On Monday evening, two large tents were pitched on the grass along a busy stretch of King Street in the Parkdale neighbourhood in Toronto’s west side. Some people set up tables and folding chairs inside them as others brought in oxygen tanks and packs of water bottles and snacks.

“I knew right away what was going on,” said Natalie Spinney, exhaling cigarette smoke. She’s lived in Parkdale for three years and was passing by when she saw the makeshift structures. By now, volunteers put up a bright pink sign welcoming people to the city’s latest unsanctioned overdose prevention site.

As someone who used to be addicted drugs like ecstacy and has lost friends to opioid overdoses, Spinney is happy to see the tents in her neighbourhood. “I’ve seen places like this work for my friends, and sometimes people even get clean after some time,” she said. “There’s people dying and it’s preventable.”

However, another resident who lives across the street could barely contain his anger as he walked by the site for the first time. “I see this bringing more problems than solutions,” exclaimed Corey Aitken. He was worried about what the site might mean for his two young kids. “I’m not against drug users, but this is not cool.”

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But advocates say they aren’t phased by the naysayers. They worked through a few angry neighbours at the Moss Park neighbourhood where they opened the first unsanctioned overdose prevention site in Ontario last August, providing a safe space for people using drugs and help if they overdosed. Those efforts helped spur the city and province to open official sites.

The new unsanctioned Parkdale overdose prevention site represents an escalation in the conflict between the provincial government and harm reduction advocates who are willing to break the law if legal sites are put on hold or stripped of their funding. It also pits Premier Doug Ford — who has declared he’s “dead against” supervised consumption sites in general — against many municipal leaders across the province who have backed the sites.

“We aren’t going to go away,” said Zoë Dodd, a harm reduction advocate who also works at one of the city’s legal sites. “We kept the Moss Park site open for 11 months and we will do that again if we have to. None of us want to sit back and watch our friends die.”

“This is the downside of mixing politics with health,” she continued. A group of volunteers laid out a piece of cardboard on the grass nearby and wrote out a list of demands, including that the government immediately move to open the three supervised injection facilities that are in limbo.

Toronto harm reduction worker Zoë Dodd at Parkdale Overdose Prevention Site. (Shawney Cohen/VICE News.)

The province saw more than 1,200 opioid overdose deaths last year, up from 867 the year before. The increase in deaths has caused a severe backlog at the coroner’s office.

Dodd and other volunteers started planning the new Parkdale tent last week after the new Progressive Conservative health minister Christine Elliott announced a “pause” in funding for any new legal safe injection sites that had been approved by the previous Liberals. Elliott said she needs until the end of September to review the evidence behind safe drug consumption sites to determine whether they will be allowed to operate in Ontario in the future. Last week, a legal Parkdale site was set to open, but Elliott’s announcement means it will stay closed for now — prompting the volunteers to erect the pop-up site.

While the federal health department grants the special exemptions needed for supervised injection sites to open, it’s the province that must provide the funding in order for them to operate, as is the case with all other healthcare expense. A spokesperson for the federal minister of health would not answer questions from VICE News about whether Health Canada would fund supervised consumption facilities if Ontario decides to halt them.

"Harm reduction is a key pillar of our strategy to fight the opioid crisis. We have approved over 25 supervised consumption sites and provided additional funding to provinces hardest hit by the crisis," the spokesperson wrote in an email, pointing out that the department has approved more than 25 supervised consumption sites. "We also believe stigma and barriers to treatment need to be reduced."

Elliott's spokesperson Hayley Chazan told VICE News in an email on Monday that the health ministry is not considering new applications for safe injection sites at this time.

“The Ministry is currently reviewing the latest data, evidence and current injection site models. Until this review is complete, we are requiring any injection sites that are not open to delay their operations,” Chazan wrote. “We fully expect all sites to comply with the directive from the Ministry of Health and Long-Term Care.”

Parkdale overdose prevention workers write out list of demands for the province. (Rachel Browne/VICE News.)

But health and addictions expert say it’s long been a proven fact they save lives, something that has been even more urgent by the spike in overdose deaths across the province, including at least seven people in Toronto alone earlier this month. Unsanctioned and sanctioned overdose sites have operated for years in British Columbia and have become a crucial tool to prevent deaths in the province that has become ground zero for the worsening opioid crisis that has resulted in thousands of deaths.

Of the 10,000 overdoses that have occurred at overdose prevention and safe injection sites in British Columbia since 2003, there have been zero deaths.