“Drug users don’t get to take breaks,” said Trey Helten.
Not even in a pandemic.
The Overdose Prevention Society ran the largest supervised consumption site in Vancouver at 58 East Hastings. It’s still running, but with COVID-19 capacity has shrunk and supplies are dwindling, said Helten, a manager at the site.
Hospitals are “number one” when it comes to prioritization of supplies, said Helten. “We’re low on the list, so we’re raising money on our own and buying online.”
Their supervised injection room has gone from 24 tables to six, placed two metres apart — supervised drug use in the age of social distancing.
But some people, rather than wait for a table, will instead choose to use in the nearby alley. Society staff are doing their best to check on them.
Overdoses could require the use of oxygen masks and intubation to keep airways open. But Helten said the Portland Hotel Society and Vancouver Coastal Health have instructed them not to use them because they could “push COVID-19 into the air.”
But if someone doesn’t get needed oxygen in the event of an overdose, “in three to five minutes, they can be turned into a vegetable,” he said.
COVID-19 has complicated their work to prevent overdoses and save lives. In B.C. last year, the coroner’s service estimates that drug overdoses were behind 981 deaths. The Downtown Eastside has been decimated by overdoses in recent years, many tied to drug users not knowing high levels of fentanyl have been cut into their supply, which advocates have called a “poisoning.”
But the virus has brought another worry — transmission when people buy drugs or use with others.
Despite this, the streets of the Downtown Eastside are packed.
“It’s business as usual here,” said Helten. “Nobody’s dispersing.”
COVID-19 has brought a new perfect storm to the neighbourhood, whose residents have long struggled with challenges around shelter, poverty, health and drug use.
Many service providers and drop-in centres have closed, cutting residents off from everything from support to showers and from meals to information.
“Our job has changed from reviving someone from a drug overdose to warning them about COVID-19,” said Helten.
Eight of the city’s nine supervised consumption sites are still open; only the Maple Hotel’s site has closed. But new protocols, as at the Overdose Prevention Society site, are affecting their ability to offer services. (You can view a map of them here.)
On Thursday, the City of Vancouver declared a COVID-19 state of emergency. The city has begun giving help to the Downtown Eastside, adding wash stations to a neighbourhood lacking in public washrooms and educating SRO operators and tenants about sanitation in their buildings. Mayor Kennedy Stewart has called on the provincial and federal governments for more help, especially around drugs, housing and income assistance.
But with reduced services in the neighbourhood, those agencies still running have an even heavier responsibility in informing locals what’s going on and what to do.
Many residential hotels have banned guests and the city-sanctioned market has been shut down, adding people to the street.
“The sidewalk is only so long,” said Laura Shaver, president of the Vancouver Area Network of Drug Users. “How are people supposed to socially distance when they don’t have a home?”
The city has also formed a task force with Vancouver Coastal Health, BC Housing and other community groups and is looking for sites to offer homeless people a place to isolate. Nearby in Victoria, the city has already allowed homeless people to set up shelter at two parks, with another park soon to open as a staffed shelter for those with more acute mental health and addictions challenges.
In Vancouver, the drug trade is still going, but it’s been disrupted by the virus. Reduced ships coming into port have limited the supply, say Helten and others.
The result is higher prices, leaving those desperate for drugs talking about robberies, Helten said.
Tomorrow is Welfare Wednesday, also known as cheque day, when people receive their provincial income assistance. The monthly day regularly results in a spike in riskier drug use, overdoses, hospital admissions and violence.
Despite COVID-19, nothing is expected to change.
“It’s like The Purge down here,” said Karen Ward, referring to a movie about anarchy and crime in a dystopian future.
Ward is a well-known neighbourhood advocate who was recently hired by the city as a full-time crisis response co-ordinator for the Downtown Eastside.
“With nothing on shelves in stores, the only thing people are going to do is buy drugs,” she said.
Since the beginning of March, Ward has been worried about the state of the area and the slow response from public agencies.
“There’s no way to get announcements out,” she said. “Many people don’t have phones. There’s been no print news since Metro [a free daily no longer in operation]. The lack of media is just brutal. Photocopiers are locked up. The flows of information between people who run agencies never reaches the street.”
Ward says she’s working with the Atira Women’s Society to get electronic screens in the neighbourhood to display key information, something that cities like Richmond have already begun doing.
Ward’s solution to counter the desperation of drug users in these times is a safer drug supply. Vancouver’s Mayor Stewart also supports this, asking higher levels of government to loosen prescribing restrictions.
“The last thing you want is 3,000 opioid addicts sick and angry, doing anything they can to get unsick,” said Ward, who’s long called for the decriminalization and regulation of hard drugs to help users’ safety. “It’s in the public’s health interest to make safe supply a priority.
“Until that supply is available, dealers are an essential service, as much as a grocery store.”
Ward adds that many dealers are looking out for their customers’ safety in the time of COVID-19, using gloves and selling prepackaged material. “Shout out to them,” she said.
On the front lines, supervised consumption sites are doing the best they can to make things even safer than usual.
Sites like these have always been extremely clean, and Provincial Health Officer Dr. Bonnie Henry complimented them in her briefing Monday.
“Now we’re doing it even cleaner,” said Lorna Bird, a supervisor at the site run by the Vancouver Area Network of Drug Users.
They’ve gone from allowing six people in their injection room to three. Another room has been opened up for anyone who might come in “sneezy,” said Bird.
The team has gloves on, hands out syringes rather than letting people get their own and is being strict with giving people 15 minutes to be in and out. Surfaces are wiped down after each visitor. VANDU’s supplies are holding up so far, but Bird is worried.
“If we run out, it’ll be like 20, 30 years ago when people started using the same syringes and there was an outbreak of hep C with people sharing needles. We’re hoping it won’t come to that.”
With so many services shuttering in the neighbourhood, they’re determined to keep the site running.
“We don’t want to turn anyone away,” said Bird.
A key 24/7 neighbourhood spot for people with alcohol and drug addictions, the Vancouver Recovery Club, announced on Friday that it would be closed until further notice. It’s all the more important for sites like VANDU’s to stay open for help and comfort.
But things are clearly different, in big and little ways.
“We used to always be hugging each other,” said Bird. “Now nobody’s doing it at all.”
You can read COVID-19 guidance from the Harm Reduction Coalition here.
Downtown Eastside groups are collecting donations for COVID-19-related supports: First United Church, Megaphone, Union Gospel Mission, the PACE Society and DTES Response, newly formed by a number of neighbourhood groups to share neighbourhood needs.
A map of available resources in the neighbourhood can be viewed here.