On April 14, 2016, British Columbia became the first jurisdiction in Canada to declare a public health emergency over rising numbers of drug overdose deaths, a measure intended to create more awareness of the situation and the need for more fulsome and timely data around overdose deaths.
B.C.’s health budget expanded, overdose prevention sites popped up in hotspots across the province, and information from coroners’ offices began to come in more rapidly. For a time, the efforts appeared to pay off. Overdose deaths levelled at the 1,500 range in 2017 and 2018, before dropping below 1,000 in 2019.
Then, of course, the pandemic hit, and with it, access to supervised consumption sites and overdose prevention sites was abruptly cut off. The death toll climbed once more. Last year, B.C.’s toxic drug supply claimed nearly 2,300 lives.
These statistics, as sobering as they are, don’t paint a holistic picture, with all the nuance and colour of the people and lives behind them. Coming off another health epidemic that peppered the news with weekly hospitalization rates and death counts, it was easy to reduce the toxic drug crisis to the black-and-white numbers.
“All these stats are real people. They’re part of families and communities. We can’t lose sight of that,” says Jackie Dickinson, executive director of the Whistler Community Services Society (WCSS). “I think in the process of going through the COVID pandemic, as we’re in the midst of the opioid crisis, maybe we disconnect a bit from the issue until it becomes part of our own life or affects a family member.”
Seven years on from the onset of B.C.’s opioid crisis, Pique looks at how Whistler, a tourism hub and partier’s paradise, can shift the conversation around substance use and the inherent dangers of B.C.’s toxic drug supply, along with delving deeper into the issue from a provincial perspective.
Drug-checking services coming to Whistler
Starting this month, WCSS’ Nesters Road office will offer drug-checking services to the wider Whistler community, one tool WCSS and other social-service and care providers hope can help chip away at the stigma around substance use in a town where few want to rain on someone else’s parade.
“This is about normalizing reaching out for support. It’s about creating a sense of community and belonging so people know it’s OK to talk about these things, creating space and time for each other with those support networks and knowing who are the safe people to talk to,” said Lisa Coulter, outreach services program manager for WCSS. “That’s our hope. That’s our goal. I don’t think it’s going to happen overnight. It’s a small step in the right direction to open up those conversations, and it will take time to build trust with community members to know it’s a safe place to come and test and have those conversations—and that doesn’t happen right away.”
The centrepiece of the WCSS’ drug checking will be a FTIR spectrometer, a machine that tests small drug samples for a range of substances, including opioids, stimulants, and other psychoactive drugs such as MDMA, ketamine, methamphetamine, and benzodiazepines. That will be supplemented with fentanyl and benzo test strips.
Fentanyl and its analogues are not uncommon to find in other substances, and even small trace amounts can prove dangerous. Para-fluorofentanyl, a fentanyl analogue that can be more potent and difficult to detect than its chemical cousin, is being found in more drug samples across the province, while, in March, 46.5 per cent of all opioids tested in the province contained benzos. When taken together, the combination increases the chance of overdose. Xylazine, a strong animal tranquilizer, is also on the rise, detected in 28 drug samples in March.
“Anytime there’s a substance present in another substance that’s not meant to be there, it adds to the level of risk,” Coulter says.
“For instance, meth and ketamine will have a different effect than someone might expect. That’s where the danger comes in if you have a safe drug plan in place and you’re expecting certain side effects of that drug, and it’s different and you don’t necessarily know what your body’s reaction will be to that other drug.”
Along with the drug-checking services to ensure clients know what they’re potentially consuming, WCSS will offer in-person “point-of-care” support that would connect them to other harm-reduction resources, such as Naloxone training and take-home kits, fentanyl test strips, as well as outreach workers who can support participants in making smart decisions and creating safe drug-use plans.
At the core of this approach is a recognition that substance use should be treated first and foremost as a public health issue.
“The help that’s being offered is a health-care issue, but we’ve criminalized it,” Dickinson says. “When someone tells you they have diabetes and they use insulin to control it, or they have an EpiPen because they’re allergic, we see no stigma attached to it. Substance use is a totally different thing. The administration of insulin is a harm-reduction approach to care, and this is the same. I think that’s pretty powerful to think about.”
The province has expanded the availability of drug-testing, but the machinery needed is “quite cumbersome,” said Premier David Eby in response to a question from Pique during a roundtable call with Glacier Media editors on May 18.
“In any event, any intervention that we can provide to minimize the risk of overdose, of accidental overdose, and keep them alive, is critically important, so we’re always looking at opportunities like that through public health,” Eby said, adding that one of the sectors the province is looking closely at is the construction industry.
“We know there are a lot of people who use opioids to manage pain that comes from the very physical work that they do, and they are at significant risk of overdose,” he said.
“We see the disproportionate impact in that community, and so we’re looking through public health for ways to respond to these specific and discrete groups in different ways, and we’re going to keep doing that.”
Shifting the conversation
Stigma around drug use persists everywhere, but especially in a tourism town where most residents have uprooted their lives to live here, talking openly about things like mental health and addiction can prove a tall task.
“I think there is a pressure on people that come to this community to focus on the fact we’re living in paradise when things get hard. When we do that, we don’t create a lot of room for people to talk about their struggles,” Dickinson says. “One thing I often hear is, ‘But look at the mountains. I get to ski here every day.’ Well, mountains don’t solve problems.’
“We’re not always creating enough room to talk about how, even in paradise, things can go wrong.”
Guy Felicella knows a thing or two about having tough conversations. The Vancouver resident fell into addiction at a young age, and spent 30 years in the cycle of gangs, drugs, and prison. He survived homelessness, multiple life-threatening bone infections, six overdoses, and the HIV/AIDS crisis on the Downtown East Side, and today works as a motivational speaker and peer clinical advisor at the BC Centre on Substance Use.
“There is still that old mentality of ‘pull up your bootstraps and get it together,’ but the reality is when you’re struggling and not reaching out, recovery is rarely possible alone. You really need to have the ability to reach out and have support,” says Felicella, who recommended Whistler hold townhall meetings to help foster the conversation around drug use and addiction.
“We all learn our beliefs from somewhere, usually from our parents, and sometimes we learn them in a way where it’s judgmental or stigmatized. The hardest part of learning is unlearning, so there needs to be an open forum where people talk about it—that can go a long way.
“I think the stigma in our society has been just as deadly as the drugs themselves, and we have an obligation to our community to break that down so people can get the help they need.”
For as many Whistlerites that have taken the step to get support for their drug use, Dickinson is concerned about all the others she doesn’t hear about—those suffering alone and in silence.
“I worry less about the amount of people accessing service and the increase in need we’ve seen. I worry more about the people who aren’t coming in,” she says. “Maybe they won’t access a counsellor. They won’t go see a family doctor. They’re stigmatized around social services. That, to me, is part of where our conversation should start going.”
Learn more at mywcss.org/mental-and-emotional-health/harm-reduction.
This article is part of an in-depth, provincewide journalistic effort by Glacier Media to examine the scope, costs and toll of the opioid and toxic drug crisis in British Columbia—a public health emergency that has taken at least 11,807 lives since 2016.
If you or someone you know is in an emergency, call 911. If you need help with substance abuse, call the B.C. government's alcohol and drug information and referral service at 1-800-663-1441. It's available 24 hours a day.