On a clear but cold afternoon earlier this week (December 12), B.C. health minister Terry Lake walked through a Downtown Eastside alley busy with drug users. The accompanying entourage was small—less than a half-dozen people—and no reporters were with him.
Near the end of the alley, the group slipped through a small opening in a fence and entered one of Vancouver’s unsanctioned supervised-injection tents.
The informal program continued normal operations during the minister’s visit. While its lead organizer, Sarah Blyth, gave Lake a brief tour, people continued to use intravenous drugs, under the mindful care of a volunteer trained in overdose response.
“I was thinking a lot about you guys, and really, you’re having a big impact on the overdoses,” Lake said to two volunteers at the tent that afternoon. “So thank you.”
Since it was established in mid-September, the supervised-injection tent pitched at 62 East Hastings has operated outside the law and without any sort of government support. Lake’s quiet visit wasn’t an official endorsement but something that came very close. (The provincial NDP’s Melanie Mark, MLA for Vancouver-Mount Pleasant, has also visited, on November 26.)
The tent sees roughly 100 users every day, according to Blyth. Before they stopped counting several weeks ago, staff used naloxone, a medication that blocks the effects of opioids like heroin and fentanyl, to reverse more than 200 overdoses that otherwise might have turned fatal.
Blyth maintains the program was established and remains needed in the Downtown Eastside because, despite the fentanyl crisis growing more severe for several years now, it wasn’t until this month that any level of government announced new programs for the Downtown Eastside.
That’s finally changing. Lake’s visit to the neighbourhood that’s been hit so hard by the arrival of fentanyl was tied to a press conference where he unveiled a new mobile emergency-response unit that opened at 58 West Hastings on Tuesday (December 13).
There, he led reporters on a tour of the facility, a large, high-tech trailer in which staff explained how they can provide most of the services that one finds at a hospital ER.
“People that can be brought here by ambulance or maybe brought here by friends or support workers, if an overdose is suspected, they can be treated right here on site. But importantly, they can then be linked to addictions-medicine specialists and further services,” Lake said.
The plan for the facility is to take pressure off of St. Paul’s Hospital, which has been flooded with more than 3,000 overdoses this year, and also to serve as a hub for overdose care in the Downtown Eastside.
Acting without Ottawa's permission
Three days earlier, on Friday (December 9), the province surprised many with an announcement that it would not wait for federal permission to open new supervised-injection sites in Vancouver, Surrey, Victoria, and other cities.
“We can’t wait for federal changes in order to save people’s lives,” Lake told the Straight in a telephone interview last week. “We know people are using in alleys, they are using in their rooms, and they are not where the people who can help them are. And so in the face of this crisis, we really just wanted to do more.”
Regarding inspiration for the plan, Lake gave partial credit to the work Blyth and her volunteers have been doing.
“I woke up yesterday at 4 o’clock in the morning and was thinking about the pop-up tent,” he recounted. “And the real challenge that we see is the cold weather. People have a combination of overdosing and hypothermia, so I know we had to do more. So we pulled the team together quickly. Vancouver Coastal had some plans in place. And so we just expedited everything.”
The three new sites sanctioned by the government are located at the Washington Needle Depot, off an alley adjacent to 177 East Hastings Street; at the Vancouver Area Network of Drug Users headquarters, 380 East Hastings; and at the Drug Users Resource Centre, 412 East Cordova Street, across from Oppenheimer Park.
On Lake's walk through the Downtown Eastside, he also stopped at the first of those three sites and met with some of the Portland Hotel Society staff that operate it.
During the first 10 months of 2016, 622 people in B.C. died of illicit-drug overdoses That’s up from 510 in 2015 and 370 the year before. Fentanyl has been detected in about 60 percent of deaths this year.
Month-to-month numbers dipped last summer, prompting authorities to suggest the situation was improving. But in September, deaths increased from 49 the previous month to 57, and then to 63 in October.
Back in the mobile clinic at 58 West Hastings, Lake signalled that the recent increase is likely to continue.
“With the September numbers, a lot of us were cautiously optimistic that we had turned a corner,” he said. “When we saw 60 [deaths] in October, you know, we still thought maybe we’re still plateauing here. I understand the numbers will be higher in November. We’ll get the numbers later this week, but that really is why we are doing all that we are doing with the overdose-prevention sites. Because we don’t feel like we’ve turned a corner yet.”