Substance-related deaths and harms, driven by the ongoing drug toxicity crisis, pose a serious health threat in Ontario. Nationally, 52,544 apparent opioid-related deaths were reported from January 2016 to December 2024, highlighting the scale of this crisis and the urgency of addressing it. Harm reduction approaches that aim to minimize the negative effects of substance use without requiring abstinence have been a critical component of the response to drug-related harms in Canada. In Ontario, this has included the establishment of “Consumption and Treatment Services” (CTS) where people are able to bring their own substances to use in designated spaces with the presence of trained staff. An international body of evidence demonstrates the effectiveness of such sites in reducing drug-related mortality and morbidity as well as facilitating other positive health- and public order-related outcomes. In August 2024, however, the Ontario government announced that it was banning the operation of CTS within 200 metres of schools or childcare centres and prohibiting the opening of new sites. This legislation came into force as of March 31, 2025, resulting in the closure of multiple CTS sites across the province and significantly limiting access to CTS for people who use drugs in the province.