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Addictions

New lawsuit challenges Ontario’s decision to prohibit safe consumption services

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Kensington Market Overdose Prevention Site in Toronto, Dec. 18, 2024. [Photo credit: Alexandra Keeler]

By 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 commenta 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.”

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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Addictions

BC overhauls safer supply program in response to widespread pharmacy scam

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By Alexandra Keeler

A B.C. pharmacy scam investigation has led the provincial government to return to a witnessed consumption model for safer supply

More than 60 pharmacies across B.C. are alleged to have participated in a kickback scheme linked to safer supply drugs, according to a provincial report released Feb. 19.

On Feb. 5, the BC Conservatives leaked a report that showed the findings of an internal investigation by the B.C. Ministry of Health. That investigation showed dozens of pharmacies were filling prescriptions patients did not require in order to overbill the government. These safer supply drugs were then diverted onto the black market.

After the report was leaked, the province committed to ending take-home safer supply models, which allow users to take hydromorphone pills home in bottles. Instead, it will require drug users to consume prescribed opioids in a witnessed program, under the oversight of a medical professional.

Gregory Sword, whose 14-year-old daughter Kamilah died in August 2022 after taking a hydromorphone pill that had been diverted from B.C.’s safer supply program, expressed outrage over the report’s findings.

“This is so frustrating to hear that [pharmacies] were making money off this program and causing more drugs [to flood] the street,” Sword told Canadian Affairs on Feb. 20.

The investigation found that pharmacies exploited B.C.’s Frequency of Dispensing policy to maximize billings. To take advantage of dispensing fees, pharmacies incentivized clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market. Pharmacies earned up to $11,000 per patient a year.

“I’m positive that [the B.C. government has] known this for a long time and only made this decision when the public became aware and the scrutiny was high,” said Elenore Sturko, Conservative MLA for Surrey-Cloverdale, who released the leaked report in a statement on Feb. 5.

“As much as I am really disappointed in how long it’s taken for this decision to be made, I am also happy that this has happened,” she said.

The health ministry said it is investigating the implicated pharmacies. Those that are confirmed to have been involved could have their licenses suspended, be referred to law enforcement or become ineligible to participate in PharmaCare, the provincial program that helps residents cover the costs of prescription drugs.

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Witnessed dosing

The leaked report says that “a significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients.” It also says “prescribed alternatives are trafficked provincially, nationally and internationally.”

Critics of the safer supply program say it enables addiction, while supporters say it reduces overdoses.

Sword, Kamilah’s father, is suing the provincial and federal governments, arguing B.C.’s safer supply program made it possible for youth such as his daughter to access drugs.

Madison, Kamilah’s best friend, also became addicted to opioids dispensed through safer supply programs. Madison was just 15 when she first encountered “dillies” — hydromorphone pills dispensed through safer supply, but widely available on the streets. She developed a tolerance that led her to fentanyl.

“I do know for sure that some pharmacies and doctors were aware of the diversion,” Madison’s mother Beth told Canadian Affairs on Feb. 20.

“When I first realized what my daughter was taking and how she was getting it, I phoned the pharmacy and the doctor on the label of the pill bottle to inform them that the patient was selling their hydromorphone,” Beth said.

Masha Krupp, an Ottawa mother who has a son enrolled in a safer supply program, has said the safer supply program in her city is similarly flawed. Canadian Affairs previously reported on this program, which is run by Recovery Care’s Ottawa-based harm reduction clinics.

“I read about the B.C. pharmacy scheme and wasn’t surprised,” Krupp told Canadian Affairs on Feb. 20. Krupp lost a daughter to methadone toxicity while she was in an addiction treatment program at Recovery Care.

“Three years [after starting safer supply], my son is still using fentanyl, crack cocaine and methadone, despite being with Dr. [Charles] Breau and with Recovery Care for over three years,” Krupp testified before the House of Commons Standing Committee on Health on Oct. 22, 2024.

Krupp has been vocal about the dangers of dispensing large quantities of opioids without proper oversight, arguing many patients sell their prescriptions to buy stronger street drugs.

“You can’t give addicts 28 pills and say, ‘Oh here you go,’” she said in her testimony. “They sell for three dollars a pop on the street.”

Krupp has also advocated for witnessed consumption of safer supply medications, arguing supervised dosing would prevent diversion and ensure proper oversight of pharmacies.

“I had talked about witnessed dosing for safe supply when I appeared before the parliamentary health committee last October,” she told Canadian Affairs this week.

“I’m grateful that finally … this decision has been made to return to a witness program,” said Sturko, the B.C. MLA.

In 2020, B.C. implemented a witnessed consumption model to ensure safer supply opioids were consumed as prescribed and to reduce diversion. In 2021, the province switched to take-home models. Its stated aim was to expand access, save lives and ease pressure on health-care facilities during the pandemic.

“You’re really fighting against a group of people … working within the bureaucracy of [the B.C. NDP] government … who have been making efforts to work towards the legalization of drugs and, in doing that, have looked only for opportunities to bolster their arguments for their position, instead of examining their approach in a balanced way,” said Sturko.

“These are foreseeable outcomes when you do not put proper safeguards in place and when you completely ignore all indications of negative impacts.”

Sword also believes some drug policies fail to prioritize the safety of vulnerable individuals.

“Greed is the ultimate evil in society and this just proves it,” he said. We don’t care about these drugs getting into the wrong hands as long as I get my money.”


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.

Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.

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Addictions

Calls for Public Inquiry Into BC Health Ministry Opioid Dealing Corruption

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Sam Cooper

The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.

A confidential investigation by British Columbia’s Ministry of Health, Financial Operations and Audit Branch has uncovered explosive allegations of fraud, abuse, and organized crime infiltration within PharmaCare’s prescribed opioid alternatives program. Internal audit findings, obtained by The Bureau, suggest that millions of taxpayer dollars are being diverted into illicit drug trafficking networks rather than serving harm reduction efforts.

The leaked documents include photographs from vehicle searches that show collections of fentanyl patches and Dilaudid (hydromorphone) apparently packaged for resale after being stolen from the taxpayer-funded “safer supply” program. This program expanded dramatically following a federal law change implemented by Prime Minister Justin Trudeau’s government in 2020, which broadened circumstances in which pharmacy staff could dispense opioids, according to the document’s evidence.

“Prior to March 17, 2020, only pharmacists in BC were permitted to deliver [addiction therapy treatment] drugs,” the audit says.

B.C.’s safer supply program was launched in March 2020 as a response to the opioid overdose crisis, declared in 2016. It allows people with opioid-use disorder to receive prescribed drugs to be used on-site or taken away for later use.

The Special Investigations Unit and PharmaCare Audit Intelligence team identified a disturbing link between doctors, pharmacists, assisted living residences, and organized crime, where prescription opioids meant to replace illicit drugs are instead being diverted, sold, and trafficked at scale.

“A significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients,” the document states.

It suggests that financial incentives have created a business model for organized crime, asserting that “prescribed alternatives (safe supply opioids) are trafficked provincially, nationally, and internationally,” and that “proceeds of fraud” are being used to pay incentives to doctors, pharmacists, and intermediaries.

BC Conservative critic Elenore Sturko, a former RCMP officer, began raising concerns about the program two years ago after hearing anecdotes about prescribed opioids being trafficked. She asserts that the program is a failure in public policy and insists that Provincial Health Officer Dr. Bonnie Henry be dismissed for having “denied and downplayed” problems as they emerged. Sturko also argues that B.C. must change its drug policy in light of U.S. President Donald Trump’s stance linking the trafficking of fentanyl and other opioids to potential trade sanctions against Canada.

The document shows that PharmaCare’s dispensing fee loophole has incentivized pharmacies to maximize billings per patient, with some locations charging up to $11,000 per patient per year—compared to just $120 in normal cases.

Perhaps most alarming is the deep infiltration of B.C.’s safer supply program by criminal networks. The Ministry of Health report lists “Gang Members/Organized Crime” as key players in the prescription drug pipeline, which includes “Doctors, pharmacies, and assisted living residences.”

This revelation confirms long-standing fears that B.C.’s “safe supply” policy—originally designed to prevent deaths from contaminated street drugs—is instead sometimes supplying criminal organizations with pharmaceutical-grade opioids.

The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.

Beyond organized crime’s direct involvement, pharmacies themselves have exploited regulatory gaps to generate massive profits from PharmaCare’s policies:

  • Pharmacies offer kickbacks to doctors, housing staff, and medical professionals to steer patients toward specific locations.
  • Financial incentives fuel fraud, with multiple investigations identifying 60+ pharmacies offering incentives to clients.
  • Non-health professionals, including housing staff, are witnessing OAT (opioid agonist treatment) dosing, violating patient safety protocols.

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