The closure of supervised consumption sites across Toronto will put an additional strain on emergency services and lead to an increase in preventable fatal and non-fatal overdoses.
Those are the claims made in a Toronto Public Health (TPH) report to be presented at Monday’s Board of Health meeting, which also calls on the provincial government to make some modifications to its new addiction treatment and recovery strategy.
In December 2024, the Ford government passed legislation which will see the closure of 10 supervised consumption sites deemed to be too close to schools and daycares by March 31, 2025.
In place of those consumption sites, the province intends to launch 19 new homelessness and addiction recovery treatment hubs – or HART hubs.
Healthcare workers, advocates and homeless people have all said consumption site closures would lead to more deaths as the HART Hub model does not permit supervised consumption, safer supply, or needle exchange services.
In the report, Toronto Public Health calls on the Ford government to allow increased access to supervised consumption sites that are available within the legislation and permit needle exchange services within HART hubs to reduce the transmission of communicable diseases.
While the law does allow municipalities to ask the health ministry for approval to apply for an exemption from the federal government to launch new supervised consumption sites, Health Minister Sylvia Jones indicated there is no situation in which she would approve a new one anywhere in the province.
“These facilities save lives, connect people to social services and are pathways to treatment. The new legislation will reduce access to an evidence-based clinical healthcare service leading to an anticipated increase in preventable fatal and non-fatal overdoses,” writes acting Medical Officer of Health Na-Koshie Lamptey.
The report states that between 2015 and 2023, approximately 3,400 people died of opioid-related toxicity in Toronto, and since 2020 the annual number of opioid toxicity deaths has remained high compared to pre-pandemic levels.
Between March 2020 and May 2024, there were more than 390,000 visits across the 10 supervised consumption sites in Toronto and no overdose-related deaths. At Toronto Public Health’s The Works location, there have been 159,254 visits and 4,060 overdose responses – including 2,436 overdoses requiring naloxone – since it opened in 2017.
“Without additional investment and increased access to a full continuum of evidence-based prevention, harm reduction, and treatment options, the number of opioid toxicity deaths in Toronto could continue to remain high compared to pre-pandemic levels,” the report says.
The report says the closure of the consumption sites will also have additional implications for Toronto Paramedic, Toronto Police and Toronto Fire Services. Since 2019, the report says paramedics have seen a 54 per cent increase in calls related to drug toxicity, driven primarily by opioid overdoses.
“Toronto Paramedic Services expects an increase in overdose-related calls, greater demand for naloxone administration, and more frequent hospital transports …due to the reduced availability of safe consumption services and supplies,” the report says.
While the impact of the closures remains difficult to predict for police and fire services, TPH notes that calls for police service around supervised consumption sites compared to pre-pandemic levels “have generally decreased.”
Toronto Public Health says its application to establish a HART hub was approved in principle earlier this month. The hub expects to begin providing services in the spring of 2025.
