Peel supervised consumption site to close after PC legislation bars Region from applying for Health Canada exemption 

Eliza Chappel was 17 when she tried fentanyl for the first time. She did not know her “life was going to change in so many ways”.

“Today, I'm grateful to be sitting here, not only alive, but four and a half years off of fentanyl,” Chappel, who identified herself as a peer with Moyo Health and Community Services, told regional councillors on February 27 as she shared her experience with the toxic supply of fentanyl. “Though, that wouldn't have been possible without places like Moyo and [Wellfort Community Health Services] and the ever adapting programs and services that are built to fit the needs of the communities that they're serving.”

On March 4, 2024, Peel opened its first supervised consumption site to respond to a growing rate of opioid-related deaths in the community. One year later, the site has successfully served over 760 clients. During that time, over 50 individuals have initiated on-site addictions treatment.

Despite its early success, the site, which provides life saving harm reduction services, has been ordered to close. 

On January 24, the Ministry of Health informed the Region of Peel its SCS “would need to cease operations for drug checking and supervised consumption services no later than March 31st.” The Ministry said any funding or hosting of an SCS on municipal property is deemed “municipal support” under Doug Ford and his PC government’s Community Care and Recovery Act, and is therefore barred from operating. Passed in December, the legislation introduced new requirements limiting the power of municipalities and local boards to support aspects of supervised consumption sites.

Following the Ministry’s decision, Moyo Health and Community Services, the operator of the site, was informed that the Health Canada exemption for Peel’s Urgent Public Health Need Site (UPHNS) would only be extended until March 31st to align with the PC government’s Bill 223. The legislation prohibits the operation of SCS within 200 metres of schools and childcare centres. An audit of Ontario’s Opioid Strategy, conducted by the Office of the Auditor General of Ontario, later found the decision, which facilitated the closure of several sites across the province and barred future sites from opening, “was made without proper planning, impact analysis or public consultations.” 

Premier Doug Ford has ordered the closure of several supervised consumption sites through Bill 223, despite evidence that these sites provide life saving services.

(Government of Ontario) 

Under the legislation, municipalities and local boards also now require provincial approval before applying for an exemption or renewal of an exemption to the Controlled Drugs and Substances Act for the purpose of operating an SCS, according to the legislation. A Health Canada spokesperson confirmed to The Pointer on Monday it is up to the provincial Minister of Health's discretion if they wish to implement the exemption or not.

“Peel staff view this interpretation as likely going beyond what the legislation actually states, as the legislation would appear to only prohibit municipal support in directly applying for, or supporting applications for, certain Health Canada SCS operating exemptions, renewals and/or Health Canada funding applications, without the approval of the Minister,” the staff reported presented to councillors stated. “Notwithstanding the differing interpretation, Regional staff feel that Peel must respond in accordance with the province’s position to minimize risk.”

Peel’s UPHNS is located more than 200 metres from schools and licensed childcare centres and is not funded by the provincial Consumption and Treatment Services (CTS) program. In 2022, council unanimously endorsed the establishment of SCS via an interim UPHNS with funding up to 24 months or until CTS funding could be secured after the need was identified in Peel’s 2019 Opioid Strategy. 

However, with the new changes, CTS funding is no longer being offered and the PCs have instead switched gears towards Homelessness and Addiction Recovery Treatment (HART) Hubs, which will increase the supply of supportive housing units, in addition to addiction recovery and treatment beds. One of these hubs has been approved in Brampton, led by CMHA Peel Dufferin, but it will not offer safe supply, supervised drug consumption or needle exchange programs. Staff said naloxone may be made available on site. 

“Other existing harm reduction services, including naloxone, will need to be enhanced to augment the loss of supervised consumption services across the GTHA, however, these services will not replace the drug testing and overdose prevention services provided at the UPHNS,” the staff report warned.

Amid the PCs laissez-faire approach to curbing the crisis, Peel recorded 705 preventable deaths between 2019 and 2023. According to data from the Region, opioid-related deaths increased in 2023, after returning to pre-pandemic levels in 2022, with a 34 percent increase when comparing 2019 to 2023. Staff said the increase “resulted in increasing strain on local emergency services with 574 opioid-related emergency department visits and 93 opioid-related hospitalizations in 2023.” The latest available data for 2024 also show 70 deaths reported between January to September. 

Preliminary data from the Region reported a decline in opioid-related deaths following the opening of Peel’s supervised consumption site in March 2024.

(Region of Peel/Public Health Ontario) 

Data on the 2023 characteristics of opioid toxicity deaths in Peel found people are dying along with nearly half (49 percent) of deaths occurring when there was no one present who could intervene, higher than the 42 percent reported in Ontario as a whole. It found people are not getting the help they need, with less than a quarter (17 percent) of deaths involving naloxone, and less than a third (31 percent) of deaths involving a resuscitation attempt.

Staff said while there is limited data available to assess opioid-related deaths in Peel since the opening of the site, “preliminary data suggests that there is a declining trend of opioid toxicity deaths post implementation of the service.” An evaluation was initially expected to take place over the first two years after opening but will now be cut short. A transition period of sixty days beginning on April 1st is now required to support clients with referrals to supports and services and to complete the year-one evaluation.

Regional staff and officials from Moyo both confirmed to council the UPHNS has operated without incident or concerns from neighbouring residents and local businesses to date. No discarded needles or drug equipment were found during needle sweeps conducted by staff, which were conducted three times per day, and there have been no reports of loitering in proximity of the site, Natalie Lapos, manager of chronic disease and injury prevention with Peel Public Health, assured councillors. She added police and paramedics have not been called to the site to date. 

Contrasting Lapos, Brampton Mayor Patrick Brown said he and his colleagues have been “inundated” with complaints from residents about the site, “probably more so than almost any other issue we've seen.” The Pointer reached out to the Mayor for evidence of these complaints but did not receive a response. 

“While we are doing our best to expand this service to ensure that individuals in our community have access to harm reduction services, it's really important to note that these do not replace the life saving services that are available at a supervised consumption site,” Lapos said. 

Jillian Watkins, executive director of Moyo Health and Community Services, added, “The Region of Peel was a safer community because of our site, and we at Moyo are hugely disappointed that the Ford government has forced the closure of our site and removed these life saving services. We're also disappointed that Mayor Brown has continued the rhetoric that our site was unsafe for the community, spreading misinformation and harmful narratives about the goals and effectiveness of harm reduction in the recent Toronto Sun op ed.”

Watkins said that prior to the site opening, Bramlea City Centre staff were responding to frequent overdoses in bathrooms. Since the site opening, officials at the Centre have seen a drastic reduction in drug related incidences, zero overdoses, and say the site has greatly reduced the burden on their security team.

With Peel’s Opioid Strategy now upended, public health will work with community partners and other stakeholders to develop an expanded substance strategy, which will serve as an update to the current response “and identify approaches and collective actions to address the causes and effects of harms of substance use, related to prevention, harm reduction, treatment and justice/enforcement.” Staff will provide council with updates as the strategy development progresses. Echoing the staff report, Lapos said existing harm reduction services will also “need to be enhanced to augment the loss of this service in our community.” 

The operating hours of the Peel Public Health Harm Reduction Program will be increased in the area of the site to align with the current operating hours of the site. The program provides free, confidential harm reduction services, including naloxone distribution and referrals to people who use substances in the community. Lapos said the expanded service will be implemented using existing resources, and public health will monitor the implementation. If any additional resources or supports are required, they will be identified through the 2026 budget process.

But the looming closure of a site that provides life-saving services has left many in a state of anxiety.

“I worry about my own safety if the day comes that I decide to use drugs again,” Chappel said. “I no longer have a place to go to ask questions, get information about the supply currently on the street, to check the supply before using it. But most importantly, a place to go to talk to someone and possibly make a different choice. I worry for the people like me who will die of an overdose if a relapse occurs, because we are now more than likely using alone and around people who will not feel comfortable calling for help.”

“That's how I would have ended up dead, and that's how so many others already have.”

Email: [email protected] 

Twitter: @mcpaigepeacock

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