photos: Photo courtesy of Nicolas D. Leech-Crier.

A year of patrolling the streets during the overdose epidemic

Viewpoints: Spikes on Bikes launched bike and foot patrols in response to the worst overdose epidemic on record—a hard-working rider shares his experience over the program’s first year

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By Nicolas D. Leech-Crier

 

Ah, another rainy night in the Downtown Eastside. Wonderful. It’s certainly been a long and stormy year out there, hasn’t it?

As one of the dedicated riders of the Spikes on Bikes outreach team, I know all too well that rain doesn’t stop people from overdosing.

In my weather-proofed and high-visibility safety gear, out we go, rain or shine, tongs and Narcan at the ready: 12 hours a day, 7 days a week, and 365 days a year.

This practical, innovative community initiative was born out of the Portland Hotel Society’s long-standing goal of compassionately protecting and empowering an often marginalized and misunderstood population, a close-knit family of neighbourly Vancouverites.

Today they stand together, as always, through shared emotional turmoil, bravely facing an unprecedented second year of almost daily rising death rates from illicit drug overdoses.

A much-needed response
The Spikes on Bikes program began as a pilot-project just over a year ago, a means of relieving a bit of workload pressure for the society’s single employee-driven needle recovery van, which was finding its own meager limits stretched to the max. It was overwhelmed with calls for used needle recovery and harm reduction supply distribution.

The Spikes model seemed to fit this simple safety need like a surgical glove, and the society was funded for a six-month trial contract. We set out to enroll two Downtown Eastside community members for part-time peer positions (peer is defined as a current or recent user).

The 'chosen locals' then began riding a regular route down alleyways, waving “hellos” of solidarity and backing it up by not only recovering more than 38,000 used needles (as of March 16) but also making sure drug users had clean gear. It's an effort to prevent another HIV epidemic like the one Vancouver experienced in the 1980s. But it also shows that—given the right opportunity—we as a community, where danger and trauma are constant, are ready and able to responsibly care for ourselves and one another.

Perhaps because someone had once cared for us.

Spikes on Bikes is actually the first program of its kind in the entire world, a truly original Canadian operation. This stark urgency is felt acutely in our collective awareness of this tragic and unrelenting emergency—which has come to be known as one of the year’s top international news items—rages on. Almost 1,000 people died of an illict drug overdose last year in B.C. alone.

As long as people are using needles alone in dark corners of back alleys, there will be a need—nay, a responsibility—to clean up the debris, to prevent harm, and to keep our city safe for all who live here.

In our community, we choose to honour the user, as a free person, with a spirit.

‘Straight to the alley’
The people of this place, though seemingly troubled, are humbly grateful to the ancestors, and the current Coast Salish Indigenous peoples, as well as plant and animal people of this beautiful, unceded land.

We, as drug users, have learned that as with most controversial life lessons—a policy of respect is the only way harm reduction works. Without respect, this amazing, lifesaving, employment-creating idea might never have become a realized dream.

As it turns out, the people who tend to happen across an overdose in time to save a life, more often than not, are the people who are actually out looking for them. Since harm reduction was already a well-established practice in this small, impoverished corner of the country when the crisis was officially declared, progressive and unorthodox tactics like Narcan kits and pop-up injection tents were much more easily introduced than they would have been in any other Canadian city.

And those tactics are working: to date, Spikes on Bikes has trained more than 300 people, dispensed more than 876 Naloxone kits, and reversed about 150 opiate overdoses.

But according to officials, this is only the beginning.

First fentanyl: 100 times more powerful than heroin. Then carfentanil. 10,000 times more powerful than morphine. Now, anything from Ketamine-cut "purple pebbles" to fentanyl-laced party drugs, is reported to be turning up on the street-level market.

Complicating matters further is the +undeniable power of addiction, which has taken what used to be manageable human opiate tolerance and intake levels, and cranked them up to elephant-dropping levels. So when people start collapsing from cardiac arrest, bystanders will literally flock to the nearest dealer in a frenzy of anticipation for “The Rush.” Of course, it’s understandable. What drug user doesn’t want to get as high as possible and thinks they can set their own limit?

So, it’s straight to the alley.

And as the number of overdoses continued to skyrocket, health authorities soon realized that they could no longer afford to keep the lifesaving opiate-reversal drug Narcan (Naloxone) listed as a controlled substance (thus only accessible to physicians and their officially prescribed and monitored patient/addicts).

So, with civilian access to Naloxone granted and their official mandate amended to include first-responder duties, the Spikes team was then expanded to include four more peer positions and the recruits were all trained (by Vancouver Coastal Health staff) in Narcan administration and overdose response.

Each person was also shown how to pass on training to anyone they encountered in the course of their harm-reduction work.

Never use alone
And they can train on-the-spot in about 10 minutes. Or, if you prefer, they can ride over to your chosen space and train a group of people, and send each one home with their own Naloxone kit, secure in the knowledge that should they be called upon to act (in the few short minutes a person has between the drug taking them down, rendering them unconscious, and leaving the person with permanent brain damage and/or death) they will be ready to respond until the paramedics arrive.

Most riders have lived in the area for years.

They’re a useful wealth of outreach/local resource information—they can find their way around and locate anything. Just ask.

Up until this project, not very many people (police officers and paramedics included) knew what to do when responding to overdoses.

They’re sudden and silent. Frantic situations, if not handled swiftly and properly, will only continue to get worse. Every second counts.

It’s a terrifying experience to watch. Once you have though, it becomes really hard to walk by a “nodder” and not check on them.

It’s a lot harder than it used to be, anyway.

Bottom line: overdoses are preventable. So, if you use, please: DO NOT USE ALONE. Safe sites are safe. Two people, at least. Take the time to test your dose. Don’t inject at the same time and if possible, have someone nearby who is trained to respond. And ask yourself one honest question: Why die for the high?

I know, in an ideal world it wouldn’t be so hard to find someone who is willing to just stop their day and come watch over us in the comfort of our homes without expecting something.

So, just call me, Nick. I’ve lost good friends to this crisis. Reach out, any time, day or night. I would be honoured to serve your safety. Better yet, call Spikes on Bikes directly and they can ride to make sure you stay safe. We’ve even expanded to include Vancouver’s West End.

And because overdoses do not discriminate, we will be out and about throughout the summer.

Crisis or no crisis.

Spikes on Bikes would like to extend our deepest sympathies to the families and friends of overdose fatalities. In June, the team is looking to recruit for the West End. Job meetings are held at the Interurban Gallery (1 East Hastings), Tuesdays at 9 a.m. There is an honourarium for each shift. You must be an active or recent user, dealt with at least one overdose, and be able to ride for four to six hours.

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