Ontario Closed Its Safe Injection Sites. The Numbers Got Worse.

I keep hearing that Ontario’s opioid crisis is getting better. The Ford government claims a 41% drop in opioid deaths since it started closing supervised consumption sites last April. Then I pull up what paramedics are actually reporting and the story falls apart. Toronto Paramedic Services went from 160 suspected opioid overdose calls in April 2025 to 350 in January 2026, that’s an 82% increase in nine months.

Something here doesn’t add up.

I’ve spent weeks trying to figure out which set of numbers is actually reliable, the answer’s not as clean as either side wants it to be.

What Bill 223 Actually Did

Bill 223, the Safer Streets, Stronger Communities Act, got Royal Assent on December 4, 2024. The government fast-tracked it through Queen’s Park without public committee hearings, which if you’re keeping score is how they handle the bills they don’t want debated on camera. Pretty standard at this point.

Headline provision banned sites within 200 metres of schools and daycares. But the real bite was further down in text: municipalities can no longer apply for federal exemptions to open new sites without approval from Health Minister. Sylvia Jones has said publicly she will never approve one.

Ever.

I’ll give the government some credit here. The event which triggered Bill 223 was real and terrible. On July 7, 2023, Karolina Huebner-Makurat, a 44-year-old mother of two, was killed by a stray bullet during a gunfight between drug dealers outside South Riverdale Community Health Centre’s supervised consumption site in Toronto’s east end. Damian Hudson was found guilty of second-degree murder in December 2025. A harm reduction worker at the site was convicted of helping one of the shooters escape. Community anger was genuine, I get why people were scared.

That said. One shooting reshaping an entire province’s drug policy is where my credit runs out.

Five of nine Liberal MPPs voted with the government on Second Reading, December 2, 2024. Worth sitting with. The party which is supposed to be the moderate alternative to Ford split nearly down the middle on harm reduction, it tells you political ground has shifted more than advocacy groups want to admit. John Fraser, then Liberal parliamentary leader (now interim leader), said he still supports SCS because “they keep people alive” but voted for the bill anyway. Make of that what you will.

The Fallout in Numbers

Before closures Ontario operated 17 supervised consumption sites. Between March 2020 and May 2024 trained workers at those sites intervened to prevent nearly 22,000 overdose deaths. Neighbourhoods in Toronto with SCS saw 67% reductions in overdose mortality, that’s from peer-reviewed research not an advocacy press release.

All gone now. Nine sites converted to HART hubs on April 1, 2025. Seven more got 90-day funding notices in March 2026. Last provincially funded site lost its money April 10, 2026.

199% in Hamilton. Let that sit.

Province-wide EMS responses for opioid overdoses jumped 69.5% after closures and emergency department visits climbed 67%. Six former Toronto mayors including John Tory wrote a joint letter urging Ford to reverse course. Ford and Jones refused publicly.

So how does government get to a 41% drop in deaths? My best read is displacement. People aren’t dying less, they’re dying in different places. Private residences, public parks, alleyways where there’s nobody trained to hit them with naloxone in time. Deaths still happen, they just happen where nobody counts them as quickly.

Can you really claim less overdose deaths when calls to paramedics nearly doubled? I don’t buy it.

HART Hubs, One Year In

The province committed $529 million over three years to build its replacement model. Nineteen new HART hubs plus nine converted from former consumption sites, 28 total (Kingston brought it to 29 in April 2026). The model is abstinence-first: primary care, mental health counselling, detox, case management, around 900 supportive housing units. They ban supervised consumption, needle exchange, and safer supply services. That’s the whole point from government’s perspective.

Of 19 new hubs 11 had opened by March 2026 in Barrie, Windsor, London, Belleville, Sudbury, Sarnia, and a handful of smaller centres. Many only partially operational. That leaves a gap, months and sometimes over a year, where old sites are closed and new ones aren’t running yet. The people who relied on those services don’t just pause their addictions while government figures out the logistics.

YWCA Hamilton CEO Medora Uppal put it plainly: the abstinence model “discourages many people from seeking help because they fear they will be pressured into treatment before they are ready.” Lines up with what I’ve seen in data. The people which most need help are the least likely to walk into a facility that requires sobriety as price of admission.

The Court Injunction That Didn’t Matter

There’s a Charter challenge working through Ontario Superior Court which most people don’t know about. The Neighbourhood Group Community Services filed in December 2024, arguing the law violates Section 7 of the Charter: your right to life, liberty, and security.

Justice John Callaghan granted an injunction on March 28, 2025, ruling all 10 existing sites could stay open. He wrote that keeping them “will have a substantial public benefit of preventing serious health risks and deaths.”

Government’s response was clever. They didn’t defy injunction directly, they just pulled funding. Hard to keep a site open with no money (good luck arguing that one in court).

As of July 2026 no final ruling has come down. Sites are closed anyway.

Look, I think the evidence here is pretty straightforward. Marit Stiles and NDP have committed to restoring supervised consumption sites if they form government. Greens are aligned. But Ford holds 80 seats to the opposition’s 44 and there is no parliamentary path to reversal. At the federal level Poilievre has called SCS “drug dens,” so rescue from Ottawa isn’t coming either.

My read on this is simple. The research on supervised consumption is about as clear as public health evidence gets: less overdose deaths, lower EMS costs, more connections to treatment. Ontario had 17 sites which collectively prevented nearly 22,000 overdoses over four years. Province shut them down, replaced them with facilities which explicitly reject harm reduction model, and paramedic calls went through the roof.

Doesn’t mean community safety concerns around the sites were fake. They weren’t. Karolina Huebner-Makurat’s death was real. But the policy response was to remove intervention entirely rather than fix what was broken about how the sites operated, and the early data says that choice is costing lives. It’s just costing them in places where they’re harder to count.

Sources and verification: Bill 223 details and Royal Assent date (December 4, 2024) confirmed via the Ontario Legislature website (ola.org). The 82% increase in Toronto opioid overdose calls (160 to 350), 69.5% province-wide EMS increase, and 67% ED visit increase from CBC reporting citing Toronto Paramedic Services and provincial data. The 22,000 overdose interventions figure from Health Infobase Canada (March 2020 to May 2024). The 67% neighbourhood mortality reduction from peer-reviewed research cited by Social Planning Toronto. The government’s 41% death claim cites Chief Coroner data; methodology has not been independently verified against the conflicting EMS numbers. Liberal caucus split (5 of 9 on Second Reading) reported by The Trillium. HART hub funding ($529M) and opening status from Ontario government press releases. Charter challenge and Justice Callaghan’s injunction from CBC and CP24 reporting.

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Track how your MPP voted on Bill 223 and other Ontario legislation at Ontario Pulse.