Nine homeless people died from overdoses in a single month. Seth was one of them
Man’s family presses for changes to prevent further deaths as pandemic worsens opioid crisis
When Seth MacLean was nine years old, his mother took him to see a concert in Toronto.
Her son was consumed with a love of hip hop, so the show — a performance by Puff Daddy and the Family — was a big deal. He scored an autographed magazine and gleefully showed it to his brother Lamar when he got home.
But the jealousy of five-year-old Lamar was fleeting, as Seth revealed a surprise. He got a second magazine signed for his little brother.
That moment was more than two decades ago, but Lamar has been thinking about it lately, as his family grapples with the news that Seth — who had been living with schizophrenia and bipolar disorder, and struggling with addiction in a Toronto shelter — died on July 12 of a fentanyl overdose.
By the time they found out, he had already been buried — on Aug. 26 in
Pickering. His family, who searched for him fruitlessly through July and August, finally learned of his fate after turning to Toronto police 51Division for answers on Sept. 10 — what would have been his 32nd birthday.
As the MacLeans demand answers about what led up to Seth’s burial and why they weren’t notified, their grief has punctuated the Toronto homeless community’s deadliest summer since at least 2007.
The COVID-19 pandemic has exacerbated the opioid crisis, experts say — with interruptions in drug supply leading to increasingly toxic substances on the street.
While the city has made efforts to safeguard the shelter system from infection spread, many residents have been placed in facilities like shelter hotels — which advocates and front-line workers warn can lead to residents using drugs alone, and overdosing with no one to intervene.
In July, as Toronto marked a historic high in suspected overdose deaths with 27 fatalities, nine took place among the city’s homeless population, said shelter system director Gord Tanner.
“It’s the most we’ve seen, well, ever,” Tanner said. “We suspected there were 13 across the whole year in 2019. To see nine in the month of July is staggering and devastating.”
Between January and August this year, 16 of the 48 deaths recorded among shelter residents or recent shelter residents in Toronto are believed by the city to have been overdoses.
“What’s needed is a comprehensive strategy here that includes a continuum of supports, including housing and harm-reduction housing for people who use drugs, safe supply … and also a range of treatment opportunities for people who would want to access those opportunities,” Tanner said. “Unfortunately, those things don’t exist.”
As Seth struggled in recent years, Lamar could still see glimmers of the kid his brother used to be — in his love for music, in his generosity toward other people.
But he didn’t know how severe his drug use had become. He didn’t know that Seth was using fentanyl, a deadly opioid, at all. “In the past two, three years, his addiction took over more,” Lamar said.
There was only so much their family could do to intervene. Seth didn’t want to take his medication for his mental illnesses, and couldn’t live at home that way. They tried to take him to treatment centres, Lamar said, but the centres let him walk away.
“It’s honestly one of the toughest things to go through, to just see your brother being what I would say is normal, and then slowly start changing … how can you help someone who doesn’t want help?”
“It was very hard for him to comprehend that what he was doing was causing harm, because he thought it was helping him,” said Seth’s mother, Nerissa. He was terrified of winding up in the hospital and being put back on the medications that left him feeling catatonic, she said.
The city’s records show that Seth lived on and off at the downtown Seaton House shelter starting in 2014. Staff there say it was difficult for him to engage with them sometimes, as he wrestled with his mental health and addictions.
But they saw his humour burst through, and the appreciation he showed when anyone went the extra mile to help. He still loved music, and would compose raps to sing in the shelter from time to time.
“His mental health and addiction never affected his heart,” Lamar said.
Officials, scientists and advocates have linked the spike in overdoses this summer to the COVID-19 pandemic, with changes like altered access to health services, disrupted international street drug supply chains, and the new need for isolation identified as contributing factors.
Dr. Jurgen Rehm, a senior scientist at Toronto’s Centre for Addiction and Mental Health, said the especially toxic supply of drugs on the streets during COVID-19 has happened because there is less travel taking place, leading to less supply of street drugs moving internationally and nationally.
That meant many users had to spend more to obtain drugs through their usual channels, Rehm said. “That led to the situation where a lot of drug users had to buy from sources they didn’t know, had to use drugs they weren’t so familiar with.”
Street-level dealers were trying to stretch their product by mixing substances. “People would, knowingly or unknowingly, get fentanyl-laced drugs that they could avoid a year ago,” said
Rehm. He called for an increase in safer supply and harm reduction programs, to combat the spike in fatalities.
“Increases in overdose deaths are not God-given,” Rehm said. “They’re part of a specific situation, the pandemic — which none of us is responsible for — but we are responsible to cope with the effects, and to do our best in order to minimize those effects.”
Front-line Toronto shelter worker Tommy Taylor pointed out that some measures intended to curb COVID-19 spread have also created riskier conditions for individuals with addictions. The shelter hotels the city was using were one example, he said.
They were a “great setup” in the sense that residents had their own living and washroom spaces to avoid infection spread.
But some, he said, had implemented rules that he believes may contribute to more residents using drugs where no one can intervene.
“Having things like no visitors allowed, sporadic room checks or rules around using so people try to hide it? You have to be realistic about who the clientele is, and certainly have a safety-first approach and try to keep people alive.”
(Tanner said there were a few “abstinence-based” programs in the shelter system, but the city’s expectation otherwise was that facilities used a “harmreduction approach and philosophy.”)
Taylor and other outreach workers are urging officials to embed more harmreduction supports — whether supervised injection facilities, nurses, safer supply programs or rules that allowed individuals to employ a sort of “buddy system” if they were using drugs — into shelters across the city, to avoid the number of overdose deaths climbing even higher.
The MacLeans, too, are calling for safer conditions for individuals using drugs in the shelter system.
“If you’re going to have people coming in with drugs, then you need to have a place to safely use the drugs — not go inside their room and put a needle in their arm, and die on your watch,” Nerissa said.
“Someone with a mental illness and a drug addiction, they don’t know what is too much,” Lamar added. The number of overdoses this summer was devastating, he said. “All levels of government need to do something.”
The system failed Seth, Nerissa believes. He went from a kid who pulled her towards a homeless man and asked her to give him money, to a man who cycled through jail for petty crimes, his mental illnesses so severe that he started eating a bar of soap during a visit.
“Seth had a lot of people who loved him,” she said. During a recent memorial, she and her family released 32 white balloons into the sky, to mark each year of her son’s short life.
Each death this summer has left scars for those who knew them. Tim Bark, who was homeless until securing his own apartment in January, said three of his friends from his shelter days have died of overdoses since the start of this year. He struggled with heroin use himself before getting clean, and stressed the change that permanent housing can make.
He urged officials to do more to address the opioid crisis in the near term — whether that means more supports and staff trained in harm reduction within the shelter hotels, or speeding up access to rehab beds and creating more for those looking to get sober.
“You just become numb to it,” he said of the overdose deaths. “I’m hoping there will be a day soon in the future where we can all have a memorial, and take a breath and give them their proper due, you know?”