“We’re good at saving lives,” the man told me.
I stopped to chat with him at one of the yellow canopy overdose prevention sites that Overdose Prevention Society runs on the downtown eastside of Vancouver, British Columbia, Canada. Like Portland’s Old Town or Skid Row in Los Angeles, Vancouver’s downtown eastside has long been a neighborhood where people struggle with homelessness, and some people meet the pain of their lives through substance use.
I traveled to Vancouver for a series of columns exploring how our overdose crisis can be met with public health responses — rather than revert further into criminalization. Measure 110, the ballot measure Oregon voters passed in 2020, has successfully reduced some of the racially inequitable arrest rates for drug possession.
According to Jeremiah Hayden’s reporting in Street Roots, arrests dropped by 68% for drug possession in Oregon during the 11 months following the implementation of Measure 110. Significantly, this decreased arrests for Black Oregonians by 77% during this period and 50% for Native Americans.
At the same time, people are dying from a toxic drug supply that includes fentanyl at wildly unpredictable levels.
Vancouver has been a leader in saving lives for the past two decades, when Insite, North American’s first safe injection site, was set up under a federal exemption. The regional health authority, Vancouver Coastal Health, and PHS, formerly known as Portland Hotel Society, now operate Insite together.
The renowned addiction physician Gabor Maté worked at the Portland Hotel Society above Insite for more than a decade, and he wrote “In the Realm of Hungry Ghosts” based on these experiences, arguing excruciating pain from gaping traumas drove much of the substance abuse he treated.
“The hell realm of painful emotions frightens most of us,” Maté wrote. “Drug addicts fear they would be trapped in their pain forever but for their substances.”
In response to being praised for “humanizing the hard-core addicted people I work with,” Maté wrote, “How can human beings be ‘humanized’ and who says addicts aren’t human to begin with?”
Beginning in 2016, British Columbia legalized overdose prevention sites like these yellow canopies run in partnership with Vancouver Coastal Health.
What’s particularly novel is that many people working at these canopies are drug users themselves.
Overdose Prevention Society and similar groups are ready to connect people to detox and recovery services. But they recognize people need connection and meaning, and in the isolation of addiction, that need for connection and meaning is a form of health.
People who use drugs can, in fact, be good at saving lives. This is something to be proud of, a source of esteem for people who are often treated poorly in society.
After all, whether or not one lives in the grips of drug use, life can feel arbitrary, cruel and grueling. My own coping strategy has been to plunge myself into purpose. It’s a form of swimming upstream, exerting myself against a current of societal sorrow. I know I’m not alone in this impulse and that the impulse takes many forms for many people — whether that’s packing a child’s lunch, or taking an elderly neighbor’s garbage out, or lending one’s brain to figuring out a system and how to fix it. These impulses ignite meaning in our lives.
I see these impulses at Street Roots. Sometimes, people who win our weekly raffle for free papers immediately donate those papers to someone else to give them a week’s boost in income. People share a blanket and some body heat to survive the night. People who are drug users carry naloxone to save lives. Sometimes, people come running to Street Roots in Old Town, where they know we distribute naloxone, to report that someone has overdosed, so we all can come running.
The Overdose Prevention Society has taken this one step further, moving people out from the shadows and under bright yellow canopies, where they are, in fact, heroes. Ready with naloxone and big canisters of oxygen, they are good at saving lives.
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