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How the toxic drug crisis looks to one Prince George frontline worker

British Columbia lost more people to toxic drugs in 2021 than any other year. At least 2,224 people died last year. Almost 10,000 British Columbians have died in the last decade.
Overdose Ride Along 2021 article
Paramedics responded to 35, 525 overdoses in the province which is up 31 per cent over the previous year.

British Columbia lost more people to toxic drugs in 2021 than any other year. 

At least 2,224 people died last year. Almost 10,000 British Columbians have died in the last decade.

Every month or two, the government says  it’s moving as quickly as it can to stem the “tragic” deaths through  decriminalization, prescribed safe supply and funding for addiction  treatment and recovery programs.

Frontline workers say that’s not what’s  happening. These are the people staffing overdose prevention sites,  doing outreach in encampments, reversing overdoses and connecting people  with safe supplies of substances, treatment or recovery services, if  they’re available.

The Tyee spoke to six frontline harm  reduction workers about how the toxic drug crisis is playing out across  British Columbia. Their contributions have been lightly edited for  length and clarity.

Juls Budau, master’s of social work candidate, freelance writer and researcher co-ordinator, Prince George

I live in Prince George. I’ve worked a lot of roles in the overdose crisis the past year: I’ve worked in harm reduction housing, I briefly managed an overdose prevention site here, I  worked as a substance use support clinician, and now I’m writing my thesis for my master’s in social work, which is looking at user perspectives on stimulant safe supply and what it means to the users. 

More people die of overdoses every month,  but the provincial government keeps bragging about what they are doing without being honest about the limitations of the expansion of overdose  prevention services.

I think this is so harmful, because the public perception is that we’ve done everything we can and it’s not working. The new BC Liberal leader campaigned on this false premise. 

But service gaps haven’t been filled. There aren’t places for people to safely consume drugs in every community and there are very few places in the province for people to smoke their substances under supervision, which is how more than half of people who died last year used their substances.

Safer prescription alternatives — safe supply — are not available to everyone who needs or wants access throughout the province. Things like supervised injection and safe supply aren’t failures, they just aren’t available to everyone who needs them.

And there’s still a lot of misconception about what medical safe supply is. People genuinely think the government  is giving out tons of free drugs and the reality is that a small  percentage of drug users are given pharmaceutical medications that are  free if they have pharmacare coverage. 

The BC Coroners Service evaluates drug overdose deaths, and there is no evidence that medical safe supply is contributing to deaths. Meanwhile, six people are dying from using the street supply every day in this province.

Why don’t I push as much for more people to be on traditional opioid substitutes or go to treatment facilities? Many of my clients used both methadone and safer prescription alternatives, but the methadone prescription is cancelled if they miss a  few days and they have to seek out a new prescription, which is not  available every day in Prince George. 

So a few days of instability causes more  chaos and upheaval in their life. It’s hard to gradually work up to a  therapeutic dose like that. Treatment centres vary on which medications they’ll accept, and the waitlists are long.

I just see all these conversations spinning in circles over and over again as drug users try to access help but  face hurdles everywhere they go, and the death spiral continues. It’s exhausting. 

Danielle Kennedy, HIV/HCV outreach educator, AVI Health & Community Services, Campbell River

I came back to work in September after my  maternity leave. And then less than a couple of weeks ago, I found out  my funding was cut. I’ve had a lot of challenges connecting with people,  because I’m only one person, and I’m not allowed to go into  encampments. 

A lot of people are living rough, and with  the end of our funding for an overdose prevention room in 2020, AVI has  nowhere near the foot traffic we used to have, and we can’t help people.  They’re not coming in. We’re not being given any tools to really bring  people in.

People are dying left, right and centre. I  had a friend die less than two weeks ago. That’s just one story. It’s  the worst it’s been since it started. It’s like nobody cares about  people who use drugs. I talk to my husband when we both read the news,  and every month it’s the same goddamn fucking news article. And  nothing’s changing.

There is more conversation that’s  happening, and some cultural ideas are shifting about people who use  drugs. But that doesn’t matter, because they’re still dying at a fucking  alarming rate.

Peers and people who use drugs outside of  the Lower Mainland are totally left out of the conversation. The  majority of B.C. is significantly lacking in resources to the point  where people might know that something exists, but do they have any idea  how to access it? Or is it even offered in their community? Places like Duncan and Port Alberni have very limited options.

And there’s definitely been a big change of  drugs. Benzos [or benzodiazepines, a class of depressants which are  added to drugs unknowingly to drug users] are pretty brutal. It’s still  an overdose, but it’s so much more challenging to deal with and requires  a lot more attention. I’ve had to monitor someone for three hours,  alone in the field. We only have two oxygen tanks and one oximeter right  now. And there’s not as much you can do about it, other than just wait  it out.

The services that are available are nowhere  near what people need to succeed at all, not even close. The treatment  centres that are here don’t work, and we see that over and over. We need  things like second-stage housing, we need long-term housing. There’s  maybe a couple more services, but they’re still not adequate.

We had one of the gentlemen who was one of  our peer workers, he died of an overdose at a facility where he was  living. Why are people dying of overdoses in a facility that’s supposed  to do harm reduction and prevent people dying from overdoses by  providing them stable housing?

We’ve got the SAFER [Safer Alternatives for  Emergency Response] program in Victoria that does safe supply, and  we’ve been trying to do that in Campbell River, but there’s so much red  tape. And we’re already doing it successfully there, so why can’t we do  it up here too?

We know what works. We know how to stop  this from happening. And we’re trying to do these things. And the  government and health authorities, it’s like they’re doing every single  thing they can to make sure that those things can’t actually succeed.

Jon Braithwaite, board member and supervisor, Vancouver Area Network of Drug Users, Vancouver

Over the past year, the thing I noticed the  most was when the benzos started to get mixed in with the fentanyl. At  first the dealers were putting the fentanyl into the heroin, and we had  to deal with that because the fentanyl is very strong, and so there was a  wave of deaths because of that.

And then the addicts started to get used to  that, and then the dealers started putting benzos into the dope. So now  we’re dealing with this new wave of dope that has benzos. In a way,  it’s more horrible because people are losing time. I’ve had it happen to  me — you do your hit and it’s just lights out, and then you wake up and  it could be hours or even days later. I’ve met three girls now that  have been raped because of it.

It’s like a war out here. Every day you hear of somebody either OD’ing, or violence that happens because of the drug trade.

There are so many cases where most of these  guys, when they start out, they’ll talk a good game to a dealer and the  dealer will say, ‘OK, well, I’ll give you a zip of this’ — a zip is an  ounce — ‘and I’ll give you a week to move it, and at the end of that  week, I want my money.’ Well at the end of that week, if they don’t have  that money, then there’s consequences. And that’s when the violence  comes into play.

When I first came here, it was actually  fairly docile. We were dealing with an overdose crisis at that time, but  there were, relatively, zero benzos. So we didn’t have to worry about  that. And we basically just had to be trained on naloxone, and once we  got the naloxone down, we could basically save anybody who’s overdosing.  I’ve saved well over 30 people since I’ve worked here.

We want to set up a safe supply to the  point where we’d eventually be a distribution centre for a safe supply  of drugs for people who use drugs. And that means they can come here,  and they can be guaranteed to be given a supply of drugs that isn’t  tainted with anything other than what they would be expecting.

Alexis Hekker, Indigenous wellness co-ordinator and lead drug-checker, ANKORS East Kootenay, Cranbrook

Most of the people we lost in our community  in the last few years have been Indigenous. In 2019 we were seeing that  harm reduction was actually working and fewer people were dying, and  that we had so much hope. 

And then deaths just piled and piled, it  hit like a brick wall in 2020. Many of them were Indigenous women at  risk and living rough. If you’re Indigenous, you’re over five times more  likely to die of any kind of fatal drug poisoning. 

What I needed when I was experiencing  trauma and surviving Missing and Murdered Indigenous Women and Girls was  that connection to my community. And as Métis person and citizen of the  Métis Nation BC, that can sometimes be very hard. My family, we don’t  have any connection to our culture because of trauma. I was relearning  my culture. So I wanted to pass that knowledge, because I know how much  strength that gave me. 

If I have a little bit of money to buy  somebody a meal that is traditional, some fried bread and some bison  stew, I will. I’m teaching other people how to bead because that was a  huge turning point for me when I was able to learn how, and why that was  so important to my culture.

People will start asking questions when  they get comfortable. They’ll start asking for referrals, they’ll start  telling you what they’re dealing with and asking, can you help me? I’m  now renting an office at Operation Street Angel, which is run by the  Ktunaxa Nation. I’m trying to decolonize harm reduction in a way, but  I’m learning as I go.

When we see some change come to Vancouver,  it feels like it will never come to us. We don’t even have an overdose  prevention site in the East Kootenays. It’s near impossible to get safe  supply, you have to hammer at the right time, the right place, and be  the right person. 

We also do not have detox. We do not have  access to anything that will help with folks like accessing recovery.  One friend who just got accepted after so long trying, they’ve had to  completely uproot themselves from their community and leave their  families behind to be able to take this journey, which isn’t realistic  for some. I think of all those single mothers that do not have access to  that. 

We just got a FTIR spectrometer to test  drugs a few years ago, so we did not have the capacity to have a full  understanding of what our toxic drug supply level was until recently.  Our Ketamine, our MDMA, everything has changed so much in the last five  years, and it’s way more toxic.

I’ve been doing drug checking since I was  19, and volunteering with ANKORS before then, too. I’m 27 now. I’m  terrified, to be honest, to see raves in our area come back because a  lot of the folks that go to these events aren’t using every day, and  they have no idea how toxic it is now.

I’m supposed to service all of the East  Kootenays, which is very difficult in the middle of winter. The roads  are bad and if I take the FTIR  drug checking instrument from Cranbrook  and go to another community, now Cranbrook doesn’t have it. So no matter  what we do, another community is going to hurt and be at risk. 

I find strength in seeing people live what  they want to be living, when they’re doing the little things to keep  themselves safer. But we’re exhausted, and we’re fucking tired of death.  Our goal is just to make people survive the night and we take it day by  day, because it’s hard to do anything else.

Garry Sandhu, peer co-ordinator and addictions counsellor, Sober Life Foundation, Surrey

In 2020, we opened a phone line when COVID  started initially. I wanted to be connected with the people who are in  addiction. We couldn’t meet them face-to-face, but we thought we should  at least have a phone line where we can be connected with each other and  they can call us anytime whenever they want. During the last year, we  received around 350 calls. [The One Life Peer Support Line can be  reached at 778-381-5686.]

When I was in addiction, I was looking for  help in 2012, and I couldn’t find any kind of resources in Punjabi or in  Hindi. My English was fine, I could speak, but I was not able to  understand — and it was very hard for me to connect with someone because  I was not able to express my emotions and feelings. Which is very  important if you want to be in recovery and come out of addiction.

So when I became sober, someone suggested  to me that I go to school to become an addiction counsellor. When I  finished my studies, I wanted to create a Punjabi program, so it’s  available especially for the Punjabi community.

In our culture, mostly families get  connected first, before a person calls for help for himself. And most of  our families, they’re more comfortable speaking in Punjabi.

We knew that when the COVID-19 restrictions  started, addiction numbers would go way higher because of the  isolation, and there would be mental health issues. But we did not  expect that street drugs would become so much more harmful, and that  there would be so many overdoses.

Over the last year, there has been a huge  shift in treatment as well. We used to discuss complete abstinence as  well as harm reduction, but because of the dangerous drugs on the  streets, we promoted harm reduction more. So that at least people are  safe from the street drugs.

In complete abstinence, if someone  relapses, there is a huge chance he could overdose. If a person is on a  harm reduction program, if that person is taking methadone or suboxone,  at least he will be way safer. He won’t be feeling that craving that a  complete abstinence person can feel. Because if we save a life, only  then there will be a future chance of complete abstinence or recovery,  depending on the choice he wants to make. 

Trey Helten, manager, Overdose Prevention Society, Vancouver

It seems like there’s just less and less  people. Like the alleyways are less crowded, and our numbers are going  down. And it’s not because people are moving on, it’s not because  they’re getting healthier or planning safe supply options or going to  treatment. It’s because they’re all dead. There’s no other way to put  it. It’s just, funerals, funerals, funerals.

It’s become so many funerals that we’re  having multiple memorials on the same day to try and streamline it. We  had three memorials on one day in December or November. And now we have a  thing, Memorial Mondays, where usually we’ll have a memorial at 3 p.m.  to remember someone, and then a barbecue after with the Heart Tattoo  Society so that people can eat and remember their friends.

The number one reason people are dying is  because of tainted supply and using alone. Don’t use alone, get your  drugs tested. Go to 880 E. Hastings, get your drugs tested. They’re open from noon to 9 p.m., seven days a week.

Go to a safe injection site, or safe  inhalation site where nice people will help you. Unfortunately, there  are a lot of drug users who feel like they would be stigmatized going to  those places.

I think the solution, for people who have  fear around being stigmatized about going to a place like the Overdose  Prevention Society or Insite, is to educate yourself and download the Lifeguard app or the Brave app.  Those are two apps you have on your phone and when you’re about to use,  you type in the substance that you’re using and your location. And you  click the start button once you’re using. And then if you don’t check  in… they can send paramedics to your location.