Maksim Goncharenok via Pexels

In the summer of 2017, Allie woke up under the harsh fluorescent lights of an emergency room, aching from another fentanyl overdose. After years of living without a stable home, the chaos of addiction had become routine—until she heard about a pop-up tent in downtown Toronto’s Moss Park, with promises of free health care and clean supplies for drug users. It sounded too good to be true, but she felt it was worth a shot.

From that first day, Allie (whom we’re identifying by first name only for privacy reasons) says the tent became her “home base,” a non-judgmental, safe place where help was always accessible. She was part of a community there, and at other safe use sites around the city. It was during a visit to one of these sites, in the midst of her addiction, that she learned she was pregnant. Overwhelmed, she was supported by street nurses who helped with appointments and updates.

Today, Allie is three years sober. She has a home and a healthy daughter, thanks to Ontario’s safe consumption services. “Had I not been able to access those sites when I needed them, I don’t think I’d be standing here having this conversation with you right now,” she says.

Many others share a similar story. Between 2020 and 2024, Ontario’s supervised consumption sites served 178,253 people, reversed 21,979 overdoses, and facilitated 533,624 referrals to services and substance use treatment, according to the Centre on Drug Policy Evaluation. But now, the sites’ very survival—and the countless Canadians who rely on them—are under threat.

Nine of Ontario’s 23 consumption and treatment services have shut down since the Ontario government’s August 2024 announcement of the Community Care and Recovery Act, legislation requiring harm reduction services to cease operations if they are located within 200 metres of a school or daycare, effective April 1, 2025. Their services have transitioned to Homelessness and Addiction Recovery Treatment (HART) Hubs, a new abstinence-based model meant to provide comprehensive addiction treatment services without supervised consumption. In a press release, the province says it was designed to “protect the safety of children and families, while improving access to recovery and treatment services for people struggling with addictions.”

Among advocates, there’s growing concern that abstinence-based treatment can do more harm than good by replacing life-saving services with programs that exclude people who continue to use drugs. Alongside loss of safe consumption, they will also lose access to essential community spaces where they can obtain food, hygiene products and emotional support.

The Neighbourhood Group Community Services, which runs the Kensington Market Overdose Prevention Site, the only supervised consumption site slated for closure that has not been confirmed as a future HART Hub, launched a constitutional challenge against the government’s decision last winter. In addition to closing existing sites, the legislation prevents municipalities from opening new supervised consumption sites or renewing exemptions for existing ones without provincial approval. It also blocks municipalities from applying for federal exemptions independently, effectively preventing these sites from operating unless they transition into a HART Hub. The case was heard in the Ontario Superior Court in March, 2025. Justice John Callaghan granted an injunction allowing the sites to remain open, without government funding, while he made his decision. However, rebranding to HART Hubs would garner the sites up to four times as much funding as they’d received previously, and the transitions of all but the Kensington site (which has not had government funding for years) were formally announced by government the next day.

Now, the future of Ontario’s harm reduction services remains uncertain. Harm reduction advocates, including the Canadian Drug Policy Coalition, the Drug Strategy Network of Ontario, and the Registered Nurses’ Association of Ontario, are concerned that closing the sites will raise barriers to care for drug users, potentially leading to more overdoses. Services like sterile supply distribution and drug checking and referrals to housing, health care, and treatment could be lost. With fewer staff and medical professionals on site, drug users will face more obstacles, while open sites will struggle to meet increased demand.

Since the closures began, advocates have been proven right. According to data collected by the Toronto Drop-In Network, overdoses at its member sites have increased by a monthly average of 179 percent from April to June compared to the collective average overdose numbers in February and March.

Despite this, and despite warnings from the community including petitions, protests and vigils, Ontario decision-makers have largely ignored the situation. In the face of overwhelming evidence showing that harm reduction strategies save lives, decades of anti-drug rhetoric and negative stigma remain a hindrance to meaningful societal and policy-based change.

The consequences of these reforms are already becoming clear: a reduction in essential services and greater risks for people who use drugs. “I don’t think people realize how many people are users and are experiencing this [problem],” says Allie. “I think not having the sites and not having a place to use safely is going to be really problematic. People are just going to die.”