Lupick, fighting for space, chap 33

Chapter 33: Fentanyl Arrives

Tyler's Story

• Janet Charlie recalls the last interaction with her son, Tyler, who avoided her due to tensions with his girlfriend.

• The last sighting was at the Downtown Eastside market; he later died from a drug overdose.

• After his collapse, Janet was informed he was in dire condition and was subsequently found unconscious in a hospital after a week, where life support was eventually removed.

Overdose Crisis in British Columbia

• In 1998, British Columbia faced a severe overdose crisis with 400 illicit-drug fatalities; half in Vancouver.

• The crisis led to effective harm reduction strategies, which significantly reduced overdose deaths from 2001 to 2010.

• By 2011, overdose deaths began to rise dramatically, peaking in subsequent years: 294 in 2012, 333 in 2013, and reaching 978 by 2016.

Introduction of Fentanyl

• Fentanyl, a potent synthetic opioid, is significantly stronger than heroin and has been widely prescribed in Canada since the 1970s.

• Illicit production mainly originates from chemists in China and Mexico, and it has contaminated the heroin supply, leading to increased overdose risks.

• The production cost is low, and its potency allows for easier smuggling, making it attractive to dealers.

• A comparison is made to cookies where the exact dosage of fentanyl in a batch is unpredictable, increasing risks for users.

Government Response

• In April 2016, BC declared a public health emergency amidst rising overdose deaths but initial government reactions were minimal.

• Although naloxone became more accessible, harm reduction as a strategy is criticized for being reactive rather than preventative.

Community Response in Downtown Eastside

Grassroots Mobilization

• After Tyler's death, community activism intensified, led by figures like Ann Livingston and Sarah Blyth.

• In September 2016, activists established naloxone distribution and overdose prevention services in the community.

Establishment of Tents for Safety

• The Overdose Prevention Society set up tents in alleys to provide a safe space for users.

• Volunteers offered clean needles, naloxone, and a safe environment, reversing numerous overdoses.

Statistics and Community Effort

• Overdose incidents soared, with rapid increases in fatalities, prompting further grassroots initiatives to combat the crisis.

• The community rejected the notion of waiting for governmental assistance, taking preventative measures into their own hands.

Personal Accounts

Continued Overdoses

• Individuals like Lee Tran share their experiences and motivations for volunteering at overdose prevention sites.

• The atmosphere starkly contrasts with the past; overdoses became frequent, necessitating an immediate response.

Individual Stories of Drug Users

• Jay Slaunwhite describes his role as an informal paramedic, indicating he offers help when needed despite limited supplies of naloxone.

• The desperate conditions underline the necessity for immediate community action.

Diverse User Experiences

• Users like Bernadette navigate the dangers of fentanyl while seeking safety through community-provided resources.

• Kevin Thompson represents a contrasting narrative as a functional addict who utilizes prescription heroin through Crosstown Clinic, revealing structural differences among drug users in the area.

Prescription Heroin and the Crisis

Crosstown Clinic's Role

• The Crosstown Clinic provides a safe supply of prescription heroin, significantly reducing overdose instances and allowing users to lead more stable lives.

• As of May 2017, only a limited number of people in BC had access, with calls for expansion to provide relief to more users amid the crisis.

Effectiveness and Expansion Needs

• Advocates argue for broadening access to prescription heroin due to contamination of illicit drugs.

• The conversation continues regarding how best to support marginalized users while addressing the crisis at a systemic level.