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Ontario to close 10 safe consumption sites and open 19 recovery hubs

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A photo of the South Riverdale neighbourhood. (Photo credit: Andrea Nickel)

News release from Break The Needle

By Alexandra Keeler

Ontario’s decision to close safe consumption sites near schools and daycares comes in the wake of a bystander’s death and class-action lawsuit

In a dramatic shift in policy, Ontario is closing 10 safe consumption sites located near schools and daycares, citing public safety concerns.

“Our first priority must always be protecting our communities, especially when it comes to our most innocent and vulnerable — our children,” said Ontario Health Minister Sylvia Jones at an Association of Municipalities of Ontario conference in Ottawa on Tuesday.

Safe consumption sites, which enable people to use illicit drugs with sterile equipment under staff supervision, will be prohibited from operating within 200 metres of schools and child-care centres after March 31, 2025.

The province also plans to introduce legislation to prevent municipalities from establishing new consumption sites, requesting the decriminalization of illegal drugs or participating in federal safe supply initiatives, a health ministry press release says.

Safe consumption sites have faced mounting scrutiny in the wake of community feedback highlighting their effect on public safety.

“We’ve noticed a real change from 2021 onwards,” Andrea Nickel, a parent who lives near a safe consumption site at Toronto’s South Riverdale Community Health Centre, told Canadian Affairs in May.

“At the beginning of last year it just escalated out of control.”

Unacceptable danger

Ontario opened its first safe consumption site in 2017 with the aim of reducing overdose deaths and providing users with a gateway to treatment. Today, there are 23 safe consumption sites across the province, 17 of which are provincially funded.

KeepSIX, the safe consumption site in South Riverdale, is among the sites facing closure. Last July, Karolina Huebner-Makurat, a local resident and mother of two, was fatally shot during a gunfight outside the site. Her death prompted Ontario to conduct two reviews of the centre and to also review the 16 other provincially funded sites.

review of keepSIX conducted by the hospital network Unity Health Toronto and released in February recommended improvements in security, community relations, law enforcement communication and staff training. It did not recommend closure.

Drugs found by a child in the South Riverdale neighbourhood. (Photo provided by Andrea Nickel.)

The second review, released in April and conducted by former health-care executive Jill Campbell, also opposed closure. It advocated instead for expanded harm reduction and treatment, enhanced security and increased mental health support.

In March 2024, two South Riverdale residents launched a class-action lawsuit against the operator of keepSIX and all levels of government, Canadian Affairs reported in May. The lawsuit alleges the site has exposed the community to unacceptable danger.

The site’s proximity to daycares and schools and its role in exposing children to illicit drugs and used needles are at the heart of that case.

Reacting to this week’s announcement, South Riverdale parent Andrea Nickel said she is supportive of the site’s services. “[But] it is not unreasonable to ask that they are balanced with community safety, specifically kids’ safety.”

South Riverdale’s response cited the centre’s role in reversing 74 overdoses in 2023.

“Every overdose reversed is a life saved,” Anne Marie Aikins, a public affairs consultant at AMA Communications, said on behalf of the centre.

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‘Devil’s in the details’

In Tuesday’s address, Ontario’s health minister also announced a $378-million investment to establish 19 new Homelessness and Addiction Recovery Treatment Hubs (HART hubs) across the province. These recovery-focused hubs will offer social support services and employment assistance to individuals struggling with addiction.

They will not provide supervised drug consumption, needle exchange programs or the “safe supply” of prescribed controlled substances.

“The devil’s in the details with these things,” said John-Paul Michael, an addictions case manager in Toronto who has extensive experience in harm reduction and lived experience with substance use.

“Everyone I know in the harm-reduction community is very much in favour of having better access to treatment, better access to detox, better wraparound care,” he said. “The problem becomes when it is at the expense of other evidence-based care.”

Michael says safe consumption sites are often the only form of health care available to individuals struggling with addiction. Eliminating them would leave these individuals without support, he says.

“Safe consumption sites are essential for saving lives, particularly for those who may never seek formal treatment,” he said. “Eliminating these supports disregards the value of human life.”

Michael is also concerned about the reduction of needle exchange services, which are crucial for managing HIV and Hepatitis C rates and lessening the burden on emergency rooms.

“Community-based nurses at [safe consumption sites] provide basic care that can prevent emergency department visits and potentially severe outcomes, such as [intensive care unit] stays,” Michael said.

The province will soon seek proposals to establish up to 10 HART hubs. Priority will be given to proposals that aim to transition existing safe consumption sites — especially those facing closure — into HART hubs.

“[T]he likelihood is that [these transitions] would happen very quickly,” Health Minister Jones told reporters on Tuesday. “The other applications — it will depend on what they bring forward.”


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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Addictions

Canada must make public order a priority again

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A Toronto park

Public disorder has cities crying out for help. The solution cannot simply be to expand our public institutions’ crisis services

[This editorial was originally published by Canadian Affairs and has been republished with permission]

This week, Canada’s largest public transit system, the Toronto Transit Commission, announced it would be stationing crisis worker teams directly on subway platforms to improve public safety.

Last week, Canada’s largest library, the Toronto Public Library, announced it would be increasing the number of branches that offer crisis and social support services. This builds on a 2023 pilot project between the library and Toronto’s Gerstein Crisis Centre to service people experiencing mental health, substance abuse and other issues.

The move “only made sense,” Amanda French, the manager of social development at Toronto Public Library, told CBC.

Does it, though?

Over the past decade, public institutions — our libraries, parks, transit systems, hospitals and city centres — have steadily increased the resources they devote to servicing the homeless, mentally ill and drug addicted. In many cases, this has come at the expense of serving the groups these spaces were intended to serve.

For some communities, it is all becoming too much.

Recently, some cities have taken the extraordinary step of calling states of emergency over the public disorder in their communities. This September, both Barrie, Ont. and Smithers, B.C. did so, citing the public disorder caused by open drug use, encampments, theft and violence.

In June, Williams Lake, B.C., did the same. It was planning to “bring in an 11 p.m. curfew and was exploring involuntary detention when the province directed an expert task force to enter the city,” The Globe and Mail reported last week.

These cries for help — which Canadian Affairs has also reported on in TorontoOttawa and Nanaimo — must be taken seriously. The solution cannot simply be more of the same — to further expand public institutions’ crisis services while neglecting their core purposes and clientele.

Canada must make public order a priority again.

Without public order, Canadians will increasingly cease to patronize the public institutions that make communities welcoming and vibrant. Businesses will increasingly close up shop in city centres. This will accelerate community decline, creating a vicious downward spiral.

We do not pretend to have the answers for how best to restore public order while also addressing the very real needs of individuals struggling with homelessness, mental illness and addiction.

But we can offer a few observations.

First, Canadians must be willing to critically examine our policies.

Harm-reduction policies — which correlate with the rise of public disorder — should be at the top of the list.

The aim of these policies is to reduce the harms associated with drug use, such as overdose or infection. They were intended to be introduced alongside investments in other social supports, such as recovery.

But unlike Portugal, which prioritized treatment alongside harm reduction, Canada failed to make these investments. For this and other reasons, many experts now say our harm-reduction policies are not working.

“Many of my addiction medicine colleagues have stopped prescribing ‘safe supply’ hydromorphone to their patients because of the high rates of diversion … and lack of efficacy in stabilizing the substance use disorder (sometimes worsening it),” Dr. Launette Rieb, a clinical associate professor at the University of British Columbia and addiction medicine specialist recently told Canadian Affairs.

Yet, despite such damning claims, some Canadians remain closed to the possibility that these policies may need to change. Worse, some foster a climate that penalizes dissent.

“Many doctors who initially supported ‘safe supply’ no longer provide it but do not wish to talk about it publicly for fear of reprisals,” Rieb said.

Second, Canadians must look abroad — well beyond the United States — for policy alternatives.

As The Globe and Mail reported in August, Canada and the U.S. have been far harder hit by the drug crisis than European countries.

The article points to a host of potential factors, spanning everything from doctors’ prescribing practices to drug trade flows to drug laws and enforcement.

For example, unlike Canada, most of Europe has not legalized cannabis, the article says. European countries also enforce their drug laws more rigorously.

“According to the UN, Europe arrests, prosecutes and convicts people for drug-related offences at a much higher rate than that of the Americas,” it says.

Addiction treatment rates also vary.

“According to the latest data from the UN, 28 per cent of people with drug use disorders in Europe received treatment. In contrast, only 9 per cent of those with drug use disorders in the Americas received treatment.”

And then there is harm reduction. No other country went “whole hog” on harm reduction the way Canada did, one professor told The Globe.

If we want public order, we should look to the countries that are orderly and identify what makes them different — in a good way.

There is no shame in copying good policies. There should be shame in sticking with failed ones due to ideology.

 

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Addictions

No, Addicts Shouldn’t Make Drug Policy

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By Adam Zivo

Canada’s policy of deferring to the “leadership” of drug users has proved predictably disastrous. The United States should take heed.

[This article was originally published in City Journal, a public policy magazine and website published by the Manhattan Institute for Policy Research]

Progressive “harm reduction” advocates have insisted for decades that active users should take a central role in crafting drug policy. While this belief is profoundly reckless—akin to letting drunk drivers set traffic laws—it is now entrenched in many left-leaning jurisdictions. The harms and absurdities of the position cannot be understated.

While the harm-reduction movement is best known for championing public-health interventions that supposedly minimize the negative effects of drug use, it also has a “social justice” component. In this context, harm reduction tries to redefine addicts as a persecuted minority and illicit drug use as a human right.

This campaign traces its roots to the 1980s and early 1990s, when “queer” activists, desperate to reduce the spread of HIV, began operating underground needle exchanges to curb infections among drug users. These exchanges and similar efforts allowed some more extreme LGBTQ groups to form close bonds with addicts and drug-reform advocates. Together, they normalized the concept of harm reduction, such that, within a few years, needle exchanges would become officially sanctioned public-health interventions.

The alliance between these more radical gay rights advocates and harm-reduction proponents proved enduring. Drug addiction remained linked to HIV, and both groups shared a deep hostility to the police, capitalism, and society’s “moralizing” forces.

In the 1990s, harm-reduction proponents imitated the LGBTQ community’s advocacy tactics. They realized that addicts would have greater political capital if they were considered a persecuted minority group, which could legitimize their demands for extensive accommodations and legal protections under human rights laws. Harm reductionists thus argued that addiction was a kind of disability, and that, like the disabled, active users were victims of social exclusion who should be given a leading role in crafting drug policy.

These arguments were not entirely specious. Addiction can reasonably be considered a mental and physical disability because illicit drugs hijack users’ brains and bodies. But being disabled doesn’t necessarily mean that one is part of a persecuted group, much less that one should be given control over public policy.

More fundamentally, advocates were wrong to argue that the stigma associated with drug addiction was senseless persecution. In fact, it was a reasonable response to anti-social behavior. Drug addiction severely impairs a person’s judgement, often making him a threat to himself and others. Someone who is constantly high and must rob others to fuel his habit is a self-evident danger to society.

Despite these obvious pitfalls, portraying drug addicts as a persecuted minority group became increasingly popular in the 2000s, thanks to several North American AIDS organizations that pivoted to addiction work after the HIV epidemic subsided.

In 2005, the Canadian HIV/AIDS Legal Network published a report titled “Nothing about us without us.” (The nonprofit joined other groups in publishing an international version in 2008.) The 2005 report included a “manifesto” written by Canadian drug users, who complained that they were “among the most vilified and demonized groups in society” and demanded that policymakers respect their “expertise and professionalism in addressing drug use.”

The international report argued that addiction qualified as a disability under international human rights treaties, and called on governments to “enact anti-discrimination or protective laws to reduce human rights violations based on dependence to drugs.” It further advised that drug users be heavily involved in addiction-related policy and decision-making bodies; that addict-led organizations be established and amply funded; and that “community-based organizations . . . increase involvement of people who use drugs at all levels of the organization.”

While the international report suggested that addicts could serve as effective policymakers, it also presented them as incapable of basic professionalism. In a list of “do’s and don’ts,” the authors counseled potential employers to pay addicts in cash and not to pass judgment if the money were spent on drugs. They also encouraged policymakers to hold meetings “in a low-key setting or in a setting where users already hang out,” and to avoid scheduling meetings at “9 a.m., or on welfare cheque issue day.” In cases where addicts must travel for policy-related work, the report recommended policymakers provide “access to sterile injecting equipment” and “advice from a local person who uses drugs.”

The international report further asserted that if an organization’s employees—even those who are former drug users—were bothered by the presence of addicts, then management should refer those employees to counselling at the organization’s expense. “Under no circumstances should [drug addicts] be reprimanded, singled out or made to feel responsible in any way for the triggering responses of others,” stressed the authors.

Reflecting the document’s general hostility to recovery, the international report emphasized that former drug addicts “can never replace involvement of active users” in public policy work, because people in recovery “may be somewhat disconnected from the community they seek to represent, may have other priorities than active users, may sometimes even have different and conflicting agenda, and may find it difficult to be around people who currently use drugs.”

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The messaging in these reports proved highly influential throughout the 2000s and 2010s. In Canada, federal and provincial human rights legislation expanded to protect active addicts on the basis of disability. Reformers in the United States mirrored Canadian activists’ appeals to addicts’ “lived experience,” albeit with less success. For now, American anti-discrimination protections only extend to people who have a history of addiction but who are not actively using drugs.

The harm reduction movement reached its zenith in the early 2020s, after the Covid-19 pandemic swept the world and instigated a global spike in addiction. During this period, North American drug-reform activists again promoted the importance of treating addicts like public-health experts.

Canada was at the forefront of this push. For example, the Canadian Association of People Who Use Drugs released its “Hear Us, See Us, Respect Us” report in 2021, which recommended that organizations “deliberately choose to normalize the culture of drug use” and pay addicts $25-50 per hour. The authors stressed that employers should pay addicts “under the table” in cash to avoid jeopardizing access to government benefits.

These ideas had a profound impact on Canadian drug policy. Throughout the country, public health officials pushed for radical pro-drug experiments, including giving away free heroin-strength opioids without supervision, simply because addicts told researchers that doing so would be helpful. In 2024, British Columbia’s top doctor even called for the legalization of all illicit drugs (“non-medical safer supply”) primarily on the basis of addict testimonials, with almost no other supporting evidence.

For Canadian policymakers, deferring to the “lived experiences” and “leadership” of drug users meant giving addicts almost everything they asked for. The results were predictably disastrous: crime, public disorder, overdoses, and program fraud skyrocketed. Things have been less dire in the United States, where the harm reduction movement is much weaker. But Americans should be vigilant and ensure that this ideology does not flower in their own backyard.

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