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In Battle Against Vancouver's Overdose Epidemic, Drug Users are Leading the Way

Gabriel Spitzer
A memorial to an overdose victim, just outside Vancouver's Overdose Prevention Society supervised injection site.

You could make a pretty good case that the epicenter of the opioid crisis in all of North America is British Columbia.


Just five years ago overdose deaths there had been holding steady at under 300 a year -- about the same as car crashes. Then it spiked -- last year 1,422 people in British Columbia died of a drug overdose.


The crisis in Vancouver has given rise to some radical solutions. Nearly 15 years ago the city opened up North America’s first legal supervised injection site, called Insite. The model has been replicated elsewhere in Canada: a clinical setting with nurses and service providers on hand. It’s also the type of place being planned for Seattle and King County.


Desperate Times, Desperate Measures


But Vancouver is going through what public health officials consider an out-and-out emergency, particularly with the arrival of fentanyl: a super-potent, and deadly, synthetic opioid that has all but displaced heroin there. As fentanyl-related deaths mount, officials in Vancouver have allowed a number of grassroots sites to spring up and operate. What makes them unusual is that they’re run by activists … and in some cases, by the drug users themselves.


"These community agencies and groups of peers and associations of drug users, they're the ones who are making the innovations. They're telling us what to do.," said Mark Lysyshyn, Medical Health Officer at government-run Vancouver Coastal Health. The agency partially funds the new sites.


"They showed us how to create popup supervised injection sites. They know the community, they know where to put these things. So they've been able to solve a lot of problems."


Reporter Travis Lupick, author of Fighting for Space: How a Group of Drug Users Transformed One City's Struggle with Addiction, led us on a tour of some of Vancouver’s frontline “harm reduction” efforts, from an ad-hoc injection room monitored by a trained volunteer and run by IV drug users, to an outdoor tent housing the continent’s only supervised smoking site, where users consume meth, crack and smoked opioids.


Get a peek inside these sites by clicking the “listen” button above.


Gabriel Spitzer is a former KNKX reporter, producer and host who covered science and health and worked on the show Sound Effect.