Open this photo in gallery A man sleeps in a doorway on Dunlop Street West in Barrie, Ont. The town is struggling with an increasing number of opioid-related overdoses. Ryan Carter/The Globe and Mail

Barrie’s downtown is looking up. Boutiques selling yoga wear, chocolates, crepes and cappuccinos welcome customers strolling along the once-rundown main drag, Dunlop Street East.

But walk a minute or two down Dunlop, and you may see a different side of this growing city an hour’s drive north of Toronto: doorways full of garbage and used syringes, sex workers patrolling to support a drug habit, a poster on a store window proclaiming in big letters: “Naloxone Kits Available Here.” The kits help reverse drug overdoses that, especially these days, can often be fatal.

Like many smaller Ontario cities, Barrie is suffering from the countrywide opioid crisis, which killed nearly 4,000 Canadians last year. The region that includes Barrie, Simcoe Muskoka, had 81 deaths from drug overdoses in 2017, up from 46 in 2016. Barrie had 36 of them, a staggering number for a city of 150,000 that typically gets a couple of murders in a bad year and two or three traffic fatalities.

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The rate of emergency-department visits for overdoses is the third-highest in the province among 26 cities with more than 100,000 residents, after Brantford and Oshawa. This month, police warned users that a dangerous strain of purple-coloured heroin or cocaine was making the rounds, responsible for a recent overdose death.

These events have come as something of a shock to Barrie, a sprawling suburban-style community. The city’s Mayor, Jeff Lehman, says the overdose wave “hit in a hurry and it hit late.” Starting in Vancouver, it moved across the country to Ontario and finally struck Barrie in earnest only in the past 18 months or so. “Maybe we just fooled ourselves,” he says.

Open this photo in gallery Mayor Jeff Lehman says overdoses hit Barrie in a hurry after the opioid crisis began in Western Canada. Ryan Carter/The Globe and Mail

The city’s summer was marked by a surge in drug-related trouble downtown. People were posting pictures on social media of users injecting drugs in public. Merchants sent a letter to city council last month complaining about open drug use, prostitution and rowdiness.

Barrie is a thriving satellite of greater Toronto. House prices doubled within three years. Permits for industrial construction have hit a record. Mr. Lehman says rising living costs may be pushing marginal people into poverty and the street life.

The city has struggled for years with pockets of poverty. With its soup kitchens, methadone clinic and men’s shelter, the downtown is a gathering place for the homeless, the mentally ill and the recently incarcerated – populations that tend to be vulnerable to drug addiction.

The opioid epidemic is cutting a swath through these groups. A trio of grizzled men outside the downtown McDonald’s outlet on Thursday morning said a woman overdosed on the opposite corner a couple of weeks before. On a recent night, a man came screaming down the street, asking if anyone had naloxone for a friend overdosing at a nearby motel. Luckily, someone had a kit on hand.

Open this photo in gallery A naloxone kit lies on the ground near the intersection of Dunlop Street West and Mary Street. Ryan Carter/The Globe and Mail

Open this photo in gallery A sign on the Pharmasave window advertises the availability of naloxone kits. Ryan Carter/The Globe and Mail

Open this photo in gallery A needle-disposal container, garbage, personal belongings and medicine packing lies strewn about in a doorway. Ryan Carter/The Globe and Mail

All this would seem to make Barrie a prime candidate for an overdose-prevention site. The sites, pioneered in Vancouver and springing up across the country, give users a safe place to use their drugs, with sterile needles, tourniquets, clean water and other supplies on hand. If users consume something laced with the powerful synthetic-opioid fentanyl and overdose as a result, support workers are there to revive them. Those working at sites that have been operating down Highway 400 in Toronto say they have saved many lives.

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But a recent decision by the provincial government means Barrie may not get a prevention site. When he was running for election this spring, Premier Doug Ford said he was “dead against” the sites. Once he was elected, his Progressive Conservative government conducted a review to see if they were working. To the relief of many, Health Minister Christine Elliott announced this month that the government would keep the sites open, but have them focus more on getting users into treatment. The hitch is that the number of sites would be capped at 21. With 18 sites open and three more on the way elsewhere, hopes for a Barrie site seem dim.

Early this year, a pair of local organizations applied for a temporary overdose-prevention site, and health authorities were planning to do a study on setting up a permanent facility. Now, says Dr. Lisa Simon, the region’s Associate Medical Officer of Health, Barrie is in limbo.

Open this photo in gallery Richard Boland, a former heroin addict, speaks about the drug problems in Barrie. Ryan Carter/The Globe and Mail

Down on Dunlop Street, Richard Boland says he can’t grasp why Mr. Ford’s government would fail to allow a prevention site in Barrie. “I don’t understand this guy, I just don’t.” When people use drugs under supervision, “if you do OD, then somebody’s there to save your life.”

Mr. Boland, 56, said he lost his best friend, Tom, to an overdose a couple of years back. A former heroin user who uses methadone to keep his cravings at bay, he lists half a dozen people he knows who he has seen overdose and die over the past year and a half. “It’s too many, man, too many.”

Not everyone is so keen on bringing the sites to Barrie. The idea became a hot potato during this month’s municipal election campaign, which ended with Mr. Lehman winning a third term as mayor. Local Conservative MP Alex Nuttall urged voters in a tweet to support a candidate “who will NOT put an illegal drug injection site in Barrie’s beautifully revitalized and historic downtown.”

Mr. Lehman was skeptical about a prevention site at first and still has qualms about the potential for normalizing drug use, but he came around when he saw the toll the opioid crisis was taking. The trouble is getting the provincial government to recognize the need.

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Many local drug users hang out at Milligan’s Pond, a wooded area near the downtown strip. The homeless sometimes pitch tents along the creek and users go into the bushes to get high. When someone dies on the streets of Barrie, people write his or her name on a boulder at the edge of the woods: Christina, Matty, Rocky, Jason, Gary. The boulder has become a kind of memorial, called simply The Rock. There isn’t room for many more names. The Rock is nearly full.