As opioid users shift to smoking over injection, Ontario has only one supervised inhalation site, raising urgent public health and safety concerns.
Drug Use Habits Are Changing Fast
In Ontario, the number of people smoking opioids has surged—but infrastructure to keep them safe hasn’t kept pace. According to 2024 data from the Ontario Chief Coroner’s Office, only 4% of fatal overdoses were linked solely to injection, down from 20% in 2018. In stark contrast, smoking-related overdose deaths climbed to 40%, more than doubling since 2018.
Experts Call for Immediate Action
Gillian Kolla, a drug-use researcher and assistant professor at Memorial University, said Ontario has fallen “behind the curve” in providing safe spaces for those who inhale drugs. Despite clear trends in how opioids are consumed, the province still lacks the infrastructure to address the shift. “We know what we need to help support people who smoke their drugs,” said Kolla, adding that multiple studies and firsthand reports all point to the same conclusion.
Only One Inhalation Booth in the Province
Toronto’s Casey House, a specialty hospital serving HIV-positive patients, runs Ontario’s only supervised drug inhalation booth. Installed in 2021, the facility is simple but effective, featuring ventilation fans and private access. CEO Joanne Simons said around 80% of clients now choose to smoke rather than inject, prompting discussions to open a second booth. “The need is so great,” she noted.
Lack of Government Funding Hinders Expansion
Ontario’s 2019 consumption and treatment services plan excluded funding for inhalation booths. With construction costs around $50,000, only facilities with private donors—like Casey House—can afford to build one. Simons said other health centres across Canada have expressed interest but are deterred by the financial barrier.
Government Maintains Hardline Stance
A spokesperson for Health Minister Sylvia Jones reaffirmed the government’s policy in a statement: “The government does not and will never support the use of illicit drugs in public spaces.” The Ford government has instead redirected focus to treatment-based initiatives, transitioning nine consumption sites into HART Hubs that provide broader addiction and housing support.
Is Smoking Actually Safer Than Injecting?
Dr. Ahmed Bayoumi, a health researcher at St. Michael’s Hospital in Toronto, said smoking drugs may reduce certain risks, including infections from dirty needles and rapid overdoses. “The rate at which drugs accumulate in the bloodstream is slower with smoking,” he explained, “which allows more control over dosage.”
Harm Reduction Workers Raise Alarm
Zoë Dodd of the Toronto Overdose Prevention Society recalled the province’s early steps toward safer inhalation with a 2017 tent in Moss Park. Though it operated without official approval, thousands used it and many overdoses were reversed. Today, she says, workers often run outside to respond to inhalation-related overdoses on the street, where no safe environment exists.
Deaths Still Alarmingly High
Over 2,200 Ontarians died from opioid toxicity in 2024—more than triple the number from a decade ago. While the total death rate has dipped slightly in recent years, experts warn that without dedicated inhalation sites, those numbers may climb again. Advocates say time is running out to catch up with changing drug-use patterns and save lives.
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