With the closure of Peterborough’s Consumption and Treatment Site (CTS) soon approaching, public health and harm reduction experts are raising concerns about the potential for increased medical need, further stigmatization of service users, and fewer opportunities for inter-agency collaboration.
“I think the closure and this loss is tremendous — I don’t understand it,” said Dr. Thomas Piggott, medical officer of health and CEO of Lakelands Public Health, in a recent interview with kawarthaNOW.
A response to the opioid crisis, the Peterborough CTS opened in June 2022 inside the renovated former bus terminal at 220 Simcoe Street in downtown Peterborough to provide a safe and medically supported space for people to consume pre-obtained illicit substances under the supervision of trained health professionals.
Medical officer of health: ‘These sites work … they do keep people alive’
Lakelands Public Health has been a leading clinical and advocacy partner in the operation of Peterborough’s CTS, in part through holding the medical directive that permits on-site staff to provide life-saving medical care such as the administration of Naloxone and oxygen.
“Most sites across Ontario have some kind of a medical director,” explained Dr. Piggott. “Because there was no budget for this (a medical director at Peterborough’s CTS), we voluntarily provided my support and services in-kind to the site.”
Dr. Piggott said that public health organizations across North America and Europe have been involved in harm reduction efforts such as safe consumption, needle exchange programs, and safer supply for 30 to 40 years.
Drug strategy collectives across Canada, including both Peterborough Drug Strategy and Haliburton, Kawartha Lakes, Northumberland (HKLN) Drug Strategy, identify harm reduction as part of their multifaceted four-pillars approach.
“We have three to four decades of knowledge that these sites work and that they do keep people alive and help to support their access to potential healthcare support,” Dr. Piggott said.
Another member of the Peterborough and HKLN Drug Strategy collectives, the Peterborough AIDS Resource Network (PARN) has also said the long history of harm reduction work has shown proven results in reducing fatalities and medical emergencies associated with substance use.
“The risk of fatal drug poisonings decrease a lot — the data tells you that,” Dane Record, executive director for PARN, told kawarthaNOW.
In December 2025, Peterborough Public Health (now merged with the Haliburton, Kawartha, Pine Ridge District Health Unit as Lakelands Public Health) reported that drug poisoning deaths were 41 over 11 months, down from reported figures of 60 in 2024 and 78 in 2023.
PARN receives funding from the Ministry of Health to provide single-use supplies such as injection and inhalation equipment to promote and enable safe use of personal illicit substances.
“There are so many benefits to having a sanctioned consumption and treatment site in that it makes the work of PARN, along with other agency partners, a little bit easier,” said Record.
EMS calls and ER visits for opioid-related overdoses increased after first nine CTS sites closed
For Dr. Piggott, the closure of the CTS will have “widespread” impacts on the healthcare system at large due to the numerous services available at the CTS beyond supervised consumption and needle exchanges.
People using the CTS are provided with information on safer consumption practices, drug checking, basic medical services, and referrals to addiction treatment services, housing, and other social services.
One direct impact Dr. Piggott noted was the loss of the CTS as an alternative drop-off location for emergency medical services when someone is experiencing a drug-related medical emergency.
“Now with the closure, they’ll be presenting in more of an emergency state at the (Peterborough Regional Health Centre) emergency department,” said Dr. Piggott.
Following the Ontario government’s closure of the first nine CTS sites in the province, the Canadian Drug Policy Coalition tracked calls made to emergency services and visits to the emergency department for opioid-related overdoses.
A release from the coalition says “Ontario-wide data shows a sharp increase in EMS calls (+69.5%) and emergency department use (+67%).”
Dr. Piggott cited this research when speaking about the likelihood of the CTS closure directly impacting emergency medical services, saying “it’s not a hypothetical — this will happen.”
In addition, Dr. Piggott said that many service users receive all of their healthcare through the CTS, as they do not have other access to primary care. As such, he explained, primary care shortages and access challenges in the wider community may be exacerbated by the closure by forcing more people onto waitlists.
Local healthcare leader Ashley Safar, executive director of the Peterborough Community Health Centre, also expressed concerns that the impending closure will impact the work of other healthcare organizations within the community.
“I am concerned about what the impact will look like on the larger healthcare system,” Safar told kawarthaNOW recently.
CTS closure will push unsafe consumption into public spaces
Further to this, both Dr. Piggott and Record identified the significant intersection between people who use substances and historically marginalized populations such as Indigenous people, 2SLGBTQ+ individuals, and people of colour experiencing barriers to accessing healthcare.
“Some people that are using the CTS have huge distrust with healthcare services,” Dr. Piggott said. “They don’t feel safe going to another family doctor or to the emergency department for care.”
When the initial CTS closures were announced by the Ontario government in August 2024 as part of their “safer communities” policy shift, one reason given for this decision was increased safety concerns in public spaces.
However, harm reduction advocates say that the closure of supervised consumption sites does not decrease the level of substance use, but rather it forces people to use in unsafe spaces — often public spaces.
“There’s always going to be a way and a means and an opportunity if somebody wants to get high,” said Record.
Dr. Piggott said that the elimination of harm reduction services “pushes consumption to other areas, but it doesn’t address the root causes.”
Both Record and Dr. Piggott spoke about the connection between public safety concerns, cuts to harm reduction services funding, and the stigmatization of substance use and addictions.
“That gets to the stigma there is against street drug use,” said Dr. Piggot. “We wouldn’t ever turn people away at the hospital if they had a health impact from alcohol or cigarettes.”
For his part, Record spoke to the safety concerns for CTS service users and identified the potential for increased surveillance of individuals using substances in public spaces.
“It’s a potential return to being surveyed — being over-surveyed,” said Record.
He said that a major concern is a rise in vigilantism, with local residents attempting to displace people using or suspected of using substances in public. Record noted instances where tents and belongings of unhoused people being damaged or removed to dissuade them from staying at a location.
“It’s vigilantism and it’s violent,” he added.
Harm reduction work will continue after CTS closes
Looking ahead, both Lakelands Public Health and PARN will continue their work in harm reduction, health education, and community engagement in the absence of the CTS.
At the same time it closed CTS sites across Ontario, the Ontario government invested $500 million in 28 Homelessness and Addiction Recovery Treatment (HART) Hubs, including one in Peterborough, that are focused on treatment, recovery, and housing. However, the hubs do not offer supervised consumption or harm reduction services like needle exchange.
Record explained that, as an HIV-prevention organization, PARN is funded by the government to provide needle exchange and clean equipment programming and therefore will continue to do so following the closure.
“Not having 220 Simcoe Street available is going to be a hindrance, but there is no disruption of needle exchange or inhalation exchange programming or resources,” he said.
Dr. Piggott and Record both said that ultimately the decision to close CTS sites is political, and as such harm reduction experts will continue to advocate for policies based on frontline evidence and past successes.
“It’s certainly not lost on me that it’s an election season,” Record said. “This is going to be a hot button topic.”
“I think we’re at a moment, a political moment, where there is a lot of upset and anger,” said Dr. Piggott, referring to the perception of issues with supervised consumption sites. “I think that is because we are attributing problems to a solution, instead of attributing problems to the root causes.”
