Ottawa’s last supervised consumption sites have closed, ending a model of care that health advocates say saved lives and connected some of the city’s most vulnerable residents with healthcare.
The closures are part of the Ontario government’s shift away from supervised consumption services and toward Homeless and Addiction Recovery Treatment (HART) Hubs, a treatment-focused model that the province says offers more comprehensive support.
But frontline healthcare workers, community organizations and opposition politicians warn the move could lead to more overdoses, increased public drug use and greater strain on emergency services.
The closures include Ottawa Inner City Health’s 24-hour supervised consumption and treatment service, commonly known as “The Trailer,” which operated for eight years.
Rob Boyd, CEO of Ottawa Inner City Health, said the site offered far more than overdose prevention. Nurses treated wounds, adjusted medications and connected people experiencing homelessness with essential healthcare services.
“The biggest worry that I have is an increase in toxic drug deaths,” Boyd said. “But I think the more likely thing that’s going to happen is an increase in injuries related to overdose.”
He said delayed intervention during an overdose can lead to acquired brain injuries because “minutes count.”
Boyd also fears more cases of HIV, hepatitis C and serious infections as access to sterile supplies decreases.
Advocates say the effects will be felt beyond people who use drugs.
Aileen Leo, director of communications for the Ottawa Mission, said the city should expect more public drug use, discarded needles and fatal overdoses.
“People could use in a safe way, and if they overdose, they would be revived by trained medical and nursing staff,” Leo said about the supervised consumption sites. “Now that these sites are no longer available, they have a much higher risk of dying.”
She said supervised consumption sites and HART Hubs should not be viewed as competing approaches. “It’s not an either-or model,” Leo said. “You can have both, and we need both.”
In a written statement, Lily Barnes, spokesperson for Health Minister Sylvia Jones, said the province is replacing what it called “the failed approach of drug injection sites” with record investments in mental health and addiction services.
“Instead of giving people tools to use harmful, illegal drugs, our government is helping people break the tragic cycle of drug addiction by making record investments in more mental health and wrap-around supports,” Barnes wrote.
The province says it is investing $560 million to create 29 HART Hubs across Ontario. According to the ministry, 28 hubs are already open and have recorded more than 100,000 client interactions. Two serve the Ottawa area and offer services including primary care, mental health support, supportive housing and transition beds.
The government said HART Hubs receive up to four times more funding than supervised consumption sites and are part of Ontario’s broader $3.8-billion Roadmap to Wellness strategy
But critics argue the two models provide fundamentally different services.
Nicole Luongo, a policy and systems change analyst with the Canadian Drug Policy Coalition, said supervised consumption sites have never recorded a fatal overdose in Canada and have been shown to reduce infectious disease transmission while connecting people to housing and healthcare supports.
“Closing safe consumption services and replacing them with abstinence-only models are not going to reduce rates of drug use,” Luongo said. “All that’s going to happen is that people who previously had a space to go to use drugs under medical supervision will no longer have that space.”
She said the changes will likely push people into using drugs alone or in concealed areas, further increasing the risk of fatal overdoses.
Ottawa-Vanier Liberal MPP Lucille Collard said the sites were providing very important services for harm reduction. “We are likely to see more people die of overdose without that kind of support,” she said.
Collard also explained residents in Ottawa-Vanier have long raised concerns about public drug use, but she believes the closures could worsen the problem rather than solve it.
“Those people are still going to be wandering on the streets,” she said. “The fact that the site is closing is not going to diminish that problem. It’s actually going to increase it.”
She also warned of added pressure on hospitals and ambulance services as overdoses increasingly occur outside supervised settings.
Boyd said Ottawa Inner City Health spent weeks preparing clients for the closure, training peer leaders in overdose response and wound care and providing information about where to obtain naloxone and harm reduction supplies.
The organization also held a closing ceremony for staff and clients to mark the end of the service.
Now, Boyd said, community organizations are documenting the effects of the closures, including overdose responses, discarded drug equipment and changes in safety perceptions among clients and neighbourhood residents.
“The next few weeks will be quite telling,” Boyd said.