Posted: September 4 2024
Author: Centre on Drug Policy Evaluation

The Centre on Drug Policy Evaluation’s Statement on the Closure of Supervised Consumption Sites

The Centre on Drug Policy Evaluation (CDPE) is deeply concerned by the Ontario Ministry of Health’s announcement of the closure of 10 supervised consumption sites across the province, including five sites in the City of Toronto. Our Centre informs best practices in drug policy by conducting research that adheres to the highest scientific standards. Given what has been demonstrated regarding their impact, the closure of supervised consumption sites will lead to greater harms across communities, including heightened overdose mortality, public drug use, and a greater burden on first responders and emergency departments. We therefore call on the Ontario government to make public the scientific evidence it used to support this decision, and to reconsider these closures. 

Supervised consumption sites offer a safe and judgement-free space for people to use substances under the supervision of medical professionals and trained staff. These sites are situated in areas of historic substance use activity and continued need. A large body of scientific evidence collected over multiple decades across the world has shown that they play a key role in reversing potentially fatal overdose events, connecting people to basic medical care as well as health and social service programs, and supporting referrals and retention in substance use treatment. Rigorous evaluations of supervised consumption sites undertaken in Toronto, across Canada, and internationally, have established the positive impacts of these services in the communities in which they are located. Research from our Centre has further demonstrated that the implementation of supervised consumption sites in Toronto was followed by a two-thirds reduction in overdose deaths in surrounding neighbourhoods (this reduction was not observed in areas without sites). Additionally, our research has shown that Toronto’s supervised consumption sites improve uptake of HIV and hepatitis C prevention, testing and treatment services, and that they contribute to reduced public drug use among their clients. Supervised consumption sites are therefore ideally positioned as a gateway for people with complex needs to enter a robust system of treatment and care. Moreover, these sites provide opportunities for community empowerment, offering people with lived experience training to transition into peer staffing roles and other employment opportunities. They are complementary to—and not mutually exclusive with—the province’s proposed Homelessness and Addiction Recovery Treatment (HART) Hubs.

There is no evidence to suggest that these services cause people with histories of substance use to relapse, or that they cause people who do not use to start. There is also no clear relationship between crime in areas with supervised consumption sites. However, a study from our Centre analyzing 13 years of data from Toronto found that homicide rates went down slightly in areas surrounding supervised consumption sites, while these rates went up slightly in areas further away. Recent analyses of crime indicators also found that many types of crime—including theft, break and enters, assaults, and property damage—went down in neighbourhoods with sites. What is clear is that the vast majority of sites in Ontario provide great benefit to their communities without major issues.

Distance requirements between supervised consumption sites and childcare facilities is a reasonable consideration. However, the government’s decision to shut down existing sites while providing no alternative locations and banning the opening of any future ones, undermines the rationale for this decision. The closure of these sites represents a radical and unnecessary step that will further worsen Ontario’s overdose and drug toxicity crisis, and it should be immediately reversed. We stand with those who will be impacted by these closures, including our network of community partners providing life-saving care for their clients, and with people who use drugs who will be placed at greater risk of harm as a result of this decision.

References: 

CBC News. Province says crime is an issue around CTS sites, but data shows that’s not the case in Kitchener. CBC News. August 23rd, 2024.

Greenwald, Zoë R, Zachary Bouck, Elizabeth McLean, Kate Mason, Bernadette Lettner, Jennifer Broad, Zoë Dodd, Tanner Nassau, Ayden I Scheim, and Dan Werb. 2023. ‘Integrated supervised consumption services and hepatitis C testing and treatment among people who inject drugs in Toronto, Canada: A cross‐sectional analysis’, Journal of Viral Hepatitis, 30: 160-71.

Kennedy, Mary Clare, Mohammad Karamouzian, and Thomas Kerr. 2017. ‘Public health and public order outcomes associated with supervised drug consumption facilities: A systematic review’, Current HIV/AIDS Reports, 14: 161-83.

Rammohan, Indhu, Tommi Gaines, Ayden Scheim, Ahmed Bayoumi, and Dan Werb. 2024. ‘Overdose mortality incidence and supervised consumption services in Toronto, Canada: An ecological study and spatial analysis’, The Lancet Public Health, 9: e79-e87.

Sung, H.S., M. Karamouzian, I. Rammohan, J. Eeuwes, A. Smoke, and D. Werb. 2024. “Investigating the spatial association between supervised consumption services and homicide in Toronto.” In 2024 International AIDS Conference. Munich, Germany.

Woodward, J. 2024. ‘Supervised consumption sites didn’t lead to crime spike in many neighbourhoods: data.’ CTV News Toronto, August 28th.

Centre on Drug Policy Evaluation
c/o Li Ka Shing Knowledge Institute of St. Michael’s Hospital
Unity Health Toronto
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Toronto, Ontario M5B 1W8
Canada

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