Kelly White, Manager of Harm Reduction Services, Street Health –
For nearly 40 years, Street Health has provided healthcare to people experiencing homelessness in Toronto’s Downtown East — some of our city’s most vulnerable residents. In 2018, we expanded this care to include a supervised consumption site – the Street Health Overdose Prevention Site, operating without government funding since 2019.
Our clients face numerous daily barriers to meeting their basic needs and coping with intense stigma. Many are disconnected from mainstream healthcare. That’s why all our programs — from nursing to identification replacement to case management — are built on a low-barrier, client-centred, harm reduction model.
However, the April 1 closure of 10 of Ontario’s 23 supervised consumption sites under the Ford government’s Community Care and Recovery Act has had devastating consequences. For people who use drugs, especially those who are unhoused, the impact has been immediate and deadly. For those providing care and support, the work has become even more urgent and heartbreaking.
The Dundas and Sherbourne area has long experienced two overlapping crises: homelessness and a toxic, unpredictable street drug supply. Even before the site closures last spring, services were stretched thin.
Now, Street Health staff are responding to overdoses not only inside our site but in alleys, stairwells and parks almost every day – something that was rare prior to April 1. Because many of these overdoses are unwitnessed, people are in far worse condition by the time we reach them — often not breathing, requiring immediate emergency response.
The mandated reduction in harm reduction services, coupled with ongoing lack of shelter and affordable housing, has made life even more dangerous for unhoused people who use drugs. Isolation has deepened and hope has waned.
To meet the growing need, Street Health continues to train all our staff and community members in overdose response, and has two new outreach staff funded by the City of Toronto for one year to help mitigate the impact of site closures. These staff connect with community members, distribute sterile supplies, train others in naloxone use, and collect hundreds of discarded needles daily. Still, there’s only so much we can do.
Recovery isn’t a single event; it’s a process built on trust, stability and connection. But for people who have faced ongoing trauma, poverty and stigma, traditional healthcare and social services often feel unsafe or judgmental. Many of these people avoid traditional services until a crisis forces an ambulance ride to the emergency department — a cycle that deepens shame and pushes the possibility of stability further away.
Supervised consumption sites break that cycle. By offering a nonjudgmental space where people can safely use drugs, these sites prevent fatal overdoses and bloodborne infections while creating pathways to healthcare, housing and treatment. For many, a supervised site is their first point of contact with a severely eroded safety net that has otherwise excluded them.
Every person who walks through our doors is offered care. Those providing support are often people who’ve been there themselves — people who understand the lived experience of substance use. This approach saves lives and builds the nonjudgmental relationships necessary for eventual long-term recovery.
Supervised consumption sites benefit entire communities. They reduce strain on hospitals, police and emergency services by taking drug use off the streets and into a safe, medically supervised setting. They make neighbourhoods safer by decreasing public drug use and discarded needles. They connect people to the broader supports that ultimately help them move towards recovery.
Such sites alone can’t solve Ontario’s drug crisis. But they are an essential part of any effective strategy. The province’s own internal reviews have confirmed their value — yet the Ford government chose to close rather than strengthen these programs.
We urgently need expanded hours, more sites, and services that reflect how people use drugs today rather than how they used them in 2018-19. Increasingly, people are smoking rather than injecting, and our harm reduction programs must evolve to meet this reality. Turning away from those who use drugs because they aren’t yet ready for abstinence-based treatment (the provincial preference) only ensures more preventable deaths.
From January 2016 to March 2025, 53,821 Canadians lost their lives to opioid overdoses. These deaths are not inevitable — they are the result of policy choices.
At Street Health, we see firsthand that harm reduction works. Meeting people ‘where they’re at’ saves lives, fosters dignity, and builds the trust needed for healing. The current wave of site closures undermines everything we know about what works. It leaves service providers like staff at Street Health running through alleys trying to resuscitate people.
We need a comprehensive, compassionate approach — that includes housing, mental health supports and harm reduction — to keep people alive long enough to recover. Anything less is a policy failure measured in human lives. At Street Health, we know this all too well.
