‘A LITTLE HELL ON EARTH’
‘It’s stressful. It’s frustrating to keep seeing these patients …’
Jay, 21, (not his real name) who lives in the suburbs of northwest Calgary, has overdosed 10 times in the five years he has used fentanyl. His experience is common in the city, where about 80 per cent of opioid overdoses occur outside the downtown.
The first two times that Jay overdosed on fentanyl, his horrified parents found him slumped and turning blue in a chair in his bedroom. They called an ambulance to their suburban home in the northwest and accompanied him to hospital.
The third time, they weren’t shocked anymore, he says. They were just sad. They called for an ambulance and went to bed.
Since then, Jay has overdosed seven more times in five years, including twice on CTrains, where strangers called for help as his breathing slowed precipitously.
Each time EMS arrived to deliver a life-saving dose of naloxone, Jay would come to, “police and paramedics climbing all around,” confused about what was happening.
“The ones in my house were the worst — the ones where my parents found me,” Jay says. “They weren’t necessarily my worst overdoses, but because it was them, they were the worst. Of anyone that could have found me, it had to be my parents.”
But that hasn’t stopped him from using nearly every day.
“It’s like a little hell on earth that I cannot seem to escape.”
A map depicting all of the opioid related calls EMS responded to last year paints a picture of a crisis that is unfolding as much in the suburbs as it is downtown.
In the last quarterly report on the crisis, the province reported that the majority of people who overdosed on fentanyl or opioids in Calgary, around 81 per cent, come from neighbourhoods outside the downtown.
In Edmonton, about 71 per cent of the people who died come from outside downtown.
Announcing an emergency commission to respond to the crisis Wednesday, Alberta’s chief medical officer noted the trend in the geography of fentanyl deaths.
“We also have to figure out why so many people are dying in the suburbs of our large cities,” said Dr. Karen Grimsrud. “Are these people using alone? Do they have access to naloxone? Has an ambulance been called? These are all questions we don’t have answers for, but … we’ll be looking into this.”
There were 363 fentanyl-related deaths in Alberta last year. There were 113 more in Alberta in the first three months of 2017.
Anecdotally, first responders say they’re seeing victims from all demographics.
“I rarely go to downtown, I work in the deep south,” says Calgary paramedic Travis Asplund. “It’s in the suburbs, it’s pretty much everywhere — rich, poor, low-income housing and big mansions.”
Asplund has worked as a paramedic for 17 years and has seen a number of drug trends come and go. “When we had PMMA (paramethoxymethamphetamine), it was mostly rave-goers, partiers, the younger population,” he said, referring to a spate of deaths in Alberta in 2011 and 2012 from the drug ecstasy.
“Now you’re just seeing this across all spectrums, from teens to people in their 40s and 50s.”
Jay’s morning routine involves taking a half pill by grinding it up using a Dr. Scholl’s metal file that’s normally used to soften calloused feet.
“It turns it into a nice fine powder,” he says.
“Places like Shoppers Drug Mart and Safeway have started to lock them up because people would go in there and steal three or four of them at a time. They figured it out.”
He snorts it, usually off the back of his iPhone, and gets on with his day.
“I can wait, but the longer I go, the more withdrawal effects I feel.”
Postmedia has agreed not to use Jay’s real name. At 21 years old, he’s already used fentanyl for more than five years. He started on opioids by taking the prescription painkiller hydrocodone with friends in Grade 10 before eventually graduating to fentanyl.
Some of those friends have since died. Jay attended six funerals last year, all for people who’ve died of drug overdoses.
Most of them, like Jay, come from the suburbs. Many of their families, friends and co-workers had no idea they were using fentanyl.
“I don’t look like the type of person that does drugs,” says Jay. “If you looked at me, walking down the street, you’d think I never touched drugs or smoked weed. You wouldn’t have that idea at all.”
And Jay has seen how varied the demographics of opioid abusers are. At Narcotics Anonymous meetings, he’s encountered more people in their 30s, 40s and 50s, than people his own age.
“It can be hard to relate to them. For one, it’s not always fentanyl they’re doing. Sometimes the doctor prescribed them oxycodone for pain and they just took it too much. I find talking to people like that is really difficult because to them, yeah, we both have problems. But in their eyes, I kind of put myself here, whereas they see their situation as the doctor’s fault.”
What Jay does have in common with some older addicts are the lengths he’s gone to feed his habit, to stave off sometimes savage withdrawal symptoms. He admits he’s stolen from friends and committed fraud to get money for drugs.
Fentanyl costs around $20 a pill, but Jay says there have been days he’s spent as much as $1,000 to $2,000 on drugs.
“When you’ve ripped everybody off that you possibly know and people you don’t know, just random people on the street, you can’t keep doing that. You basically just want to die or you want to quit. There’s only two ways out.”
Maeve, 20, lives in Edgemont. She started taking fentanyl just two months ago and within weeks noticed that she felt depressed without it.
Her first time taking fentanyl remains vivid in her mind.
“It was really nice. I hate to say that, but it was,” she says. “After that, I kept thinking about it and, honestly, I haven’t really stopped doing it since that day.” Postmedia has also agreed not to use her real name.
She has a full-time job, but admits to begging on the street for money to buy drugs.
She’s had one brush with an overdose already, when her parents found her unconscious in the bathroom.
“I’m at this point where I know that this isn’t me. This isn’t what I want to do with my life, but at the same time, it’s really comforting and makes me feel content.”
When you overdose on fentanyl, your breathing slows dramatically. A regular person breathes 12 to 20 times a minute, for someone overdosing on fentanyl, that can drop to two to three breaths per minute.
“They look like they’re dead,” Asplund says. “They’re blue. No life in them at all.”
As the brain is deprived of oxygen, parts of it are damaged or shut down altogether. The longer it goes without oxygen, the more extensive the harm.
“So long as you’ve got that heartbeat, you’re good,” said the paramedic. “Because you know you can give them the antidote (naloxone) and usually they’ll come out of it.”
But even those who survive can wind up suffering from lasting difficulties with motor function, cognition and memory.
Asplund says he and his colleagues are being called for an increasing number of overdoses from fentanyl. He says he’s seeing at least one a week, but he also said it’s not uncommon to be called for multiple overdoses in a shift or to see the same patients again and again.
“It’s stressful. It’s frustrating to keep seeing these patients. And they’re not always happy to see us.”
At his lowest point, Jay tried to deliberately overdose a handful of times. His tolerance to the drug has become so great, he wasn’t successful. He now says he’s glad he didn’t die.
He’s tried getting clean before and was successful in staying off the drug for 12 months at one point. He wants to get back on suboxone — an opioid replacement drug similar to methadone that alleviates the pain of withdrawal for addicts without getting them high.
But on this particular weekday afternoon, Jay isn’t prepared to quit just yet.
Clutching a Big Gulp drink — one of the side-effects of fentanyl is dry mouth — he says he just hopes his story can serve as a caution to others.
“I’m just sitting here wondering, what would’ve happened if I didn’t get into this? Where would I be now?” Tomorrow: One year sober — the story of how one man clawed his way back to life following fentanyl addiction.
If you looked at me, walking down the street, you’d think I never touched drugs or smoked weed.