DeepDive: Opposition to supervised consumption sites is growing—but the mainstream media hasn’t seemed to notice

DeepDives is a bi-weekly essay series exploring key issues related to the economy. The goal of the series is to provide Hub readers with original analysis of the economic trends and ideas that are shaping this high-stakes moment for Canadian productivity, prosperity, and economic well-being. The series features the writing of leading academics, area experts, and policy practitioners. The DeepDives series is made possible thanks to the ongoing support of the Centre for Civic Engagement.

For decades, supervised consumption sites (sometimes called “safe injection sites”) were heralded as a life-saving innovation by Canadian public health officials and supported by most municipal, provincial, and federal governments.

A famous Supreme Court decision in 2011, coupled with the Trudeau government’s relaxed policy for creating new sites, contributed to an elite consensus that consumption sites—and the harm reduction philosophy underpinning them—were an unambiguous public health good for individuals and communities.

As this DeepDive shows, that consensus is eroding—albeit slowly, and in some institutions more than others. There has been a growing pushback against supervised consumption and harm reduction policies from provincial governments, academics, physicians, journalists, and community organizations. Yet this resistance has not penetrated most elite institutions.

My analysis shows how the federal government, courts, and news reports from mainstream media outlets remain strongly supportive of supervised consumption sites, despite growing concerns about the efficacy of this approach to drug addiction. As provincial governments find creative ways to move away from harm reduction, they will face an uphill public relations battle.

The origins of supervised consumption: Vancouver’s Insite

In 2001, Vancouver developed a “four-pillar” approach to drug policy, focused on prevention, treatment, enforcement, and harm reduction. The new pillar of harm reduction, described as a “pragmatic approach that focuses on decreasing the negative consequences of drug use for communities and individuals,” required “accepting the fact that drug use does and will occur.” As part of this strategy, Insite, North America’s first supervised consumption site, opened in Vancouver in 2003. Insite operates as a regulated health facility where users bring and consume their own drugs while monitored by health-care staff. Users are provided with health information and can be given referrals to counselling and other services, including Onsite, a recovery and withdrawal centre upstairs. However, participation in these additional services is voluntary.

Insite received immediate buy-in from municipal and provincial governments, community organizations, and even police. It received an exemption from the federal Controlled Drugs and Substances Act by the Chrétien Liberals in 2003 and the Harper Conservatives in 2006 and 2007. Yet the Harper government was never fully on board. “If you remain a drug addict, I don’t care how much harm you reduce, you’re going to have a short and miserable life,” Harper said in 2007. Harper’s Health Minister Tony Clement called Insite “a failure of public policy” and indicated he would no longer grant the site any exemptions, which would have forced it to close.

Not for the last time, supervised consumption sites went to the court—and won. After victories in lower courts, in 2011 a unanimous Supreme Court held that the federal government’s decision not to grant Insite an exemption violated the Charter right to “life, liberty and security of the person.” The Supreme Court was unequivocal in assessing Insite’s impact: “Insite saves lives. Its benefits have been proven. There has been no discernible negative impact on the public safety and health objectives of Canada during its eight years of operation.” Insite remained open, but the Harper government passed a law making it far more difficult to open any future sites.

Supervised consumption policy under the federal Liberals

Justin Trudeau’s election victory in 2015 signalled the end of federal opposition to supervised consumption sites. Harm reduction was added as a pillar of Canada’s drug strategy in 2016, and a 2017 law simplified the application process for establishing a supervised consumption site.

As a result, a flurry of new sites opened; while the federal government’s dashboard does not track sites before 2020, my contemporaneous lecture notes show that the federal government had approved 22 sites by 2017 and 42 by 2019. Between March 2020 and February 2025, the number of active sites “reporting” to the federal government remained stable between 35 and 39.

At least 50 supervised consumption sites have been operational at some point in Canada (the federal dashboard lists 47, but does not include two current sites in Halifax and Regina, nor a Red Deer site that was recently shut down).

As of September 2025, the federal government lists 32 active sites: 14 in Ontario, five each in Quebec, Alberta, and British Columbia, two in Saskatchewan, and one in Nova Scotia. Nearly two-thirds (20) of the 32 active sites are in five cities (seven in Toronto, four in Montreal, and three each in Ottawa, Vancouver, and Edmonton). Only one application—the Snuneymuxw Traditional Medicines Wellness Centre in Nanaimo, B.C.—has been refused for “not sufficiently meet[ing] the medical purpose of a section 56.1 exemption under the Controlled Drugs and Substances Act.”

While incomplete (it does not include Alberta data), the federal dashboard shows that, between March 2020 and February 2025, there were more than 3 million visits to consumption sites across 456,000 unique “clients” (drug users), 69 percent of whom were male and 63 percent of whom were between ages 30 and 49. Fentanyl constitutes nearly half (49 percent) of the drugs used at the sites, followed by methamphetamine (21 percent) and hydromorphone/Dilaudid (11 percent). While several Ontario sites have recently shut down, there are 11 open applications for new sites, including in Winnipeg, Whitehorse, and Kelowna, and Cape Breton.

The backlash against supervised consumption 

As supervised consumption sites became normalized, a parallel policy development occurred: “safer supply.” This policy involves prescribing free drugs—opioids, stimulants, or benzodiazepines—to drug users “as a safer alternative to the toxic illegal drug supply to people who are at high risk of overdose.” Health Canada began funding safer supply projects via the Substance Use and Addictions Program in 2020. The safer supply portion of that program expired in March 2025 and was not renewed; however, many safer supply programs are still operated and funded by provinces and municipalities.

Safer supply has been heavily criticized. Journalist Adam Zivo has regularly documented how these drugs have been diverted to the black market in British Columbia and Ontario, with police, addictions experts, academics, and physicians claiming safer supply has exacerbated the opioid crisis, particularly among youth. Even the Globe and Mail has published op-eds criticizing safer supply (though its lead health columnist has called safer supply diversion “trivial”).

The parallel developments of safer supply, B.C.’s failed experiment with decriminalizing drug use in public spaces, and the normalization of supervised consumption sites have led to push back from provincial governments.

A triggering event was the 2023 death of Karolina Huebner-Makurat, a mother of two, who was struck by a stray bullet near a supervised consumption site in the Leslieville neighbourhood in Toronto. It later emerged that the shooter was treated by a nurse at the consumption site after the shooting, and that a site employee helped the shooter evade police and subsequently developed a romantic relationship with him. The shooting made national headlines for months, and the employee eventually pleaded guilty to being an accessory but avoided jail time.

This seemed to spur the Ontario government into action. In December 2024, Ontario passed a law banning supervised consumption sites from operating within 200 metres of schools or daycares, which would have forced 10 sites to close. However, as part of its new addictions strategy, the government also announced it would provide former consumption sites with up to four times as much funding to transition into rehabilitation-focused homelessness and addiction recovery treatment (HART) hubs—so long as they no longer offer supervised consumption services, which Premier Ford called a “failed policy.”

A similar shift occurred out West. A 2020 review commissioned by the Alberta government was critical of the public safety implications of consumption sites, particularly with respect to needle debris, discarded drug paraphernalia, and panhandling. Alberta has since moved towards a recovery-oriented approach to addictions and mental health. Five consumption sites still operate in the province, although the government shut down a Red Deer site earlier this year and announced plans to close another one in Calgary. Opposition leaders from the Conservative Party of Canada and the Conservative Party of British Columbia have also promised to shut down consumption sites, which they referred to as “drug dens.”

Unsurprisingly, the Ontario and Alberta closures have produced Charter litigation, with mixed results. In Alberta, the Court of King’s Bench and Court of Appeal both denied a temporary injunction to keep a Red Deer consumption site open earlier this year; the Court of Queen’s Bench issued its full judgment in August, rejecting the Charter claim and allowing the consumption site to remain closed.

In Ontario, Superior Court Justice John Callaghan granted an injunction in March preventing the government from banning sites within 200 metres of a school or daycare. Justice Callaghan held that consumption sites “provide both lifesaving and health benefits” and that permitting the sites to remain open “will have a substantial public benefit of preventing serious health risks and deaths.” While it will be months before his full Charter judgment is released, it is difficult to foresee Justice Callaghan—who chided the government days after his injunction for not providing sufficient facts—changing his mind.

In spite of Justice Callaghan’s injunction, nine of the 10 sites (including the site of the Leslieville shooting) shut down anyway, as they opted for the government’s carrot of increased HART hub funding over the uncertainty of future litigation. The only site of the 10 that remained open is operated by the Neighbourhood Group in Toronto, which initiated the litigation.

Media portrayal of supervised consumption

The Ontario judicial injunction provides an opportunity to assess how the media covers consumption sites during a time of heightened scrutiny. I conducted a content analysis of coverage from seven mainstream media outlets—CBC, CTV, Global News, The Globe and Mail, the National Post, the Toronto Star, and the Toronto Sun—from March 28 to April 10, 2025, a period covering the two weeks following the decision (and which happened to coincide with a federal election). Using the search terms “supervised consumption” and “safe injection,” I found 32 unique articles with a detailed discussion of the Ontario judicial decision or supervised consumption sites more broadly. Hard news pieces (30) dominated coverage, with only two opinion pieces discussing consumption sites (by the Sun’s Brian Lilley and the Globe’s André Picard).

Of the 32 stories, 11 (34 percent) focused on the judicial decision or the Ontario policy fallout, with an additional seven (22 percent) featuring a closer look at specific supervised consumption sites in several Ontario cities, several of which were about to shut down. The remaining articles were related to Pierre Poilievre’s opposition to consumption sites (six), Alberta’s decision to close down a Calgary site (two), the opening of Ontario’s HART Hubs (two), data on overdose deaths dropping (two), the sentencing hearing for the Leslieville SCS worker (one), and a follow-up story about the Ontario judge seeking greater clarity on facts in the Charter case (one).

As the table below shows, the CBC had the most stories, with 14 over two weeks, four of which were written by Canadian Press reporters. This is in keeping with CBC’s extensive and generally positive coverage of consumption sites. More surprising was the relative absence of stories from the National Post, which only featured two news articles during this period (about Poilievre’s opposition and the injunction judge gathering facts for the subsequent full hearing). The Post has published more than half a dozen pieces critical of consumption sites, safer supply, and judicial activism in 2025 alone, but an activist judicial decision preventing the Ontario government from shutting down the sites flew under the paper’s radar—presumably because its coverage was focused on the ongoing federal election.

To see how the judicial injunction was portrayed, I focused on the 11 stories about the judicial decision and/or the Ontario policy fallout. I coded every person or organization quoted in the articles, separating them into supporters of the injunction and supervised consumption sites on the one hand, and opponents of the injunction/sites on the other (excluding quotes from government officials and from the injunction itself). In total, supporters were quoted 28 times, an average of 2.5 times per article. These quotes typically came from leaders of non-profits and public health organizations and often used stark language, such as: “Today’s decision means people will be allowed to stay alive at least a little bit longer” (quoted by  The Canadian Press) and “the 200-metre rule, which will close the sites, will cause people to die” (quoted by CBC). On the other hand, only three opponents of consumption sites were quoted (0.3 times per article)—all in the same Toronto Star story that also quoted three supporters of consumption sites. These quotes came from materials presented at the hearing itself from a government lawyer, a criminologist, and an intervener factum.

The contrast was most prominent in pieces written by the CBC and The Canadian Press (the latter separated out in the table below), which collectively contained quotes from 14 proponents of consumption sites and zero opponents. In these 14 stories, the only mild criticism of consumption sites came from the same Ontario government spokesperson, who typically offered a brief statement such as “Our priority is to protect children and families from violent crime and dangerous public drug use occurring at drug injection sites located near schools and daycares.”

It is worth noting one final thing about the media portrayal: the nuanced position of Neighbourhood Group CEO Bill Sinclair, whose organization launched the legal challenge and remains firmly opposed to closing down consumption sites. Sinclair himself was quoted in seven of the 11 articles, primarily praising the judicial decision and defending the importance of consumption sites. Yet in two stories—both from Global News—Sinclair also praised the Ontario government’s creation of its recovery-focused HART hubs, saying “HART Hubs are important …It’s more doctors, more nurses, more treatment, more housing” and “I am so glad [the province] were so generous and that there are going to be so many” new hubs. The journalists at Global News and Sinclair both deserve praise for presenting a more nuanced view than was typically present in the media coverage of the consumption sites.

Conclusion

For two decades, Canadian supervised consumption sites have benefitted from a strong elite consensus that they presented a life-saving public health intervention. That consensus is starting to crack, with a growing chorus of opposition towards harm reduction, safer supply, and the sites themselves.

My analysis leads me to four conclusions. First, even in the face of provincial opposition, the federal government continues to promote a highly sanitized and “clinical” narrative on supervised consumption sites. Drug users are referred to as “clients,” while the sites themselves provide “a safe, clean space for people to bring their own drugs to use in the presence of trained staff.” As the evidence for harm reduction is increasingly contested, Canada’s federal government remains undeterred.

Second, supervised consumption proponents continue to have a firm ally in the courts. Fourteen years after the Supreme Court of Canada found that Vancouver’s supervised consumption site had “no discernible negative impact on the public safety and health objectives,” an Ontario court declared that consumption sites provide such “lifesaving and health benefits” and that government cannot even prevent them from operating near daycares or schools. In recent years, provincial superior courts have issued injunctions or declared rights violations when governments have tried to evict people from encampments, prevent public drug use, ban panhandling, and even remove bike lanes. It is no surprise that consumption sites were next on the list.

Third, mainstream media reporting on Ontario’s judicial injunction was far more likely to cite supporters than opponents of supervised consumption sites, leading readers to believe that the only opposition to such sites comes from conservative provincial governments. This is especially notable insofar as the op-ed pages of the National Post and even The Globe and Mail have been increasingly likely to feature criticism of harm reduction. However, the combination of a strong advocacy community, a judicial ruling, and a federal election meant that criticism of Ontario’s judicial injunction was almost entirely absent from media coverage.

Finally, recent events show that politicians opposed to supervised consumption sites can find clever ways around adverse judicial decisions. The judicial injunction required the Ontario government to permit the 10 consumption sites to remain open, yet nine of them closed anyway. The Ford government has encouraged the sites to transition towards treatment and recovery by restricting funding to non-consumption activities. While some have proposed using the stick of the notwithstanding clause, it turns out the carrot of government funding may—for now—be sufficient to thwart an activist judiciary.

Editor’s note: This article has been updated to reflect the release of the Alberta Court of Queen’s Bench decision.