Disclaimer: We recognize that this blog series cannot capture the full complexity and nuance of substance use and the ongoing drug toxicity crisis. We acknowledge the many intersecting factors and diverse experiences that shape this issue. These blogs are intended as a starting point for important conversations about better understanding the crisis, the role of Supervised Consumption Sites (SCS), and the need to reduce stigma toward people who use drugs. We encourage readers to explore the additional resources linked throughout and at the end of each blog for further information.
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For many, the word “drug” holds negative associations. Substances such as caffeine, nicotine, or prescribed medication are also drugs; however, they are rarely identified as such. Instead, there is a tendency to associate the word “drug” with illicit use, which attaches judgement to the word and stigmatizes people who use certain types of drugs. The reality is that many people use different types of drugs regularly.
Drug use is not inherently bad. A prescription medication may be part of a treatment plan to address pain after an injury, or to support immune systems or mental health. Over-the-counter medication may help relieve a cold or headache. Many people smoke cigarettes or consume alcohol recreationally. These are all more commonly accepted substances, but are still “drugs.” To reduce stigma, we need to interrogate our typical interpretation of drug use.
Why do people use non-prescription drugs?
The practice of self-medicating – treating symptoms outside of doctor supervision – is not uncommon. With certain types of drugs – like over-the-counter painkillers or cold medicine – this practice is safe and manageable because these substances are regulated. Alternatively, self-medicating with illicit drugs can quickly become unsafe and difficult to manage.
For many people, illicit substance use begins as a method of coping with chronic physical or emotional pain, poverty or homelessness, or trauma. Consider individuals who experience chronic pain; prescribed medication that once provided relief may become ineffective over time as their body builds up a tolerance, which can result in self-medicating with stronger or illicit substances for relief.
The use of substances, prescription or otherwise, can develop into substance use disorder (SUD). Contributing factors are often considered to be bio-psycho-social in nature, which means that susceptibility to SUD includes biological factors (genetic predisposition and brain chemistry), psychological factors (mental health, trauma, and emotional regulation), and social factors (social networks, social location, and systemic barriers). Considering these factors, some individuals are at higher risk of developing SUD; those who have experienced trauma or are living with mental health challenges, those who do not have their basic health and safety needs met, and communities that continue to face stigma or barriers when navigating social and health services.
Why focus on overdose risk?
Health care officials have deemed Canada to be in a public health crisis resulting from the widespread use of illicit opioids – often referred to as the “opioid epidemic” or “opioid crisis.” Over the last 10 years, provinces across the country have seen an increase in opioid-related hospitalizations and deaths.
As prescribing opioids became more widespread, so too did dependency and SUD. This resulted in an increased use of unregulated drugs to manage dependency, a situation many pain patients face if they lose access to their prescribed medication. Unregulated drugs can contain unexpected substances, increasing the risk of overdose because the content of the drug may be unclear to the user. Testing services, which were commonly offered at Supervised Consumption Sites (SCS), are a critical harm reduction tool for supporting safety – they allow people who use drugs (PWUD) to know exactly what substances they are using. The unpredictable nature of unregulated substances, often tainted with high potency opioids, can lead to accidental drug poisonings, which was the leading cause of death for women, aged 20-39, across Canada in 2024.
So how do we address this crisis?
Substance use is complicated, and there is not one simple solution. However, doctors, nurses, social workers, and PWUD attest that harm reduction services are an effective approach to mitigating risk. Instead of criminalizing substance use, harm reduction initiatives achieve more successful health outcomes by addressing the needs of the individual.
Public SCS, which have now been de-funded across Ontario, offered these life-saving harm reduction tools, including drug testing, needle exchange, and a space to safely use drugs while under the supervision of trained medical professionals. They also helped PWUD to navigate the exact bio-psycho-social factors that contribute to SUD by providing access to healthcare, referrals for mental health support and housing, resources for food and financial security, and a non-judgmental community.
Between March of 2020 and February of 2026, SCS across Canada responded to more than 53,000 overdoses – with zero fatalities. Every life saved is a success. The recent closures of publicly-funded SCS have been followed by an immediate, significant, and avoidable increase in overdose-related EMS calls, in turn adding pressure to our healthcare system.
Why should you care?
PWUD are your friends, your co-workers, and your neighbours; harm reduction is a critical component of community safety. De-funding a service that has proven to be life-saving and effective in reducing harm during an epidemic that kills 15 people in Canada daily sends a clear message: the safety of PWUD does not matter.
As the last public sites close their doors, we will see a rise in drug use in public spaces like sidewalks, parks, and public transit. We will also continue to see increased pressure on our strained public health system.
The opioid crisis is a feminist issue, with Indigenous communities, people experiencing housing instability, and low-income individuals all at higher risk of opioid poisoning. At YWCA Toronto, our frontline service providers see firsthand the impacts of the opioid crisis, and the recent closure of publicly funded SCS, on women and gender diverse people experiencing poverty and housing instability in Toronto. As we strive to support a society where communities can thrive, we must do our part in protecting life-saving services. Investing in harm reduction and preventative care is foundational to a thriving society and safe communities for all.
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This blog is the second in our Harm Reduction and the Critical Role of Supervised Consumption Sites series. Review our last blog to learn about Safe Consumption Sites, and stay tuned for Part Three: Supervised Consumption Sites from a Feminist Perspective: Understanding the Gendered Impacts.
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If you or a loved one needs substance use support, resources and services are
available here.
Learn about naloxone, a fast-acting medication that can temporarily reverse the effects of an opioid overdose, and access free take-home naloxone kits here.
Need immediate support or information about addiction? Contact the Toronto Addiction Call Centre at 1-888-370-7175.
Do not use alone. Contact National Overdose Response Service here.
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To better understand the content in this blog, here are few key terms:
- Drug: a chemical that affects the body or mind, including medications – used to describe a specific type of substance.
- Substance: often used interchangeably with the word “drug,” a broad term that can be used to refer to active medication ingredients, or drugs that that have high rates of dependency.
- Medication: a specific drug prescribed by a doctor to treat or prevent a condition.
- Illicit substance use: the use of an illegal substance or misuse of prescription medications.
- Substance Used Disorder (SUD): a term that has largely replaced the word “addiction” and is defined by a person's uncontrolled use of a substance despite harmful consequences.
- Opioids: A group of drugs typically prescribed to treat pain, which are considered to have high potential for dependence.
- Toxic drug supply/Drug toxicity crisis: terms used to describe the unpredictable nature, and danger, of unregulated substances (drugs not obtained from a pharmacy).