The imminent closure of the supervised consumption sites in Greater Sudbury and Timmins prompted the Canadian Drug Policy Coalition (CDPC) and representatives of several Ontario supervised consumption sites to share an open letter penned to the provincial government, and to call on the health minister to meet with them before March 13.
The March 5 letter also issues a deadline of March 29 to approve funding, which is the last day to which Sudbury’s site, The Spot, is funded. Timmins is set to close March 31.
“We are calling on you to immediately provide direct emergency funding on or before March 29 to SCS sites that have submitted their applications to the province and are under imminent threat of closure or have closed due to lack of funding, eliminated the Consumption and Treatment Services approach to funding SCS and urgently provide, improve, and sustain uninterrupted provincial funding for SCS that includes inhalation services.”
The Spot has been awaiting funding from the province since it began its operations in 2021. The city is no longer able to fund the site, as it did during its first year, and The Spot is now running on community donations.
As to why the applications have not been approved, the province is pointing to a shooting that took place at a consumption site in Toronto in July as a reason to re-evaluate every site in Ontario, but some have said the pause is an attempt to end the harm reduction sites.
In their letter, the CDPC stated “the tragedy of an isolated instance of gun violence in Toronto must not prevent people in diverse locations across the province from accessing the vital health services any longer.”
The CDPC also hosted a press conference March 5 to speak to the contents of the open letter. The letter is signed by several Sudbury community workers, including Nick Boyce, senior policy analyst for CSPC, Michael Parkinson, co-ordinator, Drug Strategy Network of Ontario as well as Dr. Julie Samson, co-lead of the addiction medicine consult service at Timmins and District Hospital and Timmin’s hospital-based site and Amber Fritz, manager of supervised consumption services at Sudbury’s The Spot.
Fritz told attendees that Sudbury’s site has had to shorten hours to work within their short-term donation-based funding, and had to close for the first time this weekend. Fritz said “the effects were felt almost immediately.” She said for some, it is the only place they feel safe.
“If you don't have supervised consumption sites, you're going to have unsupervised consumption sites,” and with the toxic substances in the drug supply, that means death, she said.
And The Spot is not just a consumption site, Fritz told Sudbury.com. It’s a chance to help people secure housing, and even identification, which is a required for many services.
“We connect with individuals to replace their identification, we connect individuals with housing services,” she said. “If someone identifies that they want to go to treatment for their substance use, we support them to navigate that process, which can be very confusing and very overwhelming for folks.”
She said it is also a place where substance users can be themselves, without fear of judgment. The loss of the site is the loss of safety, she said.
“We have built an incredible community within this site,” said Fritz. “And (losing it) is absolutely heartbreaking and it's infuriating, if I'm perfectly honest.”
Samson spoke to the impacts of the Timmins site closure, calling it “devastating” and pointing to the significant risks associated with the site’s closure.
“There will be an increase in death,” she said.
She told attendees that if the site closes, the community should expect an increase in emergency services calls and visits, which increases response and wait times for non-drug related emergencies.
“Our site has helped reduce calls to paramedics by almost 20 per cent,” she said.
Samson said not only has the site reversed more than 360 overdoses since opening, they've provided “basic medical care” to close to 150 clients, as well as distributing naloxone and harm reduction supplies to more than 1,500 individuals, all services that will be lost without funding. but without funding.
Additionally, as the site is operated by the hospital, the site is uniquely positioned to funnel those who wish to into more traditional health care.
“This has led to 40 direct admissions to our withdrawal management and treatment unit located at our hospital allowing immediate access to treatment services.”
Both Samson and Fritz noted the possible site closures also speak to unequal access to health care in the North.
Of the regions with submitted, but still pending supervised site applications, three are included in the top ten highest mortality rates in the province: Timmins, Windsor and Sudbury. Each has an opioid toxicity mortality rate that is nearly three times the provincial average.
There are currently no supervised consumption services between Sudbury to Thunder Bay. At a ‘Save the Spot’ Rally in November, MPP and provincial health critic, France Gelinas, told Sudbury.com the lack of funding is “a case of inequitable health care for those in the North.”
“In every other community in Ontario, I'm really happy to say that the rate of deaths from overdose is going down,” said Gélinas at the time. “Except for in my community, except for Northern Ontario, Timmins, and Sudbury; there, the number of deaths continued to go up, the number of overdoses continue to go up.”
There are at least five submitted applications for CTS sites that have been “inordinately delayed” by the Ontario government, reads the letter, pointing to Sudbury most of all. The site has been waiting 30 months since their application was submitted.
Barrie has been waiting 28 months, Windsor, 19 months, and Timmins (13 months.)
Timmins is set to close March 31, and Sudbury is currently running on community donations, which will last until March 29.
The letter writers call these delays “unacceptable and deadly.”
The CDPC’s Boyce said that in June of 2017, there were 20 supervised sites across the province. Now, there are 17, and “not one new site has opened in the last six years.”
As well, the group said the supervised site models are outdated. According to the letter the group penned, inhalation now accounts for significantly more overdose deaths than injection in Ontario, yet the current supervised site models prohibit inhalation services. “Services must be designed and supported to reflect the magnitude of the crisis and the data regarding regional need and modalities of drug use,” reads the letter.
The letter also contains eight calls for government action:
- Immediately provide direct emergency funding on or before March 29 to supervised consumption services (SCS) sites that have submitted their Consumption and Treatment Services (CTS) applications to the province and are under imminent threat of closure or have closed due to lack of funding.
- Urgently provide, improve, and sustain uninterrupted provincial funding for SCS, including inhalation, and ensure equity in regional service availability, particularly in northern communities.
- Phase out the Consumption and Treatment Services (CTS) approach to funding SCS, which requires additional and overly stringent conditions over and above Health Canada’s requirements.
- In the interim, immediately remove the cap on the number of funded SCS sites and the prohibition on inhalation services under the provincial CTS model.
- In the interim, introduce transparency and an expedited 30-day timeline for responding to applications under the provincial CTS model.
- Introduce a low-barrier process by which community organizations can seek provincial funding for SCS.
- Integrate SCS into Ontario’s core funded healthcare system with ongoing, integrated funding and resources.
- Meet with us by March 13.
“All we want to do is support our community and keep people alive, and we know that supervised consumption sites do this,” said Fritz. “People are dying and people will continue to die if we don't have action on this issue.”
Jenny Lamothe covers vulnerable and marginalized communities for Sudbury.com.
