Nearly one year after Ontario replaced nine supervised consumption sites with recovery-focused centres, many are still only partially operational.
Staff at the new Homelessness and Addiction Recovery Treatment (HART) Hubs say they are seeing many positive outcomes. But they also note demand far exceeds capacity and that some of the promised services are still being rolled out.
“It’s a drop in the bucket,” said Chris Curry, program director of the Lanark, Leeds and Grenville HART Hub in Lanark.
“They could easily put another $500 million, I’m sure, and it would go to good use.”
HART Hub rollout
Supervised consumption sites allow individuals to use pre-obtained drugs under professional supervision to reduce the risk of overdose and other harms.
The sites have long been controversial, with some neighbourhood residents saying they contribute to public disorder and safety concerns. In July 2023, for example, a young mother was fatally shot near Toronto’s South Riverdale Community Health Centre supervised consumption site.
The following December, Ontario banned supervised consumption sites from operating within 200 metres of schools and child-care centres. Nine sites across the province were ordered to transition to HART Hubs by April 1, 2025.
The province also pledged $550 million to open 19 new HART Hubs. HART Hubs offer primary care, case management, mental health and addiction counselling, but do not offer supervised drug consumption or needle exchanges.
Ontario also promised to create 560 supportive housing units and addiction treatment beds.
As of this February, all nine former safe consumption sites have been transitioned to HART Hubs.
Of the 19 additional HART Hubs that were announced, 11 have opened. One was opened in each of Barrie, Windsor, London, Belleville, Dufferin County, Sarnia, Sudbury, Renfrew, Lanark, Leeds and Grenville, and two opened in Sault Ste. Marie. It is not clear when the remaining eight are expected to open.
Community impacts
HART Hub staff say the hubs are a welcome addition.
In Lanark, which did not previously have a supervised consumption site, the new HART Hub has been “extremely successful so far,” said the hub’s program director Chris Curry.
“If you were to talk to any of the clients who are in there right now, they would tell you their life has changed forever, and they’re the happiest people you’ll ever see.”
In Kitchener-Waterloo, the HART Hub has been operating since April 1, 2025. According to the hub’s leadership, the hub is “currently at 94 per cent operations.” Twelve transitional housing beds are expected to open in March, at which point the hub will be fully operational.
The Kitchener-Waterloo hub delivers services in partnership with seven community agencies that were already serving vulnerable residents.
“These trusting relationships and familiarity allow ‘change oriented’ individuals to access some or all available supports regularly,” a representative told Canadian Affairs in an email.
In Toronto, Bill Sinclair, CEO of the Kensington Market-based social agency Neighbourhood Group Community Services, says the addition of a HART Hub to the neighbourhood has been beneficial.
“We’re big fans — we think they’re great,” said Sinclair. “We’ve been asking for more treatment, more doctors and nurses, more housing for forever.”
He says clients are visiting daily to learn what services are available.
Neighbourhood Group Community Services continues to run a supervised consumption site in the neighbourhood; while ordered to close, its closure is currently being challenged in the courts.
Sinclair says the supervised consumption site has seen a 30 per cent increase in users since other nearby sites were closed. “It has been busier than ever, as we feared,” he said.
![Kensington Market Overdose Prevention Site in Toronto, Dec. 18, 2024. [Photo credit: Alexandra Keeler]](https://i0.wp.com/www.canadianaffairs.news/wp-content/uploads/2025/01/photo_2025-01-02-14.13.21.jpeg?resize=780%2C585&ssl=1)
In Hamilton, the city’s only supervised consumption site was transitioned to a HART Hub. Sandy Ezepue, the hub’s executive director, said individuals were slow to engage due to misinformation. Some clients feared the hub would force them into treatment.
Ezepue says the hub has been a good addition, but is not a direct replacement for the former site.
“There’s still a gap there, because some people still just want a safe space to use [drugs] that the hub cannot provide,” she said. “Both programs are needed.”
Ezepue says Hamilton has seen an increase in drug overdoses since the closure. In January, paramedics responded to a record number of suspected overdose calls.
“Some of these overdoses are people that … we used to [serve] in the past,” she said. “So it’s been difficult for the frontline staff.”
Operational challenges
Nearly a year after they were due to be operational, many hubs are still waiting on housing, residential treatment beds, withdrawal management and transitional beds.
In Thunder Bay, Juanita Lawson is CEO of the NorWest Community Health Centre, which leads the city’s new HART Hub. Lawson said harsh winter conditions and unstable housing have worsened health outcomes.
“If you’re living on the street, or … an encampment, it’s really hard to make progress forward,” she said.
Lawson noted the abrupt closure of the city’s only supervised consumption site has also led to former clients using drugs in worse locations.
“[People are using drugs] in public spaces or, more often than not, in the back alleyways,” Lawson said.
In the Guelph-Wellington region, a new HART Hub is offering primary care, peer support and a clinic that helps people get identification cards. However, withdrawal management beds are not yet available, and the 20 to 30 supportive housing units are already fully occupied, a hub representative said by phone.
In Ottawa, Somerset West Community Health Centre closed its supervised consumption services in March 2025, and did not open its HART Hub until that September. It currently only offers showers, meals and leisure activities. The centre did not respond to multiple requests for comment.
Curry, program director of Lanark’s hub, says even successful hubs face client needs that exceed the available resources.
“These are extremely complex clients,” Curry said. “No one comes with one issue. It’s not like, oh, I drink too much. It’s… I have childhood trauma. I am precariously housed. I don’t have a good employment history. I have credit problems. I have debt.
“It’s just almost insurmountable for these folks. So a little bit of a patchwork and just giving someone, here’s your house, and good luck to you… I don’t personally think that’s going to work.
“I think you really do have to build the person back up.”
As a mother, daughter, and wife, this topic is something I think about deeply. I also carry my own experiences with childhood trauma and other forms of trauma, and those experiences have shaped how I see people who struggle with addiction and mental health challenges. Trauma changes people, and many individuals who are struggling today are carrying pain that started long before their substance use began.
Working in the mental health and addictions field has opened my eyes even more to how complex these situations are. Many of the people we see in our communities are not just dealing with addiction. They are also facing trauma, unstable housing, mental health challenges, poverty, and a lack of support. Recovery is not simple, and it cannot happen without the right supports in place.
When I think about people out in our communities who are struggling, I think about how important it is to meet people where they are at. Some people are ready for treatment and recovery, while others are not there yet. Both still deserve support, dignity, and compassion. Services that provide treatment, counselling, housing, and mental health support are incredibly important, but we also have to recognize that harm reduction services have helped keep many people alive long enough to even have a chance at recovery.
At the end of the day, the people we see struggling are someone’s child, someone’s parent, someone’s partner. As a mother, I cannot help but think about that. No family hopes their loved one will struggle with addiction. People deserve more than judgment — they deserve understanding, support, and real opportunities to rebuild their lives.