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Vancouver's overdose crisis, one year later

Overdose prevention sites and other initiatives are making a difference, but frontline workers call for action at the federal level

Sarah Blyth trims a harm reduction Christmas tree at an overdose prevention site in the Downtown Eastside.

Jennifer Gauthier/For Metro

Sarah Blyth trims a harm reduction Christmas tree at an overdose prevention site in the Downtown Eastside.

December 2016 is seared into the memory of people who live or work with people from the Downtown Eastside, the epicentre of B.C.’s opioid overdose crisis.

“People were going down in alleyways,” Karen Ward remembers. “It was a year ago that nine people died in one weekend.

“I remember the night when three people died in my building.”

“BC Ambulance had its busiest day in history, St. Paul’s hospital was fully blocked up and we were seeing the highest rates of overdoses that we had seen in the emergency room and at Insite,” Dr. Mark Lysyshyn recalls.

“It just seemed to get worse and worse and worse, and in clusters,” said Sarah Blyth.

“It felt like we were not only doing the (Downtown Eastside Street) Market but tending to overdoses one after the other.”

There’s disagreement whether the crisis has improved since then. Lysyshyn, a medical health office at Vancouver Coastal Health, said the fatality numbers have started to fall from the peak reached from December 2016 to April 2017. This September, 85 people died and in October the number was 91, compared to 151 deaths in April.

So even though 2017 will certainly see double the deaths than 2016, “that was the peak and we’re coming down from it,” Lyshyshyn said.

Ward, a member of the Canadian Asssociation for People Who Use Drugs, doesn’t see it that way.

“The level of threat is not acceptable, and to say that the graph dipped a little bit as if we’re tracking the weather is profoundly disturbing,” she said.

But Lysyshyn and Ward do agree that one particular new tool — overdose prevention sites — has made a dramatic difference in keeping people from dying.

Along with others from the DTES neighbourhood, Blyth, the manager of the DTES Street Market, had been running an unsanctioned overdose prevention site in the alley behind the market starting in September 2016. The site, originally in a tent, offered a place where people could inject or smoke drugs in the presence of trained volunteers who could do first aid and call for help in case of an overdose.

In December of 2016, the province got on board to support the concept and to open more of the sites. The sites are much easier and faster to open than supervised injection sites, and it’s that flexibility that has made them a key tool in the battle to prevent deaths from overdose, said Lysyshyn.

Sarah Blyth helped set up this overdose prevention site in an alley in the 100 block of East Hastings in September of 2016. Dr. Mark Lysyshyn, a medical health officer with Vancouver Coastal Health, credits the sites — which can be set up quickly and without a lot of bureaucracy — as a key tool in bringing the death toll down.

Jennifer Gauthier/For Metro

Sarah Blyth helped set up this overdose prevention site in an alley in the 100 block of East Hastings in September of 2016. Dr. Mark Lysyshyn, a medical health officer with Vancouver Coastal Health, credits the sites — which can be set up quickly and without a lot of bureaucracy — as a key tool in bringing the death toll down.

“Previously when we created supervised injection sites it was a many years long process of planning and consultation and sometimes by the time you established the site, it might not even be in the exact right location,” Lyshyshyn said, adding that the tent and now trailer behind the market is still the only site in the city that allows people to smoke, not just inject, their drugs.

“What we’ve seen with the overdose prevention sites when they’re established very quickly with the community agency leading it, right in the place where people need them, they can have a tremendous impact.”

Lysyshyn listed other initiatives put in place this year that have made a difference: drug testing at many of the overdose prevention sites; rapid access clinics to help people transition to opioid replacement therapies like suboxone and methadone; and a mobile team that connects with people who have overdosed with treatment.

When asked what still needs to be done to curb the crisis, Ward and Blyth want to see more overdose prevention sites open in cities across Canada. The federal government declaring a national health emergency — something it has so far refused to do — would make it easier to do that, Blyth said.

Greater access to safe drugs, such as the prescription heroin program at Crosstown Clinic, is another ask. All drugs purchased on the black market are now completely tainted with fentanyl, a powerful synthetic opioid and the main cause of the spiking deaths.

“It’s not even a political thing. It’s across all political boundaries,” Blyth said.

“I don’t know how they can meet with mothers and families of victims and not see this for what it is and do what needs to be done.”

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