Update: The Safe Health Site Timmins has closed its doors permanently as of August 14. A press release from the Cochrane-Timiskaming branch of the Canadian Mental Health Association states, "As the organization and partners have yet to receive a response from the Ontario government on funding, the operation of the site is no longer viable."
Michelle Couture still remembers Timmins in the early days of the pandemic, when the northeastern city of 40,000 had the highest rate of overdose-related deaths in Ontario, at 75.3 per 100,000 — more than four times the provincial rate.
“People would use in public bathrooms or laneways or at the shelter,” says Couture, formerly a harm-reduction worker at SHST. “They didn’t know when they could get their next shot — so they would use really fast and a lot.”
In 2021 alone, 41 people died from overdoses in Timmins, spurring the creation of northeastern Ontario’s sole safe-consumption site the following year.
At Safe Health Site Timmins, across the street from city hall, clients can access harm-reduction supplies, such as clean needles and kits to safely consume crystal meth, and be connected with housing options and addictions and mental-health services. Until recently, those who’d already procured opioids could sit at one of three tables and use them in a controlled environment with staff able to deliver Narcan, naloxone, and other opioid-agonists in case of an overdose.
“The main thing is people were not using as fast or as much, because they have an environmental control,” Couture says.
Michelle Couture was a harm-reduction worker at Safe Health Site Timmins. (Kunal Chaudhary)
Since opening in July 2022, the site has received 40,000 visits and reversed more than 400 overdoses. According to Cochrane District Paramedical Services, the creation of the site reduced calls for overdose intervention by 20 per cent, freeing up resources for other emergencies in the community. The monthly cost of operating SHST, including its safe-consumption services, was about $86,000 per month; the Timmins and District Hospital estimates that the site has saved the community more than $7 million in health-care costs.
Despite such results, the site has faced constant threats to its approval status and funding. Funded first by the municipality and then by the local hospital, the site is, as of July 2, being operated by the local branch of the Canadian Mental Health Association.
The lack of consistent funding means it will no longer be able to provide safe-consumption services, a loss that many in the community — including clients, emergency services, and former staff like Couture — say will push people who use drugs into isolated corners of the city once again and lead to more avoidable deaths.
“More than a place to use substances”
Patrick Nowak, manager of addictions and outpatient mental health at Timmins and District Hospital, describes the past two years as a “roller coaster.”
“It takes a long time to build up enough trust with someone who has traditionally been stigmatized by the health-care system for them to say, ‘I think I’m ready to give recovery a shot,’” says Nowak, who managed harm-reduction services at SHST. “No one quits smoking cigarettes the first time, you know — it takes dozens of times to get off something like nicotine. Fentanyl is a whole different scourge.”
It’s this trust, painstakingly earned over repeated positive encounters with people who use drugs, that Nowak says was threatened every time SHST came close to shutting its doors.
“You’re already working with a group that has experienced many traumas, and you’re starting to build that trust back up again. But on several occasions [over the past two years], we have had to announce that the site is closing,” he says. “Now that it’s gone for good, what happens to that trust?”
Agenda segment, September 2, 2022: Northern Ontario's opioid challenge
Nowak isn’t concerned just about the loss of safe-consumption services — he points to a range of medical treatments and adjacent resources that will be pared down without dedicated funding.
“The site is a lot more to people than just a place to use substances,” he says. “It’s a place to maintain their medical regimen, to get foot care, to get access to withdrawal-management services and get their monthly Suboxone injection. A lot of that is at risk of being markedly reduced.”
According to SHST, the majority of client visits were not for safe-consumption services. In its first 18 months of operation, around 70 per cent of clients who accessed harm-reduction services never used at the site.
“It’s not too often that people get it just right the first time in terms of recovery,” Nowak says. “Treatment beds are great, but sometimes it takes multiple discharges, admissions, hitting rock bottom to build up the motivation to quit. In the meantime, places like this keep people alive.”
Future remains unclear
In January 2023, the Cochrane-Timiskaming branch of the Canadian Mental Health Association applied to establish SHST as a provincially funded safe-consumption site.
To date, the province has not given it that approval, though SHST has received a federal exemption from Health Canada to offer safe-consumption services.
“It’s not usable at the moment, because we don’t have the dedicated funding for safe consumption,” says Angele Desormeau, director of addictions and housing services at the CMHA-CT. “That’s the sad part of all this. As much as we remain optimistic that the province will move quickly to approve this important, life-saving service, we don’t know from one day to the next. So we just want to maintain the location, because it is directly connected with our applications for funding.”
Safe Health Site Timmins opened in July 2022. (Kunal Chaudhary)
In the interim, she says, the site will continue to provide harm-reduction supplies and connect people with resources, including withdrawal-management services at the Timmins and District Hospital.
“It’s a variety of things we want to be able to offer, and we’re reaching out to partners in the community to have them available as well.”
In response to questions about the status of the application, a spokesperson for Health Minister Sylvia Jones told TVO Today that the province is engaged in a review of all 17 provincially approved sites.
“These reviews include consulting with Public health, community engagement and are focused on enhancing accountability measures and oversight,” they wrote in a statement. “These reviews will determine the next steps taken by the Ministry of Health including funding, location and application decisions. All applications remain on pause.”
While they wait, Couture says the community of people who use drugs in Timmins will be left to look out for one another.
“These people are not bad folks — there are people here who are genuinely very kind and just don’t want to get sick,” she says. “Best-case scenario, I foresee people in that community committing to watching each other more and not using alone. Worst-case scenario, a lot of good people are going to die.”
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