By Myles Sauer

If you’re looking for a case study in the escalating fentanyl crisis in British Columbia, look no further than its capital.

By April of 2017, 34 fentanyl-detected deaths were recorded in Victoria—already more than half of the 53 recorded in all of 2016.

One-hundred-and-twenty-nine people have died across the province as a result of illicit drug overdoses during the month of May, according to updated numbers released by the BC Coroner’s Service on June 30.

That brings the total number of overdose deaths in B.C. up to 640 so far this year.

The first four months of the year saw an increase from 60 per cent of overdoses in 2016 to 72 per cent.

Conor King, staff sergeant with the Investigative Services Division of the Victoria Police Department, is one of the primary officers dealing with the police department’s response to the overdose crisis.

And while he acknowledges the statistics are concerning, King says his way of looking at the problem is not to concentrate so much on Victoria’s overdose numbers so much as on all of B.C.’s numbers.

“When you look at the numbers for the first five months of 2017, and you extrapolate those for the remainder of the year, if they stay the same, we’ll have over 1,500 fatal overdose deaths,” King says.

“And I can tell you that, in 20 years of policing, I never envisioned that number of fatalities due to illicit substances.

“It’s nothing short of shocking, and completely unacceptable.”

The ground level
While the overdose numbers don’t appear to be slowing down as the year goes on, grassroots organizations are working at the ground level to support those who use drugs in the city. One such organization is the Society of Living Illicit Drug Users, better known as SOLID, which provides support, education, and advocacy for drug users.

Among other initiatives, SOLID volunteers conduct street outreach seven days a week, dispensing harm reduction supplies and recovering used or discarded needles. On the day I visited the office, located across the street from the Victoria Police Department, one volunteer sat in the lobby preparing “rig kits,” which included packaged needles and sterilized wipes so that users could ensure wherever they injected on their body was properly cleaned.

“Everything we do is peer run,” says Jack Phillips, SOLID project coordinator and outreach supervisor. “Everybody here is either a drug user or has a history of experience with drug use. And I don’t mean smoking weed on the weekends, or doing a couple rails in university ... like, real lived experience.”

Phillips, a former drug user himself, says he knows firsthand the importance of harm reduction services organizations like SOLID and AIDS Vancouver Island provide. “I remember the value of having somebody treat you as a real human when you’re out there in the streets, and so when I had the opportunity to go back and do the same thing, that’s what I wanted to do,” he says, explaining how he came to be involved with SOLID after volunteering with AIDS Vancouver Island.

Grassroots support
AIDS Vancouver Island, located in downtown Victoria on Pandora Avenue, is the largest harm reduction provider in Victoria for drug users; on top of a needle exchange that’s been offered since the 1980s, it also provides peer support, street nursing, counselling, and advocacy. “It’s a pretty comprehensive service for people who use drugs, and that’s our primary population,” says Heather Hobbs, AIDS Vancouver Island manager of harm reduction services.

As part of her job, Hobbs provides harm reduction training to members of the community. Training includes teaching people how to properly administer naloxone, an opioid inhibitor used in instances of an overdose.

Similar to the steadily rising number of overdose deaths, the number of people receiving harm reduction training has also increased. “In May alone, we gave out 600 kits and trained almost 500 people,” says Hobbs. That number is significant by any metric, but even more so when considering that by October of last year, Hobbs had trained nearly 800 people and given out 843 naloxone kits.

The group recently opened an overdose prevention room last January—one of four in the city. “We have about 1,500 people who use our service here in Victoria alone, and a good majority of those folks are people who could benefit from safer places to use,” Hobbs explains. “And that has been an incredibly positive experience for both the people who are using the service and also for our staff.”

Hobbs says that providing a space for drug users to use safely, with support workers standing by in case of an overdose, builds “an extra level of trust ... where people are not being judged for using drugs, [and know] that they’re accepted.”

An effective model
“The quality and depth of conversations that comes in those spaces has been really heartwarming,” she says.

However, Hobbs worries that with Island Health submitting two proposals this year for supervised consumption services, the government will overlook the value of grassroots, community-based services such as the ones provided by SOLID and AIDS Vancouver Island.

“I think the focus is still on a fairly clinical model, or [medical] model,” Hobbs says. “And it worries me that those services may not be as accessible or as culturally appropriate for serving people who use drugs.

“These overdose prevention sites are working, they’re effective, they’re responsive, they’re nimble, and there’s lots of community involvement. And that’s what we need at the ground level for addressing overdoses.”