In photos: Three months in the Downtown Eastside as the fentanyl crisis grows from bad to worse

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      In 2016 it's projected the overdose epidemic will kill more than 800 people in British Columbia.

      “It’s desperate times in Vancouver and it’s hard to see any silver lining right now when we don’t seem to have hit rock bottom with the number of people dying on any given day from an overdose,” Mayor Gregor Robertson on December 16. The night before, there were nine fatal overdoses in Vancouver and 13 across the province. Robertson warned the numbers are almost certain to continue to increase.

      “We’re not able to tread water anymore," Robertson said. "We’re losing way too many people. Harm reduction alone can’t solve this.”

      The number of deaths each month has increased since August. That month, there were 50 fatal overdoses in B.C. Then 57 in September and 67 in October. In November, illicit drugs killed 128 people in B.C., an all-time high in 30 years of record-keeping.

      During the last three months of this year, Straight reporters spent significant time documenting how this crisis is unfolding in the Downtown Eastside. Below is a selection of the photographs they captured.

      According to testing at Insite, more than 80 percent of drugs sold as cocaine or heroin are testing positive for fentanyl, a synthetic opioid that’s been associated with 60 percent of fatal overdoses this year.
      Travis Lupick
      On September 21, a group of activists led by Sarah Blyth and Ann Livingston pitched a tent facing into an alley near the intersection of East Hastings and Columbia Street. Since then, about 100 people have visited every day to use intravenous drugs there under the supervision of volunteers trained in overdose response.
      Travis Lupick
      Several drug users interviewed at an unsanctioned supervised-injection site in the Downtown Eastside last October told the Straight they suspected fentanyl was introduced by the government to kill people intentionally. "Like smallpox and the Indians but to kill poor people down here,” one said.
      Travis Lupick
      Volunteer staff at two overdose-prevention tents say that since mid-September, they’ve used naloxone to reverse more than 250 overdoses. (They stopped counting weeks ago so the actual number of lives saved is much higher.) They provide a place where addicts can go so they don’t have to use alone. A place that’s relatively safe just because there are other people around to catch someone when they fall.
      Amanda Siebert
      A man who volunteers at an unsanctioned supervised-injection tent in the Downtown Eastside was found unconscious in a portapotty there. He was out for quite a while but finally came back after three naloxone shots. Lately the tent is seeing about half a dozen overdoses every day. So far, nobody has died there, thanks to volunteers equipped with naloxone.
      Travis Lupick
      Sarah Blyth, a former member of Vancouver’s park board, established two unsanctioned supervised-injection tents in the Downtown Eastside last September. “People were overdosing in the back alley and they would call to us for help,” she said. “So here we witness them and talk to them about different things and just create an atmosphere that is safe and clean that is not the alley.”
      Amanda Siebert
      Back in the 1990s, when the Downtown Eastside was breaking under the AIDS epidemic and the arrival of intravenous cocaine, Ann Livingston cofounded the Vancouver Area Network of Drug Users (VANDU) and, in 1994, opened the city’s first unsanctioned injection site, on Powell Street. As bad as things were back then, she maintained there is no doubt the situation is worse today.
      In November, the province deployed new ATV ambulances in response to the fentanyl crisis and record numbers of overdose deaths. During their first week on the ground, one tended to a call from an unsanctioned supervised-injection tent that faces a back alley in the 00 block of East Hastings.
      Travis Lupick
      "We need Narcan! Who's got Narcan?" a man called out. Another volunteer named Dan had found his friend around the corner from the tent, on the ground and already turning blue. Dan had used naloxone dozens of times before. But this time there was panic in his voice.
      Amanda Siebert
      Vancouver’s sanctioned supervised-injection site, Insite, has operated at capacity for many years now. That’s led drug addicts to use in the alleys surrounding the facility, where there’s no line for equipment but also no nurse to catch them should they overdose.
      Travis Lupick
      As the overdose epidemic grew more intense through October and then November, activists pitched a second unsanctioned supervised-injection tent in the Downtown Eastside, this one near the intersection of Main and East Hastings Street.
      Travis Lupick
      Ambulance ATVs roll through Downtown Eastside alleys. Here one passes ab unsanctioned supervised-injection site where a lone nurse was volunteering there that evening. The new vehicles were deployed a few weeks ago as part of $5 million the provincial government allocated in response to the fentanyl crisis.
      Amanda Siebert
      Sue Ouelette, a retired nurse who volunteers at one of the Downtown Eastside's unsanctioned injection sites, says she was prompted to volunteer after a friend who lives in her building died of a fentanyl overdose.
      Amanda Siebert
      During the first eight months of 2016, the number of 911 calls for drug overdoses placed from the 100-block of East Hastings was less than 40 per month (with the exception of June). Then in September, the number of overdose calls jumped to 74. Then to 93 in October and to 155 in November.
      Travis Lupick
      Hugh Lampkin, a longtime member of the Vancouver Area Network of Drug Users (VANDU), helps oversee teams that make foot patrols through Downtown Eastside alleys.
      Amanda Siebert
      Last November, Health Minister Jane Philpott and her B.C. counterpart, Terry Lake, met first responders in the Downtown Eastside to discuss the ongoing epidemic of overdose deaths.
      Travis Lupick
      In early November, the Vancouver Area Network of Drug Users (VANDU) partnered with the city of Vancouver for a community training session in naloxone and overdose response. More than 100 people received instructions that day.
      Travis Lupick
      Jay Slaunwhite is a resident of the Downtown Eastside's dilapidated Balmoral Hotel who posted a notice on his door letting other tenants know the he stock naloxone and is available to help if anybody encounters a drug overdose.
      Travis Lupick
      Volunteer nurses have held overdose-response tutorials inside a number of the Downtown Eastside’s rundown hotels, teaching residents how to use naloxone should they be with someone who experiences a drug overdose.
      Travis Lupick
      Wendy Pedersen, a well-known activist in the Downtown Eastside, sat in an overdose-response training session in the Balmoral Hotel where she learned how to use naloxone.
      Travis Lupick
      Barbara Carter lives in the Regent Hotel, a rundown building on the zero-block of East Hastings Street. After several people in her building overdoses, she posted a notice on her door letting people know that she keeps a supply of naloxone with her.
      Travis Lupick
      On December 15 there were eight overdose deaths in the Downtown Eastside and 13 across all of B.C. VPD chief Adam Palmer revealed those grim statistics at a news conference where he made an impassioned plea for the province to spend more on addiction treatment. “B.C. is in the midst of a serious health crisis,” Palmer said. “Fentanyl is killing people every day in our city and in this province.”
      Travis Lupick
      The last time Janet Charlie saw her son sober was last May, on Mother's Day. "Him and his brother dropped off some chocolates for me," she says. He died of a drug overdose last August, shortly before his 27th birthday.
      Amanda Siebert
      The idea behind a supervised-injection site is to give users a place where they can inject drugs where they know other people will close by to help them should they encounter an overdose. Since some addicts are homeless, activists have established such sites in alleys in the Downtown Eastside.
      Amanda Siebert
      "Who's next?" reads graffiti in the Downtown Eastside.
      Travis Lupick
      As managers with the Portland Hotel Society, Andy Bond and Duncan Higgon have intervened in dozens of overdoses over the course of their careers. “Everyone is overwhelmed,” Bond said. “And it doesn’t seem to be getting better. It’s getting worse as we go along.”
      Amanda Siebert
      Peter Radomski and Tegan Dempsey work as frontline staff in the Stanley Hotel, a building operating by the Portland Hotel Society that houses tenants with mental-health and addictions issues. “I don’t shake anymore, but it’s still traumatic,” Radomski says. He has dealt with so many overdoses that the experience has become nearly routine. “But I often have dreams about the OD after,” he adds.
      Amanda Siebert
      The Portland Hotel Society's Coco Culbertson (left) prepared Brie Leaber and Cori Wilson, the nonprofit's first team of bicyclists equipped with the overdose-reversing drug naloxone. They patrol the alleys watching out for anybody who might need help.
      Travis Lupick
      In late-November, the Portland Hotel Society dispatched a team of doctors to set up informal clinics alongside unsanctioned supervised-injection tents that had been pitched by activists. There, they offered consultations on methadone and other treatments for addiction and taught users how to administer naloxone.
      Travis Lupick
      Kate Bodkin (sitting) is part of a team of doctors that the Portland Hotel Society has dispatched to alleys throughout the Downtown Eastside. They offer consolations on addictions treatment and train people in overdose response, going to wherever their clients are most comfortable.
      Travis Lupick
      On December 8, B.C. health minister Terry Lake (centre) took journalists on a tour of a new mobile health-care facility that's operating at 58 West Hastings Street.
      Travis Lupick
      On December 12, B.C. health minister Terry Lake made a quiet visit to one of the Downtown Eastside’s unsanctioned supervised-injection tents for drug users. It was an extraordinary show of support from a top-level government official for a health-care program that operates completely outside the law.
      Travis Lupick
      At an unsanctioned supervised-injection tent for drug users, B.C. health minister Terry Lake met with the program’s lead organizer, Sarah Blyth, and expressed his appreciation for volunteers trained in overdose response and naloxone intervention. “You’re saving lives,” Lake told them.
      Travis Lupick
      Hugh Lampkin, a long-time board member of the Vancouver Association of Drug Users (VANDU) showed off the organization's new "overdose-prevention site" at 380 East Hastings Street. It’s one of 18 the province has established across B.C. since the beginning of December.
      Travis Lupick
      On December 12 B.C. health minister Terry Lake visited unsanctioned supervised-injection sites in the Downtown Eastside and walked through alleys where drug users are known to congregate. “My view is that, as a society, we are taking a different sort of approach to drug use than we used to,” he said last June. “I think that any politician that I have talked to understands that the so-called war on drugs has been a failure and that we need to have different approaches. That will take some time.”
      Travis Lupick
      Three months after it was pitched in mid-September, an unsanctioned injection site in an alley near the intersection of East Hastings and Columbia Street was busy every hour it was open.
      Travis Lupick
      It’s projected that more than 800 people in B.C. will die of illicit drugs in 2016, based on data for the first 11 months of the year. The dangerous synthetic opioid fentanyl has been detected in more than 60 percent of 2016 deaths.
      Travis Lupick

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