“Everyone else is too afraid”: DULF’s unsanctioned compassion club saves lives

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      Eris Nyx didn’t think she’d be spending her time running a compassion club.

      “I’m an artist by trade, I’m not a fucking drug dealer,” she says in a phone call with the Straight. “And I certainly don’t like doing math.”

      And yet, the co-founder of the Drug User Liberation Front (DULF) is running an ambitious, unsanctioned program that’s trying to remove people at high risk of poisoned drug death from the unregulated illicit supply by selling its club members pure, tested drugs—and studying what happens next. 

      As the unregulated drug emergency hurtles toward its seven-year anniversary, almost seven people are dying from poisoned drugs in BC every day. In Vancouver’s Downtown Eastside, one in 200 people die every year from unregulated illicit drug poisonings. The municipal and provincial government’s interventions do little to change this death toll, leaving community members to come up with their own solutions. 

      DULF’s compassion club buys heroin, cocaine, and meth from the dark web and sends it to Substance in Victoria for batch testing. The substances are sent back, measured, packaged, and sold to the club’s 42 members at a fulfillment centre that operates like a regular storefront. Members participate in internal reviews, and researchers from the British Columbia Centre on Substance Use (BCCSU) are helping to gather data to study the impacts.

      Since the program started around seven months ago, no member has died from toxic drugs.

      Compassion clubs aren’t a new idea. They proliferated through the 1980s and ‘90s in response to the HIV/AIDS epidemic, where buyers’ clubs and cannabis compassion clubs bought and distributed hard-to-access or illegal medications to their members. The BCCSU wrote a whitepaper advocating for heroin compassion clubs back in February 2019.

      Heroin compassion clubs could “reduce the number of fentanyl-related deaths and impacts of organized crime,” be set up with “little to no operating cost to the public,” and undertake “scientific evaluation to assess impacts.” The authors urge “an evaluation of this model” should be “urgently undertaken.”

      Four years later, DULF is the only one—and it’s doing this work illegally. 

      Nyx doesn’t mince her words. “I’m only doing this because everyone else is too stupid and too fucking afraid.” 

      While the organization originally started off doing free drug hand-outs at the beginning of the COVID-19 pandemic, Nyx and co-founder Jeremy Kalicum decided something more organized needed to happen. The pair incorporated DULF in 2021 and spent months researching the best framework for a compassion club. 

      They wrote a proposal to Health Canada in August 2021, asking for Section 56 exemption to the Controlled Drugs and Substances Act. The exemption would give DULF permission to purchase pharmaceutical-grade substances for supervised sales. Vancouver city council voted that October to support DULF’s application, and then-Mayor Kennedy Stewart wrote a letter of support. But the request was denied almost a year later, in July 2022. 

      “There was no working with us. There was no back-and-forth iterative process to figure out something that works,” Kalicum said. “They were just like, ‘Hard no. We’re not talking to you.’ And we felt like that was the wrong decision.”

      DULF started the compassion club in August 2022, and to date has distributed over a kilogram of tested substances to drug users at high risk of overdose. But the point isn’t just to give out drugs: it’s to gather evidence on whether compassion clubs work, and how they could be better.

      “In the harm reduction field, there’s a whole long history of the affected community taking matters into their own hands,” said Dr. Thomas Kerr, the BCCSU’s director of research and head of the division of social medicine at UBC’s department of medicine. He helped DULF with some initial ideas on a research framework while it was organizing the compassion club, but the organization very much led the way—as is the case for many harm reduction interventions. 

      Drug users have spearheaded needle exchanges, crack pipe giveaways, safe consumption sites, and overdose prevention sites, he noted, long before any of those things were legal or regulated. 

      “Not a lot has happened on [the compassion club] front from the system level, but here we have people who use drugs kind of leading the way. This sort of seems like history repeating itself, where these demonstration projects happen, and then eventually they become standard practice,” Kerr said.

      Distribution of hard drugs to people who use them is also nothing new. But safe supply programs, such as the heroin program at the eastside Providence Crosstown clinic, are medicalized: participants need diagnoses, prescriptions, and titration to carefully decide their dosage. Those programs are inaccessible to many drug users, especially ones who live more chaotic lives, as missing a single appointment can lead to losing all access. And that’s if you can find a family doctor or registered nurse to be your primary care provider in the first place.

      “The thing that makes our [program] unique is that it’s demedicalized,” Kalicum said. “You don’t need a doctor, you don’t need a nurse.”

      But the lack of legal recognition causes problems for a large, complicated operation. 

      “It’s a tremendous pain in the ass,” Nyx said. “It’s very difficult for us to expand when our operations are illegal, let alone 10-years’-jail-time illegal, or find volunteers, or find manufacturers, or other such institutions that want to work with us.” 

      And 40-ish people is all the compassion club can handle right now, as trafficking larger amounts of drugs is costlier and riskier. But the current sample size isn’t really big enough to draw quantitative scientific conclusions from. 

      “We haven’t wrecked anyone’s lives or increased the amount of crime. People aren’t getting sick, people aren’t dying. All these metrics that we’re taking, they’re not increasing, but if we are seeing them decrease, there’s not enough of a sample size,” Nyx said. “Were the results of our evaluation to be negative, we would pull the plug on the project. But that’s not what we’re seeing.”

      Although the sample size is small, there’s solid qualitative data that’s gathered in interviews with the subjects. 

      “People aren’t really overdosing and needing to be revived… people don’t overdose off [heroin, cocaine, or meth] like they do off fentanyl,” Kalicum said. “People are telling us… which is a surprising finding, that they’re using less drugs.”

      Kalicum said other reported effects include members feeling “safer and protected from overdose,” that they are involved in less crime, have less police interaction, and have improved mental and physical health. But the compassion club isn’t a magical panacea.

      “It doesn’t help with housing stability,” Kalicum said. And “for some people, heroin’s not going to cut it, and they have to continue to use fentanyl and [be at risk of] overdose.”

      DULF is expecting to hear back from Health Canada about its judicial review by the end of summer. If the decision is overturned, it could buy drugs from pharmacies and eliminate the need for testing. It could scale up operations, and look into distributing other drugs or helping other communities set up similar compassion clubs, without the ever-present risk of criminal conviction. 

      If the original ruling stands, “that’s exactly where we are right now,” Kalicum said.

      DULF is hosting a Parade of Horribles on April 14, “because horrible drug policy kills,” to mark the seventh anniversary of the unregulated drug emergency.