Supervised consumption sites have a strong evidence base for improving the health of people who use drugs, but the service remains politically controversial. The Government of Ontario has announced plans to close five of 10 sites in Toronto by March 2025, and another site is likely to close after its lease expires. This report estimates the impact of site closures on potential and actual use of supervised consumption sites.

How we studied this

This study used administrative health data, data reported by supervised consumption sites to the Ontario Ministry of Health, and data reported directly by supervised consumption site operators to estimate:

• the number of people who use opioid and stimulant drugs in Toronto, where they were located, and how many would lose potential access to supervised consumption sites
• the number of people who currently use supervised consumption sites
• the number of current clients who would lose access or shift their use to a different supervised consumption site
• the extra capacity required to address service losses

Researchers analyzed data under varying assumptions of how many sites will remain open and each supervised consumption site’s service radius (the distance clients would travel to access services, analyzed at 500, 1000, and 2000 m).

What we found

Each month, 636 people (47% of supervised consumption site current clients) would lose access if six sites close in Toronto. These estimates will change depending on how many sites stay open, how far people are willing to travel to go to an alternative site if their preferred site closes, and how much capacity sites that remain open will have to accommodate new clients. The remaining supervised consumption sites will be more than 500m from where over 90% of people who use opioids or stimulants are located in Toronto.

Why this is important

The announced closures of supervised consumption sites have the potential to decrease access to an important health service for people who use drugs. This is the first analysis on how large this impact will be in Toronto.

Currently, supervised consumption sites are accessible to only a small minority of people who use opioids and stimulants, and closing existing sites would exacerbate this disparity. If sites close, many clients will lose access, and sites that remain open would need to expand capacity considerably. Even with large increases in capacity among sites that remain open, many current clients will remain very distant from an open supervised consumption site and are therefore likely to lose access.

This report underscores the urgency of reconsidering the planned supervised consumption site closures. Understanding how many people are affected is important for the ongoing policy discussion amongst decision makers.