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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2025 Federal Election
Poilievre to invest in recovery, cut off federal funding for opioids and defund drug dens
From Conservative Party Communications
Poilievre will Make Recovery a Reality for 50,000 Canadians
Conservative Leader Pierre Poilievre pledged he will bring the hope that our vulnerable Canadians need by expanding drug recovery programs, creating 50,000 new opportunities for Canadians seeking freedom from addiction. At the same time, he will stop federal funding for opioids, defund federal drug dens, and ensure that any remaining sites do not operate within 500 meters of schools, daycares, playgrounds, parks and seniors’ homes, and comply with strict new oversight rules that focus on pathways to treatment.
More than 50,000 people have lost their lives to fentanyl since 2015—more Canadians than died in the Second World War. Poilievre pledged to open a path to recovery while cracking down on the radical Liberal experiment with free access to illegal drugs that has made the crisis worse and brought disorder to local communities.
Specifically, Poilievre will:
- Fund treatment for 50,000 Canadians. A new Conservative government will fund treatment for 50,000 Canadians in treatment centres with a proven record of success at getting people off drugs. This includes successful models like the Bruce Oake Recovery Centre, which helps people recover and reunite with their families, communities, and culture. To ensure the best outcomes, funding will follow results. Where spaces in good treatment programs exist, we will use them, and where they need to expand, these funds will allow that.
- Ban drug dens from being located within 500 metres of schools, daycares, playgrounds, parks, and seniors’ homes and impose strict new oversight rules. Poilievre also pledged to crack down on the Liberals’ reckless experiments with free access to illegal drugs that allow provinces to operate drug sites with no oversight, while pausing any new federal exemptions until evidence justifies they support recovery. Existing federal sites will be required to operate away from residential communities and places where families and children frequent and will now also have to focus on connecting users with treatment, meet stricter regulatory standards or be shut down. He will also end the exemption for fly-by-night provincially-regulated sites.
“After the Lost Liberal Decade, Canada’s addiction crisis has spiralled out of control,” said Poilievre. “Families have been torn apart while children have to witness open drug use and walk through dangerous encampments to get to school. Canadians deserve better than the endless Liberal cycle of crime, despair, and death.”
Since the Liberals were first elected in 2015, our once-safe communities have become sordid and disordered, while more and more Canadians have been lost to the dangerous drugs the Liberals have flooded into our streets. In British Columbia, where the Liberals decriminalized dangerous drugs like fentanyl and meth, drug overdose deaths increased by 200 percent.
The Liberals also pursued a radical experiment of taxpayer-funded hard drugs, which are often diverted and resold to children and other vulnerable Canadians. The Vancouver Police Department has said that roughly half of all hydromorphone seizures were diverted from this hard drugs program, while the Waterloo Regional Police Service and Niagara Regional Police Service said that hydromorphone seizures had exploded by 1,090% and 1,577%, respectively.
Despite the death and despair that is now common on our streets, bizarrely Mark Carney told a room of Liberal supporters that 50,000 fentanyl deaths in Canada is not “a crisis.” He also hand-picked a Liberal candidate who said the Liberals “would be smart to lean into drug decriminalization” and another who said “legalizing all drugs would be good for Canada.”
Carney’s star candidate Gregor Robertson, an early advocate of decriminalization and so-called safe supply, wanted drug dens imposed on communities without any consultation or public safety considerations. During his disastrous tenure as Vancouver Mayor, overdoses increased by 600%.
Alberta has pioneered an approach that offers real hope by adopting a recovery-focused model of care, leading to a nearly 40 percent reduction in drug-poisoning deaths since 2023—three times the decrease seen in British Columbia. However, we must also end the Liberal drug policies that have worsened the crisis and harmed countless lives and families.
To fund this policy, a Conservative government will stop federal funding for opioids, defund federal drug dens, and sue the opioid manufacturers and consulting companies who created this crisis in the first place.
“Canadians deserve better than the Liberal cycle of crime, despair, and death,” said Poilievre. “We will treat addiction with compassion and accountability—not with more taxpayer-funded poison. We will turn hurt into hope by shutting down drug dens, restoring order in our communities, funding real recovery, and bringing our loved ones home drug-free.”
By Adam Zivo
Sweden, the U.K., and Canada all experimented with providing opioids to addicts. The results were disastrous.
[This article was originally published in City Journal, a public policy magazine and website published by the Manhattan Institute for Policy Research. We encourage our readers to subscribe to them for high-quality analysis on urban issues]
Last August, Denver’s city council passed a proclamation endorsing radical “harm reduction” strategies to address the drug crisis. Among these was “safer supply,” the idea that the government should give drug users their drug of choice, for free. Safer supply is a popular idea among drug-reform activists. But other countries have already tested this experiment and seen disastrous results, including more addiction, crime, and overdose deaths. It would be foolish to follow their example.
The safer-supply movement maintains that drug-related overdoses, infections, and deaths are driven by the unpredictability of the black market, where drugs are inconsistently dosed and often adulterated with other toxic substances. With ultra-potent opioids like fentanyl, even minor dosing errors can prove fatal. Drug contaminants, which dealers use to provide a stronger high at a lower cost, can be just as deadly and potentially disfiguring.
Because of this, harm-reduction activists sometimes argue that governments should provide a free supply of unadulterated, “safe” drugs to get users to abandon the dangerous street supply. Or they say that such drugs should be sold in a controlled manner, like alcohol or cannabis—an endorsement of partial or total drug legalization.
But “safe” is a relative term: the drugs championed by these activists include pharmaceutical-grade fentanyl, hydromorphone (an opioid as potent as heroin), and prescription meth. Though less risky than their illicit alternatives, these drugs are still profoundly dangerous.
The theory behind safer supply is not entirely unreasonable, but in every country that has tried it, implementation has led to increased suffering and addiction. In Europe, only Sweden and the U.K. have tested safer supply, both in the 1960s. The Swedish model gave more than 100 addicts nearly unlimited access through their doctors to prescriptions for morphine and amphetamines, with no expectations of supervised consumption. Recipients mostly sold their free drugs on the black market, often through a network of “satellite patients” (addicts who purchased prescribed drugs). This led to an explosion of addiction and public disorder.
Most doctors quickly abandoned the experiment, and it was shut down after just two years and several high-profile overdose deaths, including that of a 17-year-old girl. Media coverage portrayed safer supply as a generational medical scandal and noted that the British, after experiencing similar problems, also abandoned their experiment.
While the U.S. has never formally adopted a safer-supply policy, it experienced something functionally similar during the OxyContin crisis of the 2000s. At the time, access to the powerful opioid was virtually unrestricted in many parts of North America. Addicts turned to pharmacies for an easy fix and often sold or traded their extra pills for a quick buck. Unscrupulous “pill mills” handed out prescriptions like candy, flooding communities with OxyContin and similar narcotics. The result was a devastating opioid epidemic—one that rages to this day, at a cumulative cost of hundreds of thousands of American lives. Canada was similarly affected.
The OxyContin crisis explains why many experienced addiction experts were aghast when Canada greatly expanded access to safer supply in 2020, following a four-year pilot project. They worried that the mistakes of the recent past were being made all over again, and that the recently vanquished pill mills had returned under the cloak of “harm reduction.”
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Most Canadian safer-supply prescribers dispense large quantities of hydromorphone with little to no supervised consumption. Patients can receive up to 40 eight-milligram pills per day—despite the fact that just two or three are enough to cause an overdose in someone without opioid tolerance. Some prescribers also provide supplementary fentanyl, oxycodone, or stimulants.
Unfortunately, many safer-supply patients sell or trade a significant portion of these drugs—primarily hydromorphone—in order to purchase more potent illicit substances, such as street fentanyl.
The problems with safer supply entered Canada’s consciousness in mid-2023, through an investigative report I wrote for the National Post. I interviewed 14 addiction physicians from across the country, who testified that safer-supply diversion is ubiquitous; that the street price of hydromorphone collapsed by up to 95 percent in communities where safer supply is available; that youth are consuming and becoming addicted to diverted safer-supply drugs; and that organized crime traffics these drugs.
Facing pushback, I interviewed former drug users, who estimated that roughly 80 percent of the safer-supply drugs flowing through their social circles was getting diverted. I documented dozens of examples of safer-supply trafficking online, representing tens of thousands of pills. I spoke with youth who had developed addictions from diverted safer supply and adults who had purchased thousands of such pills.
After months of public queries, the police department of London, Ontario—where safer supply was first piloted—revealed last summer that annual hydromorphone seizures rose over 3,000 percent between 2019 and 2023. The department later held a press conference warning that gangs clearly traffic safer supply. The police departments of two nearby midsize cities also saw their post-2019 hydromorphone seizures increase more than 1,000 percent.
The Canadian government quietly dropped its support for safer supply last year, cutting funding for many of its pilot programs. The province of British Columbia (the nexus of the harm-reduction movement) finally pulled back support last month, after a leaked presentation confirmed that safer-supply drugs are getting sold internationally and that the government is investigating 60 pharmacies for paying kickbacks to safer-supply patients. For now, all safer-supply drugs dispensed within the province must be consumed under supervision.
Harm-reduction activists have insisted that no hard evidence exists of widespread diversion of safer-supply drugs, but this is only because they refuse to study the issue. Most “studies” supporting safer supply are produced by ideologically driven activist-scholars, who tend to interview a small number of program enrollees. These activists also reject attempts to track diversion as “stigmatizing.”
The experiences of Sweden, the United Kingdom, and Canada offer a clear warning: safer supply is a reliably harmful policy. The outcomes speak for themselves—rising addiction, diversion, and little evidence of long-term benefit.
As the debate unfolds in the United States, policymakers would do well to learn from these failures. Americans should not be made to endure the consequences of a policy already discredited abroad simply because progressive leaders choose to ignore the record. The question now is whether we will repeat others’ mistakes—or chart a more responsible course.
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