In March 2024, lack of government funding led to the closure of The Spot, the only overdose prevention center (OPC) in the Northern Ontario city of Sudbury. The Spot had opened its doors in 2022, in response to a nearly 350-percent increase in overdose deaths—three times the average for the rest of the province.
In Canada and around the world, most OPC are located in densely populated areas. The Spot was different. By land area, Sudbury is the biggest city in Ontario and the second-biggest in Canada. As the city’s only OPC, The Spot served a community that was spread out and relatively isolated.
In the September edition of the International Journal of Drug Policy, researchers published a study examining what happened to the community of people who use drugs (PWUD) in Sudbury after The Spot closed its doors. The research focused on systemic exclusion and oppression of marginalized communities.
“[W]e understand stigma as a governmental tool that can mark specific populations as less deserving of care and resources,” the authors wrote, “oppressing and harming the health of marginalized communities through the systemic exclusion of health care investments.”
With funding from the Canadian Institutes of Health Research, the authors hired five local peer research assistants with lived experience of injection drug use “to ensure the perspectives and experiences of people who use drugs are central to both the research design and analysis.” Some also had lived experience with hepatitis C. The authors also hired a “principal knowledge user” with lived experience of HIV.
“Participants often felt stuck. Caught between stigma, limited resources and geographic challenges.”
“[S]ubordinated groups (e.g., PWUD) have an epistemic advantage regarding their material, social and political worlds,” the authors wrote. “As such, we utilized a community-based participatory research (CBPR) approach that emphasized the voices of PWUD rather than those in positions of privilege.”
I have the utmost respect for corresponding author Dr. Geoff Bardwell and for people who work the way he does. Bardwell is an assistant professor in the School of Public Health Sciences at the University of Waterloo in Canada. Many know him as the director of Drug Lab, a research project that partners with PWUD in vulnerable communities.
The Sudbury study is titled “Necropolitics of the North: A rapid ethnography examining the effects of the closure of one of Northern Ontario’s only supervised consumption sites.” Bardwell told Filter that the simplest definition of “necropolitics” is that it’s a framework for understanding policy decisions that result in death—not always in an obvious way, such as laws that authorize the death penalty, but in ways that “dictate who is worthy and unworthy of living.”
“Northern people who use drugs are subjected to many risks that those living in an urban environment are not,” Lucas Tucker, an Ontario-based graduate research assistant at University of Waterloo and one of the study co-authors, told Filter. “Participants often felt stuck. Caught between stigma, limited resources and geographic challenges.”
People who had used The Spot before it shut down—some of them multiple times a day—described how fear of police arrest led them to use alone, in alleyways or in the bush, significantly raising their risk of fatal overdose. But if they used in more public settings, they faced discrimination.
“I’m around people, so if I do go down, I know that someone will save and be there to help,” one of The Spot’s participants told the study authors. “And if I’m alone, then I won’t. I won’t be able to come back, you know?”
“The loss is not simply losing supervised consumption, but also losing a sense of belonging.”
Words like these make my bones shiver. My heart goes out to those people; I can feel their pain.
Canada recorded 52,544 overdose deaths between January 2016 and December 2024. That’s an average of 16 people every day for nine years. But in December 2024, the Legislative Assembly of Ontario banned overdose prevention centers (OPC) from operating within 200 meters of schools and childcare centers. Out of the 17 OPC that were operating in the province, this meant 10 were faced with shutting down.
One of the sites is suing the administration in order to keep operating. Nine have been converted to “homelessness addiction and recovery treatment hubs,” which allows them to receive a lot more government funding to provide other harm reduction services, but not OPC services.
Of the 10 OPC targeted by the new law, five were in Toronto—which is one-fifth the size of Sudbury, but has 16 times more people. There is an abundance of literature discussing the public-health benefits of opening OPC, and the harms of closing them. But little of it is focused on less densely populated communities, since it’s rare that they had an OPC in the first place.
The Spot was more than a safe place to use drugs. It was a haven, a place to call home for the day. It’s customary for OPC to offer wraparound services and referrals to other housing and health care services, and their closure has an outsized impact for rural northern communities, where PWUD don’t have access to other harm reduction services the way they might in other parts of the country.
If Bardwell had the chance to speak his mind in the House of Commons, he’d tell officials to read the evidence in front of them and listen to the communities they supposedly serve. When people lose their routine and have no safe, supervised place to use drugs, that means they use drugs alone. Former participants have died since The Spot shut down.
Bardwell described the community as resilient, but also devastated, and feeling the sense of hopelessness that many advocates have shared as the government continues to move away from harm reduction.
“The loss is not simply losing supervised consumption, but also losing a sense of belonging,” he said. “I don’t think anything will replace The Spot.”
Image of The Spot in 2024 via Kaela Pelland/Creative Commons 4.0