Peel’s opioid strategy hangs in the balance as Ford refuses to back down on shuttering of supervised consumption sites

The Region of Peel’s response to the opioid crisis has been upended by the PC government’s decision to close several supervised consumption sites across the province, sparking fear over Peel’s efforts to reduce an alarming number of deadly opioid poisonings within its borders.   

Over the last decade the health and social harms associated with the overdose crisis have been worsening, with an increasingly toxic drug supply across the region. Between 2005 and 2013 an average of 26 opioid toxicity deaths were reported in Peel annually, but as the street drug supply became more contaminated with deadly additives like fentanyl, the number of people dying from laced drugs surged. 

Between 2018 and 2022 the Region of Peel reported 682 deaths, primarily due to a dangerous drug supply (deaths attributed to opioid toxicity increased by 68 percent from 2018 to 2021). The number of deaths jumped 36 percent between 2019 and 2020 alone, with 156 overdose fatalities in 2020—Peel’s deadliest year of the opioid crisis. Things only got worse from there. 

A total of 189 Peel residents died of an overdose linked to opioids in 2021. That same year also saw the highest rate of emergency department visits for opioid toxicity.

In response to the growing crisis, a report to the Region of Peel in 2022 revealed opioid-related deaths had increased 249 percent since 2014, noting that “without immediate intervention” the harrowing trend was expected to persist. In an effort to act swiftly to combat the rising rates of overdoses the Region prioritized establishing a Supervised Consumption Site (SCS) — a key pillar in the Region’s Integrated Opioid Strategy, approved in 2019, and a critical part of Peel’s long-term strategy to reduce harm.

“Supervised consumption services help prevent and reverse overdoses, decrease the spread of infectious diseases, and reduce public drug use,” it stated. At the time, staff said delaying the implementation of an SCS would result in more preventable deaths.  

But the harm reduction element of the Region’s response was uprooted by the PCs last week in an announcement that left experts, community advocates and healthcare professionals stunned. During the annual conference of the Association of Municipalities of Ontario (AMO) Health Minister Sylvia Jones revealed the Ontario government would be ordering the closure of 10 supervised consumption sites across the province due to their proximity to schools and childcare centres. These sites (five are located in Toronto) will be required to close their doors by March 31, 2025. 

Legislation will also be introduced by the PCs in the fall to prevent any future sites from opening. Instead, the Province will be redirecting funding to 19 new Homelessness and Addiction Recovery Treatment (HART) Hubs. The PCs will not offer safe supply, supervised drug consumption or needle exchange programs.

The announcement came despite clear evidence from countries across the globe that indicate safe injection facilities save lives by reversing overdoses and help reduce risky behaviour like injecting with dirty needles, or sharing needles which can spread infectious diseases. While the purpose of these sites is not treatment, pathways to help people get off drugs are available for users if they are willing and able to take that step.

Minister Jones did not immediately respond to The Pointer’s requests for comment on which reviews or experts the PCs used to support their decision to abandon these sites. 

The decision, which is not grounded in any available healthcare literature or scientific backing, also went against the recommendations outlined in the government’s own review, commissioned after a woman was killed by a stray bullet near a Toronto consumption site at the South Riverdale Community Health Centre last July. While it remains unclear what connection the shooting had to that Toronto location aside from occurring in close proximity, the incident prompted a review of all 17 provincial consumption and treatment sites (CTS) and put on hold the approval of any future sites until the assessments were completed.

Critics have charged Premier Doug Ford, Jones and the rest of the PCs with putting people’s lives at risk just to score political points in potential swing ridings ahead of a provincial election Ford has suggested will be called early.

Residents have heard a string of unsubstantiated claims by the Premier and his health minister, who have repeatedly said safe injection sites are not wanted by communities. It is unclear where their information is coming from. Ford has claimed his family has firsthand knowledge that safe injection sites do not work but has failed to offer details around his vague remarks.

During a press conference Monday, Ford made it clear to reporters he is not backtracking on the decision, stating people should be “grateful” for the latest announcement and that he is “quite proud of what we’re doing.” 

“Certain communities can tolerate [these sites]. The communities I hear [from] don’t want it. It’s very simple. I believe we’re going in the right direction. I’ve seen what works and what doesn’t work and in my opinion, it's a failed policy.” 

Jones, the person who oversees healthcare in the country’s largest province despite no background in any related career, continues to make claims about the efficacy of safe injection sites that contradict data and evidence which show how successful these programs are in jurisdictions across Canada and around the world. 

Ahead of an election, it appears the PCs see the issue as a win in parts of the province that are, ironically, struggling with the ongoing overdose crisis.   

As the PCs stand by the decision to scrap a number of supervised consumption sites, they have not provided any studies or reviews to support the decision to close these facilities which are proven to save lives.

(Government of Ontario)

Two reviews released by the Ministry of Health last week reiterated the need for these facilities, with one study noting they “are a necessary public health service, implemented to save lives and prevent accidental overdose death related to substance use.” 

“Recent evidence demonstrates that these health services make a difference in opioid-related death rates based on proximity to the CTS,” and recommended, in direct contradiction to the Province’s decision, preserving existing locations and expanding harm reduction efforts. 

Questions are now swirling around the future of Peel’s interim site, which opened earlier this year in Brampton, and the initial plan to add sites in downtown Brampton and Cooksville. 

The interim location was approved to meet the urgent need, with funding from Regional reserves to be provided for up to 24 months or until provincial CTS funding could be secured. Staff said at the time that they would learn from the interim site and scale up to a more permanent model that would rely on sustainable funding from the Province. A spokesperson for the Region told The Pointer earlier this year that Peel Public Health would be conducting a review of the site to “assess effective implementation and achievement of intended outcomes for people who use substances.” 

According to data from the Region, in 2023, Peel had 145 opioid-related deaths — an increase over the previous year — with 19 in April, the worst month. In 2024, 27 deaths were reported in Peel between January and April (the latest available data), a 53 percent decrease from the 58 deaths reported during the same period last year.  

“Without a safe place to use, we are sentencing people to death,” Jasmine Flynn, member of the Peel Drug Users Advisory Panel and a harm reduction worker with Moyo Health and Community Services, said in July 2023 upon council’s site approval. “People who use drugs have the right to live, and these services will save lives.” 

In 2019 the Region developed its own Opioid Strategy in an effort to respond to the growing death rate, centered around a four-pillar approach. A needs assessment and feasibility study identified a desperate need for an SCS to reduce substance related harms. It explained, would ultimately prevent overdoses, reduce the risk of transmission of bloodborne illnesses, decrease public drug use and drug litter, and provide linkages to care for people who use drugs. 

The study, which documented the perspectives of people who use substances alongside community perception, found that a large majority of people who use drugs (86.5 percent) would use the service if it were available. It revealed that, in addition to their ability to reduce overdose deaths, these sites “reduce public drug use and publicly discarded injection equipment, increase uptake of social and health services by those at risk, and have proven to be a cost-effective service. SCS do not contribute to higher crime activity in the vicinity surrounding a site or promote drug use.”

Data from the Region of Peel is reporting a decrease in opioid-related deaths so far this year, but numbers have steadily increased over much of the past decade. 

(Region of Peel/Public Health Ontario)

Stigmas have long surrounded the use of these sites to mitigate opioid-related fatalities. The report also found a lack of awareness of the magnitude of drug and substance use leading to morbidity and mortality in Peel. It revealed there was a knowledge gap in residents’ understanding around the services provided at safe consumption sites and that a majority didn’t want one in the region with approximately 61 percent of respondents expressing concerns with a SCS in Peel. This included worries about the site leading to more drug use and trafficking in the area, alongside decreased property values and personal safety concerns. Contrary to such attitudes, often stoked by conservative politicians, safe injection sites have been shown to improve business traffic in communities, reduce visible signs of drug use in areas, contribute to a decline in property crime and vandalism and help address a range of street issues associated with unchecked drug use often exploited by criminal elements that prey on vulnerable residents.  

In contrast to the clear misconception about these sites, the survey found several benefits of safe consumption facilities. Along with reduced risk of injury and/or death from overdose, it revealed that benefits also included decreased crime in neighbourhoods by having a safe place for people to use drugs, reduced numbers of emergency room and hospital visits, less frequent public drug use and a reduction in needles found in public spaces.

In 2016, Toronto’s Police chief at the time, Mark Saunders, publicly voiced his support of safe consumption sites as overdoses overwhelmed the city.  

“I am supportive of measures that reduce the incidence of overdoses and death," he wrote in a letter that also ensured to public health officials his force would support safe injection sites where users "will be given meaningful opportunities to be treated and reintegrated into society." 

More than a decade ago, RCMP in B.C. acknowledged privately (media later reported on it) that police claims of negative impacts associated with safe injection sites were not substantiated and that pioneering facilities in the province provided significant benefits for users and communities. 

All of these benefits stand to be reversed should the PC government move forward with plans to introduce legislation in the fall, ahead of an election.  

Peel’s strategy recommended regular evaluation and monitoring of SCS to determine whether the Region should establish other sites including the possibility of a mobile SCS to provide services to less densely populated areas across Peel. Two potential future sites were identified in Mississauga’s Cooksville area and in Brampton’s city centre where most paramedic calls to administer live saving naloxone occurred. These two areas were also identified by survey respondents as the preferred site locations. The PCs’ proposed legislation would ban any future sites from opening, including those planned in Peel.  

“We are concerned, but we are waiting for further details and are committed to working with Regional Council and the province to ensure our community receives the care and support they need,” a spokesperson from the Region told The Pointer following the announcement. 

Staff are planning to bring an update to council, but “timing will be determined as more detailed information from the province is received.” With several Toronto sites closing, they said, “It’s still too early to determine how these changes will impact the number of clients who may visit the site in the future.” 

Asked how the PCs’ proposed legislation will impact Peel’s opioid strategy, the spokesperson told The Pointer on Monday, “the Region is waiting for more information about the details of the Province’s announcement and will evaluate how to move forward as more guidance emerges.”

As the PCs close several sites across the province, Addictions and Mental Health Ontario (AMHO) has underscored that the most effective way to protect people who use drugs from the increasingly toxic supply is to expand the province’s harm reduction and addiction services. The organization has warned that, “Without access to harm reduction and addictions services, Ontarians are more likely to use alone, where they become increasingly susceptible to the often harmful and even fatal effects of an increasingly toxic drug supply.”

In a statement last week following the announcement, AMHO said it was concerned by the PC decision to permanently close over half of the Province’s CTS sites, which they pointed out save lives and reduce harms.

“The closure of CTS sites risks pushing individuals into more dangerous environments, increasing their risk of injury, overdose, or death.” The Association also revealed that between March 2020 and January 2024, these sites reversed nearly 21,000 overdoses in Ontario with no reported fatalities on site.  

During an announcement in London on Monday, Doug Ford reiterated his support for the Province’s latest decision to move away from safe consumption sites as a response to the opioid crisis. He provided no hard evidence to support the decision.

(Government of Ontario) 

A 2018 review by the Province itself found there was a reduction in illness and death from overdoses in areas where Supervised Consumption Services are located as well as lower rates of public drug use and needle sharing. It also revealed these sites improve the health of those who use drugs, are cost-effective and reduce strain on the healthcare system.
Ford has provided no evidence, only anecdotes to support his claim that supervised consumption sites are “a failed policy” which goes against evidence-based research and the experience of specialists and healthcare professionals at safe consumption sites who confirm the facilities work, and save lives. 

With Ford dug in on his position ahead of an election, a letter from Canadian Drug Policy Coalition released earlier this month ahead of the PC announcement revealed the drug poisoning death rate now represents approximately one Ontario resident dying every 2.5 hours. The organization called for emergency funding to support safe consumption sites. Previous reports from AMHO have also highlighted that the province is on pace to surpass 3,000 annual drug poisoning deaths, more than eight deaths per day. 

Email: [email protected] 

Twitter: @mcpaigepeacock

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