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Activist and harm-reduction worker Zoë Dodd uses tongs and a garbage bag to collect discarded syringes in Moss Park in Toronto on Thursday.

Fred Lum/The Globe and Mail

The construction trailer that houses the illegal, volunteer-run overdose prevention site in Toronto's Moss Park is about to open for another evening, as a dozen drug users, some clearly anxious for their fix, cluster around its muddy entrance in the cold.

Activist and harm-reduction worker Zoë Dodd, named one of Toronto Life magazine's most influential people last year, alongside Foreign Affairs Minister Chrystia Freeland and R&B star the Weeknd, unloads an extra box of anti-overdose naloxone kits from her beat-up sedan.

It has been almost seven months since her band of crowdfunded volunteers started reversing overdoses in this gritty east-end park, first operating out of flimsy tents that blew away in a windstorm. They have always said the many desperate drug users who live in this neighbourhood would shoot up, and potentially die alone, in nearby alleyways before walking to the city's nearest legal supervised-injection site near Yonge-Dundas Square, one kilometre away.

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Now, after months of delay, a legal, Health Canada-approved supervised injection site has opened almost directly across the road, at the nearby Fred Victor Centre for the homeless. Some of Ms. Dodd's former volunteers even work there. And echoing the city's long-held position, Mayor John Tory said this week that with the new, legal site now open, Ms. Dodd's illegal site should work to transfer its clientele across the road and leave the park.

But Ms. Dodd says the illegal Moss Park trailer is still needed and staying put, for now. However, her group now hopes to use new provincial rules to become authorized, get funding and then find a new home somewhere near Moss Park.

"Even though Fred Victor opened, we're still so inundated with the need," Ms. Dodd says as she ushers a bearded man with a backpack into a small room behind a curtain, where drug-users shoot up with a nurse standing by.

"This is the epicentre of the overdose crisis, Moss Park."

After the province released new numbers this week, showing an opioid-related death toll of more than 1,000 across Ontario in just the first 10 months of 2017, Ms. Dodd says governments are going to have to set up many more supervised injection sites – even multiple ones, side-by-side, in areas with high overdose rates – to respond to the crisis.

This week, St. Stephen's Community House sent letters to neighbours in Kensington Market, another hotspot for overdoses, announcing that it has just won approval for a temporary overdose-prevention site there, set to open in April. The process, launched by the Ontario Ministry of Health after pressure from activists such as Ms. Dodd, avoids the lengthy federal approval process for permanent sites, of which Toronto already has three. St. Stephen's says it will hold an open house for neighbours next month.

A similar site has already opened in London, Ont. And more such applications for temporary facilities are expected to surface at clinics in other parts of Toronto, as well.

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Ms. Dodd said the Moss Park site officially applied for that same new status on Wednesday. She says it was time her operation won legal status and proper government funding, and stopped relying solely on volunteers with day jobs.

However, her trailer is still sitting in a city park without a permit, and without washrooms or running water. She says the city should find her group a new home nearby, where they could continue their work. And on Friday, city councillor Joe Cressy, who chairs Toronto's drug implementation panel, said city officials would start doing just that.

A new home was actually the idea last year, when her operation was supposed to move into Fred Victor. But talks broke down after the homeless centre balked at allowing an illegal operation inside its walls.

The homeless centre then pursued opening its own legal site, with the help of city officials, including Mr. Cressy, who said in early November that it could win federal approval in mere weeks. It did not open until Feb. 21.

In an interview, Mr. Tory says he wants the illegal site to move out of Moss Park after a "transition" period that would see its users move to the Fred Victor location.

"Look, I believed from Day 1, and you can go back and look at all my prior public statements, that a public park is not an appropriate place to any kind of a harm-reduction site," Mr. Tory said in an this week. "It's a public park."

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Ms. Dodd says her volunteers are trying to move their regulars over to Fred Victor, but many of the people who show up every night feel more comfortable in her trailer, where many of the volunteers are also drug users.

There is clearly still a demand. Ms. Dodd says as many as 40 or more people still use her service each night, and that many frequent both the trailer and Fred Victor, which is open later at night. On Monday alone, she said, they reversed four overdoses in one night. No one has died of an overdose while using the site.

According to Jane Eastwood, director of programs at Fred Victor, between seven and 23 people have used their service each night so far. She said the centre hopes to get approval from the province to expand into a 24-hour service.

But both Ms. Eastwood and Ms. Dodd say that, in recent weeks, the police presence in the area has increased, putting some drug users on edge. The Moss Park site had enjoyed an arrangement with police that saw them take a hands-off approach, provided the illegal site closed its doors at 10 p.m. and volunteers scoured the park for needles.

Several local business owners have complained for months about an increase in drug use and anti-social behaviour around the park – and called for the removal of the trailer once Fred Victor was up and running.

But Mr. Cressy says public attitudes have changed.

"The landscape has shifted dramatically in the last year," Mr. Cressy said. "The question is no longer, should we be opening harm-reduction facilities, but, why can't we open more and sooner?"

Ms. Dodd acknowledges that eventually, her team will have to leave the park. But if the opioid crisis means there are drug users who need their services here, she says her volunteers will keep showing up every afternoon.

"I think it would be great for this to return to a park," Ms. Dodd says, before taking a bag and some barbecue tongs to look for discarded needles in the muddy grass. "But we are in a public health emergency."

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