans to spend nearly $400-million to set up a network of homeless and treatment centres.
The opioid crisis, spurred by the increasingly toxic drug supply, killed more than 2,500 people in Ontario last year. But the debate over how to best tackle addiction and combat illicit drugs has taken centre stage in political debate in recent months as critics point to concerns about public disorder near the sites and argue that recovery, not harm reduction, should be the focus of addictions policy.
Ontario’s changes echo policies put in place in Alberta in 2021 over similar concerns, as well as a pledge by federal Conservative Leader Pierre Poilievre to pull funding from the sites, which he calls “drug dens,” and instead direct money to addiction-recovery programs. Harm-reduction advocates, however, say the sites are crucial to saving lives and warn that government-imposed restrictions on them could prove fatal.
The office of Ya’ara Saks, federal Minister of Mental Health and Addictions, said drug-consumption sites save lives, help reduce public drug use and stop the spread of infectious diseases.
“These are lifesaving health services that, when properly managed, are critical in keeping people alive and preventing harms amidst a toxic drug supply that has cost far too many lives,” spokeswoman Emily Kanter said in a statement.
The Ontario government launched a review last year after a bystander was fatally shot outside a supervised consumption site in Toronto.
Ms. Jones defended the closings and denied that the government is putting anyone at risk. “People are not going to die. They are going to get service,” she told reporters after announcing the new policy at the Association of Municipalities of Ontario’s annual conference in Ottawa.
“I do not call watching someone inject an illicit drug to be health care in the province of Ontario. We need to do better and we can do better.”
The closings will leave Thunder Bay, Kitchener, Hamilton and Guelph without any supervised consumption sites, while five will remain in Toronto, including sites that operate without any provincial funding.
Ontario also said Tuesday it would introduce legislation this fall to prohibit municipalities or any organization from setting up new consumption sites or participating in what the federal government calls “safer supply” – programs that see medical professionals prescribe controlled substances as an alternative to the illegal drug supply.
Ontario said the bill would also prohibit municipalities from requesting the decriminalization of illegal drugs from the federal government.
Ms. Jones said the government needs to do more to focus on treatment and recovery. She said Ontario will spend $378-million for 19 new “Homelessness and Addiction Recovery Treatment (HART) Hubs,” which will add 375 supportive-housing units as well as addiction recovery and treatment beds. The province said the 10 consumption sites that are closing will be encouraged to submit proposals to transition to HART Hubs, but Ms. Jones said they will not provide “safer” supply, supervised drug consumption or needle-exchange programs.
Toronto Mayor Olivia Chow’s office on Tuesday said the mayor is concerned the closing of existing harm-reduction services in Toronto “will have significant consequences, such as increased overdose deaths, greater strain on first responders and emergency rooms, and more public drug consumption,” and that changes should be made in consultation with Toronto Public Health.
Amber Fritz, outreach co-ordinator at Réseau Access Network in Sudbury, where a consumption site closed at the end of March because of a lack of funding, called the news “horrifying.”
“We know that the closure of life-saving services in the midst of an unprecedented drug-poisoning crisis is going to result in more deaths,” she said.
The government’s announcement was the result of a provincial review of the sites, which came after the death of a 44-year-old mother of two who was killed by a stray bullet outside the South Riverdale Community Health Centre in east Toronto last July. That centre is one of the ones that will be closing next year. Gabriella Skubincan, director of community engagement and communications at South Riverdale, said the centre is reviewing the announcement and its focus is on ensuring there is a plan in place for “continued compassionate care” for their clients.
The Kensington Market Overdose Prevention Site in Toronto, part of the Neighbourhood Group, is one of the sites ordered to close by the provincial government. It is funded not by the provincial government but by donors. Bill Sinclair, chief executive officer of Neighbourhood Group Community Services, a social agency that serves low-income families, said the facility also runs a child-care centre near the supervised consumption site.
“We worry that there will be a lack of services for people who need it,” Mr. Sinclair said. “We have a great relationship with our neighbourhoods, and our neighbours have been very supportive of all the services we provide.”
Guelph Mayor Cam Guthrie, however, commended the province on its announcement and said he hopes his city’s location can transition to a treatment centre. He said he has heard growing concerns from parents, businesses, visitors and others about the current site downtown.
Timmins Mayor Michelle Boileau, a member of the board of the Association of Municipalities of Ontario, said Tuesday’s announcement provides the additional resources to respond to the needs of communities, and that she is happy to see there will be funds for treatment and recovery services.
But she noted the news means an open application for a supervised injection site in Timmins will no longer be considered. She said Timmins, like many other communities in the province, is seeing higher levels of opioid toxicity and overdose fatalities, and that it is among the top 10 municipalities in the province for such deaths.
“Medically supervised consumption sites are one part of the greater system that needs to be built to be able to address the crisis our municipalities are facing today,” she told reporters in Ottawa.
Ontario’s new approach appears to emulate that of Alberta, which favours recovery-oriented services over harm-reduction supports. Alberta has said supervised consumption sites must meet a number of requirements, such as ensuring safety and security of clients and the public, as well as putting into place “good neighbour” agreements.
Last spring, British Columbia clawed back its drug-decriminalization pilot project. Mayors, hospitals and opposition critics had called for the province to reverse course, citing increased public drug use and disorder.