Brian Hutchinson: The fentanyl scourge, up close in a Vancouver alley

published on November 22, 2016 by Brian Hutchinson in National Post

VANCOUVER “” It’s not quite noon, and three people have overdosed after using drugs at an unsanctioned injection site set up inside a filthy alleyway, in the middle of Vancouver’s Downtown Eastside.

Next to a fixing table, under a portable canopy, a thin, middle-aged woman pitches forward and then slumps back in a chair. She has almost certainly injected herself with fentanyl, enough to kill her. She is today’s alleyway overdose No. 4. There will be many more.

She wanted a heroin high, a mellow buzz. She got something else. Now she requires medical attention, or she will die. Before the paramedics arrive, volunteers are on hand to administer Naloxone, an antidote to the toxic sludge she has just put in her veins.

The woman slowly comes around, struggles to her feet and wanders off. Seconds later, the chair is again occupied, this time by a burly young man. Another roll of the dice: He mixes water with drugs he’s just bought, pulls the liquid through a strainer and into a syringe, shoves the syringe needle into his right arm, pushes the plunger down and closes his eyes.

He’s lucky. He manages stand up and walk away.

The Downtown Eastside (DTES) has long been notorious for poverty, crime and open drug use. But the situation here has never seemed worse, or more frightening. Walking through it Monday morning, I saw more than two dozen women and men sitting or lying on the filthy pavement. Using. Bleeding. Passing out.

“It’s total insanity, it’s crazy,” says Keith Ahamad, an addiction medicine clinician researcher and physician at St. Paul’s Hospital. “We’re seeing two deaths a day. And that’s just a fraction of the total number of overdoses.”

The culprit, of course, is fentanyl.

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