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Q&A with Don Evans

The executive director of the Victoria-based, United Church of Canada-affiliated Our Place Society and the former acting executive director of Vancouver's First United talks about the opioid crisis in British Columbia

By Kevin Spurgaitis

Q With the arrival of the opioid fentanyl, British Columbia reached a new peak of 914 illicit drug overdose deaths in 2016 — a number that British Columbia’s health minister said may be higher. How would you characterize this situation in Vancouver, Victoria and the rest of province?

A It’s a public health crisis that’s in its early stages. The number of deaths is staggering, and I worry that this is only the beginning, as fentanyl appears to be here to stay.

Q British Columbia Chief Coroner Lisa Lapointe said in December that “the introduction of fentanyl to our province is a game-changer.”

A Yes. The spike in overdose deaths is definitely a game-changer, as it affects so many people. From outreach workers becoming first responders to family members and friends dealing with the loss (of a loved one), everybody in our community has been impacted. Anyone purchasing opioids on the street is at an extremely high risk of an overdose from fentanyl.

Q Who exactly is using, abusing and overdosing on opioids in Vancouver, Victoria and the rest of British Columbia?

A I’m definitely seeing a lot more young men struggling with opioid addiction. Fentanyl is appearing in most street drugs, which is affecting many different groups of people, regardless of income, age or social standing in the community. The majority of deaths have occurred inside people’s homes

Don Evans, executive director of the United Church of Canada-affiliated Our Place Society in Victoria and the former acting executive director of First United in Vancouver. Photo courtesy of Our Place Society
Don Evans, executive director of the United Church of Canada-affiliated Our Place Society in Victoria and the former acting executive director of First United in Vancouver. Photo courtesy of Our Place Society

What types of opioids are they using, if not fentanyl?

A The most commonly used opioid on the street is heroin, which nowadays almost always contains fentanyl. But they’re finding fentanyl in other non-opioids, such as crystal meth, cocaine and crack. And we’re just starting to see carfentanil arrive on our streets, which is a worry because of how potent it is.

Q Where are they getting opioids from?

A Most people who we see are getting them from street dealers, which is the easiest way for a person struggling with addiction to acquire opioids.

Q What factors are contributing to this opioid crisis exactly?

A The potency of the drug; the lack of education and knowledge around the dangers of drug use; and the low self-worth of the user; as well as a lack of prevention, harm reduction and treatment options.

Q What other effect has the opioid crisis had on Vancouver’s Downtown Eastside, Victoria and surrounding communities?

A There is an overwhelming feeling of grief and loss among users, service providers, first responders, family members and friends. We have conducted so many memorials in such a short period of time that people are feeling fatigued and don’t want to show up.

Q To what extent has First United Church and Our Place been on the front lines of this crisis?

A Outreach workers have become first responders. Our Place has opened the Overdose Prevention Pod, which involves paramedics, in its courtyard. In January, there were 26 overdoses here, but no fatalities. Our Place is also a distribution and training centre for naloxone, the opioid blocker that revives people who have overdosed. First United will soon be a naloxone training centre also.

Overall, staff at both organizations are assisting people in accessing detox and treatment facilities, as well as getting counselling for underlying issues, such as trauma and abuse.

Q Has the opioid crisis put a strain on the resources of First United and Our Place at all?

A So far, the health authorities have covered the financial costs associated with the crisis, but it has strained our human resources, and it has taken quite a toll on staff. . . . Some have taken a medical leave due to stress, PTSD, depression and anxiety. They have been responding not just to people in a medical crisis, but to people they have built a close relationship with.

Q In your two decades of being involved in the social issues of poverty and homelessness, have you seen anything like this opioid crisis? How does it compare to individuals dying on the street from drinking rice wine, for example — what you witnessed when you first started volunteering in Vancouver’s Downtown Eastside in the late 1990s?

A Since I’ve been working in this field, there have been many crises that have contributed to deaths on the street: the murder of sex trade workers, the HIV/AIDS epidemic, drug overdoses and, yes, even rice wine. But this recent spike in deaths is the worst that I have seen. The sheer numbers are devastating.

Q To what extent has your personal experience with addiction, as reported by the Times Colonist in January 2016, helped your work?

A My personal experience has produced an emotional connection with those struggling with addiction. I have become more compassionate and empathetic in my work as a result.

Q The federal government has yet to set aside funding to combat the opioid crisis. Provinces, though, are spending more to address the harm related to opioids, as they brace for cuts to federal health-transfer payments. What is your assessment of governments' response to this issue to date?

A The federal government has been slow to react and is just beginning to get on board with the B.C. government. We would all like to see things happen quicker so that more lives can be saved, but I’m pleased to finally see all levels of government working together. Of course, much more still needs to be done to address the crisis.

Q The B.C. Centre For Disease Control last year launched a take-home program involving the opioid antidote, naloxone, in order to reverse the effects of opioids. B.C. also announced that overdose prevention sites would be established in communities across the province, where people could take illicit drugs while being monitored by trained professionals equipped with naloxone. How beneficial is this, in your view?

A Getting naloxone into people’s homes in extremely beneficial because that’s where most of the overdose fatalities are occurring. This is a critical step while we wait for permanent supervised consumption sites to be opened. These overdose prevention sites are saving lives every day and reducing the stigma and shame that people feel. It also brings the issue out of the darkness so that staff can better assist people.

Q Senator and Former Vancouver Mayor Larry Campbell, who oversaw the installation of Vancouver’s first open safe injection site, says that he wants the federal and provincial governments to allow free opioid prescriptions for people with addictions. Do you agree with this?

A I agree with the former mayor. Taking the opioids out of the hands of the drug dealers and putting them into the hands of doctors would be the quickest way to reduce and even eliminate the risk of opioid overdoses. This would be the best way to control the purity and dose of the drug. And medical professionals would also be able to assist the individual in dealing with the issues contributing to their drug use in the first place. Plus, allowing free opioid prescriptions would help combat other societal issues related to drug addiction, such as poverty, public disorder and crime.

Q What do you see as signs of hope here?

A I find hope in the shift in community perspective — looking at addiction as a health issue instead of a criminal activity. This will help move people out of the back alleys or their homes, and bring them into the community. And this will help to reduce the stigma and shame that people are crippled by.

Q You told the Times Colonist in January 2014 that “most vulnerable people in our community are suffering needlessly and dying on our streets.” Can you elaborate?

A The effects of poverty-related issues on this vulnerable population are devastating and could be prevented if we addressed the many government programs that are contributing to people’s dire situation.

Q You also emphasized “bringing together business and community leaders — those who understand the power of philanthropy.”

A Business and community leaders have influence and access to big money. Working together with them can only produce positive change in our communities.

And the only way to get government to respond more to this opioid crisis or any other important issue is speaking up and demanding government do something. So don’t sit and wait around for others. We’re all responsible for keeping our government accountable.

This interview has been condensed and edited.

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