What Support Is Available for Substance Use and Opioid Addiction in Ontario?

If you or someone you care about is struggling with opioid addiction or substance use, knowing where to turn for help can feel overwhelming. Between 2016 and 2023, Canada faced a severe public health crisis with over 40,000 deaths attributable to the toxic drug supply, and Ontario alone accounted for approximately 25% of these fatalities, with 10,900 deaths reported during this period . You are not alone, and support is available. Opioid agonist therapy has also been shown to: reduce the harms related to your drug use, so you can engage in therapy, other treatment options, or other aspects of your life like social, financial or family issues . Ontario offers a range of evidence-based services including harm reduction programs that prioritize safety and dignity, opioid agonist therapy that reduces cravings and prevents withdrawal, treatment and recovery programs tailored to individual needs, and peer support from people with lived experience. This guide explains how to access these services and find the support you need.

What is opioid agonist therapy and how does it work?

Opioid agonist therapy, sometimes called OAT or medication-assisted treatment, is a medical treatment for people with OUD. It reduces your cravings for opioids and prevents severe withdrawal symptoms. With opioid agonist therapy, long-acting opioid medications are given under the supervision of a health care provider . Treatment involves taking medications that prevent withdrawal and reduce cravings. These medications include methadone, buprenorphine (Suboxone, Sublocade) and slow-release oral morphine (Kadian) . Extended-release OAT: Extended-release buprenorphine (brand name Sublocade). This medication is administered once a month by a healthcare provider, injected under the skin . OAT works by activating the same opioid receptors in your brain as other opioids but in a controlled, stable way that prevents the highs and lows of street drugs. With the correct dose, these medications won't get you high, sedate you or cause trouble with your thinking. You should be able to function, feel and think normally .

Where can I access opioid agonist therapy in Ontario?

Most programs reported that they admitted clients on OAT (88%) and only a minority expected or encouraged clients to taper (14%) or discontinue (6%) , showing that OAT is widely accepted as evidence-based treatment. TPH offers an opioid substitution program that includes methadone and suboxone. Services offered include counselling, support and referrals to housing and other community services. This is a self-directed, client-centred program that does not require abstinence . You can access OAT through your family doctor or nurse practitioner if they are trained to prescribe these medications, specialized addiction clinics and Rapid Access Addiction Medicine clinics that provide same-day or walk-in access, community health centres across Toronto and Ontario, or Toronto Public Health programs. Of the cohort, 56.1% began OAT after 2014. Southern Ontario participants more often started on methadone (53.2%), while Northern Ontario patients favored buprenorphine/naloxone (62.7%) . You do not need to wait for a referral to start OAT. You can self-refer or walk into a Rapid Access clinic to begin treatment quickly.

Is opioid agonist therapy covered by OHIP or insurance?

The cost of OAT medication varies depending on your age and coverage. If you are under 25 and have an Ontario health card, OAT medications are fully covered through OHIP+ at no cost to you. If you are 65 or older or receiving social assistance through Ontario Works or ODSP, your medications are covered through the Ontario Drug Benefit program. If you do not qualify for these programs and do not have private insurance, you can apply for the Trillium Drug Program, which caps your annual medication costs at approximately 4 percent of your household income. Doctor visits and pharmacy dispensing fees for OAT are generally covered by OHIP. Some programs also provide additional wraparound supports like counseling, case management, and harm reduction supplies at no cost.

What harm reduction services are available in Toronto?

Harm reduction refers to policies, programs, and practices that seek to reduce the negative health, social, and legal impacts associated with substance use, without requiring an individual to have the goal of abstinence . TPH Harm reduction services will be available through on-the-ground outreach teams. Street & Mobile Van Outreach – Providing harm reduction supplies (naloxone, needle exchange) . Toronto harm reduction services include free naloxone kits and training to reverse opioid overdoses, needle and syringe distribution programs that provide sterile equipment and safe disposal, drug checking services that test unregulated substances to identify contents and potency, wound care and nursing services for people who inject drugs, education on safer drug use practices, and peer support and outreach programs. These services are confidential, non-judgmental, and designed to keep you safe while meeting you where you are at.

How do I access free naloxone in Ontario?

Naloxone, also known by the brand name Narcan, is a drug that can temporarily reverse an opioid overdose. Naloxone can be picked up for free from your local harm reduction agency or pharmacy and free training is available online. Consider carrying multiple doses of naloxone . TPH provides training to opioid users, their friends and family in preventing, recognizing and responding to an overdose. Program participants are trained on how to administer naloxone. Opioid users, their friends and family are provided with a take-home naloxone kit that contains naloxone and instructions on how to use it . You can get free naloxone at most Ontario pharmacies without a prescription, harm reduction agencies and community health centres across Toronto, supervised consumption sites, Toronto Public Health programs, and through mobile outreach teams. Training on how to recognize an overdose and administer naloxone is available online, in person at pharmacies and harm reduction agencies, or through community workshops.

Are supervised consumption sites still operating in Toronto?

TPH closed its services at 277 Victoria Street on April 1, 2025. TPH will no longer offer supervised consumption services . The last supervised consumption site in Toronto's west end is being forced to "wind down" services after the Ontario government said it will be pulling the service's funding as of Nov. 22 . The supervised consumption site landscape in Ontario has changed significantly due to government policy changes. Several sites have closed, while others remain open under court injunction while legal challenges are resolved. Street Health (338 Dundas St. E.), Parkdale Queen West Community Health Centre (1229 Queen St. W.), Moss Park of South Riverdale Community Health Centre (134 Sherbourne St.) continue to provide supervised consumption services as of early 2026. We posit that rate reduction at larger distances is potentially a result of naloxone dissemination across neighbourhoods, or an indirect effect of SCS acting as sites of low-barrier referrals to opioid agonist treatment, which is protective against overdose mortality . Supervised consumption sites save lives by preventing fatal overdoses and connecting people to health and social services.

What is drug checking and where can I access it?

Have your drugs checked to find out what's in them. Knowing what's in the drugs you use is a harm reduction strategy that can help you make educated choices about your drug use. Please see information at Toronto's Drug Checking Service . In Toronto, drug checking services are offered at Parkdale Queen West Community Health Centre (Parkdale and Queen West and sites), Regent Park Community Health Centre, South Riverdale Community Health Centre (KeepSix and Moss Park sites), Street Health, and The Works at Toronto Public Health . Drug checking allows you to test a small sample of your drugs before using them to identify what substances are present, how potent they are, and whether they contain dangerous contaminants like fentanyl or benzodiazepines. The service is free, confidential, and non-judgmental. Results help you make informed decisions about whether and how to use drugs more safely.

What treatment options are available beyond medication?

OAT, like other treatments for substance use disorder, works best in combination with additional psychosocial support, such counselling, peer-led and mutual support groups, and culturally focused interventions . A slight majority of programs provide some type of specialized services to clients with OUD (58%), most frequently providing or facilitating access to OAT but also specialized counselling, case management, education, and harm reduction services . Treatment options in Ontario include individual counseling with addiction counselors or therapists, group therapy and mutual support programs, residential treatment programs that provide intensive support in a structured environment, day programs that offer therapy and support while you continue living at home, culturally focused interventions for Indigenous peoples and other communities, and family therapy that involves loved ones in the recovery process. Many programs now take a harm reduction approach that does not require abstinence as a condition of participation.

How can I get help right now if I need it?

If you need immediate support for substance use or addiction, several resources are available 24/7. Call ConnexOntario at 1-866-531-2600 to speak with someone who can connect you to mental health, addiction, and problem gambling services in your area. The Distress Centre line provides crisis support and can connect you to resources. If you or someone you are with is experiencing an overdose, call 911 immediately. Good Samaritan laws in Canada protect you from being charged with simple drug possession when you call for help during an overdose. Rapid Access Addiction Medicine clinics provide same-day or walk-in appointments for people seeking help with substance use, often including same-day access to OAT. Community health centres across Toronto offer drop-in services, harm reduction supplies, and referrals to treatment.

What support is available for families and loved ones?

If someone you care about is experiencing substance use challenges, you also need support. Family education programs help you understand addiction, set healthy boundaries, and support your loved one without enabling harmful behaviors. Al-Anon and Nar-Anon are peer support groups for families and friends of people with substance use disorders. Community health centres often offer family counseling and support groups. Toronto Public Health provides education and naloxone training for friends and family members. Some addiction treatment programs include family therapy as part of their services. Remember that you cannot force someone into treatment, but you can offer support, express concern without judgment, and ensure they know where to access help when they are ready.

Are there culturally specific addiction services in Ontario?

Traditional Healing and Indigenous cultural support services are available to enhance culturally safe care for Indigenous clients in home or the community by incorporating traditional approaches to care . Overall, the results demonstrate that psychosocial programs provide some specialized services for OUD but desire further support specifically to provide OAT, including training, knowledge, and the expertise of individuals qualified to prescribe and dispense OAT . Ontario offers several culturally focused addiction services including Indigenous healing programs that incorporate traditional practices and ceremonies, Black-focused mental health and addiction services, services for newcomers and refugees in multiple languages, 2SLGBTQ+ affirming programs, and youth-specific services like the Trip! Project for young people who use drugs. Anishnawbe Health Toronto, Native Child and Family Services of Toronto, and other Indigenous organizations provide culturally safe addiction support.

What should I know about safer supply programs?

Prescribed alternatives (also known as safer supply) are another approach that may be available for some people at risk of drug toxicity. This approach involves providing short-acting opioids (e.g., hydromorphone tablets) as an alternative to unregulated substances, with the primary goal of reducing drug toxicity and other harms associated with unregulated drugs . If you use opioids, learn more about safer supply programs. Safer supply programs provide people who use drugs with prescribed alternatives to opioids obtained from the unregulated supply . Safer supply programs are available in some Ontario communities and aim to reduce overdose deaths by providing pharmaceutical-grade alternatives to the toxic unregulated drug supply. These programs are controversial but are based on evidence that they reduce harms for people who are not ready for or have not been successful with OAT. If you are interested in safer supply, ask your healthcare provider or contact a harm reduction agency for information about programs in your area.

Key tips for accessing substance use support in Ontario

• You can self-refer to most services: You do not need a doctor's referral to access OAT, harm reduction programs, or many treatment services.
• OAT is evidence-based and covered: Medications like methadone and Suboxone are proven to save lives and are covered by OHIP+ for people under 25, ODB for seniors and people on social assistance, and Trillium for others.
• Carry naloxone: Free naloxone kits are available at pharmacies and harm reduction agencies and can reverse opioid overdoses, saving lives.
• Harm reduction services are confidential and non-judgmental: You can access needle exchange, drug checking, and other services without fear of judgment or legal consequences.
• Treatment does not require abstinence: Many programs now support harm reduction approaches and will work with you wherever you are on your journey.
• Help is available 24/7: Call ConnexOntario at 1-866-531-2600 anytime to find services near you.
• Recovery looks different for everyone: Your path may include OAT, treatment, harm reduction, peer support, or a combination. There is no wrong way to seek help.

Substance use and opioid addiction are health issues, not moral failures, and Ontario offers comprehensive, evidence-based support to help you stay safe and work toward your goals. Whether you are looking to reduce harm, start medication-assisted treatment, access peer support, or explore recovery options, services are available that will meet you where you are without judgment. Taking the first step to reach out for help, whether for yourself or someone you care about, is an act of courage, and you deserve compassionate, effective support on your journey.