Addictions
New lawsuit challenges Ontario’s decision to prohibit safe consumption services
Kensington Market Overdose Prevention Site in Toronto, Dec. 18, 2024. [Photo credit: Alexandra Keeler]
Critics says Ontario’s plan to replace supervised consumption sites with HART Hubs will exacerbate harms to drug addicts and strain the health-care system
The operator of a Toronto overdose prevention site is challenging Ontario’s decision to prohibit 10 supervised consumption sites from offering their services.
In December, Neighbourhood Group Community Services and two individuals launched a constitutional challenge to Ontario legislation that imposes 200-metre buffer zones between supervised consumption sites and schools and daycares. The Neighbourhood Group will be forced to close its site in Toronto’s Kensington Market as a result.
In its court challenge, the organization is arguing site closures discriminate against individuals with “substance use disabilities” and increase drug users’ risk of death and disease.
The challenge is the latest sign of growing opposition to Ontario’s decision to either shutter supervised consumption sites or transition them into Homelessness and Addiction Recovery Treatment (HART) Hubs. The hubs will offer drug users a range of primary care and housing solutions, but not supervised consumption, needle exchanges or the “safe supply” of prescription drugs.
Critics say the decision to suspend supervised consumption services will harm drug users and the health-care system.
“We’re very happy that the HART Hubs are being funded,” said Bill Sinclair, CEO of Neighbourhood Group Community Services. “They’re a great asset to the community.”
“[But] we want HART Hubs and we want supervised consumption sites.”
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‘Come under fire’
On Thursday, the Ontario government announced that nine of the 10 supervised consumption sites located near centres with children would transition into HART Hubs. The Neighbourhood Group’s site is the only one not offered the opportunity to transition, because it is not provincially funded.
Laila Bellony, a harm reduction manager at a supervised consumption site at the Parkdale Queen West Community Health Centre in Toronto, says she is worried that drug users may avoid using HART Hubs altogether if they do not facilitate the use of drugs under the supervision of trained staff.
Data show this oversight can prevent deaths by facilitating immediate intervention in the event of an overdose.
Bellony is also concerned the site closures will increase the strain on other health-care services. She predicts longer wait times and bed shortages in hospital emergency rooms, as well as increased paramedic response times.
“I think the next thing that will happen is the medical or health-care system is going to come under fire for being sub-par. But it’s really all starting here from this decision,” she said.
She questions how the HART Hubs will meet demand for detox and recovery services or housing solutions.
Parkdale Queen West Community Health Centre and its sister site, the Queen West Site, serve hundreds of clients, Bellony says. By contrast, Ontario’s HART Hub rollout plan indicates all 19 hubs will together provide 375 new housing units across the province.
“The HART Hub model is not a horrible model,” said Bellony. “It’s the way that it’s being implemented that’s ill-informed.”
In a response to requests for comment, a media spokesperson for the Ontario Ministry of Health directed Canadian Affairs to its August news release. That release lists proposals for increased safety measures at remaining sites, and a link to a HART Hub “client journey.”
On Dec. 3, the Auditor General of Ontario, Shelley Spence, released a report criticizing the health ministry’s “outdated” opioid strategy, noting it has not been updated since 2016.
National data show a 6.7 per cent drop in opioid deaths in early 2024. But experts caution it is too soon to call it a lasting trend. Opioid toxicity deaths in 2023 were up 205 per cent from 2016.
“We concluded that the Ministry does not have effective processes in place to meet the challenging and changing nature of the opioid crisis in Ontario,” the auditor general’s report says.
“The Ministry did not … provide a thorough, evidence-based business case analysis for the 2024 new model … [HART Hubs] to ensure that they are responsive to the needs of Ontarians.”
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Parkdale Queen West Community Health Centre’s Queen West Site in Toronto, Dec. 18, 2024. [Photo credit: Alexandra Keeler]
‘Ill-informed’
Ontario has cited crime and public safety concerns as reasons for blocking supervised consumption sites near centres with children from offering their services.
“In Toronto, reports of assault in 2023 are 113 per cent higher and robbery is 97 per cent higher in neighbourhoods near these sites compared to the rest of the city,” Ontario Health Minister Sylvia Jones’ office said in an Aug. 20 press release.
The province has also cited concerns about prescription drugs dispensed through safer supply programs being diverted to the black market.
Police chiefs and sergeants in the Ontario cities of London and Ottawa have confirmed safer supply diversion is occurring in their municipalities.
“We are seeing significant increases in the availability of the diverted Dilaudid eight-milligram tablets, which are often prescribed as part of the safe supply initiatives,” London Police Chief Thai Truong said at a Nov. 26 parliamentary committee meeting examining the effect of the opioid epidemic and strategies to address it.
But Bellony disputes the claim that neighbourhoods with supervised consumption sites experience higher crime rates.
“Some of the things that [the ministry is] saying in terms of crime being up in neighborhoods with safe consumption sites — that’s not necessarily true,” she said.
In response to requests for information about the city’s crime rates, Nadine Ramadan, a senior communications advisor for the Toronto Police Service, directed Canadian Affairs to the service’s crime rate portal.
The portal shows assaults, break-and-enters and robberies in the West Queen West neighborhood have remained relatively stable since the Queen West supervised consumption site opened in 2018.
In contrast, crime rates are higher in some nearby neighbourhoods without supervised consumption sites, such as The Junction.
“While I can’t speak to perceptions about a rise in crime specifically around supervised consumption sites, I can tell you that violent crime is increasing across the GTA,” Ramadan told Canadian Affairs. She referred questions about Jones’ statements about crime data to the health minister’s office.
Jones’ office did not respond to multiple follow-up inquiries.
Mixed feelings
In July, Canadian Affairs reported that business owners in the West Queen West neighbourhood were grappling with a surge in drug-related crime.
Rob Sysak, executive director of the West Queen West Business Improvement Association, says there are mixed feelings about their neighbourhood’s site ceasing to offer safe consumption services.
“I’m not saying [the closure] is a positive or negative decision, because we won’t know until after a while,” said Sysak, whose association works to promote business in the area.
Sysak says he has heard concerns from business owners that needles previously used by individuals at the site may now end up on the street.
Bellony supports the concept of HART Hubs offering addiction and support services. But she says she finds the province’s plan for the hubs to be unclear and unrealistic.
“It seems very much like they kind of skipped forward to the ideal situation at the end,” she said. “But all the steps that it takes to get there … are unaddressed.”
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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News release from Alberta RCMP
Virtual Opioid Dependency Program serves vulnerable population in Red Deer
Since April 2024, your Alberta RCMP’s Community Safety and Well-being Branch (CSWB) has been piloting the Virtual Opioid Dependency Program (VODP) program in Red Deer to assist those facing opioid dependency with initial-stage intervention services. VODP is a collaboration with the Government of Alberta, Recovery Alberta, and the Alberta RCMP, and was created to help address opioid addiction across the province.
Red Deer’s VODP consists of two teams, each consisting of a police officer and a paramedic. These teams cover the communities of Red Deer, Innisfail, Blackfalds and Sylvan Lake. The goal of the program is to have frontline points of contact that can assist opioid users by getting them access to treatment, counselling, and life-saving medication.
The Alberta RCMP’s role in VODP:
- Conducting outreach in the community, on foot, by vehicle, and even UTV, and interacting with vulnerable persons and talking with them about treatment options and making VODP referrals.
- Attending calls for service in which opioid use may be a factor, such as drug poisonings, open drug use in public, social diversion calls, etc.
- Administering medication such as Suboxone and Sublocade to opioid users who are arrested and lodged in RCMP cells and voluntarily wish to participate in VODP; these medications help with withdrawal symptoms and are the primary method for treating opioid addiction. Individuals may be provided ongoing treatment while in police custody or incarceration.
- Collaborating with agencies in the treatment and addiction space to work together on client care. Red Deer’s VODP chairs a quarterly Vulnerable Populations Working Group meeting consisting of a number of local stakeholders who come together to address both client and community needs.
While accountability for criminal actions is necessary, the Alberta RCMP recognizes that opioid addiction is part of larger social and health issues that require long-term supports. Often people facing addictions are among offenders who land in a cycle of criminality. As first responders, our officers are frequently in contact with these individuals. We are ideally placed to help connect those individuals with the VODP. The Alberta RCMP helps those individuals who wish to participate in the VODP by ensuring that they have access to necessary resources and receive the medical care they need, even while they are in police custody.
Since its start, the Red Deer program has made nearly 2,500 referrals and touchpoints with individuals, discussing VODP participation and treatment options. Some successes of the program include:
- In October 2024, Red Deer VODP assessed a 35-year-old male who was arrested and in police custody. The individual was put in contact with medical care and was prescribed and administered Suboxone. The team members did not have any contact with the male again until April 2025 when the individual visited the detachment to thank the team for treating him with care and dignity while in cells, and for getting him access to treatment. The individual stated he had been sober since, saying the treatment saved his life.
- In May 2025, the VODP team worked with a 14-year-old female who was arrested on warrants and lodged in RCMP cells. She had run away from home and was located downtown using opioids. The team spoke to the girl about treatment, was referred to VODP, and was administered Sublocade to treat her addiction. During follow-up, the team received positive feedback from both the family and the attending care providers.
The VODP provides same-day medication starts, opioid treatment transition services, and ongoing opioid dependency care to people anywhere in Alberta who are living with opioid addiction. Visit vodp.ca to learn more.
“This collaboration between Alberta’s Government, Recovery Alberta and the RCMP is a powerful example of how partnerships between health and public safety can change lives. The Virtual Opioid Dependency Program can be the first step in a person’s journey to recovery,” says Alberta’s Minister of Mental Health and Addiction Rick Wilson. “By connecting people to treatment when and where they need it most, we are helping build more paths to recovery and to a healthier Alberta.”
“Part of the Alberta RCMP’s CSWB mandate is the enhancement of public safety through community partnerships,” says Supt. Holly Glassford, Detachment Commander of Red Deer RCMP. “Through VODP, we are committed to building upon community partnerships with social and health agencies, so that we can increase accessibility to supports in our city and reduce crime in Red Deer. Together we are creating a stronger, safer Alberta.”
By Alexandra Keeler
Across Canada, mobile health models are increasingly being used to offer care to rural and underserved communities
Saskatchewan has launched a small fleet of mobile wellness buses to improve access to primary health care, mental health and addiction services in the province.
The first bus began operating in Regina on Feb. 12. Another followed in Prince Albert on March 21. Saskatoon’s bus was unveiled publicly on April 9. All three are former coach buses that have been retrofitted to provide health care to communities facing barriers to access.
“Mobile health units are proven to improve outcomes for people facing barriers to healthcare,” Kayla DeMong, the executive director of addiction treatment centre Prairie Harm Reduction, told Canadian Affairs in an email.
“We fully support this innovative approach and are excited to work alongside the health bus teams to ensure the people we support receive the care they need, when and where they need it.”
Wellness buses
Like all provinces, Saskatchewan has been grappling with the opioid crisis.
In 2023, an estimated 457 individuals died from overdoses in the province. In 2024, that number fell to 346. But the province continues to struggle with fatal and non-fatal overdoses.
In late February, Saskatoon firefighters responded to more than 25 overdoses in a single 24-hour period. Just over a week later, they responded to 37 overdoses within another 24-hour window.
Saskatchewan’s wellness buses are part of the province’s plan to address these problems. In April 2025, the province announced $2.4 million to purchase and retrofit three coach buses, plus $1.5 million in annual operating funds.
The buses operate on fixed schedules at designated locations around each city. Each bus is staffed with a nurse practitioner, nurse and assessor coordinator who offer services such as overdose reversal kits, addiction medicine and mental health referrals.
“By bringing services directly to where people are, the health buses foster safer, more welcoming spaces and help build trusting relationships between community members and care providers,” said DeMong, executive director of Prairie Harm Reduction.
Saskatoon-based Prairie Harm Reduction is one of the local organizations that partners with the buses to provide additional support services. Prairie Harm Reduction provides a range of family, youth and community supports, and also houses the province’s only fixed supervised consumption site.
The mobile model
Saskatchewan is not the only province using wellness buses. Across Canada, mobile health models are increasingly being used to expand access to care in rural and underserved communities.
In Kingston, Ont., the Street Health Centre operates a retrofitted RV called PORCH (Portable Outreach Care Hub) that serves individuals struggling with homelessness and addiction.
“Our outreach services are extremely popular with our clients and community partners,” Donna Glasspoole, manager at Street Health Centre, said in an emailed statement.
“PORCH hits the road two to three days/week and offers a variety of services, which are dependent on the health care providers and community partners aboard.”
Street Health Centre also has a shuttle service that picks up clients in shelters and brings them to medical clinics or addiction medicine clinics.
The PORCH vehicles are not supported by provincial funding, but instead rely on support from the United Way and other grants. Glasspoole says the centre’s permanent location — which does receive government funding — is more cost-effective to operate.
“The vehicles are expensive to operate and our RV is not great in winter months and requires indoor parking,” she said.
Politically palatable
Many mobile health models currently do not provide controversial services such as supervised drug consumption.
The Saskatchewan Health Authority told Canadian Affairs the province’s new wellness buses will not offer supervised consumption services or safer supply, where drug users are given prescribed opioids as an alternative to toxic street drugs.
“There are no plans to provide supervised consumption services from the wellness buses,” Saskatchewan Health Authority spokesperson Courtney Markewich told Canadian Affairs in a phone call.
This limited scope may make mobile services more politically palatable in provinces that have resisted harm reduction measures.
In Ontario, some harm reduction programs have shifted to mobile models following Premier Doug Ford’s decision to suspend supervised consumption services located within 200 metres of schools and daycares.
In April, Toronto Public Health ended operations at its Victoria Street fixed consumption site, replacing it with street outreach and mobile vans.
The Ontario government’s decision to close the sites is part of a broader pivot away from harm reduction. The province is investing $378 million to transition suspended sites into 19 new “HART Hubs” that offer primary care, mental health, addictions treatment and other supports.
Glasspoole says that what matters most is not whether services are provided at fixed or mobile locations, but how care is delivered.
Models that “reduce barriers to care, [are] non-judgemental, and [are staffed by] trauma-informed providers” are what lead more people toward treatment and recovery, she said in her email.
In Saskatchewan, DeMong hopes the province’s new wellness buses help address persistent service gaps and build trust with underserved communities.
“This initiative is a vital step toward filling long-standing gaps in the continuum of care by providing low-barrier, community-based access to health-care services,” she said.
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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