Consumption and Treatment Services (CTS) save lives, strengthen public systems, and protect workers. Closing them makes Ontario less safe.
Ontario is in a toxic drug crisis. Loved ones die every day from an unregulated and unpredictable drug supply. Families are grieving and communities are carrying the weight. At the same time, government policy choices are forcing workers across sectors to respond to preventable emergencies—in libraries, shelters, parks, community centers, emergency rooms, and other public spaces.
The Ford government’s decision to close CTS pushes preventable emergencies into public spaces and puts even more pressure on workers and already-strained public services. CTS are a necessary part of a full spectrum of services and supports that our communities need to be well: that includes harm reduction services, access to a range of voluntary, evidence-based treatment options, and basic needs like safe housing, adequate income, connection to culture, and robust public health care. The Ford government has claimed their HART Hub model justifies closing lifesaving CTS amid a crisis. In doing so, they incorrectly argue that HART hubs, which mandate abstinence as a goal, are an adequate crisis response on their own. The truth is, some people who use drugs do not need or want treatment, or are not ready or able to seek it out. Their safety and lives still matter. There are many pathways to well-being: we need to expand those pathways, not narrow them.
As of May 2026, more than a year after their initial announcement, communities report that many HART Hubs are still not fully operational.
CTS Closures Are a Workers’ Issue
CTS keep our communities safer: they shift drug use out of public spaces and into safer environments, prevent deaths and injuries, and connect people with care. For people often shut out of mainstream care, CTS offer not only basic health services, but accessibility, dignity, and connection to longer-term supports. These are proven services with decades of evidence showing their effective role in our health system.
By closing CTS, the Ford government is moving drug use from supervised, safer spaces into washrooms, parks, shelters, libraries, and emergency rooms, leaving workers across sectors to respond without adequate resources or support.
Paramedics have been clear that CTS reduce pressure on emergency services by safely managing overdoses, freeing up ambulances to respond to other calls. Library, municipal, and school board workers have spoken out about how without supervised consumption sites, they have been thrust onto the frontlines, administering Naloxone and navigating medical emergencies and complex situations at their workplaces. Nurses and other workers in hospitals, already managing unrealistic workloads without necessary supports, are now managing care in emergency rooms and ICUs for people experiencing overdoses – care that previously happened at supervised consumption sites.
Workers need public services that prevent emergencies–not policy decisions that make those emergencies more frequent and severe.
This Is a Rights Issue
People who use drugs have the right to life, health, dignity, safety, and equal access to care. These rights do not disappear because a person is poor, unhoused, Indigenous, racialized, disabled, queer, or criminalized.
The Ford government is moving in the wrong direction. Amid this crisis, Ontario should be expanding access to lifesaving care. Instead, the province is closing CTS, restricting evidence-based harm reduction, and increasing punitive responses to people who are unhoused or visibly poor. Our elected leaders are choosing to criminalize and punish the people most exposed to provincial policy failures.
Encampments, public drug use, and visible suffering are symptoms of deeper crises. They are not solved by tickets, arrests, displacement, or forcing people out of sight. Criminalization makes people less safe, pushes people away from support, increases stigma, and adds pressure to public systems that are already overburdened.
We need approaches that address the roots of this crisis: a toxic drug supply, poverty, lack of housing, and under-resourced public services.
Solidarity Means Refusing Abandonment
CUPE has a long history of fighting for public services, workplace safety, human rights, and the dignity of people harmed by political choices. Drug policy belongs in that same fight.
Solidarity means refusing the idea that some people deserve care while others deserve punishment. It means recognizing that workers responding to drug poisonings, workers who use drugs, and community members facing the toxic drug crisis all deserve safety, dignity, and support.
We can build real safety through public systems that work: CTS, harm reduction, voluntary evidence-based treatment, safe and supportive housing, income supports, low-barrier health care, mental health supports, Indigenous-led services, and well-resourced public systems.
A serious provincial response requires every tool that keeps people alive and supports community well-being.
CUPE Members Can Fight Back
The Ford government must re-open CTS, restore and expand harm reduction services, fund voluntary and evidence-based public treatment, invest in housing and low-barrier care, and stop criminalizing people already suffering under flawed systems.
Closing CTS will increase preventable emergencies in public spaces and place even more pressure on workers across sectors who are already carrying the impacts of a failing system.
Drug policy is a worker issue. It is a rights issue. It is a solidarity issue.
The Honourable Vijay Thanigasalam, MPP Associate Minister of Mental Health and Addictions Via email: [email protected] | [email protected]
Dear Premier Ford, Minister Jones, and Associate Minister Thanigasalam,
RE: Defunding of all supervised consumption sites in Ontario
On behalf of the organizational signatories below, we urge you to reconsider the decision to defund the last eight provincially-funded supervised consumption sites (SCS) in Ontario. The evidence in support of SCS — provided to you by internal staff and reports as well as recommendations from Ontario’s Chief Medical Officer of Health and the Ontario Association of Chiefs of Police, among others — is unequivocal and validated by decades of research. SCS prevent deaths, injuries, and other negative health impacts disproportionately borne by Ontarians who use drugs; reduce the burden on overtaxed first responders, hospital personnel and social service staff; and reduce both public drug consumption and drug debris.
The eight sites facing June 2026 closure have served 120,997 unique people and reversed 15,402 overdoses while maintaining or improving community safety and providing numerous wraparound services including primary health care. These sites directly provide and/or connect people with addiction and mental health treatment opportunities and have reduced Ontario’s tax burden by millions of dollars annually through the prevention of HIV and hepatitis C transmission. Ontario-wide data following the 2025 SCS closures demonstrate a sharp increase in EMS (+69.5%) and emergency department use (+ 67%) for opioid-related overdoses, as well as an increase of deaths in private residences and outdoor settings.
SCS are an essential part of the ecosystem of community care that includes a wide variety of treatment and supports highly valued by local communities — and not available anywhere else. While HART Hubs offer some supports, they cannot replace SCS and the low-barrier, emergency care they offer when people experience a life-threatening overdose. The intentional exclusion of SCS at HART Hubs as well as the prohibition on needle and syringe distribution creates needless barriers to people accessing broader healthcare and social services. The choice to cut these services represents not only the loss of desperately needed emergency care, but also the fracturing of relationships nurtured between healthcare providers and people who use drugs — relationships that are a pathway to other supports. For example, if someone chooses to pursue abstinence, SCS can support them to connect with abstinence-based care.
Notably, wait times for publicly-funded withdrawal management services, outpatient services, and residential addiction treatment facilities in Ontario can often be several months long, despite recommendations since 2017 for universal, evidence-based, publicly available, voluntary addiction treatment on demand. Further, the pursuit of abstinence is far from a linear process. Following a course of treatment, the immediately increased risk of life-threatening overdose is well-documented. In Ontario, treatment is also provided in the context of an unregulated industry where anyone can offer services. SCS keep people alive until treatment is available or until they can meet their own goals, including but not limited to abstinence.
Effective law and policy must be grounded in evidence, and shifting funding from SCS elsewhere is not supported by evidence or the public at large. Defunding SCS in Ontario will hurt the most marginalized people in our communities, namely people experiencing homelessness, people living in extreme poverty, and people who consume criminalized drugs. The urgent calls are clear from grieving Ontario residents, people who consume or serve people who consume unregulated drugs, health professionals, community safety experts, and more: SCS are an essential service in need of expansion, not elimination.
There is a formidable wealth of experience and expertise on issues of substance use in Ontario available to policy makers. We encourage and remain open to dialogue.
We urge a reversal of the decision to defund SCS.
Signed,
Canadian Drug Policy Coalition Drug Strategy Network of Ontario HIV Legal Network ANCS Sénégal 2-Spirited People of the 1st Nations 2039192 Ontario Inc A Womb With A View Aboriginal Legal Services Access Alliance Action Hepatitis Canada Adam Newman MPC Addiction Services Central Ontario Addictions and Mental Health Ontario Advocacy Centre for Tenants Ontario Africa Network of People Who Use Drugs (AfricaNPUD) AIDS and Rights Alliance for Southern Africa AIDS Bereavement and Resiliency Program Of Ontario (ABRPO) AIDS Committee Newfoundland & Labrador AIDS Committee of Durham Region AIDS Committee of Ottawa AIDS New Brunswick AIVL akzept e.V. Bundesverband für akzeptierende Drogenarbeit und humane Drogenpolitik Alliance for Healthier Communities Alliance to End Homelessness Ottawa Amnesty International Canada (ES) Anglican Diocese of Toronto Anishnawbe Health Toronto AQPSUD ARCH Disability Law Centre ArtHouseTO Asian Community AIDS Services Association des intervenants en dépendance du Québec Association for Humane Drug Policy, Norway Association pour la santé publique du Québec Awen Consulting Services (International Harm Reduction Capacity Building) BC Civil Liberties Association BC-Centre for Excellence in HIV/AIDS Being Alive/People with AIDS Action Coalition Blood Ties Four Directions Centre BOOM Health Bras outaouais Breakaway Community Services Bronx Movil Butterfly- Asian and Migrant Sex Worker Support Network CACTUS Montréal Cambridge council on aging Canadian Civil Liberties Association Canadian Federation of Mental Health Nurses Canadian Mental Health Association – Sudbury/Manitoulin Canadian Mental Health Association – Champlain East Canadian Mental Health Association, Ontario CanHepC Care Through Chaos Casey House CASON CATIE CAYR Community Connections Centre for Addiction and Mental Health Centre on Drug Policy Evaluation Centretown Citizens Ottawa Corporation Centretown Community Health Centre Changemark Research + Evaluation Church of St Stephen-in-the-Fields Clinique juridique Grand-Nord Legal Clinic Coderix Medical Clinic Community Health Project Los Angeles Community-Based Research Centre (CBRC) Comprehensive Treatment Clinic Comprehensive Treatment Clinic – Community Initiatives Cornerstone Housing for Women Cranstoun CUPE 3903 CUPE 5536 CUPE Local 5399 CUPE Ontario DAP Health Harm Reduction Davenport 4 Palestine Davenport-Perth Neighbourhood and Community Health Centre Deliberar ORG DIY Community Health Timmins Doctors for Safer Drug Policy Dopamine Dr Joel Voth Medicine Professional Corporation Drug Injecting Services in Canterbury Trust (NZ) EACH+EVERY: Businesses for Harm Reduction East Coast Prison Justice Society East End Community Health Centre Elementa Elevate NWO Elgin-Oxford Legal Clinic Elizabeth Fry Society of Northwestern Ontario Eurasian Harm Reduction Association (EHRA) European Network of People who Use Drugs CLG Evangel Hall Mission Families for Addiction Recovery (FAR) Feast Centre for Indigenous STBBI Research FightBack! KW Flemingdon Health Centre Fontbonne Ministries Forearms of Change Center to Enable community Fred Victor Freddie Gay Men’s Sexual Health Alliance George Hull Centre for Children and Families Gerstein Crisis Centre Grandmothers Act to Save the Planet (GASP) Guelph & Wellington Poverty Elimination Collaborative Guelph Community Health Centre Harlem United Harm Reduction Australia Harm Reduction Nurses Association / L’association des infirmiers et infirmières en réduction des méfaits Health Equity Alliance of Nova Scotia Health Providers Against Poverty Healthcare for All Coalition HealthRIGHT 360 Hepatitis C Elimination Roadmap Ontario HIV & AIDS Legal Clinic Ontario (HALCO) HIV Justice Network Homeless Youth Alliance HOPS – healthy options project Skopje House Of Sophrosyne Housing Works, Inc. IAVGO Community Legal Clinic Income Security Advocacy Centre (ISAC) Indigenous Harm Reduction Network Indonesian Harm Reduction Network Inner City Family Health Team Inner City Health and Wellness Program, University of Alberta instituto RIA Interfaith Grand River International Network of People who Use Drugs International Network on Health, Hepatitis and Substance Use (INHSU) Into the Outside Mind IRIS Estrie Jean Tweed Centre JM Drama Alumni John Humphrey Centre for Peace and Human Rights Kensington Health Kensington-Bellwoods Community Legal Services Kickstart Medical Kootenay Insurrection for Safe Supply LAMP Community Health Centre Langs Farm Village Association (Langs) Legal Assistance of Windsor Lembaga Bantuan Hukum Masyarakat Mad Studies Hub York University Magpies place volunteer for outreach Mainline Maytree Médecins du Monde Canada – Doctors of the World Canada Médecins du Monde International Network META:PHI Metzineres sccl Mindful Nurse Gardener Inc. Moms Stop the Harm Mothercraft, Breaking the Cycle Moyo Health and Community Services Mozia Women’s Network Society My Brain My Choice Initiative (Germany) National Harm Reduction Coalition National Overdose Response Service National Right to Housing Network Native Child and Family Services of Toronto Neighbourhood Legal Services Neighbourhood Legal Services (London & Middlesex) Inc. Niagara Region Anti-Racism Association Nurse 2 Nurse Peer Support Oasis unité mobile d’intervention OCRINT Ontario Aboriginal HIV/AIDS Strategy Ontario AIDS Network Organisation for the Prevention of Intense Suffering (OPIS) Ostrowski Medicine Professional Corporation PACT de rue PAN Parkdale Activity-Recreation Centre (PARC) Parkdale Community Legal Services Parkdale Queen West Community Health Centre PASAN (Prisoners with HIV/AIDS Support Action Network) PATH: Peterborough Action for Tiny Homes PEERS Alliance Penticton and Area Overdose Prevention Society (P+OPS) People’s Health Movement-Canada Planned Parenthood Toronto Positive Living Niagara Pozitive Pathways Community Services PREKURSOR Foundation Reach Out Chatham Kent (ROCK) RECAP RECLAIM Collective Recovery Care Regent Park Community Health Centre Regent Park Community Ministry Regional HIV AIDS Connection Registered Nurses’ Association of Ontario (RNAO) Registered Nurses’ Association of Ontario, Sudbury & District Réseau ACCESS Network Respect Rx Pharmacy Retired Executives for Social Equity Rideauwood Addiction and Family Services Righting Relations Canada Shelter Health Network Shelter Housing Justice Network Skana Family Learning Centre Skoun, Lebanese Addictions Center SLO Bangers Syrunge Exchange and Overdose Prevention Program Social Development Centre Waterloo Region Social Planning Toronto South African Network of People who Use Drugs South Asian Legal Clinic of Ontario South Riverdale CHC St Felix Centre St. Michael’s Homes Street Cats YYC Street Haven Street Nurses Network Substance Overdose Prevention and Education Network (SOPEN) Substance Use Health Network Sudbury Temporary Overdose Prevention Society Sunset Country Family Health Team The Ally Centre of Cape Breton The Centre for Psychology and Emotion Regulation The Gilbert Centre for Social and Support Services The Neighbourhood Group Community Services The Ottawa Mission The Peterson Foundation The Seeking Help Project The Sidewalk Project Thrive HIV Prevention and Support Toronto Board of Health Toronto Harm Reduction Alliance (THRA) Toronto Indigenous Harm Reduction Toronto Overdose Prevention Society Toronto’s Drug Checking Service and Ontario’s Drug Checking Community Tracking(IN)Justice Project Unison Health and Community Services Up North Harm Reduction Vibrant Community Health VIRCAN Care & Research Inc. Washington Office on Latin America Waterloo Region Community Legal Services Waterloo Region Drug Action Team Welcome Centre Shelter for Women & Families Wellington Guelph Drug Strategy West Neighbourhood House Women and HIV / AIDS Initiative WoodGreen Community Services Workers for Ethical Substance Use Policy Youth RISE YWCA Toronto
As organizations working to advance policies grounded in human rights and public health, HIV Legal Network and the Canadian Drug Policy Coalition strongly condemn the decision by the Government of Alberta to close the last remaining supervised consumption sites in Calgary and Lethbridge and urge its immediate reversal. If left to proceed, this policy decision will result in needless deaths of loved ones, increased rates of preventable injury and transmission of HIV and Hepatitis C, increased strain on overburdened emergency services, and increased drug consumption and debris in public spaces.
The evidence on these issues has been well-established for decades. We note that the Alberta government is attempting to support its decision with its own flawed six-month study that contradicts the overwhelming evidence demonstrating the harmful impacts on communities when a site closes. In Ontario, supervised consumption site closures have been associated with several harms over the past year, including sharp increases in EMS-treated opioid toxicities (+69.5%) and in emergency department visits for opioid toxicities (+67%), as well as an increase of deaths in private residences and outdoor settings.
As experts in drug policy, we emphasize that the rate of toxic drug deaths is directly impacted by the composition and volatility of the unregulated drug supply, which is currently outside of the oversight and control of any regulatory body. Shockingly, the Government of Alberta says now is the time to close these sites because overdose deaths have dropped “about 39 per cent” since a peak in 2023. But 602 people lost their lives in only six months in 2025. We are still in the midst of a toxic drug crisis, and supervised consumption sites are crucial to reducing overdose deaths. Eliminating a critical, evidence-based overdose prevention tool defies all logic.
The supervised consumption site in Calgary alone responded to 475 drug-related events in the first three quarters of 2025. To be clear, these numbers represent lives that would have been lost without the availability of supervised consumption services.
People who use drugs in Calgary and Lethbridge will lose a lifeline when these sites close in June 2026. Removing access to one of the most evidence-based, proven tools available to reduce preventable drug-related deaths and injuries is a reckless choice with clear consequences: more needless suffering. In the context of the volatile, toxic, unregulated drug supply, supervised consumption services are an essential element of a broader approach that includes access to voluntary, regulated, evidence-based substance use treatment. Increased investments in abstinence-based treatment services do not replace the unique and life-saving service provided by supervised consumption. It is well established that working towards abstinence, for those that choose to do so, is not a linear process. For example, the increased risk of life-threatening overdose following substance use treatment is well-documented. By ensuring the availability of a range of evidence-informed services, including supervised consumption, we are better able to support people and reduce preventable deaths. Harm reduction and access to voluntary treatment services go hand in hand.
We stand in solidarity with people who use drugs and their families, as well as frontline workers who will bear the brunt of harm from this policy decision. We are committed to working with allies in Alberta to advance substance use policy that is grounded in evidence and creates safer, healthier communities for every member of our society, regardless of their relationship to substance use.
The HIV Legal Network and Canadian Drug Policy Coalition call on the Government of Alberta to immediately reverse this decision.
Supervised Consumption Sites (SCS) and Overdose Prevention Sites (OPS) are critical, evidence-based interventions that save lives. In Ontario, an estimated 6 to 7 people die every day due to the toxic, unregulated drug supply.
Despite this, the provincial government has increasingly restricted access to these essential services through funding cuts and stricter regulations. In response, communities are taking action. Grassroots organizations, volunteers, and harm reduction advocates are stepping in to operate OPS independently and meet urgent local needs.
This document provides an overview of key legal considerations for individuals and groups involved in supporting or running an OPS in Ontario.
Dear Minister Jones and Associate Minister Tibollo,
RE: Supervised Consumption Services site closures due to lack of funding from Ministry of Health
This is a follow up to our letter dated March 4 2024 regarding the need to implement emergency funding for supervised consumption services, to which we have received no response. Ontario’s drug poisoning death rate – now approximately one Ontario resident dying every 2 ½ hours – is dire.
We reiterate our urgent request that the Ministry of Health provide immediate funding for supervised consumption services (SCS) in Ontario, and to act collaboratively and with transparency to deliver life-saving services for existing and future applications for SCS under the provincial Consumption and Treatment Services (CTS) model. We urge the Ontario government to respect the needs of local municipalities, end the deadly and discriminatory delays, and provide relief for emergency responders in establishing evidence-based health and social supports via SCS.
While treatment and recovery options must be made available to all who wish to access these services, it is paramount that a spectrum of harm reduction services and other health and social supports are immediately scaled up. We remind the government that hundreds of people have died who were not diagnosed with a substance use disorder and would not have been eligible for addiction treatment services. The Ontario government’s ongoing delays further entrenches stigma and discrimination while contributing to needless and preventable deaths, injuries, grief and trauma.
Tragically, since our previous letter, supervised consumption services sites in Timmins and Sudbury, where applications have been awaiting a response from the province for 16 months (Timmins) and 33 months (Sudbury), have been forced to shut their doors in June 2024 and March 2024 respectively, along with the Windsor site (application submitted 21 months ago) which was forced to shut down in December 2023, leaving an increasing number of local communities without the necessary services to prevent overdose-related death. In Barrie, applicants have been forced to rescind their application submitted two and a half years ago due to the unsustainability of maintaining rental payments for a location without having any confirmation of funding nor timelines from your government. It is unacceptable that the provincial government is acting as the central roadblock in establishing urgently needed life-saving services, despite local support and significant local investment into these services that will all go to waste.
The 2023 annual report of the Chief Medical Officer of Health recommended that Ontario increase access to harm reduction services, like supervised consumption services, as part of a fulsome response. The Association of Municipalities of Ontario, the Association of Local Public Health Agencies, and Addictions and Mental Health Ontario are among the many, many organizations urging immediate action establishing new SCS sites. Data shows that there were an estimated 3,812 drug-related deaths in 2023, and an additional 1,842 suspected-drug toxicity deaths in the first six months of 2024. In Timmins, Windsor and Sudbury, the opioid toxicity mortality rate is nearly three times the provincial average. There is a dearth of supervised consumption services in northern Ontario contributing to service inequities between the north and south.
This crisis has worsened under the current provincial government, with deaths totaling more than 21,000 Ontario residents since 2018. Given the inordinate delays and lack of transparency in providing timely funding for simple, life-saving services, we are concerned about this government’s unwillingness to adequately implement a successful holistic and comprehensive provincial drug strategy.
We reiterate our calls to:
Immediately provide direct emergency funding to supervised consumption services (SCS) sites that have submitted their Consumption and Treatment Services (CTS) applications to the province and have closed due to lack of provincial funding.
Urgently provide, improve, and sustain uninterrupted provincial funding for SCS, including inhalation, and ensure equity in regional service availability, particularly in northern communities.
Phase out the Consumption and Treatment Services (CTS) approach to funding SCS, which requires additional and overly stringent conditions over and above Health Canada’s requirements.
In the interim, immediately remove the cap on the number of funded SCS sites and the prohibition on inhalation services under the provincial CTS model.
In the interim, introduce transparency and an expedited 30-day timeline for responding to applications under the provincial CTS model.
Introduce a low-barrier process by which community organizations can seek provincial funding for SCS.
Integrate SCS into Ontario’s core funded healthcare system with ongoing, integrated funding and resources.
Meet with us by September 13.
Signed by,
DJ Larkin, Executive Director, Canadian Drug Policy Coalition
Dear Minister Jones and Associate Minister Tibollo,
RE: Supervised Consumption Services site closures due to lack of funding from Ministry of Health
We write to you with grave concern regarding the Ontario government’s inaction in ensuring the provision of urgently needed supervised consumption services (SCS) amidst a worsening public health emergency caused by the toxic unregulated drug supply. We are calling on you to immediately provide direct emergency funding on or before March 29 to SCS sites that have submitted their applications to the province and are under imminent threat of closure or have closed due to lack of funding, eliminate the Consumption and Treatment Services (CTS) approach to funding SCS and urgently provide, improve, and sustain uninterrupted provincial funding for SCS that includes inhalation services.
Unregulated drugs of unknown contents and potency are driving increased deaths, hospitalizations, injuries and trauma across Ontario, with an estimated 3,644 drug-related deaths in 2023. Several communities in Ontario have declared a state of emergency due to drug toxicity deaths. SCS, and particularly low-barrier overdose prevention sites, are a necessary emergency response to this crisis and must be immediately scaled up. In 2018, the Ontario government arbitrarily capped funding to only 21 CTS. Six years later, the government has still not delivered on funding 21 sites. Despite overwhelming need and local support, the Ontario government has approved and funded only 17 CTS locations across the entire province. Only one of these is located in northern Ontario (NorWest Community Health Centre in Thunder Bay). Meanwhile, the toxic unregulated drug crisis has taken far too many lives since 2018 – nearly 20,000 and rising, with many more family and friends left grieving.
In the context of this preventable public health emergency, urgent action is required. There are at least five submitted applications for CTS sites that have been inordinately delayed by the Ontario government in Sudbury (30 months since application was submitted), Barrie (28 months), Windsor (19 months), Timmins (13 months), and Hamilton, where the application was withdrawn in October 2023 after two years, in part due to the Ontario government’s delays and lack of transparency in providing the necessary approvals and funding to sustain the site. These delays are unacceptable and deadly.
The tragedy of an isolated instance of gun violence in Toronto must not prevent people in diverse locations across the province from accessing vital health services any longer. The Ontario government’s decision to stop processing applications altogether for more than seven months is punitive and irresponsible. After the significant years of work and investment in each community to prepare the onerous applications under the provincial CTS model, to secure a suitable location and community support, and – in the case of Sudbury, Windsor and Timmins where the sites have been established with municipal stopgap funding – to hire and train staff and build trust and service uptake amongst people who use drugs, these sites are at imminent risk of closure or have been forced to close due to a lack of provincial funding. It should not fall to municipalities to fund healthcare services, which are a provincial responsibility. Moreover, management of these sites is extremely challenged by the Ontario government’s lack of transparency and accountability regarding site funding and approval timelines. In the case of Windsor, lacking the much-needed provincial support, the site has been forced to close.
Of the regions with submitted, pending CTS applications, data released in 2024 from the Office of the Chief Coroner indicates that three of these regions have amongst the ten highest mortality rates in the province: Timmins, Windsor and Sudbury each have an opioid toxicity mortality rate that is nearly three times the provincial average. Further, inhalation now accounts for significantly more overdose deaths than injection in Ontario, according to data from the Office of the Chief Coroner, yet the current CTS model continues to prohibit inhalation services. Services must be designed and supported to reflect the magnitude of the crisis and the data regarding regional need and modalities of drug use.
Failure to equitably provide for lifesaving health services like SCS is discriminatory and violates the right to life and security of the person for people who use drugs. The inordinate delays in processing applications, onerous requirements and lack of inhalation services under the provincial CTS model are also fiscally irresponsible, unsustainable and ineffective for the provision of a service that is fundamentally necessary amidst the worsening public health emergency that is the toxic unregulated drug crisis.
SCS are evidence-based, highly effective, and must be recognized as an integral part of Ontario’s publicly funded healthcare system. As such, these services must be universally available wherever there is need. These sites relieve the burden from overtaxed emergency first responders and are not complex to implement; they require an accessible location, oxygen, naloxone, sterile medical and first aid supplies, and supervising staff. It is indefensible as a matter of public health and fiscal policy that we currently have a two-tiered healthcare system where SCS are available in some southern Ontario communities and not in northern Ontario. It is a violation of the fundamental rights to equality and security of the person.
We call for urgent action from the province, commensurate with the magnitude of the crisis our communities are facing. It is vital that the Ontario government embrace a harm reduction approach to substance use, which centres the dignity, health and safety of people who use drugs while providing pathways to care, services, and community.
We are calling on the Ontario government to:
Immediately provide direct emergency funding on or before March 29 to supervised consumption services (SCS) sites that have submitted their Consumption and Treatment Services (CTS) applications to the province and are under imminent threat of closure or have closed due to lack of funding.
Urgently provide, improve, and sustain uninterrupted provincial funding for SCS, including inhalation, and ensure equity in regional service availability, particularly in northern communities.
Phase out the Consumption and Treatment Services (CTS) approach to funding SCS, which requires additional and overly stringent conditions over and above Health Canada’s requirements.
In the interim, immediately remove the cap on the number of funded SCS sites and the prohibition on inhalation services under the provincial CTS model.
In the interim, introduce transparency and an expedited 30-day timeline for responding to applications under the provincial CTS model.
Introduce a low-barrier process by which community organizations can seek provincial funding for SCS.
Integrate SCS into Ontario’s core funded healthcare system with ongoing, integrated funding and resources.
Meet with us by March 13.
We look forward to hearing from you as soon as possible on this urgent matter.
Signed by,
DJ Larkin, Executive Director, Canadian Drug Policy Coalition
A misinformation campaign around public use legislation distracts from real solutions
January 31, 2024 | One year ago today, British Columbia decriminalized personal possession of small amounts of some drugs in limited locations in a three-year pilot project. Since then, an organized political campaign has spent time and money to cloud public perception and discredit evidence-based efforts. Let’s cut through the rhetoric and talk about what is and isn’t working with decriminalization, and what a better way forward could be.
It’s understandable people are concerned, as drug poisoning deaths reach their highest-ever levels: with 2511 deaths last year alone, communities across B.C. feel the impact of this crisis. Under decriminalization, adults carrying up to 2.5 grams of opioids, cocaine, methamphetamine and MDMA in specific places will not be subject to criminal charges: police cannot seize their drugs, arrest or charge them for simple possession. Instead, they are directed to services. The pilot excludes schools, childcare facilities, playgrounds, splash pads and skate parks, among other locations. Decriminalization has support amongst public health and policy experts, including B.C.’s provincial health officer and chief coroner.
If you think you are seeing more unhoused people than ever, you’re right – but not because of decriminalization. While drug use rates remain stable, homelessness has risen considerably: up 32 per cent across 11 Lower Mainland communities and 65 per cent in Surrey. Some critics wrongly attribute these worsening social issues to decriminalization. Content creators, treatment industry lobbyists and municipal mayors alike have blamed the policy for alleged spikes in public drug use, fuel for a politicized assault.
But decriminalization cannot build homes; open supervised consumption sites; undo decades of housing divestment; reverse generational traumas of colonization; create responsive health care systems; or influence the unregulated drug market. If the government was serious about tackling the drug poisoning crisis and finding solutions to public drug use, there are clear places to start. Scaling up permanent welfare-rate housing and renewing modular housing leases would reduce visible poverty. Opening overdose prevention services in every community, per the still-unfulfilled 2016 Ministerial Order, would create safer indoor spaces for use while facilitating access to healthcare and treatment, reducing emergency costs, and improving neighbourhood cleanliness.Most importantly, B.C. could prevent deaths by responsibly regulating the drug supply to standardize content, access and use, all while increasing tax revenue and diverting hundreds of millions of dollars of profit from organized crime.
Although evidence-based solutions exist, the government is choosing reactionary politics to push the poorest people in society out of voters’ line of vision. Despite existing limits on decriminalization, the Province introduced Bill 34, which encourages racist and anti-poor stereotyping, ordering police to remove people from public spaces based on suspected rather than observed drug use. Pushing unhoused people into isolation will increase overdose deaths and countless other social harms. So if you are upset about rising poverty and death despite decriminalization, please redirect your anger toward the politicians who care more about getting re-elected than building healthy, happy communities.
Authors:Anmol Swaich, SUDU (Surrey Union of Drug Users) Sarah Lovegrove, the EIDGE (Eastside Illicit Drinkers Group for Education) and Aaron Bailey
Anmol Swaich is a MSc student and Research Assistant in the Faculty of Health Sciences at Simon Fraser University and a Community Organizer with Surrey Union of Drug Users.
Aaron Bailey holds a Master of Science in Health Promotion from Queen’s University, serves as Program Coordinator at the Eastside Illicit Drinkers Group for Education (EIDGE) and supports operations of the VANDU Overdose Prevention Site.
Canada is known around the world as a leader in harm reduction. It is host to the first, and only supervised consumption site in North America, Insite, which has saved lives and helped to build a healthier community in one of the most at-risk neighbourhoods in the county. Unfortunately, the federal government has moved away from harm reduction and more towards a criminal approach to drugs. Of course, there is a way forward. In our policy brief, we make the case that not only should the federal government restore the harm reduction model, but expand upon what is already in place. Please click and read below.
The tragedy of drug overdose has increased dramatically in recent years. The rise of fentanyl, an extremely potent opioid, has dramatically increased overdose deaths in recent months. Policy change at the federal level is urgently needed. Fortunately, overdoses are preventable. From allowing for easier access to lifesaving medication such as naloxone, to testing the purity level of street drugs, there are several actions the government can take right now to put an end to these avoidable deaths. Our policy brief contains many commonsense policy solutions that the government can enact immediately. Please click and read.
Cannabis law is changing around the world. From the United States to Latin America, a wider consensus is growing that cannabis prohibition has failed to prevent both the sale and consumption of the plant for non-medicinal purposes. Public opinion in Canada and worldwide is experiencing a paradigm shift, and the mindset of policymakers needs to change with it. Clearly, an alternative strategy to this broken system needs to be taken seriously. In the following brief, we outline our strategic recommendations on how the federal government can end prohibition, and use its power to begin the process to create a regulatory system that works.
In 2013, 308 people lost their lives due to illicit drug overdoses in BC alone. The worst part? Drug-related deaths from opiate overdose are entirely preventable.
And not in the sense that “well if people didn’t use drugs… there wouldn’t be overdoses.” Because while that’s essentially true, we know that people will use drugs. One hundred years of prohibiting drugs and arresting and incarcerating people who sell and use drugs hasn’t stopped that.
We need to be realistic and practical. Drug use does happen and it will happen. So let’s get on with preventing deaths and injuries from drug overdose. Here at the Canadian Drug Policy Coalition, we’ve worked with experts across the country to come up with set of policy changes that can save lives and make Canada safer for all.
While putting together this brief, we met many dedicated, compassionate people who work in frontline overdose prevention programs across Canada. One of the most pragmatic and effective interventions to prevent overdose injury and death is the “take-away naloxone program.” Based on 180 similar initiatives in the US, the program involves distributing overdose response kits – dubbed take-home-naloxone kits – to people who have been trained to prevent, recognize and respond to an overdose. Naloxone is a 40-year old medication that when administered during an opiate overdose reverses the effects of the drug. It has no narcotic effect and people cannot become dependent on this drug.
Streetworks in Edmonton pioneered this initiative in Canada and similar programs have spread throughout Canada. The country’s most robust overdose program – “take-home naloxone” (THN) – can be found at British Columbia’s Centre for Disease Control’s (BCCDC) harm reduction resource Toward the Heart.
Through a series of participating organizations throughout BC, the naloxone program operates in 35 sites, from large urban hubs such as Vancouver and Surrey, to smaller rural centres such as Cranbrook, Campbell River and Fort St. John. Nearly 1000 people have been trained including staff and volunteers at health and social service agencies, as well as friends and family members of people who use drugs. Over 600 kits have been dispensed to clients who use opioids and various resource materials are being developed to assist community partners to increase the reach of the program. Since its origins in 2012, 55 overdoses have been reversed.
While these simple yet effective initiatives are demonstrably preventing overdoses, significant challenges prevent these programs from being scaled up. Naloxone remains a prescription-only medication, and it’s costly and not covered by provincial drug plans. An even more significant challenge is the lack of a national Good Samaritan law, one that prevents people from being arrested and charged with drug possession if they call for help during an emergency. Eleven US states have passed Good Samaritan laws, often with bipartisan support from legislators.
Our hope is that this policy brief will help support efforts to clear away the barriers blocking overdose programs. That’s the most realistic way to prevent drug-related deaths from opiate overdose.
