National Post (National Edition)
FENTANYL SCOURGE ‘TOTAL INSANITY’
VANCOUVER • It’s not quite noon, and three people have overdosed after using drugs at an unsanctioned injection site set up inside a filthy alleyway, in the middle of Vancouver’s Downtown Eastside.
Next to a fixing table, under a portable canopy, a thin, middle-aged woman pitches forward and then slumps back in a chair. She has almost certainly injected herself with fentanyl, enough to kill her. She is today’s alleyway overdose No. 4. There will be many more.
She wanted a heroin high, a mellow buzz. She got something else. Now she requires medical attention, or she will die. Before the paramedics arrive, volunteers are on hand to administer naloxone, an antidote to the toxic sludge she has just put in her veins.
The woman slowly comes around, struggles to her feet and wanders off. Seconds later, the chair is again occupied, this time by a burly young man. Another roll of the dice: He mixes water with drugs he’s just bought, pulls the liquid through a strainer and into a syringe, shoves the needle into his right arm, pushes the plunger down and closes his eyes.
He’s lucky. He manages to stand up and walk away.
The Downtown Eastside (DTES) is notorious for poverty, crime and open drug use. But the situation here has never seemed worse, or more frightening. Walking through it Monday morning, I saw more than two dozen women and men sitting or lying on the filthy pavement. Using. Bleeding. Passing out.
“It’s total insanity, it’s crazy,” says Keith Amahad, an addiction medicine clinician researcher and physician at St. Paul’s Hospital. “We’re seeing two deaths a day. And that’s just a fraction of the total number of overdoses.”
The culprit, of course, is fentanyl.
It is everywhere. It’s why B.C. declared a state of public health emergency in April, why federal and provincial politicians met in Ottawa last weekend to discuss a national fentanyl strategy, why activists and volunteers are throwing together “pop up” injection sites in the DTES.
A second makeshift facility appeared in the neighbourhood this week. Both pop-up sites are just a short walk from Canada’s first fully staffed, supervised injection facility, called Insite. It’s jammed to capacity these days, with people lined up outside.
Drug dealers mill around the Insite entrance. Chances are, everything they sell contains fentanyl. Their customers know it, and they buy the stuff anyway.
Sarah Blyth was Vancouver park board chairwoman just two years ago. Now she’s helping run the two DTES improvised injection sites. People show up with drugs in hand. They either shoot up and leave, or they overdose and fall down. At least they don’t die. “This is basic triage,” says Blyth. “People are dropping everywhere. We’re the boots on the ground.”
The irony is that for decades, fentanyl was considered a wonder drug, extremely effective when used as intended. A synthetic version of morphine, the opioid was invented by a Belgian chemist nearly 60 years ago, patients suffering terminal illness such as cancer, and comes in different forms: In patches, and, in countries outside Canada, in oral combinations and nasal sprays. Criminals have learned how to produce it, as well; fentanyl is being manufactured in illicit laboratories, mostly in China, authorities believe.
Because of its strength — about 100 times more potent than morphine — it can be smuggled across borders in relatively small quantities and at great profit.
On the street, it’s injected, snorted, taken orally in tablet form. Fentanyl in its basic powder formula is passed off as heroin, or cut with other drugs, such as cocaine.
It may look the same as other illicit chemicals and opiates, but there’s no mistaking fentanyl once it’s in the bloodstream, says Glenn, a 56-year-old cocaine addict whom I encountered this week at one of the DTES pop-up injection sites.
“With fentanyl, there’s no such thing as a good feeling,” he says. “There’s no chance to get high, because when you take it, the lights just go out. I’ve gone down three times in the last month.”
Will he use it again? “Probably,” he says. “I’d prefer something else, but there’s not much of that around here anymore.”
WITH FENTANYL, THERE’S NO SUCH THING AS A GOOD FEELING. THERE’S NO CHANCE TO GET HIGH, BECAUSE WHEN YOU TAKE IT, THE LIGHTS JUST GO OUT. I’VE GONE DOWN THREE TIMES IN THE LAST MONTH. — COCAINE ADDICT GLENN, 56, AT A VANCOUVER ‘POP-UP’ INJECTION SITE