The last week of August is Overdose Awareness Week, an international campaign to address a truly international crisis. In the Bay Area, the opioid epidemic is often talked about focuses on San Francisco, where 806 people died last year.
This week, KPIX looks at the opioid crisis through the lens of another city. It’s a West Coast city known for its incredible natural beauty, diverse culture, and cosmopolitan lifestyle. In fact, it’s often ranked as one of the most desirable places to live in the world.
Vancouver, like San Francisco, has become one of the epicenters of the drug crisis. In both cities, fentanyl has been the leading cause of the surge in overdoses over the past decade. But Vancouver and British Columbia have responded differently, with approaches that we often only hear about in the United States.
“Like I said, I’ve been here way too long,” Jeffrey Brocklesby explained. “There’s no one alive since I started my addiction. Not one person. Not one.”
Brocklesby spent 20 years in the streets and alleys of Vancouver’s Downtown Eastside. Everyone he knew when he started out lost on the exact same gamble.
“So there’s crystal meth in there,” he said of the drugs on a piece of aluminum foil. “And there’s fentanyl in there. Hopefully that’s what it is.”
He admits he’s surprised to be alive, given that he’s been thrown into a crisis that will be very familiar to the residents of San Francisco.
“This is Main and Hastings,” Brocklesby said of the nearby intersection. “Also known as ‘pain and wastings.’ It’s ground zero for poverty in the city.”
“I’ve seen everything happen here,” said Todd Allgood, another Downtown Eastside drug user. “I’ve seen the streets evolve. When it was heroin here, it was very quiet. This is new stuff. This is new with fentanyl. It’s everywhere now. Fentanyl has changed the lifestyle. It’s wiped out a whole f—ing generation.”
“We didn’t even have a choice,” Brocklesby said. “We were doing heroin. Then we slowly started tasting something else. Dropping left and right. Oh, now there’s a crisis. Everyone’s dying.”
Fentanyl became popular in Vancouver around 2014, with overdoses doubling in two years after Downtown Eastside became an emergency room.
“These guys are here in case there’s an overdose in the area,” explains health educator Sarah Blyth as she walks to one of her Narcan distribution tents.
“It’s the community helping the community itself,” she explained.
Blyth is Executive Director of the Van City Overdose Prevention Society. But in 2016, she was managing a street market in Hastings.
“And because we were outside, more and more people with overdoses were coming to us,” she said. “So we basically set up exactly this. A tent, table and chairs.”
At the time, Vancouver had one official safe injection site. Blyth effectively forced the city to open more by opening her own.
“This is a public health emergency,” Blyth said of the action. “I don’t care what any level of government says. Nobody is going to sit there and watch people die.”
“So in 2016, the government of British Columbia [British Columbia] “We issued an emergency ministerial order telling health authorities that we could open and operate overdose prevention sites, despite them being illegal in Canada,” explained Dr. Mark Lysyshy, Chief Medical Officer for Vancouver Coastal Health.
In the eight years since the emergency was declared, British Columbia has embraced the idea in dozens of locations.
“Now that people have switched to inhalation, we offer injections and inhalation, but these have to be done indoors or outdoors,” Lysyshyn said of the changing usage habits.
On-site treatments are also offered, but the emphasis is primarily on limiting the risks associated with the unpredictable supply on the street.
“We’re all rolling the dice,” Brocklesby said of the risk. “It’s not fentanyl anymore. We’re using tranq and benzos.”
Alternatively, British Columbia also provides government-regulated medications, known as “safe delivery.”
“We saw the risk that can come from unregulated drugs,” Lysyshyn explained. “And so we legalized them and made regulated versions so that people don’t die right away when they use them.”
Todd Allgood, who has a back injury, is receiving two medications.
“I go to the IO twice a day for my half gram of heroin,” he said of the treatment. “And that takes the pain away.”
“We know this helps people get treatment,” Lysyshyn said. “It’s part of the treatment journey. Because people who don’t have access to this, who are using dangerous drugs, are at high risk of dying and may never get treatment.”
So with safe use and safe delivery, Vancouver’s approach is definitely different from San Francisco’s. It’s a more aggressive use of harm reduction tools eight years into an emergency that these cities share. Almost a decade in the fight to save the next life.
“I want to wake up and live, and not just survive,” Brocklesby said of his hopes for the future. “I want to find some peace.”
The human toll in suffering and lives is something both cities know all too well. The big question of course is how does this work for Vancouver? How do they measure the success of these programs? Do the people of Vancouver and British Columbia feel that these strategies are working?
There are some familiar conflicts in this shared emergency. How some say these policies dramatically reduce overdose deaths, and why there has also been significant public and political resistance to some of these strategies, including an experiment with decriminalization. That’s the subject of the next chapter of KPIX’s look at Vancouver and what San Francisco might learn from its experience.
Wilson Walker
