Resistance = Life: Civil society mobiizing to defend overdose prevention sites and supervised consumption services in Ontario, Canada

Cécile Kazatchkine, Richard Elliott, Nicholas Caivano, Sandra Ka Hon Chu, Janet Butler-McPhee

Canada is in the midst of an opioid overdose crisis, with nearly 4000 opioid-related deaths in 2017, up 34% from the previous year. Most (69%) involved fentanyl. Frustrated with legislative barriers to secure federal exemptions to operate “supervised consumption sites” (SCS) without risk of prosecution, community activists began to open unsanctioned pop-up “overdose prevention sites,” adding to pressure for legislative reform and other action by governments.

In December 2017, pursuant to agreement with Ontario's provincial government, Canada’s federal Health Minister issued a time-limited “class exemption” from drug possession charges for any person attending an “overdose prevention site” (OPS) approved (and funded) by Ontario. This was issued under the Controlled Drugs and Substance Act (s. 56) as being “in the public interest.”

In June 2018, a Conservative government was elected in Ontario, headed by a leader who actively condemned “safe injection sites” during the campaign. In August 2018, his government announced it would (1) review the evidence about SCS, (2) “pause” the imminent opening of 3 already-approved OPS, and (3) refuse to approve new OPS pending the review; a decision about continued support was anticipated by September 30, when existing exemptions were to expire.

Advocates mobilized via: submitting evidence to the health minister; media advocacy; direct action, including a pop-up OPS near one of the approved “paused” sites and planting 1265 crosses in front of the legislature to mark those dead of overdose in Ontario the previous year. The Legal Network also mobilized an open letter from 120+ organizations, including all the major national health professional organizations (physicians, nurses, public health), HIV organizations, community health centres, mental health organizations and others, which generated national media coverage.

On September 30, 2018, Ontario announced it would continue its review, postponing a final decision but continuing the moratorium. (Additional developments anticipated before HR19.)