If a drug user needs to use, but fears overdosing, Fergus Gibbs and Miles Crombleholme will be there.
Gibbs and Crombleholme are part of the peer witness program at 'The Bridge to Housing' project, the Squamish Helping Hands temporary housing complex on the Mamquam Blind Channel.
"They are part of the community and they have shown a lot of willingness to help out and just generally be helpful," said Rhea Thompson project co-ordinator with the Sky Community Action Team — or CAT, which operates the peer witness program.
The team — which includes participants from organizations such as the District, Squamish Helping Hands Society, Squamish Fire Rescue, Squamish RCMP, Vancouver Coastal Health, Sea to Sky Community Services and more — works on projects in the corridor to support overdose prevention and culturally-safe, trauma-informed public education.
The team was created in the fall of 2019 and is funded by the Overdose Emergency Response Centre (OERC) and the Ministry of Mental Health and Addictions.
How it works is the peer witnesses come on shift and are equipped with a backpack that has Naloxone kits, a phone, walkie-talkies and harm reduction supplies.
"While they are on duty, the phone is on, the volume is up and they are maintaining a presence at The Bridge," said Thompson.
When someone wants to use and is alone or concerned, they can call a witness to "lay eyes on them" while they use.
"Right now, the drug supply is really highly toxic and it is very unpredictable, so you never know what you are getting," Thompson said, adding it is not just fentanyl being found hidden in other drugs, but also benzodiazepines (benzos) and other concoctions that can impact the respiratory system.
"It is pretty scary right now."
The witness — outfitted with pandemic protective gear — watches the user take their dose and stays to make sure all is well. If the person overdoses, the witness calls 911 and initiates an overdose response. The witness alerts the shelter staff with the walkie-talkie.
Gibbs and Crombleholme live at The Bridge complex and are trusted by those who live there, Thompson said.
They were given training on how to administer Naloxone, the drug that can reverse the effect of an opioid overdose.
"We will run through various overdose scenarios," Thompson said of the training, adding that when responding to an overdose, it involves the peer witness, the two Helping Hands shelter staff members on duty, bystanders if needed and first responders.
Thompson stressed that being a peer witness is more than being in the room during drug use.
They also hand out harm-reduction supplies and keep an eye on their neighbours.
There is a peer witness station on-site and Gibbs and Crombleholme make journal entries each shift about how things went.
Thompson would like to see more witnesses in the community to relieve Gibbs and Crombleholme.
"So if they need to take a break for a few days, or want to step away for whatever reason, that they can," she said.
The program has been in place at The Bridge for a little over a week. So far, it has been successful beyond Thompson's expectations, she said.
"It is going so well," she said. "They are doing so much and... it has a positive impact on the well being of the shelter support staff and it empowers the residents and the peers — and ultimately, it should save lives."
In May, there were 170 suspected illicit drug toxicity deaths in B.C.— that's about 5.5 deaths per day.
May's total is a 93% increase over the number of deaths seen in May 2019 (88) and a 44% increase over the number of deaths in April 2020 (118), according to the BC Coroners Service.
This increase comes four years after the province declared the overdose epidemic a public health emergency in 2016.
"COVID has forced people into isolation and it is a really dangerous time for drug users. People are feeling really isolated and really anxious," Thompson said.
According to the BC Coroners Service, so far in 2020, 85% of overdoses happened inside (57% in private residences and 28% in other residences including social housing) and 13% were outside or in vehicles.
The provincewide Lifeguard App is also in place at The Bridge. It has been active in the corridor since June 1.
An individual drug user activates this app when they take their dose. They pre-enter their address, what they think they are taking and other details first responders would need.
After 50 seconds, the app sounds an alarm. If the user doesn't push a button to indicate she is OK, the app grows louder and after 75 seconds a call goes to 911 and alerts medical dispatchers to a potential overdose.
"The Lifeguard app is a powerful tool right now — especially during COVID," Thompson said. "It has come just in the nick of time."
Asked if these tools may enable people to use drugs, who might not otherwise, Thompson said an emphatic, no.
"It is not enabling drug use, it is saving lives," she said.
"The fact that people would think that, just speaks to the importance of the work that the Community Action Team is doing. Public education around the link between trauma and addiction — between trauma and substance use and mental illness — a lot of people are very uninformed about it."
Thompson noted that people who use drugs often face discrimination when they go to the emergency room. "Without an advocate, it simply isn't a given that someone at risk will receive proper care," she said. "I saw this on a regular basis during my years providing advocacy as a street outreach worker. We need more public education about the connections between trauma, substance use, and mental illness, and that is what our CAT has aimed to do."
She also said that affordable housing is key to helping people with addictions.
"Council consistently fails to prioritize truly affordable housing. This puts people at risk in terms of the tough choices they have to make. No one can heal while they are in survival mode," she said.
"We understand this on a neurobiological level, and we see it playing out on the streets of our town. The fact is, we can't address any of these problems in a sustainable or meaningful way if we don't engage people with lived experience."
To contact Thompson for more information or to support the Sea to Sky Community Action Team, email: [email protected].
Find out more with these resources:
Illicit drug overdose death report.
Fentanyl-detected death report.
Risk mitigation prescribing guidelines in the context of dual public health emergencies.
BC Centre for Disease Control Overdose Response Indicators.
