Cheque Day in the Downtown Eastside

published on January 1, 2017 by Andrea Woo, Sunny Dhillon, Wendy Stueck, Mike Hager, Mark Hume, Ian Bailey, and Luiz Lopes in The Globe and Mail

The prevalence of fentanyl and carfentanil means drug users in the Downtown Eastside are always at risk, but never more so than when social assistance cheques arrive every month. The Globe spent roughly 24 hours in the troubled neighbourhood for a first-hand look at the overdose crisis

Deirdre is leaning against an alley wall, prepping a needle full of crystal methamphetamine that could be contaminated with fentanyl. She and a friend have paused to cheer as an employee of a nearby needle exchange rushes over to revive an overdosing man.

“Breathe bro, breeeeathe!” another bystander shouts as he gently slaps the man’s blue face while the employee preps oxygen and a syringe of naloxone that can reverse the deadly effects of opioids.

A small team of firefighters and paramedics take over. The first responders believe the man – Justin – is the one they revived in the same spot a day earlier.

Deirdre, who asked that her real name not be used, and her friend prepare their rigs and inject them into their arms, the scene in front of them no deterrent to the risk that could put them on the pavement in need of a similar lifesaving intervention.

It is 11:29 a.m. on a frigid Wednesday morning- the second-last Wednesday of December, when millions of dollars of social-assistance payments flood into the Downtown Eastside, or DTES. For recipients who regularly use drugs, this day – known in the neighbourhood as “Cheque Day,” “Welfare Wednesday” or “Mardi Gras” – dramatically increases their risk of a fatal overdose.

Though much of Canada has felt the effects of the fentanyl-driven overdose crisis, British Columbia has been hardest hit, experiencing more fatal overdoses this year than in three decades of record-keeping. The death toll is expected to climb to more than 800. Two weeks ago, eight overdose deaths were recorded in the Downtown Eastside in a single day.

In the troubled neighbourhood, more than 6,300 people draw social assistance and more than half the 18,000 residents are thought to be drug users.