By Jesse Donaldson

When Sarah Blyth, Ann Livingston, and Chris Ewart first pitched the Overdose Prevention tent in the alley behind 62 East Hastings, they didn't set out to be lawbreakers.

They weren't doing it to serve a political agenda or for personal gain. Their goal was simply to save lives.

“I was a Park Board person, so I know how long things can take,” recalls Blyth, who had previously served two terms as a Vancouver Park Board commissioner. “Even the simplest things take so long. Doing it [officially], I knew there would be tons of hoops and red tape, so we just said, 'No, we're doing this.’”

The trio knew the stakes were high; involved in coordinating the Downtown East Side Street Market, they were already on the frontlines of the worst overdose crisis in B.C.'s history, one which claimed 922 lives in 2016 alone—many of them friends and neighbours.

“I was morbidly staring at Netflix, listening to sirens night after night,” notes Livingston. “And every day people would be shouting 'NARCAN! We've got an overdose.' You'd be rifling through your purse, but you'd given it away. You'd be running up the road. So it made sense to everybody. Why not have a place people could go? It was a very organic project.”

Opened on Sept. 21, 2016, it was initially a simple operation: tables, needles, jugs of water, a volunteer, and a supply of Naloxone, the lifesaving medication used to combat opioid overdoses—in particular fentanyl, the driving force behind the current crisis. Volunteers worked long hours (sometimes up to 12 hours, according to Livingston), for which they would be given a $30 honorarium paid for through a GoFundMe page set up by Blyth. Small though it was, word quickly spread, and before long the site was well-known around the neighbourhood.

“I think at first, people didn't really know what we were,” Blyth recalls. “Some of them thought we were trying to be Insite [Vancouver’s first safe injection site]. But really, we were just a medic tent. It was something we did because we had to. The conversation was simply, 'We're going to do this. We're doing it because people will die if we don't.'”

Stepping up
Responding to a surge in demand, the newly-minted Overdose Prevention Society put up a second tent on November 18 in an alley near Main and Hastings, during a month that saw overdose deaths climb to an all-time high of 128. More than four people a day. By then, word had begun to spread about the unsanctioned sites, not just to law enforcement, the media, and health authorities, but to those eager to lend a hand. Volunteers began to step up, first in the form of harm-reduction group Karmik (who have been involved since late 2016) and then of neighbourhood residents—many of them users of the site themselves.

“We can't ignore the peer volunteers in this,” Livingston says. “They're superheroes. People who take shifts, and become volunteers, it really changes their lives. I think they're much less likely to die, and I think they're much more likely to fight for things like welfare, and view themselves as capable human beings.”

Thanks to the efforts of those volunteers, not a single person has died at any of the sites during the six months they've been operational, despite hundreds of overdose incidents (the group stopped counting after they reached 200). And while the sites have been operating without any form of legal sanction since their inception, provincial authorities quickly made it clear they had no intention of interfering. Then, on December 8, just two-and-a-half months after the first tent opened, B.C.’s Health Minister Terry Lake made a surprise announcement: the provincial government would immediately open two overdose prevention sites in the Downtown Eastside, as well as a mobile medical unit, and additional facilities in Victoria and Surrey.

“Terry Lake just said, 'We're not going to wait for Ottawa,'” Livingston muses. “Just put them up! Terry Lake goes rogue! It's like a miracle.”

From there, things began to move quickly; on December 12, federal Health Minister Jane Philpott introduced a bill to amend the Controlled Drugs and Substances Act. The next day, the City of Vancouver joined the fight, raising $3.5 million through increased property taxes. On December 23, Vancouver Coastal Health announced they would begin paying the society's volunteers, and construction company EllisDon provided a first aid trailer to replace the tent at the original Hastings site. More than 300 community members have since been trained in the use of NARCAN, and the operation has expanded to include five sites in the Downtown Eastside, and 20 province-wide.

“VCH did a great job at stepping up and doing something,” Blyth says. “We said to them, 'We have these facilities open. They're saving lives. This is a good thing.' And they recognized that. We talked to Terry Lake, and he was willing to help. But it's going to take more than Terry Lake. It's going to take a lot of Terry Lakes.”

No end in sight
Today, thanks to cooperation between the city, VCH, and the Overdose Prevention Society, the Downtown Eastside sites have been able to move indoors. The Hastings site, however, remains in its original location, featuring portable toilets and a smoking tent—the first of its kind in the province. As of this writing, none have a legal exemption from the federal government, however, as Livingston points out, moving away from a medical model was always part of the plan.

“I feel really strongly that we need to push for this more casual style of injection site,” she says. “It's non-medical.

It's a community injection site. Eighty-five per cent of the people who are dying are shooting alone in their rooms. I think if you want to encourage people to go to an injection site, you need to make it a pleasant experience for them.”

Moving forward, Blyth and Livingston say, the crisis shows no signs of abating. To that end they're working to refine their strategies.

The group is developing an app to track and respond to future overdoses. However, when asked about the future of the opioid epidemic, and whether there's an end in sight, Blyth is quick to point out that the real solution lies in a change of perspective.

“Nothing we're doing is a solution in all of this,” she says. “It's all just emergency response. It's a big waste of time and energy, putting this together, when we could be doing the cheaper version—and it is cheaper—where people come to us and say 'I need heroin or methodone,' and they get a scrip, they take the drug while we watch them, and then they go on.

“It's better, cheaper, there's less stealing of people's stuff, less survival sex work, fewer women in vulnerable, Picktontype situations. If you're not having overdoses in the first place, then there's more room in hospitals. It makes so much sense. It's the most cost-effective thing to do. It's the most humane thing to do. And it's the right thing to do. There's just so much stigma attached to it that it stips governments from acting.”