Spikes on Bikes
VANCOUVER’S SPIKES ON BIKES PROGRAM IS HELPING THOSE IN THE MIDST OF THE OPIOID CRISIS
ONE NIGHT A FEW MONTHS INTO HIS NEW JOB RIDING A BIKE THROUGH VANCOUVER’S DOWNTOWN EASTSIDE looking for lives to save, Randy Pandora came upon a man sitting between two Dumpsters. Most passersby wouldn’t have noticed, but here, in the midst of a national opioid crisis, Pandora, who has worked for 15 years helping the homeless and drug-addicted in this neighbourhood, saw danger. If the man was suffering from a drug overdose, he was moments from falling between the Dumpsters where he would be invisible to the street as his breathing would slow until it stopped completely. It would be a lonely death in a place where such deaths are heartbreakingly common. Pandora pedalled directly to the man and leaned in to investigate. It was an overdose. Pandora also realized the man was an old friend.
Pandora, a tall man with a hunch and a limp, recounted this story while dressed in a dapper newsboy cap as he walked with me down East Hastings Street, the notorious boulevard in Vancouver that has become synonymous with Canada’s callous treatment of drug addiction, and ground zero for the country’s opioid crisis. As we walk, he nods at friends and acquaintances passing by.
Pandora, an artist who describes himself as an “occasional drug user” and who speaks with a gravelly worldliness borne of familiarity with these streets, works with phs Community Services Society on harm-reduction strategies, an approach to treating drug addiction that focuses on health rather than law enforcement. For years, this meant handing out clean needles and encouraging healthy lives. But when the opioid crisis hit Vancouver – and everybody here has no doubt it’s a crisis – new needs arose. A little more than two years ago, the number of overdoses on the streets grew. There were also more calls to remove used needles from streets and parks. People in need of help were turning up more often in more places. To address these growing problems, phs needed a program that could get help into the community more quickly and nimbly than its existing services. The result was Spikes on Bikes.
The plan was to use bicycles to get aid workers into the community more quickly and deeply than is possible in a motor vehicle. But something unexpected happened. The bicycle did more than just get help onto the streets more efficiently. It opened up new avenues to those in need, became a symbol of community and acceptance and, most important, delivered purpose and focus, not just to those receiving aid, but to those riding the bikes, too. In a place where high-minded talk of hope tends to get worn down by the day-to-day realities of pain, trauma, overdoses and politics, the bike has forged a path forward.
A few blocks east of tourists taking selfies in front of Vancouver’s famous steam clock, the rustic tourist trappings of Gastown abruptly give way to the Downtown Eastside. Here, down an alley of litter and a damp smell of humanity, is a dispensary window, where a lineup of people has formed at 9 a.m. on a Friday morning to pick up clean needles. I’m behind that window, in the office of phs, an organization that has been working in this neighborhood for years to help its residents. It’s an organized but packed space where floor-toceiling shelves hold boxes of medical supplies, and a bustle of activity blends young social workers from middle-class neighbourhoods with aged-before-their-time residents of the street. It’s about as far from the image of Gastown as you can get, a dichotomy not lost on my host, Sarah Whidden, who gave up a comfortable corporate gig at the nearby office of Lululemon to work here.
The opioid crisis has infiltrated all parts of Canadian society. Overdose deaths killed nearly 4,000 Canadians in 2017, according to Canada's chief public health officer Dr. Theresa Tam, in her annual report on the state of public health. “This is the most significant public-health crisis that we’ve seen for many decades,” Tam told cbc News.
But this neighbourhood remains – stubbornly, probably unfairly – the image of the crisis for many Canadians. The area is also at the forefront of harm reduction in Canada, the place where the country's first safe-injection site opened, and the neighbourhood where phs operates with a simple focus: keep people alive.
Part of what makes programs here work, Whidden says, is people like Pandora. phs often employs “peers” to execute its harm-reduction strategies, meaning people who aren’t far from the street themselves – former and recovering drug addicts, the homeless and others with connections to this neighbourhood. “There are a lot of people hurting down here,” Pandora says. “We do what we can.”
As such, it was the peers who were among those who felt the first waves of North America’s opioid crisis. According to statistics from the BC Emergency Health Service, Vancouver emergency services was called for an average of 49 overdose calls per month in the Downtown Eastside in early 2016. By November of that year, it had reached 262. That number has fallen slightly from that peak, but remains high.
In the midst of this, phs workers realized they needed a way to move throughout the neighbourhood quickly to complete the mundane tasks of harm reduction, such as cleaning up needle sites, educating residents and handing out kits of lifesaving naloxone to those who too often see
their cohorts dying. Into this process came a machine that was already on its way to becoming a symbol of the city: the bicycle. Driven by a bike-friendly mayor and a flurry of new bike lanes, Vancouver was in the midst of a bike boom that saw the bicycle driving itself i nto the consciousness of the city and, more practically, showing that getting around on two wheels was faster, easier and cheaper than other transportation modes, which didn’t go unnoticed over at phs.
In late 2016, workers got a handful of refurbished workhorse bikes, then installed baskets and racks loaded with pamphlets, clean needles and latex gloves. After peers got a few hours of training in safe cycling and the rules of the road, Spikes on Bikes was off.
Pandora was among t he fi rst group of workers on bikes under the Spikes on Bikes program. He quickly realized the program was capable of more than just responding to dirty-needle complaints. On a bike, he was able to cover more ground and meet more people, distributing information about free meals, shelters, safe-injection sites and healthy habits. There are more direct benefits to the program, as well.
Spikes on Bikes sees pairs of cyclists running five shifts a day, covering large swaths of the community. At the end of each shift the peers tally up the results – the number of people they contact, the number of needles they picked up, the number of times they call 911. Also on the list is the a column labelled “OD Responded,” meaning the number of times they aided