Frontline workers can no longer use oxygen to save lives in overdose crisis

VANCOUVER (NEWS 1130) — There are only a few days of illegal fentanyl and opioid supplies left on B.C.’s streets, according to frontline workers and advocates who want to see safe supply measures prioritized.

They say border closures have stopped smuggling and shipments, driving prices up and making users desperate and uncertain what they will do when the supply dries up completely.

“This may be the brewing of a perfect storm for the (Downtown Eastside),” says Trey Helton, manager of Overdose Prevention Society.

“Many local drug users in the DTES community are getting more desperate than usual. Street level dealers and suppliers will most likely be the first targets of robbery. We need safe supply more than ever,” he adds.

With social distancing virtually impossible in the area, homeless and drug users are more exposed to the novel coronavirus, leaving frontline workers who lack personal protection gear vulnerable as well.

Increasing opioid prices mean people with little to no income are forced to extreme measures to access their supply, which could lead to increases in violence, robberies and tensions, say advocates.

What happens when street drug supplies dry up completely? Already prices have shot up, making it difficult to get opioids. Those on the frontlines tell me they estimate 3 to 4 days of illegal fentanyl and opioids are left and then things get desperate. @NEWS1130 (FB screenshot) pic.twitter.com/qeshIhx3v8 — Ash 'I work from home now' Kelly (@AshDKelly) March 24, 2020

Outreach services are running at three-quarters capacity, he says, and some overdose prevention sites have closed completely, while OPS has reduced the number of tables from 24 to just six to maintain distancing between users.

While overdoses continue, frontline workers are being instructed to not use oxygen bags or masks as they could facilitate the spread of COVID-19, and instead use only Naloxone to revive victims.

Leaving the brain without oxygen can lead to brain injury or death within minutes.

“It is horrific: leaving someone and watching them turn blue in front of you when you know rescue breathing could save them,” says Helton.

But withdrawal, too, can be deadly — at best debilitating — even forcing people into hospitals and the already overburdened healthcare system making workers fearful of what happens when there are no opioids left.

Now what?

Infectious disease expert and well-known safe supply advocate Dr. Mark Tyndall says there is no pharmaceutical supply within Canada that he knows of that could possibly scale up within three to four days, the time he believes is left before street fentanyl and opioids run out.

He has proposed his biometric dispensing machines (so-called opioid vending machines) as a potential mid-to-long-term solution but says the next few weeks will be incredibly difficult for everyone involved.

Meriah Main is a registered nurse who runs a private practice on the DTES. She says survival sex workers have to take more jobs to be able to afford current drug prices and if the supply dwindles, they will be even more exposed to violence and feel the need to take more work — work that is becoming increasingly likely to see them infected with the virus.

Main is hearing from frontline workers who don’t have PPE and fear the virus will ravage the homeless and low income community, where Indigenous populations are dramatically over-represented. She says others have lost their jobs and many agencies are short staffed.

Hey non profits if you were paying peers to do work in the DTES just bc you shut down don’t stop paying them it’s not the time to leave folks high and dry. #vanpoli — Sarah Blyth (@sarahblyth) March 21, 2020

Main believes a basic guaranteed income, housing and safe supply are the only options to keep this virus from spreading through the DTES, Tyndall echoes her calls.

The City of Vancouver is working to secure hotel rooms for those in need and has added hand-washing stations to the streets.

The province says it is centralizing supplies for frontline workers including masks and gloves.

“Frontline workers are working tirelessly to ensure that vulnerable residents are protected across the province, recognizing the significant added risks that vulnerable people face in the context of the COVID-19 crisis,” Selina Robinson, Minister of Municipal Affairs and Housing, has said.

“We are committed to making sure these frontline workers have the support they need to do their job – whether that’s in the form of safe spaces for people who need isolation or personal protective equipment for staff working in the field. We are all in this together.”

A government release says a provincial Vulnerable Population Working Group “is working to identify, assess and address the immediate challenges faced in particular by five groups – people living on the street, people experiencing homelessness living in encampments, shelter residents, tenants of private SROs and tenants in social and supportive housing buildings.”