In the fall of 2024, the government of Ontario's own advisers warned that closing supervised consumption sites in the province would result in "increased emergency department visits, health impacts, overdoses and death." Despite these warnings, the government forced the closure of nine Consumption and Treatment Services (CTS) sites on March 31, 2025.
As predicted, people are seeing the harmful impact of the closures in their communities. Residents in the area around the shuttered CTS in Ottawa are reporting an increase in people being forced to consume their drugs in public, and the nearby Centre 507 is reporting that its staff are responding to an increased number of overdoses since the closure of supervised consumption services at the Somerset West Community Health Centre.
A similar situation is taking place across the province. The Toronto Drop-In Network, representing 50 drop-in centres in the city, recently reported a massive increase in overdoses at its member sites. These are the numbers that the Ontario government's internal advisers warned them about: in the months prior to the CTS site closures, Drop-In Network sites were reporting an average of 10 overdoses per month. That number now hovers in the high-60s.
By closing down CTS sites earlier this year, the Ontario government took away a critical health service where people who use drugs could often access drug-testing services and would use their drugs under the supervision of health professionals and peers in a safe and closed space. The sites were also a crucial point of access for sterile drug-use equipment, such as needles and syringes, and provided essential "wraparound" care: making connections for people who use drugs to treatment, mental health support, housing and other much-needed social services.
Minimizing the impact of closure, Ontario pretended people could simply transition to another site to access services; this misguided view was not only unrealistic, it was dangerous. The closure of CTS sites has imposed an extraordinary burden on the few remaining sites in Toronto that are experiencing a "huge increase in volume of patients" while many people have still not found a supervised consumption site that is accessible to them -- indeed, there are many localities where none exist. On top of this, the painfully slow and opaque implementation of the government's so-called Homeless and Addiction Recovery Treatment (HART) Hubs has led to drastically fewer supports for people who use drugs.
We've spoken with medical professionals in Toronto who said the transition to HART Hubs has disrupted care, leaving some people in need of services to feel abandoned. Additionally, there is a substantial discrepancy between what HART Hubs have promised to provide and what they currently entail, with some HART Hub workers telling us that people have come to HART Hubs under the impression they will have immediate access to treatment services that are not available.
Moreover, as a part of the agreement to receive HART Hub funding, not only are sites prohibited from providing supervised consumption services, but they can no longer distribute sterile needles and syringes. This senseless prohibition will only result in preventable HIV and HCV transmissions, and is another example of the Ontario government ignoring its own evidence: Ontario guidelines state that sterile equipment should be made available because the "distribution of needles/syringes and other drug use supplies has proven to be an effective method in reducing blood-borne infections associated with injection drug use, such as HIV and hepatitis C."
The province chose to create the conditions for increased death and harm. Government officials ignored well-established evidence and warnings from its own internal advisers. We are hopeful that the Ontario Superior Court of Justice will soon rule that the legislation that led to the forced closure of CTS sites in the province is unconstitutional, but so much damage has already been done and so many lives have already been lost. This has been a terrible, failed policy decision, gambling with the lives of people who use drugs in this province.
Ontario can still reverse course and reinstate CTS sites as vital, evidence-based health services for people who need them -- some of the most marginalized in our communities. On Sunday, International Overdose Awareness Day, we call on the government to do so, immediately, before more people lose their lives.
Cécile Kazatchkine is a senior policy analyst with the HIV Legal Network. Dylan DeMarsh is a digital and strategic communications officer with the HIV Legal Network. (The HIV Legal Network promotes the human rights of people living with HIV or AIDS and other populations disproportionately affected by HIV, punitive laws and policies, and criminalization, in Canada and internationally.)