From the Toronto Star, by Manisha Krishnan
“Closing down safe drug consumption sites in the midst of a historic overdose epidemic will not help anyone to thrive and our politicians should know that by now,” Manisha Krishnan writes.
By Manisha Krishnan, Contributor
It’s been five months since Sudbury’s only safe drug consumption site was forced to close due to a lack of funding, and former manager Amber Fritz is terrified of what’s happened to users of the space.
“A lot of people I used to see with regularity I just don’t see anymore,” she told me. “That’s scary because I’m like, where are they? Are they still alive? Because it’s a brutal fact that they may not be.”
Now, as Ontario Health Minister Sylvia Jones announced Tuesday the government will be shutting down a swath of safe consumption sites — spaces where people can consume unregulated drugs under supervision and be revived if they overdose — Fritz’s fears will be realized across a province that’s already losing one person to a drug death every three hours.
“It’s a nightmare,” Fritz said. “We’re in the midst of a crisis and it’s not being treated as such.”
Ontario currently has 17 provincially-regulated safe drug consumption sites, but Jones said those within 200 metres of schools or daycare centres will be forced to close by March 31, 2025. That means at least 10 of the current sites will shut down, including five in Toronto. In addition to Sudbury, sites in Timmins and Windsor closed in the last year because they ran out of money, leaving drug users in large swaths of the province without services.
Jones pointed to an increase in violent crime in neighbourhoods where these sites are located, including the shooting death of Karolina Huebner-Makurat, a mother in Toronto’s South Riverdale last July.
“In Toronto there’s been numerous stories of altercations, stabbings, shootings and even a homicide in the vicinity of these sites,” she said. “Our first priority must always be protecting our communities, especially when it comes to some of our most innocent and vulnerable: our children.”
Huebner-Makurat’s death is a disturbing tragedy. It warrants investigation that perhaps leads to reforms to the site in question and lessons for safe injection sites around the country. But it is also not the norm. It certainly should not result in the abolition of safe consumption sites in populated urban areas, places where they’re most needed.
The government also has not demonstrated that increases in crime are a direct result of people using safe consumption sites, as opposed to other wider societal factors including poverty, homelessness and untreated mental illness. As for the fear of picking up needles, which Jones also referenced, safe consumption sites can actually reduce needle debris in surrounding areas, in addition to reducing overdose and rates of HIV.
Protecting our kids is a priority, but the provincial government seems willing to trade off for increased rates of preventable death, harmful waste and infectious disease — all of which could conceivably put children at risk.
The province claims it will simultaneously invest $378 million into homelessness and addiction treatment services, providing 375 supportive housing units as well as treatment beds. Nine of the safe consumption sites that will shut down have the option to turn into one of these treatment hubs, according to Jones, but they won’t be able to supervise drug consumption or even provide needle exchange services. While more treatment capacity is badly needed, it can’t replace the urgent, life-saving work of overdose reversal.
Not everyone who dies of an overdose is addicted to drugs and not everyone who is addicted to drugs is ready to stop using. The decision to keep using should not mean a death sentence. Nor do these options have to exist in silos. After all, safe consumption sites can be a gateway to drug treatment but people cannot enter drug addiction treatment if they aren’t alive.
“If the government chooses to focus only on treatment, it will not provide the relief that we all seek,” said Michael Parkinson, co-ordinator of the Drug Strategy Network of Ontario, a harm reduction advocacy group. “There are hundreds of thousands of Ontario residents who might benefit from treatment but we cannot scale that up fast enough.”
Ontario’s decision comes as part of a larger backlash to the harm reduction movement, with Conservative leader Pierre Poilievre promising to pull federal funding for consumption sites, which he refers to as “drug dens.” Alberta has already forced two sites to close, including one in Lethbridge — the busiest one in North America at one time.
Safe drug consumption sites aren’t new and there’s good evidence backing their efficacy. There are over 200 such sites in 14 countries around the world, with North America’s first one, Insite, opening in Vancouver in 2003. There has only been one recorded death at a site in B.C., which is pretty remarkable when you consider that more than 44,000 Canadians have died of a drug overdose since 2016.
Fritz noted that many of these sites, including Sudbury’s, were never given the types of resources needed to operate at full scale. For example, despite the fact that deaths from smoking drugs are outpacing those that come from injection drug use, most sites in Ontario don’t have spaces for inhalation.
Meanwhile, the street drug supply is getting worse, as fentanyl mixed with strong benzodiazepines and animal tranquilizers are killing people and causing more severe withdrawals. In spite of that, Jones said the province does not support safe supply — the prescribing of pharmaceutical opioids to replace much more dangerous street drugs.
Considering the alarming number of deaths we’re facing and the gut wrenching sight of visible poverty and addiction in many neighbourhoods, it’s not surprising that people are frustrated. That frustration is leading people to blame harm reduction policies on the current crisis. Rather than creating more awareness about how harm reduction works, politicians like Ontario Premier Doug Ford and Poilievre are bolstering that narrative, contradicting evidence coming from public health experts.
Fritz remembers the looks of betrayal in the faces of people who used Sudbury’s site when it closed down. The space had been designed with their input and half of the staff were community members, she said.
“It was so painful to see. They’re like ‘All my friends are dead and we have nowhere to go’.”
During Jones’ announcement, she said people who use drugs deserve support, resources, and the “opportunity to recover and thrive.”
Closing down safe drug consumption sites in the midst of a historic overdose epidemic will not help anyone to thrive and our politicians should know that by now.
If they continue to let drug users die at this shameful pace, while ignoring or eliminating solutions we know save lives, it will become harder and harder to believe that’s not what they actually want.
Manisha Krishnan is an Emmy award-winning journalist who covers drug policy. Follow her on X: @manishakrishnan
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