The vendor stalls of Vancouver’s Downtown Eastside Street Market are piled high with ’80s action-movie DVDs, parasols, hand-knitted booties and Justice League comics—a trove of treasures for all types. The sprawling social enterprise gives sellers, many of whom are living on low incomes, a chance to earn extra money. It buzzes with the chatter and convivial chaos typical of such places, but in 2016, when the city’s opioid issue became a full-blown crisis, that flurry of activity turned ominous.
At the time, community activist Sarah Blyth was working as a manager at the market, which is located in an area that is popular with drug users. She started witnessing more and more overdoses—sometimes up to five a day. (According to a B.C. Coroners Service report, fentanyl-detected deaths increased in Vancouver from 32 in 2015 to 280 in 2017 due to the potent opioid narcotic contaminating the drug supply.)
“Whenever there was an overdose, someone would come screaming, ‘Narcan, Narcan, where is it? Do we have enough?’” says Blyth, referring to the nasal spray version of naloxone, a drug used to block the effects of opioids, especially in overdose situations. “I thought, We need to be more organized than this. The market is filled with hundreds of people, and we only have a few minutes to respond.”
When there was a death up the street, Blyth and two market volunteers decided things had to change. In September 2016, unsanctioned by the market or any agency, they established a pop-up overdose prevention site nearby. They put up a tent, secured some Narcan, found a volunteer trained in administering naloxone and started a GoFundMe page to raise money for supplies and honorariums for their volunteers. In 2017, the pop-up—now called the Overdose Prevention Society (OPS) and supported by Vancouver Coastal Health—received more than 100,000 visits, saw more than 300 overdoses and logged zero deaths.
Blyth knows that doing the right thing sometimes means doing what many consider to be wrong. From Nanaimo to Ottawa, nurses and harm-reduction workers have come to the same conclusion, as the opioid crisis places them in the difficult position of having to take illegal action to save lives. It was Blyth who inspired nurse Leigh Chapman and her fellow volunteers to open a pop-up safe-injection site in Toronto’s Moss Park neighbourhood in the summer of 2017.
Several cities, including Kamloops, Edmonton, London, Toronto and Montreal, have approved supervised safe-injection sites in the past two years. But unlike the pop-up versions, sanctioned sites take some time to establish—and the number of overdoses continues to balloon. While making it easier for people to inject drugs safely is controversial, Blyth says it’s a matter of public health. “In order to really help people, we need to change our opinions and the way we’ve addressed the crisis. We’re not going to police our way out of this.”
In December 2017, OPS moved into a building owned by B.C. Housing. The organization is open seven days a week and has between 300 and 500 visitors daily. Blyth, now the executive director of OPS and of the Downtown Eastside Street Market, oversees 30 trained volunteers, all members of the Downtown Eastside community.
Joy is a peer-support worker at OPS and a recovering opiate addict. “Me being able to relate with using needles, and being able to relate with being homeless, it helps. I understand what they’re going through,” she says. Joy credits OPS with supporting her to quit using. “Working here, I’m changing my life.”
Helping others should never be optional, says Blyth. “Saving a life isn’t something you don’t do if you can.”
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