Social-aid workers in Vancouver's Downtown Eastside say the drug-overdose crisis that is sweeping through the community is taking a heavy psychological toll on them.

Some staff are booking sick days or going on leave after months of providing naloxone treatment to people who have been overdosing on synthetic opioids known as fentanyl and carfentanil. The deadly effects of the drugs can be reversed by naloxone.

In an attempt to turn back the rising tide of overdose deaths – 128 in B.C. last month – health authorities have flooded the DTES with naloxone kits.

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The overdose problem is expected to get worse over the next few days because social-assistance payments were made by the government on Wednesday. Health officials have noted a significant upswing in overdose cases in the week after social-assistance cheques are delivered.

Before dawn Wednesday, more than 100 people had lined up to cash their assistance checks at Pigeon Park Savings, a credit union with a single branch on the unit block of East Hastings Street funded by Vancity and run by staff with the non-profit Portland Hotel Society.

Behind the branch, street-level dealers sold various drugs to dozens of people injecting in the alley or walking into the nearby tent to use the drugs under the supervision of volunteers trained in administering naloxone, which is sold under the brand name Narcan.

The dire situation in the DTES is part of a national crisis as governments across the country scramble to adjust policies related to the misuse of opioids, as well as developing strategies to help front-line workers respond to a surge in overdoses.

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On the front lines, workers are facing burnout. Shayne Williams, executive director of the Lookout Emergency Aid Society, which provides housing and support to clients in several Lower Mainland cities, said injecting naloxone into someone who is overdosing isn't easy and it comes at a high emotional cost.

"On some of our sites, I've had reports of eight to 10 interventions having to happen on an eight-hour shift," Mr. Williams said on Wednesday at the Powell Street Getaway, a Lookout drop-in centre.

"Imagine you're on an eight-hour shift – you're working at a homeless shelter, you want to house people, you want to feed people, you want to see people get happier, healthier and get opportunities to get off the street – and here you are injecting someone," Mr. Williams said. "And you're going from helping what looks like a dead person to someone who's alive and up again. And just that overwhelming emotion and panic – it's incredibly taxing."

In October, Vancouver Coastal Health submitted applications to Health Canada for two new supervised-injection sites in Vancouver, including one at the Powell Street Getaway.

But as of this month, a small room at the Powell Street Getaway is operating as an "Overdose Prevention Site" – one where injections are not technically supervised, but where help is close by.

On Monday, the BC Coroners Service said 755 people have died of illicit-drug overdoses from Jan. 1 to Nov. 30 – a 70-per-cent increase over the same period last year.

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Between midnight and noon Wednesday, the BC Ambulance Service reported 15 overdose calls in Vancouver.

Hugh Lampkin, of the Vancouver Area Network of Drug Users, said he is worried about what could happen over the next few days.

"We're crossing our fingers and hoping that it doesn't get out of hand," he said, adding that the rash of overdose deaths in the DTES last week, when eight people died on one day, caught him by surprise.

The BC Centre for Disease Control has been running a take-home naloxone program – distributing 2,500 kits across the province each week – which are then distributed to drug users or their friends and family to reverse the effects of an opioid overdose. Jane Buxton, who oversees the program, said the agency had run into problems with one of its suppliers, which was unable to meet the demand for naloxone, but the centre found a second supplier to fill the gap.

"As far as I know, and we have been keeping track because we have so many going out the door every week, we don't believe that is an issue," Dr. Buxton said.

Jessica Hannon, executive director of Megaphone, a monthly magazine sold by homeless residents of Victoria and Vancouver, said she was donating her office's lone naloxone kit to the unsanctioned supervised-consumption site at the back of the DTES street market. A member of the Pivot Legal Society had called her earlier that morning to say the organizers at the site, a small tent surrounded by a couple of folding tables and a portable toilet, were almost out of the antidote.

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"We figured they probably needed it more here than we do there," she said.

With reports from Sunny Dhillon and James Keller