The Ontario government’s decision to shutter multiple supervised drug consumption sites in Toronto runs counter to the expert opinions it sought about one of those sites.
After Karolina Huebner-Makurat was fatally hit by a stray bullet while walking in Leslieville in July 2023, the Ministry of Health commissioned two reviews into supervised consumption and treatment services operated out of the South Riverdale Community Health Centre (SRCHC).
The two reviews were quietly posted online earlier this week.
Both recommended changes to the operations of the centre, and both recommended the province expand harm reduction resources — consumption and treatment services included.
“Evidence shows that consumption treatment services are a necessary public health service, implemented to save lives and prevent accidental overdose death,” says the SRCHC supervisor’s report, dated April 2024.
An earlier review, conducted by Unity Health Toronto and dated February 2024, made a host of recommendations geared toward improving on-site security and relations with the broader community.
The South Riverdale Community Health Centre has been instructed to shutter its consumption services no later than March 31, 2025.
“We cannot continue to enable drug use in neighbourhoods that have schools and daycares,” Health Minister Sylvia Jones told CBC Radio’s Metro Morning on Wednesday.
“Our focus is very much on offering treatment and ensuring that we have those treatments available for people,” said Jones, who did not mention either review or their findings and recommendations.
Five supervised drug consumption sites are slated to close in Toronto after the provincial government announced a ban on such facilities near schools and child-care centres. CBC Metro Morning host Molly Thomas spoke to Health Minister Sylvia Jones about the changes.
While the province’s decision to shutter consumption sites within 200 metres of schools or daycares, announced Tuesday, has been welcomed by some — including residents in Huebner-Makurat’s neighbourhood — it has been heavily criticized by others.
“Supervised consumption sites are located where people are at highest risk for overdoses,” Zoë Dodd, a harm reduction worker, told Metro Morning on Wednesday.
Dodd, who has been affiliated with the SRCHC, was among those who defied the law to open an overdose prevention site in Moss Park after a spike in overdoses in summer 2017.
“What we do know is that where they are located, there’s been a massive reduction in overdose deaths and calls to paramedics,” she said. “They have been successful at reducing overdose deaths.”
Toronto’s top doctor reported 523 overdose deaths from opioids in 2023.
Part of the Ontario government’s new addictions plan would see the creation of 19 homelessness and addiction recovery treatment hubs, called HART hubs.
While the supervised consumption sites within 200 metres of schools and child-care centres have been given a March 2025 deadline to shut, it’s not clear yet when the HART hubs will be operational.
Ontario is introducing new rules for supervised drug consumption sites, including banning all locations within 200 metres of schools or child-care centres. It comes more than a year after a woman was killed by stray bullet outside a Leslieville community health centre. As CBC’s Dale Manucdoc reports, some residents in that area have been asking for this change.
On Metro Morning, Jones said applications are open and will be reviewed in October. She said further announcements can be expected in early 2025.
But Dodd criticized the plan — which the government said comes with a $378-million price tag — for not being evidence-based.
“You should start with a pilot … see if it reduces mortality and overdoses and connects people to recovery services, check their outcomes, evaluate it, and then roll it out as a model,” Dodd said.
“At this point, there’s been no piloted model to demonstrate its effectiveness or efficacy at saving lives.”
Meanwhile, the Centre for Addiction and Mental Health (CAMH) said in a statement Tuesday that consumption sites “are evidence-based and life-saving interventions, known to reduce the incident of blood-borne infections, and increase referrals to treatment.”
CAMH welcomed the creation of the HART hubs in a statement Tuesday but expressed concern over the pending closures.
“They are a necessary part of a comprehensive response to the drug toxicity crisis,” the statement says. “The loss of supervised consumption sites and needle exchange programs will cause harm to people and communities across the province and put pressure on other parts of the health-care system.”
Harm reduction services like needle exchanges and supervised consumption sites have been a topic of heated debate on P.E.I. CBC’s Tony Davis talks to advocates and public health officials about what harm reduction is, and how those services are intended to work.
It’s clear the best way to reduce harm is to eliminate it, said Dr. Samir Gupta, a respirologist and associate professor in the University of Toronto’s department of medicine. But he said it’s more realistic to acknowledge that people don’t quit overnight.
“It’s obviously a sensitive issue for the community,” Gupta told CBC News on Wednesday.
“There are lots of misconceptions about what happens on these sites,” he said.
“People think of them as maybe a place that facilitates drug use or normalizes it, or even promotes drug use. But it isn’t that.”