Zoning out methadone and rising opioid-related deaths in Ontario: Reforms and municipal government actions.

In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above. Changes that exacerbate these factors may lead to increased use of bylaws to curtail access at a time when efforts are underway to reduce alarming rates of opioid-related overdose.