Supervised consumption sites saved lives; closure spark fear

Miles loaded the syringe that day, about two years ago, with far more fentanyl than he knew he could handle.

“I hated myself, I hated all the things I had done. I didn’t think I deserved to ever be in my kids’ life again … I’d lost all sense of who I thought I was.”

The health centre was closed, but a staff member working late found him unconscious and called 911. Miles survived. South Riverdale had saved his life before, he says — not only as a safe place to inject but somewhere to get a shower, clean underwear, and medical treatment without the stigma that people who are homeless or addicted feel in walk-in clinics and even hospitals.

South Riverdale is among five supervised consumption sites in Toronto that Premier Doug Ford’s government has ordered closed by the end of this month due to proximity to schools and child-care centres. They will be replaced by so-called HART hubs offering some of the same services — but no sanctioned drug use. 

Opponents of supervised consumption sites argue they merely enable a cycle of addiction — or as Premier Doug Ford told the Star at a recent media availability, “get people wired onto drugs.” 

But site users and staff say this is a gross mischaracterization of what they do. While they do save people in the midst of an overdose, they also connect people with primary care, treatment and counselling. 

A November 2024 report by the Centre on Drug Policy Evaluation says supervised consumption sites have facilitated more than 530,000 service referrals for housing, case management and substance abuse treatment — not to mention successfully reversing 22,000 overdoses.

Toronto’s acting public health chief, Dr. Na-Koshie Lamptey, warned in January that closing supervised consumption sites will cost lives by driving users to shoot up out of sight, away from help. “These facilities save lives, connect people to social services and are pathways to treatment,” she wrote in a report to the city’s board of health.

South Riverdale “gave me hope,” Miles said, and a referral to a detox centre that got him back on his feet. Sober for 16 months, he is working on reconnecting with his children and living in his own apartment, in supportive housing, found through a referral and support from South Riverdale.

He volunteers with a South Riverdale men’s group and regularly attends addiction support groups. His face lights up describing his mother, after years of strained relationship, visiting to see him receive a medallion to celebrate one year of sobriety — along with the worker who found him in the alley that dark night.

“She’s actually been one of my biggest champions for getting better.”

The woman’s faint wheezing is barely audible amidst the buzz of activity at the Moss Park Overdose Prevention Site.

Riley Bisson is slumped back on a couch, her eyes heavy-lidded, her toque askew. The scar across her nose and her calloused fingers suggest she hasn’t had the easiest time as of late.

Upon hearing someone is experiencing chest pains, nurse Karen Elumir attaches Bisson’s finger to a vital signs machine to check her blood pressure, pulse and oxygen levels. Her heartbeat is quick, but the rhythm is steady. While her blood oxygen level is not optimal, Bisson is able to answer questions, follow directions and her complexion is normal. Overall, she’s OK.

It’s a typical scene at Moss Park, but a fraction of what Elumir deals with daily. Staff help people obtain prescription opioids, such as hydromorphone, to get off street drugs, or to get into treatment. They assist with, or provide referrals for, other hazards of street living, including bruises and cuts, dental problems or infectious diseases.

Some days, Elumir is simply a shoulder to lean on. After checking on Bisson, she’s helping a man soak his feet in warm water and epsom salt to get some relief from blisters formed by walking the streets.

“Living outside is hard on the body,” Elumir says. “Some of the drug use is treating the physical pain. And some of it is treating the human soul that’s hurt.”

Bisson, feeling better from the chest pains she was experiencing — brought on by a combination of fentanyl and crack, or what she refers to as a “John Belushi” — feels indebted to the medical staff here. But she’s even more grateful knowing she has somewhere to go where people care.

“It’s a shoulder to lean on,” she says. “I got nobody. So they’re family.” 

Elumir worries that the closures will result in some clients choosing to use their drugs alone elsewhere — and potentially losing access to the wraparound services these sites provide.

“For many folks, it’s unrealistic to jump from doing this to abstinence. There’s too much withdrawal, there’s too much mental health trauma, there’s too much physical damage (to their bodies),” she said.

On another day, when the site is gaily decorated for Valentine’s Day, Tony Williams, 63, stops by Moss Park to see Sarah Greig, the site’s director of substance use and mental health.

Williams, a beloved figure known to many as “Uncle T,” has spent much of his adult life addicted to drugs. He is no stranger to overdoses, including one last August when the Star observed him being revived with oxygen.  

But a brush with near-death last December, followed by help from Moss Park staff, put him on the road to recovery.

After injecting at the site, he went into immediate cardiac arrest. Greig pumped his chest while other staff administered Naloxone, a medicine that reverses opioid overdoses. Williams’s heart stopped for minutes but jumped back to life before paramedics arrived. A quick hospital visit confirmed that he suffered no permanent damage. 

Upon discharge, Williams immediately returned to Moss Park, surprising staff and scaring some clients who believed he was dying or dead when paramedics wheeled him out a short time earlier.

He returned the next day for a “heart to heart” with Greig, who said he would be supported in whatever decision he made. A nurse arranged a starter dose of Suboxone, a drug to reduce withdrawal symptoms and opioid addiction that he now takes under medical supervision.

While his near-death experience triggered his desire to change, he says it was the trust and lack of judgement from Moss Park staff that has kept him on it.

“They stuck with me through thick and thin … I’ve known people that died because their families or friends flat out rejected them,” he says. “This place is family and they are behind me all the way.”

Greig said the site’s staff are committed to helping people get into treatment when they’re ready. But they also help people find a source of income, get up to date on their taxes, and host activities such as art and yoga. They’ve provided palliative care and prenatal care, attended funerals and births, and regularly do hospital and home visits.

Williams, who appeared bone-thin last summer, has regained a thick chest and brawny arms by exercising at the nearby apartment he shares with his sister and niece. He says he feels lucid and hopes to do peer work with other people dealing with addictions.

Moss Park workers started visiting his apartment after his near-fatal overdose. They still pop in to see how he is doing, and laughed when they recently found him watching “Judge Judy.”

Greig said home visits are part of caring for the person. “When we have relationships with people, in long term relationships that we’re invested in, and people are doing well, that means going and interrupting ‘Judge Judy.’”

After 15 years in news, he switched to communications work, earning a six-figure salary and also some fame as a three-time winner on the TV trivia show “Jeopardy!”, winning $77,998.

Stress, pressure and deadlines, he says, took a toll on his mental health, leading him to using drugs. Leaning against a tree on College Street, he rolls up his sleeves to show track marks, abscesses and blisters from injecting crystal meth. “These are my cuff links,” he says with a smirk.

After separating from his partner, he lost access to his kids and ended up on the streets suffering from cellulitis, a skin infection that can result from injecting drugs. He still injects drugs, under supervision at the Parkdale Queen West Community Health Centre, which is among those slated to close this month. But, with help from staff, Wilson has started to get back on his feet.

He suffered another setback after breaking his wrist. A case worker at Parkdale Queen West secured him a respite bed to heal, a spot in the shelter system and, as of Dec. 1, 2024, his own supportive housing unit. They also helped him recover his birth certificate, health card and bank card.

“None of that would have happened without the help and support from the people at Parkdale Queen West,” he said, echoing others who told the Star feelings of being judged and blamed for substance abuse can be a barrier to treatment for it.

He’s “highly doubtful” the HART Hub model will serve his needs or respect his autonomy. 

“How motivated is anyone going to be to take treatment seriously when they’re being forced to do it against their will?”

One of the common themes among clients who spoke to the Star was a distrust of the health-care system. They say they often feel judged, stigmatized and blamed for having a substance-use disorder. Wilson says that was never the case at Parkdale Queen West and the main reason he kept going back. 

“I never once felt like I was being marginalized, I was encouraged to be an active participant in my treatment when they were treating me for any medical issues,” he said.

“I never felt like I was just an addict, a crazy person or a homeless person. I was just a person.”