OPINION: Ontario cannot claim its supervised consumption site closures saved lives

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The decline in opioid toxicity deaths in Ontario in early 2025 is welcome. Every life saved matters, and every reduction in preventable deaths should encourage us to strengthen what works.

But we must be equally clear about what the data does not show. The decline is not evidence that the Ford government’s decision to close supervised consumption services saved lives.

Some commentators have, however, chosen to present it in that way. In a recent Toronto Sun column, Brian Lilley argued that the decline proves the government was right to reject the advice of harm-reduction experts and replace supervised consumption services with a treatment-and-recovery approach.

That conclusion does not withstand scrutiny.

Death not the only measure of harm

The most important evidence comes from the Office of the Chief Coroner for Ontario, whose statistics are being used to support this claim. In its August 2025 quarterly update, the coroner’s office stated:

“The decrease in drug toxicity deaths shown in Q1 2025 reflects the time period before the closure of Consumption and Treatment Sites (CTS). The short- and long-term effects of the closures have not yet been reflected in the data collected.”

Opioid toxicity deaths fell by 25%, from 428 in the final quarter of 2024 to 319 in the first quarter of 2025. The nine consumption and treatment sites affected by the government’s policy were not required to close until March 31, 2025, meaning the decline occurred before many of the closures took place.

By the first quarter of 2026, Ontario recorded 389 opioid toxicity deaths – 19% more than in the second quarter of 2025. The mortality rate in the first quarter of 2026 was 10% higher than the 2025 annual rate. These preliminary figures do not prove that the closures caused the increase, but they clearly contradict the assertion that closing the sites produced a continuing decline in deaths.

Mortality is also not the only measure of harm.

An evidence review published in March 2026 reported that opioid toxicities treated by emergency medical services increased by 69.5% across Ontario during the six-monthperiod beginning in April 2025, with EMS calls rising from 604 in the first quarter of 2025 to 1,024 in the third quarter.

Opioid-related emergency department visits also increased by 67%, from 608 in March 2025 to 1,015 in September, after a 47% decline in the nine months preceding the closures.

Figures don’t prove closures caused increases

Local figures were similarly troubling. In Toronto, EMS calls for opioid toxicities increased from 192 in March 2025 to 350 in January 2026. In Hamilton, where the city’s consumption and treatment site closed in April 2025, opioid-related EMS responses rose from 66 to 199 between April 2025 and February 2026 – the highest monthly number recorded since reporting began.

These trends do not prove the closures caused the increases. Many factors influence overdose outcomes, including changes in the unregulated drug supply. The same caution, however, must apply to claims of government success: a decline that occurred before the closures cannot be attributed to them.

The debate also rests on a false choice between supervised consumption services and treatment.

Ontario needs timely, voluntary, evidence-based treatment alongside mental health services, primary care, supportive housing and prevention programs. But treatment alone cannot protect everyone at immediate risk from a toxic drug supply. The Canadian Public Health Association has emphasized the need for a full continuum of interventions, from prevention and harm reduction to treatment and recovery.

Treatment, harm reduction not competing ideologies

Nurses put this continuum of care into practice at supervised consumption services by responding to overdoses and connecting people with health and social services. Nurses build trusted relationships with people who have often experienced stigma elsewhere in the health system. Between March 2020 and May 2024, Ontario’s sites reversed more than 22,000 overdoses and facilitated over 530,000 referrals, including to health services, housing and substance use treatment. Closing the sites removed proven points of care that save lives and connect people to treatment and recovery.

The emerging evidence following Ontario’s closures should not be dismissed because it complicates a preferred political narrative. Treatment and harm reduction are complementary health services, not competing ideologies. Nor should a welcome reduction in deaths be repurposed to claim that a policy caused an outcome that began before it took effect.

The province should independently evaluate the closures across health, treatment and community outcomes, publish the findings and act on the evidence. Most importantly, the government should listen to nurses, public health experts, people with lived experience and the evidence.

Ontario should restore supervised consumption services as part of a comprehensive, accountable and compassionate system of care. Nurses understand this from daily practice: people must survive long enough to reach treatment, benefit from recovery services and rebuild their lives.

— Dr. Doris Grinspun is the Chief Executive Officer of the Registered Nurses’ Association of Ontario (RNAO)

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