Some Canadians opposed to Vancouver's liberal approach to fentanyl crisis
As part of Overdose Awareness Week, KPIX is presenting a series of special reports on the opioid crisis through the lens of another West Coast city.
Much like San Francisco, Vancouver has been fighting to save lives amid the explosion of fentanyl for about a decade. Both cities have seen overdose numbers soar over the past ten years. But as KPIX showed in the first part of our special report, Vancouver has tried some strategies that San Francisco and the United States, largely, have not.
However, the results of those efforts have Canadians divided.
"Weeks went on and it became more and more of a stronger flavor," explained Jeffrey Brocklesby, a drug user in Vancouver's Downtown Eastside. "Then, lo and behold, all you got is fentanyl and no heroin. And everybody's f----d.".
It may have started a few years earlier in Vancouver, but it is the same story as San Francisco: an overdose crisis that arrived with fentanyl and drags on, now with plenty of other drugs mixed in.
The response in Vancouver has been different. In 2016, British Columbia declared a health emergency. expanded from one official safe use site to dozens, and started offering users the option of a regulated drug supply.
"We've seen the risks that come from unregulated drugs, and we know people use them," explained Dr. Mark Lysyshyn with Vancouver Coastal Health. "So we legalized them, and we made regulated versions and then people don't immediately die when they consume them."
Lysyshyn says the goal has been to reach for every possible tool to slow the epidemic that continues to claim lives. The overdose rate in Vancouver has risen, before dropping, and then climbing again. By comparison, San Francisco has followed a roughly similar path, if on a bit of a delay, finishing 2023 slightly higher.
One might look at the per capita numbers and conclude that Vancouver isn't faring any better than San Francisco in limiting overdoses, but health officials here say they would be doing much worse, were it not for the different steps they are taking.
"The BCC, the [British Columbia] Centre for Disease Control, has done modeling about the main interventions we've been using: take home naloxone, overdose prevention sites, opiate agonist therapy," Lysyshyn said. "And it shows that we are reducing about a third of the overall overdoses that are occurring. Of course, you don't see those overdoses, because they are not happening. So we would see one third more overdoses were we not doing those things."
The outcome of these policies, the question of whether it is all working, is now the subject of intense debate, and public pushback.
"That person there," said Elenore Sturko, looking at a body slumped on Hastings Street. "And these are our neighbors, and our neighbors' children. I just feel we have to do better."
Sturko is a former police officer who now works as a British Columbia Conservative Party member of the BC legislature, She is also part of a political shift, local and beyond, that has criticized the province's drug policies as having shifted too far in one direction.
"Harm reduction is very important," Sturko said. "But harm reduction has to include the harms not only on the individual but the harms on our community as well. The impact on our first responders -- particularly firefighters in the city of Vancouver -- has been extraordinary."
Beyond the frontline challenges, she points to evidence that some of the safe supply is making its way into the black market.
"First and foremost, if we're giving people medication, we should make sure people are taking that medication," Sturko said.
Then there was the 2023 move by the province to legalize simple possession of all drugs as part of a three-year study project.
"We tried to do this decriminalization pilot to reduce stigma around drug use," Lysyshyn said of the plan.
One result was a wave of complaints about public drugs use, from playgrounds to hospitals. In April, the province decided decriminalization should be rolled back.
"There are too many different communities in British Columbia," Lysyshyn said of the public's reaction to the effort. "Not all of them were on board with the idea. So when it happened, the pilot really galvanized people on two sides. And made it almost more stigmatizing to do drugs."
Finally, there is the overarching concern that the shift towards expanded drug freedoms did not come with expanded plans for helping those who need a way out of deep opioid addiction.
"It wasn't accompanied by any kind of administrative process or way for us to help compel people into those services," Sturko said of the move towards increased harm reduction.
The primary safe-use site in Vancouver does offer treatment services in the upstairs floors, but Lysyshyn admits that getting people into those services is challenging.
"Yeah, the thing is, the addiction treatments we have available are not perfect," he said. "They're good for opioids, they're not so good for stimulants. They work for people sometimes, not all the time. People are not always ready to accept them. Also, sometimes there's a waitlist to get into them."
Similar to San Francisco, for all of its different policies, Vancouver is having that familiar debate over the balance of priorities, and even what it means to provide help.
"Peoples hearts were in the right place, and you don't want to put people who are sick in prison," Sturko said. "But at the same time. We need to stop being the one legged stool of harm reduction, and truly get back to that multi-pillared approach that has multiple entrances for people to get into help"
"But we need people to stay alive to be able to access those services," Lysyshyn added. "And that's what harm reduction does "