As Guelph’s only supervised consumption site prepares to close March 31, advocates warn people will die and the surrounding community will suffer.
“We know that there’s going to be drug poisonings, we know that people are going to die, and we know it’s all preventable …. It’s heartbreaking,” says Ingrid Ohls, the consumption and treatment services (CTS) support coordinator at Guelph Community Health Centre. Ohls has first-hand experience of some of the challenges clients will face, having gone through fentanyl and meth addictions herself.
On Dec. 4, Ontario passed Bill 223, the Safer Streets, Stronger Communities Act, prohibiting CTS sites from operating within 200 metres of schools or child-care centres. The ban will close one privately funded and nine provincially funded sites by March 31, leaving 13 sites in operation across the province, six of them in Toronto. Four of the CTS sites (also known as supervised consumption services) are the only ones in their communities and have led to warnings that beyond deaths, the communities will see more public drug use, overdoses and discarded needles.
All provincially funded sites had the option of applying to transition to a Homelessness and Addiction Recovery Treatment (HART) Hub. The hubs focus on treatment and recovery, and will not offer safer supply, supervised drug consumption or needle exchange programs. The province is investing $529 million to create a total of 27 HART Hubs across the province.
On Jan. 27, the Ontario government announced 18 new HART Hub locations in addition to nine sites approved earlier this year. Guelph’s CTS site was one of those approved.
Guelph’s CTS began operating in 2018 as an overdose prevention site, then transitioned to a full CTS site the next year. Since 2018, it has had more than 41,000 visits and made 1,000 referrals to primary care, says Melissa Kwiatkowski, Guelph Community Health Centre’s chief executive officer. On average, it has connected about 45 people a month to onsite, on-demand addiction services. In the past five years, staff members have reversed 311 drug poisonings; only 12 have led to transfers to an emergency department. There have been no deaths.
“We know this decision is going to have devastating impacts in our community during a public health crisis,” Kwiatkowski.
Ohls says staff is exploring safety plans with service users that would take effect in April, but the landscape has changed substantially in recent years, making planning more challenging. “Fentanyl was dangerous (before), but now there’s all of the additions to the fentanyl (like benzodiazepines) and the housing crisis has made the situation so much worse.”
Ohls says staff is encouraging people not to use alone and to use services such as the National Overdose Response Service when possible. But such services require a phone, which many users do not have.
Kwiatkowski says closing Guelph’s only CTS will place additional burdens not only on those who respond to overdoses such as emergency services personnel but also in libraries, businesses and by the general public.
Ohls agrees. She says that without the CTS, community members will be forced to respond to public drug poisonings. “It’s scary to think you could be walking down the street and see somebody overdosing and you’re in the position now where you don’t have the nurses and the trained staff available like we do (at the CTS) to respond.”
The community health centre has been working with partners to develop mitigation strategies, including training and educational resources for businesses, social agencies and the general public on how to respond to overdoses, how to administer naloxone to reverse a drug overdose and de-escalation strategies.
“We know this decision is going to have devastating impacts in our community during a public health crisis.”
It is also working with the Wellington Guelph Drug Strategy, public health, emergency services and the hospital because emergency calls and emergency department visits are expected to increase once the CTS closes.
Guelph’s main library also is already working closely with community agencies to provide extra support. Samantha Wellhauser-Bells, the main library branch manager, says her staff works closely with agencies such as Royal City Mission and Hope House and also relies on outreach workers through the Welcoming Streets Initiative, a partnership between the Guelph Police, the Downtown Guelph Business Association, the County of Wellington and the Guelph Community Health Centre. However, the Welcoming Streets Initiative is in its final year of funding.
“We have really great community partners in Guelph, and there are just so many people at the table,” says Wellhauser-Bells. She says she understands the apprehension around HART hubs, but she remains cautiously optimistic. “It is a big change … but I do feel like community is really, really important and I think there’s a community answer to all of this.”
Derrick Rutherford, creative director of Valentini Hair Design, which has been in business in downtown Guelph for 35 years and is down the street from the community health centre, says he wants to see better community collaboration to ensure everyone’s needs are met.
“We have to work together, and there has to be rules … and community standards no matter what you’re going through,” says Rutherford. “Everyone still deserves to be safe and be able to walk around, shop and live in their community. Nobody should be alienated.”
Rutherford has been concerned about public drug use and safety but says he hopes that transitioning the CTS site to a HART hub will get more people into treatment and make the community safer. He has empathy for those using the CTS, but “I want to see people in treatment and, hopefully, getting off drugs.”
But critics say HART hubs cannot replace CTS sites.
Ohls says that there is a place for the hubs but as additions to harm reduction services, not as replacements: “I entirely agree (that) we need more supportive housing, we need more treatment, but it doesn’t need to be an ‘either or.’ It needs to be a ‘yes and.’ ”
In her annual report released Dec. 3, Ontario Auditor General Shelley Spence said the province’s Opioid strategy does not meet the increased risks to and needs of Ontarians. The report added that “the decision to change supervised consumption services was made without proper planning, impact analysis or public consultations.”
The report noted that CTS sites have been proven to prevent overdose deaths. It cited data from 2022-23 showing that though more than 3,600 overdoses occurred at CTS sites, none resulted in death. Additionally, it said that more than 1,500 potentially fatal overdoses were prevented at the 10 CTS sites that are set to close.
Kwiatkowski agrees the HART hubs will leave gaps in the continuum of care, putting lives at risk. “The auditor’s report highlights that these hubs lack the scale planning and comprehensive services required to meet the needs of vulnerable people…. (The HART hub) investments are much needed, but they’re not a replacement for CTS.”
Says Ohls: “Taking harm reduction away is not going to help…. People are worried now about needles and drug paraphernalia being out (but) it’s not going to improve. It’s going to get worse when you take those services away.”
