Overdose prevention sites save lives

For the past six years, the Kensington Market Overdose Prevention Site has operated just around the corner from St. Stephen in-the-Fields church in Toronto. It is run by the Neighbourhood Group – formerly St. Stephen’s Community House, founded from the parish several decades ago. It is a small, low-profile, well-managed site – so much so that many people in the neighbourhood were unaware that it existed until 2019, when the provincial government arbitrarily defunded it, with the excuse that there was also a site at Queen and Bathurst streets. Since that time, it has run on donations and the work of extraordinarily dedicated staff and volunteers.

Though the KMOPS is one of the smallest sites in Toronto, it has saved hundreds, perhaps thousands, of lives. As the toxic drug crisis has escalated, staff have taken it upon themselves to become a sort of mobile crisis unit, dashing through the streets and alleyways with naloxone and oxygen tanks, in response to emergency calls. I have worked alongside them to reverse overdoses near the church. The workers at the overdose prevention site distribute a full range of harm reduction supplies and also package them for my parish to distribute. They provide community, support and compassion, as well as connections to medical care, mental health care and addictions counselling. Many people have moved from being clients of the site to entering the Neighbourhood Group peer worker program, which has given them a sense of meaning and value, and often helped them significantly reduce their use of street drugs. Although Kensington Market is a hotspot for overdose deaths, there has never been a single death at the site, and a study in the Lancet last year showed that overdose death rates had actually declined in the area immediately around it.

Unusually, the KMOPS serves not only opiate users but also users of crystal meth, who may be less vulnerable to overdose but often need a calm, quiet space in which they can come down. Indeed, the site has been a space of peace for reasons quite unrelated to street drugs. Last year, when one of the residents of the encampment outside the church was dealing with the terminal illness of his beloved dog, the overdose prevention site became a space where he and his pet could have privacy and rest together. When people are in distress or escalated emotional states, it is normal for outreach workers or church volunteers to take them to the site, not for overdose prevention but for peace and community.

And it is this small oasis of safety and kindness that the provincial government has seen fit to label as a “drug den” and a threat to children and public safety. The KMOPS is one of 10 sites scheduled to be closed by provincial mandate, in March 2025 or before.

The Ford government has tried to create a false dichotomy between harms reduction and treatment, but all experts and frontline workers in the field know that they are part of one continuum and that harms reduction, and especially safe drug consumption sites, are one of the most efficient pathways into treatment. It’s now widely known that even the expert reports commissioned by the government did not recommend shutting down any sites, and in fact recommended creating more.

The story has been spun as being about the safety of children (ironic, coming from a government that seems fiercely dedicated to making round-the-clock access to alcohol as easy as possible, including at convenience stores right beside schools). But we know that if these sites are closed, children, and everyone else, will be much less safe. There will be deaths in our parks, in our streets, very possibly in our schoolyards. There will be more discarded needles, since the government’s proposed new “treatment hubs” will be banned from having needle exchange programs. There will be more infectious and bacterial illness, as people use old and contaminated equipment. There will be more drug dealing, more organized crime, more violence. Just as clearing encampments does not make homeless people magically housed, so closing overdose prevention sites will not somehow make drugs go away.

The alternative: allow these spaces of kindness, encourage them, resource them, create more. They will not solve all the problems of our very troubled and broken society. But they will keep some people alive, and some of them for long enough that they can heal, can know themselves to be loved, can live without being driven to use street drugs for a momentary feeling of value. And to save one life, as Rabbi Hillel may have said, is to save the world entire.