Peterborough will soon become the 10th Ontario city to open a government-sanctioned supervised drug consumption site. The province announced funding to run the service out of the downtown opioid response hub on Simcoe Street last month.
The milestone is the culmination of more than four years of effort by social service agencies, community members and politicians. They faced long delays: first, in securing a willing landlord to host the site downtown; and second, due to onerous government applications and a 14-month wait for a decision.
The push for a safe consumption site in Peterborough stretches back to 2017. As plans for one inched forward, the drug poisoning crisis accelerated – taking more than 160 lives in the Peterborough area since 2017, according to public health data.
Ontario’s health ministry says that its model for safe consumption sites, which it calls Consumption and Treatment Services sites, saves lives. That’s because there are health care workers on hand to immediately reverse overdoses, which prevents death. And the sites can connect drug users to addictions treatment, mental health services, primary health care and social services, which can turn lives around.
So why has it taken more than four years to bring this life-saving service to Peterborough? Peterborough Currents cannot answer that question fully. But we can provide the following timeline of events, which is the most comprehensive account of the local efforts to open a government-sanctioned safe consumption site yet published.
To pull this timeline together, we have consulted many sources, including media reports, press releases, board meeting minutes and reports, and provincial policy documents. We also interviewed key figures in the local push to open a site, some of whom only spoke on the condition of anonymity. We spoke to these figures during the events they describe as well as more recently in preparation for publishing this timeline.
2003: Canada’s first sanctioned safe consumption site opens
Insite, a safe consumption facility serving injection drug users in Vancouver’s downtown eastside, opens in 2003. To operate legally, Insite obtains a federal exemption from the Controlled Drugs and Substances Act (CDSA). It is the first such exemption given to a safe injection site in Canada, and it will be the only one for more than a decade.
2011: Supreme Court rules in favour of Insite
Years of legal challenges culminate with a unanimous decision from the Supreme Court of Canada stating that the Harper government’s efforts to close Insite violated Charter rights and “contravened the principles of fundamental justice.” This ruling paves the way for other jurisdictions to pursue safe injection sites as a harm reduction tool.
2017: Toronto community sets up unsanctioned site
The opioid crisis takes a drastic toll across the province in 2017. More people are experiencing medical emergencies from overdoses than ever before and communities begin to take action.
Through the summer of 2017, harm reduction workers in Toronto open an unsanctioned safe consumption site. Health Canada moves quickly to sanction this location and Toronto Public Health takes over the project.
By fall 2017, Peterborough community members begin discussing whether a safe consumption site, sanctioned or unsanctioned, could address the crisis locally.
December 2017 – January 2018: Federal and provincial governments make opening sites easier
The federal government offers provinces the power to approve CDSA exemptions for temporary safe consumption sites without federal review, and Ontario accepts this offer in December 2017. The province follows up in January 2018 by launching a funding program for these facilities, which it calls Overdose Prevention Sites (OPS).
Service providers can now request legal approval and funding for the sites in a single provincial application. This greatly streamlines the process and makes opening temporary sites easier. In less than a year, more than a dozen sites will be sanctioned across Ontario. Most of those will be in Toronto and Ottawa. None of them will be in Peterborough.
Early 2018: Peterborough committee forms
In January, community agencies and individuals meet to discuss potential actions on the opioid crisis. At this meeting, organizers decide to pursue a sanctioned site for Peterborough under the OPS framework. By early February, they form a steering committee to guide the process.
According to harm reduction agency PARN – Your Community AIDS Resource Network (PARN), the intention is to work towards a permanent facility under a different provincial funding program – Supervised Consumption Sites (SCS). But the application process for an SCS is long, so the immediate focus is on opening an OPS in the meantime. The intention is to place the site downtown, and the search for a suitable location begins.
In March, organizers make their intentions known at a press conference. A site could open “within months,” Global News reports, with PARN acting as the lead agency on the application.
Spring 2018: Incomplete application submitted
In April 2018, the application is nearly complete. However, it is missing one essential component: a property owner willing to lease a location. Multiple strategies are used to try and secure a location for the OPS, but no property owners are willing, according to a 2019 report to the board of health.
Cognizant that the upcoming provincial election will impact government work, the steering committee submits an application to the Ministry of Health even though a location hasn’t been found. With no location identified, the application is deemed incomplete and is held as pending.
June 2018: Progessive Conservatives sweep election victory
The Progressive Conservative (PC) party under Doug Ford, who stated he was “dead against” safe injection sites during the campaign, wins a majority government. In Peterborough, PC candidate Dave Smith is elected MPP.
Organizers at PARN worry that the election result could derail their plans to open an OPS.
In July, the provincial health minister announces the PCs are reviewing the previous Liberal government’s policies on supervised consumption.
October 2018: OPS program axed, replaced by new CTS program
After the Ministry of Health’s review, the Ford government axes the OPS and SCS funding and exemption programs. They are replaced by a new funding program called Consumption and Treatment Services (CTS).
The CTS application demands more from the agencies that operate supervised drug consumption sites in Ontario. For example, CTS sites must demonstrate they offer additional addictions and mental health services, either on-site or via referrals, but the program doesn’t provide any new funding for these services.
Also, potential CTS operators must now obtain their federal exemption from the CDSA for themselves rather than rely on the provincial government’s power to grant them. Because of these changes, existing sites need to reapply for their federal exemptions and for their funding.
According to Toronto-based health and drug policy researcher Gillian Kolla, the stringent program requirements put an end to the expansion of supervised consumption services that Ontario had seen in 2017 and 2018. “What happened was a change in the administrative bureaucracy at the provincial level,” she says. “It was a move towards increasing the amount of regulation, the number of applications and the bureaucracies that organizations had to go through in order to open a site.”
Most sites that were approved and funded under the provincial Liberals will keep their funding and transition to the CTS model. But few new sites will be approved by the province moving forward.
Spring 2019: Starting from scratch while public interest builds
In March, PARN regroups local stakeholders to explore the option of opening a CTS under the new provincial program. At this time, the biggest hurdle remains securing a location for the CTS. Stakeholders consider a movable safe consumption site that could provide services in both the city and the county. PARN had recently secured a decommissioned ambulance, which could fill this purpose.
As they work, public interest in the opioid crisis builds. Between January and June, Peterborough Public Health (PPH) issues three drug alerts due to worrying upticks in suspected opioid-related deaths.
The CTS project gains a heightened profile after a public meeting in June 2019 organized by city councillors Gary Baldwin and Keith Riel draws nearly 100 people, including family and friends of people who died from drug poisonings. The bid for a safe consumption site is discussed and Smith tells the crowd, “If my government doesn’t approve it, after we have put something together, the responsibility falls on me.”
Later that month, Smith organizes the first meeting of a new committee that will work towards opening a CTS site.
July 1, 2019: Smith’s new committee meets
On the morning of July 1, the new committee convenes for the first time. PARN is still the lead agency on the application, though now the committee is led by Smith.
The new committee includes local politicians as part of the working group for the first time. City of Peterborough mayor Diane Therrien and deputy mayor for the County of Peterborough Sherry Senis are brought in to directly work on the application alongside Smith.
According to multiple sources who later spoke with Peterborough Currents, Smith tells agencies at this meeting that any application for a CTS must be approved by him before being submitted to the Ministry of Health. This is not a requirement laid out in the province’s application guidelines. However, in March 2022, Smith denies that he said this, calling the claim “100 percent false.”
July 2019: Mayor convenes a summit on opioids
People with experience of drug use share the Market Hall stage with political leaders and health leaders to discuss solutions to the local opioid crisis. The need for a supervised consumption facility is acknowledged. Smith says he is “standing behind” Peterborough’s application for a CTS and receives a warm ovation.
Mid-to-late 2019: Competing visions for a “hub”
A staff report to the board of health writes that the CTS steering committee settles on a “hub model” for the site. There are two visions for what a hub might look like.
One vision follows the example of the Fred Victor centre, a Toronto-based charity which hosts housing and homelessness programs alongside health care services (including a CTS) and poverty reduction programs. Under this vision, the facility would house existing services in the community – like housing services, addictions treatment and social services – that would relocate to the hub and provide services on-location.
The report by PPH staff states that “this approach would require extensive time and resources to make it a reality.” Given the urgent need in the community, the committee prefers a less ambitious plan that would provide referrals to treatment and social services, rather than host them on-site. This smaller-scale plan could be achieved more quickly, the report states.
Several community agencies are identified as eligible to host a CTS, but their landlords declined to host it when approached.
Fall 2019: Committee zeros in on two potential locations
Two potential locations emerge as the steering committee searches for a suitable location. One is 225 George Street North, a retail space that is sitting empty. The second is 415 Water Street – the downtown headquarters of the Haliburton, Kawartha, Pine Ridge branch of the Canadian Mental Health Association (CMHA). The committee comes to refer to these options as the “south site” and the “north site,” respectively.
Both sites are downtown. But the north site is 80 metres away from Victoria Park, which would trigger additional community engagement requirements. Some committee members are wary of this, given the neighbourhood’s recent reactions to the temporary encampment that sprung up in the park during the summer.
The majority of the committee prefers the south site, one source familiar with the deliberations will later tell Peterborough Currents. This is partly because the south site is “neutral territory” that isn’t yet associated with any existing agency in town.
There are also concerns that the plans emerging for the north site will make it inaccessible for some high-needs service users, according to other sources.
“I had frank conversations with CMHA about their ability to offer a CTS that has to be much lower-barrier than other services offered in the community,” remembers Suzanne Galloway of these discussions. At this time, Galloway is executive director of the Peterborough 360 Degree Nurse Practitioner-Led Clinic (360 Clinic) which was a partner on the application.
But there are also concerns about the viability of the south site. It is much larger than is necessary, for example, and it will require more renovations to bring up to fire code than the north site, according to CMHA board meeting minutes.
Significantly, Smith does not support the south site, as he will later make clear in a phone call to Peterborough Currents.
The October CMHA board meeting minutes appear to reflect a conflicted discussion surrounding CMHA’s involvement. “The board of directors support the concept,” the minutes state, but the board discussion brings up issues around long-term funding, whether there is “an exit strategy” and if they will receive negative publicity for their involvement.
Much remains unclear about the decision-making around this time. All that is clear is that time was running out to choose between the two locations. “There is a 30-day window left to decide on either location,” the November CMHA minutes state. “MPP Dave Smith will need to advise community partners of decision.”
By December 2019, there is still no clarity. “Deadline has passed for committee(s) to make a decision,” the CMHA’s December minutes state. “Future discussions are on hold until after the holidays.”
Despite this apparent holdup, the Peterborough Drug Strategy issues a press release in December announcing that the results of a community engagement survey show broad support for a downtown CTS among respondents.
January 2020: A sanctioned home for a different drug – cannabis
KawarthaNOW reports that a cannabis retailer has applied to open a shop at the south site location, under the name Grower’s Retail.
The property’s owner, Chris Schejbal, will write to Peterborough Currents in August 2020 that the parties who were interested in renting the space for a safe consumption site “backed out due to government approval/funding issues.” He says, “Had they met their own conditions they would be operating out of our building.”
The site negotiations have stalled and Smith’s office hasn’t convened the full steering committee since late 2019, sources say.
Donna Rogers will later say it is unclear at this time who could and should lead the project. Rogers is the executive director of local addictions treatment provider Fourcast, which is a partner in the CTS application at this time. Agencies continue to work on the application but “people were starting to become unglued,” she says.
March 2020: Pandemic hits Peterborough
A new public health emergency arrives in Peterborough. COVID-19 will dominate headlines for the next two years, but less attention will be paid to the catastrophic impact the pandemic will have on drug users in Peterborough.
Access to basic services is curtailed and the provincial government issues a stay-at-home order, which increases the likelihood of people using drugs alone – a risky behaviour that public health discourages.
In an update to the board of health, then-medical officer of health Dr. Rosana Salvaterra reports that the search is ongoing for a suitable location for the CTS.
Spring 2020: North site application progresses; stakeholders expect results before the end of the year
By April, the south site hasn’t panned out; Grower’s Retail is already moving in there. But it appears the north site – within the existing CMHA offices – is still on the table. The board of directors of the local CMHA branch votes in March 2020 “to move forward with continued negotiations with community partners,” according to meeting minutes.
CMHA staff are scheduled to attend a meeting with Smith in May 2020, and the CMHA board discusses the application through the spring and summer of 2020, the minutes show. By July, the minutes state the application is almost ready to submit, with PARN, CMHA and the 360 Clinic serving as co-applicants. “[Agencies] may know results of application within three months,” the minutes state.
August 6, 2020: “They couldn’t all work together”
In an August 6 phone call with Peterborough Currents, Smith looks back on the efforts of the last year. He says a major challenge has been the inability of local agencies to cooperate. “They couldn’t all work together,” he says.
Rogers will later deny this claim. Local harm reduction, addictions treatment and mental health agencies “are interconnected across all of our service offerings. So the notion that we don’t work together … just isn’t true,” she tells Peterborough Currents in March 2021.
Smith confirms that the larger steering committee has stopped meeting as a result of the disagreements. “We’ve refocused,” he says. “There is still a group committed to it. But it is a much smaller group working towards a CTS application.”
Smith doesn’t specify which partners he is still working with, but judging by the CMHA’s board meeting minutes, it appears to be the application put together by PARN, CMHA and the 360 Clinic which he is referring to. “We’re close to an application,” he says.
In the phone call, Smith also states that without increased local options for addictions treatment, a safe injection site alone will only “kill more people.” Smith questions the suitability of the south site, saying that “some proponents of a certain model” preferred it but he did not.
“How effective is treatment going to be at the back of a cannabis store?” he asks. “That’s like having Alcoholics Anonymous at a brewery.” Peterborough Currents understands that there was never a plan to co-locate a CTS with a cannabis store, but that operating both on the same property with separate entrances was considered.
August 16, 2020: Former bus station listed for sale
The Peterborough Examiner reports that the Liftlock Group has put 220 Simcoe Street up for sale. The property had served as Greyhound’s Peterborough terminal until the company suspended service in the wake of the pandemic.
August 19, 2020: CMHA board votes to “discontinue negotiations”
By August 19, it appears the north site plan has fallen apart. On that date, the CMHA board votes to “discontinue CMHA negotiations with respect to the Consumption Treatment Site,” according to meeting minutes.
“Unfortunately, at the time, a consensus on a suitable site was never reached,” CMHA CEO Mark Graham writes in a March 2022 statement to Peterborough Currents.
One source who later speaks with Peterborough Currents says an application was submitted to the Ministry of Health around this time, but it was withdrawn shortly after.
Writing to Peterborough Currents, Smith will later say that PARN and the 360 Clinic “chose to end the relationship” with the CMHA around this time.
August 20, 2020: Former bus station receives a conditional offer
myKawartha reports that a conditional offer has been made on 220 Simcoe Street.
October 2020: Opioid response hub announced for 220 Simcoe Street
By fall, the sale of 220 Simcoe Street has closed and the new owner is local property developer Kevin MacDonald.
In early October, Peterborough Drug Strategy partners announce that a five-year lease has been secured to use 220 Simcoe Street as Peterborough’s new opioid response hub and that applications will be made to operate a CTS there. Though PARN will be the active lead on the application, Fourcast is the agency to sign the lease. Salvaterra calls the news “a breakthrough achievement.”
The location announcement is not welcomed by adjacent property owner Don MacPherson, who tells the Peterborough Examiner that he would scrap his plan to build condos across the street if the site goes ahead.
Smith is present at the virtual press conference about the hub, but when a reporter asks him what he will do to speed the CTS application along, the event moderator steps in to say Smith is not participating in the announcement.
December 2020: Applications submitted
The Peterborough Drug Strategy partners announce that applications have been submitted to Ottawa for an exemption from federal drug laws and to the provincial government for funding to operate a CTS site at 220 Simcoe Street. The wait begins.
By the end of 2020, an increasingly toxic drug supply is exacerbating the opioid crisis. The number of people killed by opioid poisonings in Peterborough has soared, from 29 in 2019 to 43 in 2020. Experts point to a highly volatile drug supply as one root cause.
Early 2021: Fourcast takes over the application
In early 2021 PARN is experiencing a second change in leadership in a short period and questions its capacity to maintain the lead applicant role. PARN requests Fourcast take over as lead with the understanding that PARN will continue as a key partner in the project.
Rogers will later say that up until this point Fourcast’s role had been to support the project and follow the lead set by other organizations. While feeling the project is outside the scope of their treatment work, Fourcast agrees to become lead applicant. Rogers will later say it felt like it needed to be done to keep progress moving.
April 2021: “In the coming months”
Responding to a question from Councillor Kemi Akapo during his annual update to city council, Smith says he is unable to comment on the status of the CTS application. He reiterates the need for enhanced treatment options in the city, and says he hopes to announce progress on that front “in the coming months.”
June 15, 2021: Federal exemption approved
At a press conference, Fourcast announces that it has received its federal exemption to operate a supervised consumption site at 220 Simcoe Street. This gives the agency legal permission to allow consumption of illicit drugs at the location, but it doesn’t come with any funding to run it.
“The experience of other Ontario CTS [sites] is that the Health Canada exemption is followed closely with the approval of operating funding,” says Rogers at the announcement.
At this point, the provincial government is funding only 16 of the 21 CTS sites it says it has set aside funding for.
June 23, 2021: Trinity United votes to disband congregation
A statement from Trinity United Church says its congregation has voted to disband, according to the Peterborough Examiner. This frees up Trinity’s Reid Street property for other uses. A few weeks after the vote to disband, Trinity’s minister Joanna MacQuarrie writes to Peterborough Currents that the congregation is “exploring a number of options regarding how to proceed in ways keeping with Trinity’s mission and vision.”
MacQuarrie does not provide further details, but Peterborough Currents later learns that Smith has turned his attention to Trinity as another site where health care, addictions treatment, and potentially consumption services could be located.
Fall 2021: Successful campaign raises over $160,000 for renovations at 220 Simcoe Street
Months pass following the Health Canada exemption and there are no updates forthcoming on provincial funding.
In September, the Community Foundation of Greater Peterborough (CFGP) announces a campaign to raise $160,000 in support of renovating 220 Simcoe Street using the floorplan developed for the CTS. Over 100 community members, local businesses, and the City of Peterborough rally to raise the money, and the CFGP’s goal is met by December.
But behind the scenes, Smith raises objections to hosting a supervised drug consumption site at the former Greyhound bus terminal, as he later tells Peterborough Currents.
”When you look at that application, and you look at the floor plan that they’ve put forward, the question you have to ask: Where’s the treatment? Because it’s not on-site,” he says in a February interview. “You have to be working towards getting people to treatment. Continuing to get high is not going to get anyone better.”
The agencies behind the opioid response hub say they will have an addiction counsellor, mental health intake worker, nurse paramedic and harm reduction workers on-site who will provide services and referrals to the other health care and social services in the community.
January 12, 2022: Losing patience as the death toll climbs
In January, PPH reports that there were a record 44 suspected opioid-related deaths in 2021. The death toll has climbed significantly since 2017, when 18 people in the region died due to opioids.
Peterborough’s board of health votes to write a letter to provincial Health Minister Christine Elliott seeking an update on the CTS funding application. Peterborough city council follows suit with its own letter to Elliott.
January 19, 2022: Opioid response hub reopens after renovations
The opioid response hub opens at the Simcoe Street location after its renovations. The hub offers harm reduction supplies such as sterile needles and wound care kits to drug users. It is also the homebase of MSORT, a federally-funded local outreach team that responds to people who have survived overdoses and provides referrals to addictions and mental health treatment providers.
Addictions counseling and opioid withdrawal support will be available once COVID-19 public health measures allow for more staff to work on-site.
There is a sense of excitement as the hub finally opens. But there is also frustration that more than a year after the application was submitted, and more than seven months after the federal government granted its approval, there is still no answer from the provincial government on whether or not it will fund the CTS.
“We request updates, and we’re told the application has been accepted and they’ll contact us when a decision has been made,” says Kerri Kightley, program manager for Fourcast.
Meanwhile, Smith has been pushing for a new, larger facility that would bring more addiction and mental health services together under one roof. Discussions about a potential site are already underway, he says in a February interview. While Smith doesn’t name a location, sources tell Peterborough Currents that the discussions surrounding Trinity United’s potential to become what Smith calls “a community health and wellness hub” are continuing.
Smith asks Rogers to commit to moving the CTS to a larger facility, if one becomes available. Rogers says she is open to the idea. “If this is a hold up … yes, we’ll look at any options that are available to us that could potentially improve the chances of getting this thing moving forward,” she says.
February 2022: A new approach to funding
With provincial funding still in limbo, PPH seeks emergency funding from local municipalities to open a temporary supervised drug consumption site. The temporary site would offer fewer services than a CTS, but it could be opened as soon as March. The goal would be to keep it running until November, or until provincial funding for the permanent site comes through.
The region’s new medical officer of health, Dr. Thomas Piggott, asks Peterborough County to pitch in $200,000. “With every month that goes on we lose four additional lives in this community,” he tells county council. “We can’t continue to sit back and see nothing done for this crisis.”
Some councillors argue against funding the interim site because health care is a provincial responsibility. Council votes to defer a decision on the request until April, so they can meet with local MPPs to try to find out what’s holding up provincial funding. Meanwhile, Piggott intends to make a similar request to Peterborough’s city council.
Piggott also asks Peterborough’s board of health to kick in funding, and it votes to provide up to $250,000 toward the interim site, if provincial funding doesn’t materialize by March.
February 25, 2022: Provincial funding comes through
Smith holds a press conference to announce that the province has agreed to fund a Consumption and Treatment Services site at the opioid response hub.
The funding agreement is for $1.357 million annually – the full amount of Fourcast’s budget request, according to Rogers.
Rogers tells reporters that her team will move quickly to hire staff and begin operations, but does not say when the service will be up and running.
Given the objections Smith had raised about the Simcoe Street site earlier that month, Peterborough Currents asks him repeatedly what changed to lead to the funding approval. He does not answer, saying he prefers to focus on “the fact that we’re making a positive difference in this community.”
There is no mention of one day moving the drug consumption and treatment site to a larger location with more on-site services. However, Smith says that the funding approval is only “one step” in dealing with the drug poisoning crisis. “I want to make it very clear to our community that this is not the finish line,” he says.