In recent weeks, the Ford Government made an unexpected announcement to close 10 of 17 Supervised Consumption Sites (SCS) across Ontario, thanks to new zoning regulations regarding proximity to schools and daycares. The likes of Premier Ford and Conservative leader Pierre Poilievre blame those struggling in our communities for the problems created by a capitalist society. Closing SCSs is a clear attack on our most vulnerable community members, and is nothing short of class antagonism.
The Ford government’s decision is irresponsible
Under the new regulations to be implemented by March 2025, SCSs would not be allowed within 200 meters of schools or daycares (previously 150 meters). This change puts 10 sites within this range, thus they are expected to close their doors in March 2025 without. The Ford government also announced a “new model” that focuses on treatment, seemingly without a harm reduction or public health lens. These decisions were all made without the consultation of people who use drugs (PWUD), frontline staff, social service organizations, healthcare experts, or the municipal governments. The alternative proposed is the creation of Homeless Addiction Recovery Treatment (HART) Hubs. These hubs would not include life saving overdose response nor needle exchange programs. Instead of continuing an evidence based model of SCSs, the government is sidelining science.
This decision is straight from the Ford playbook — to attack and divide the working class. Despite evidence that public healthcare, including SCSs, support safer communities and support public health broadly, the conservative government is fear mongering to scapegoat those experiencing homelessness and who use substances.
Supervised Consumption Sites are vital to the health and safety of our communities. While overdose response is the foundational aspect of these sites, the true impact extends far beyond that. SCSs provide significant cost savings to the healthcare system, reduce public drug use and discarded paraphernalia, facilitate access to essential wrap-around services, and most importantly, keep people alive.
A brief history of SCS
Supervised Consumption Sites were started out of necessity by grassroots activists who saw their friends and community dying due to an unregulated drug supply. Before these services were regularized, there were no safe places to use substances. While naloxone (the drug used to reverse an opioid overdose) was available, it was not the most effective and trauma-informed response to an opioid overdose. Lives were being lost, and the health impacts from using in a criminalized and stigmatized environment were evident. These grassroots organizers in Ontario set up illegal sites in parks, and volunteered their time to keep people safe and alive.
Through mobilization of community and creation of evidence-based practices, the first SCS opened in Ontario in 2017. Since then, growing evidence from their operation shows that these services are essential and not only support wider public health needs — they save lives.
SCS are a healthcare necessity
One of the most evident reasons for the existence of SCSs are the cost savings they generate for the healthcare system. Consider the cost of treating HIV, which can run into hundreds of thousands of dollars over a person’s lifetime. The use of new and unused needles provided by these sites supports the prevention of chronic diseases such as HIV or Hep C. Preventing even a single transmission has a profound financial impact.
Furthermore, emergency room admissions due to overdoses are significantly lowered. Thousands of overdoses are treated each year solely by the staff at these sites. If these incidents occurred outside, emergency medical services (EMS) would be tied up responding to these calls, which often require prolonged attention and hospital transfers.
Lastly, SCSs offer primary care in a non-judgmental environment. Nurses address important health issues such as wounds and infections that might otherwise go untreated. These sites also provide harm reduction education that supports preventive care for these conditions. By providing care that regards the root causes of these conditions, such as homelessness and poverty, they prevent costly hospital admissions.
In Toronto alone, over 100,000 injections occur annually within SCSs. Crucially, 100 percent of the syringes used are disposed of safely in sharps bins. Without these sites, hundreds of thousands of needles would be discharged unsafely. The injections would likely occur in public spaces, leading to hazardous waste and increased public drug use.
SCSs do more than just provide a place to inject safely — they are critical hubs for connecting people with additional support. Since many sites are located within health centers, those using the services can access primary care, social workers, housing supports, and if they choose -‒ treatment. The integration of service access with a safe injection environment is crucial. Many individuals fail to follow through with other support programs simply because they must choose between accessing those services and managing withdrawal symptoms. At SCSs, they don’t have to make that choice—they can do both, which significantly improves outcomes.
Reducing overdose deaths
In May, Toronto Public Health confirmed that there were 523 overdose related deaths in Toronto last year. This is a 74 percent increase from 2019, underscoring the dangers of an unregulated drug supply. Its cause is not that more people are using drugs, but far more are overdosing due to the potency and unpredictability of unregulated substances. Moss Park CTS, a SCS in Toronto, reversed 67 overdoses in July 2024 — 67 potentially fatal overdoses in one month from just one SCS. Programs such as Safer Opioid Supply (SOS), which prescribe a pharmaceutical grade opioid such as dilaudid or hydromorphone, have shown success in decreasing the amount of overdoses in patients on the program. This is because people on the program use less unregulated fentanyl where the potency is unknown.
Unfortunately, these life saving programs have also been cut by the conservative government. As unregulated substances such as fentanyl are unpredictable in their toxicity, those using these substances are at high risk of an overdose, which can lead to death. A SCS is a health centre where trained staff supervise substance use and respond to overdoses when they occur. Those that oppose SCSs are by default supporting unsupervised injection — an option that is far more dangerous and costly for both individuals and society.
SCSs are not just places where people can inject drugs; they are essential community resources that save lives, reduce public health risks, and alleviate burdens on our healthcare and emergency response systems. Ignoring their benefits is a costly mistake we cannot afford to make.
Closure of SCSs is a class issue
Last year, I wrote an article outlining the need for SCSs and how violence is not a side effect of having a safe injection site or PWUD in a community but of poverty. SCSs provide a safe place for people to use drugs in a friendly and non judgemental environment. Violent crime, according to Toronto Police themselves, has decreased in the city; there is no evidence that suggests SCSs increase violence or crime. Unfortunately, PWUD and those living in poverty are again being scapegoated instead of addressing the larger systemic issues that our government continues to ignore.
In the new HART Hub model, the Conservatives boasted about their implementation of 375 supportive housing units. In Toronto alone, there are over 10,000 estimated people who are unhoused or precariously housed. 375 units are nowhere near enough to address the homelessness crisis, and they do not address the toxic drug supply nor how they are preventing overdose deaths. Their focus on treatment does not address the underlying conditions that influence substance use such as PTSD, including the trauma of homelessness and poverty. This new model is nothing more than a horribly inadequate housing plan and not one that addresses substance use or the overdose crisis.
In the past year the rhetoric to villainize PWUD has been used to divide our communities and blame poor and unhoused people for structural issues. Instead of supporting our struggling neighbours and community members, the right wing has chosen to target a marginalised population with fear mongering. People like Doug Ford and Pierre Polieve use this tactic to divide the poor and working class; they blame the most vulnerable people in our communities to shift focus away from the fact that their policies create the conditions for poverty and the unregulated drug trade. Throughout history, prohibition has never stopped the distribution of the substances people used — it has only made using those substances unsafe. Closing safe consumption sites will not make our communities safer, nor will it stop drug use. Closing SCSs will just make it more visible.
Drug use has never been the reason that SCSs or other harm reduction services are attacked. Many people in society use drugs for various reasons, and addiction is a complex issue that requires supportive and non-judgemental healthcare services. Using illicit substances is common across many walks of life; the issue is not the drugs but about who is using them. While the middle and upper class also use substances, they are not being targeted. While not everyone using SCSs is unhoused, many people who are homeless and consume drugs use these services as a community environment to safely use in. The “war on drugs” is not about drugs, but about controlling and incarcerating poor and working class people. Due to the nature of homelessness, those without housing and who use substances are more visible in our communities as they have limited places to use privately or safely. SCSs are a place for vulnerable people to use safely and access community, along with healthcare and social services. The “war on drugs” is a war on the poor. Closing SCSs is a class issue.
Prison industrial complex
In 2022, close to 11,000 “offenses” in Ontario were drug related. In Canada, a first time offence for drug possession is a $1000 fine or up to six months in prison. This number increases to $2,000 or up to one year in prison for a second offence. As drug use becomes publicly visible when one is homeless, unhoused individuals are more likely to be arrested for drug possession. Furthermore, people who experience homelessness, like most working class people, are unable to pay the $1,000 (or more) fine, and thus end up serving time in prison. If the consequences for drug possession (for personal use) are a fine, then drug use is only punishable if you are poor.
As such, many people who are both homeless and who will be affected by the closures of the SCSs will also be more vulnerable to incarceration. As their substance use becomes more visible, and with the increase of police in our communities, logic follows that more vulnerable people will be arrested and charged for drug possession. Prison has long been criticised by people like Angela Davis as institutions that are used to hide our societal issues rather than address them:
“Prisons do not disappear social problems, they disappear human beings. Homelessness, unemployment, drug addiction, mental illness, and illiteracy are only a few of the problems that disappear from public view when the human beings contending with them are relegated to cages.”
Instead of housing those who do not have shelter, our society relies on policing and incarceration to “solve” the problem of public drug use and homelessness. This necessitates increases in police budgets and expansion of jails and prisons. Prison labour, where inmates work for far below the minimum wage, is still regular practice in Canada. In the words of Assata Shakur, “If every state had to pay workers to do the jobs prisoners are forced to do, the salaries would amount to billions… Prisons are a profitable business.” While Shakur was speaking about incarceration in America, Canadian prisons functionally aren’t so different. Closing the SCSs — combined with the increase in police budgets in many cities — will lead to mass incarceration of houseless PWUD, hiding our societal issues and creating an even larger exploited labour force in Ontario prisons.
Approximately 20 percent of all people who are incarcerated have a substance use disorder. According to a study from 2016, 1 in 10 overdose deaths occur within a year of being released from prison, 20 percent of these died within a week of release, and 10 percent within 48 hours. This makes it evident that drug use and addiction are not solved through criminalization and incarceration. In fact, it makes it more dangerous for PWUD and those who struggle with substance use to be incarcerated. The combination of SCS closures, which leads to more public substance use, and the criminalization of drug possession will lead to a greater increase in people being targeted by police due to their class position.
SCS closures are a death sentence
Safe Consumption Sites provide life saving services to PWUD, and are an essential part of our healthcare system and fight against the opioid overdose epidemic. Closing these sites due to fear-mongering, and shifting to a abstinence and treatment focused model is removed from an evidence based model of care. Harm reduction, and thus SCSs, have proven to reduce overdose deaths and connect people to other healthcare and social services. The issue isn’t one of drug use, but one deeply rooted in generational poverty and capitalist society that the provincial government will not address. Treatment doesn’t work when people are homeless and surviving day to day on the streets. Treatment doesn’t matter if people are dead.
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