Experts did not recommend closing Leslieville drug consumption site
‘Consumption treatment services are a necessary public health service,’ says report commissioned by province
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.
Premier Doug Ford acknowledged the expert reports at an unrelated news conference in St. Catharines, Ont., Wednesday afternoon and reiterated the sites don't belong near schools or daycares.
"You wouldn't like it" if a consumption site was next to your home, Ford said, adding that he's received "endless calls, non-stop on my cell phone [from Leslieville residents], saying 'thank you for doing this.'"
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."
In a statement on Wednesday, Unity Health Toronto, which conducted one of the reviews, welcomed the new provincial spending for addictions and mental health.
"We are concerned about the reduction in access to supervised consumption, which evidence shows saves lives, reduces pressure on emergency services and helps connect people to treatment," the statement also says.
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.
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 incidence of fatal overdoses, help reduce the transmission of HIV, hepatitis C, and other 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."
However, Ford said he considers the sites "a failed policy, simple as that."
"Giving someone, an addict, a place to do their injections, we haven't seen it get better," he said. "This was supposed to be the greatest thing since sliced bread. It's the worst thing that could ever happen to a community, to have one of these safe injection sites in their neighbourhood."
Dan Werb, executive director of the Centre on Drug Policy Evaluation at St. Michael's Hospital, co-authored a study published in the medical journal The Lancet earlier this year, which showed a two-thirds reduction in overdose mortality in Toronto within five kilometres of a supervised consumption site.
"It's quite odd to me that you should shut down what is a really effective gateway into a treatment and care system at the same time that you're investing so much into that same treatment care system," he said Wednesday.
"It's sort of like building a hospital and forgetting to build doors into it."
In a statement, Ontario NDP Leader Marit Stiles criticized Ford's government for "putting ideology over evidence."
"The Ford government's own reviews tell a very different story from the one they have been telling to justify this dangerous shift in policy. To take away these services in the midst of a crisis is going to cost lives," Stiles said.
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."
With files from Mike Crawley