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Overdose epidemic – how did we get here?

Overdose epidemic – how did we get here?

by Keri Vermeulen

It is a memorial to life. Measured by a dog-eared and worn piece of white cardboard, the little billboard erected last winter told passersby quietly, in a faded whisper, just some of the names of almost 1,000 people who have died in the last year in BC – succumbed to the effects of drug addiction, mostly through overdose. No gravestone, no celebration of life, no ashes scattered in a sacred place, these lives were memorialized only in felt penned names, written by the aching hearts of those who miss them most – other drug addicts surviving on the streets of downtown Whalley – mostly 135A Street, notoriousy known as “the strip”. Erected only a few months ago, today the sign is in weather-worn tatters.

Like 100-block East Hastings in the Downtown Eastside of Vancouver, Whalley’s strip is “home” to dozens, hundreds even, of people who are considered end stage drug addicts – those who will likely die of causes related to an insatiable desire to get high. The two areas account for more than two thirds of BC’s 214 drug overdose deaths from January to March 2017. Just over 10 per cent of those deaths occurred outside – in vehicles, sidewalks, streets, parks, etc., according to BC Coroners Service statistics.

Cassie, homeless and surviving along the 135A strip, is friendly and smart, and has compassion for others. She has ideas too, about how to help the throngs of people who are drug addicted and barely living on the streets. She ought to know something about the pain, fear and hopelessness this community lives in. It’s her community too. With brightly dyed, aqua coloured hair, her head is perpetually tilted to one side, she rocks and sways a bit as she talks, common with people who are drug addicted, sleep deprived and undernourished. But there is also an undeniable spark of light behind her tired eyes and pale skin. In spite of the fact that she is addicted to drugs, Cassie wants to live and she wants to see other people in her neighbourhood make it out alive too.

She says she has known known personally 11 people who have died in the last year from overdose of the deadly drugs that are now plaguing the Lower Mainland. And she is afraid. “Yeah, I’m scared,” she shares. “I tell every dealer, ‘make sure you tell people not to use alone.’” Cassie is referring to using Fentanyl, the potentially deadly synthetic opiate that has permeated virtually every illicit drug sale in Metro Vancouver.

Cassie is not alone in her loss. In the Downtown Eastside of Vancouver, Randy Barnetson, pastor of Street Church on the 100 Block East Hastings, estimates he has known well two people a week who have died  in the last six months from drug overdoses in his neighbourhood. “I often see memorials on the street or candles lit on a corner with somebody’s name there,” Barnetson says from his inner city church building. “When we have memorial services, people always come. It’s just more pain and hopelessness in an area that’s already full of it.”

As service providers, law enforcement, and first responders struggle to stay ahead of the new opioid crisis that is taking lives on a daily basis, people who are addicted, like Cassie, face a new “normal” in their addiction. Many make efforts to never use alone, while other addicts are ready to revive their friends with naloxone, the opiate overdose antidote, that when administered (either by injection or nasal spray) will often revive the overdosing person. Sometimes, several doses of naloxone are required. Sometimes, it’s too late.

With overdoses happening on a daily basis, and the resulting death toll from 2016 estimated at over 900 in British Columbia, many people wonder, ‘why do addicts continue to use drugs, even when faced with death?’

New Westminster-based Dr. Paul Sobey, who specializes the treatment of substance, drug and alcohol abuse says the unique nature of addiction, a disease, causes a pathological relationship between the substance and the behaviour. “That pathological relationship causes certain areas of the brain to not function normally. It causes what we call dis-inhibition,” Sobey explains. “Everybody with the disease has an abnormal reward pathway… but in addition to that it also causes other areas of the brain to malfunction, and that’s what causes the lack of inhibition.”

This is part of why drug and alcohol users return, again and again, to the very substances that are killing them. According to the BC Coroners Service report, the number of illicit overdose deaths in March 2017 alone was 120 – about 3.7 people a day. This is more than a 50 per cent increase over the number of similar deaths in March 2016.

So how did we get here? Sobey says Canada is one of, if not the top, opiate consumers in the world. Data collected in 1964 showed that Canadians were consuming eight oral morphine equivalents per person per year. Today, it is over 100. Many people’s addiction is initiated with prescription opiates and escalates to the use of street level drugs, like heroin and synthetic Fentanyl.

Detected in the majority of opiate overdose deaths, Fentanyl is readily available in the Lower Mainland, according to the RCMP’s E-Division Chief Superintendent Brian Cantera. “Fentanyl just happens to fall into one of the easily affordable and easily attainable substances which can be mixed as an adulterant into another drug, so (drug traffickers) can ultimately provide more drugs to more people. As the world becomes a smaller place, in terms of the ability to acquire materials such as Fentanyl offshore … it’s easy for people to make and utilize and ship by way of mail or courier. So people are fully aware of those opportunities for making a dollar and they are turning towards it.”

As Cantera puts it, illicit drug producers and traffickers are motivated by money, and have no sense of care or concern about the people who are using the drugs – people like Cassie, in Whalley, and the people seeking treatment in the office of Dr. Sobey, or the people in the Downtown Eastside neighbourhood where Barnetson pastors. Barneston remembers when God called him to the area. “God was telling me that these people were not just drug addicts, but that they were made in the image of God and He loved them and there was something better for them than just dying, and there was something more that we could do than just cleaning the bodies up after they die.”

In the coming months, the Light Magazine will continue to look at the opioid crisis, through the lens of people who are on the front lines – ministry, medical, law enforcement, people who are addicted, and people who have found recovery. There is hope, as we will hear from Sobey, Barnetson and more.

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