Concerns that safe injection sites not accessible for users outside the downtown, many of whom are racialized.
In depth: Part three in a three-part series examining the opioid crisis in the city.
Amy Wright’s brother was homeless for three weeks in rural Nova Scotia and died by suicide in September 2011. Drugs and alcohol were a factor, said Wright. It was not from an overdose, but the lack of resources in the area, such as harm reduction, that contributed to his death.
Weighing about 90 pounds with barely any teeth, Wright left Vancouver on a Greyhound bus and moved back to Toronto in 2011 to help herself get clean. She had four front teeth that were badly broken and cracked. Recalling the memories of a passport picture she had taken two days taking the Greyhound, Wright said she had aged about 10 years and was extremely pale looking.
“What strikes me the most from those visuals, is that I had no life or light in my eyes,” Wright said. “They were so dark.”
She said her brother opened her eyes to where her life was going and gave her an out. He helped her find her true self and passion in life.
“I’ve lost a number of people to substance use,” said Wright, who is now a community support worker in the 24-hour harm reduction drop-in at Sistering.
Despite having a safe place to inject drugs, users will remain in a difficult position whereby they must still buy drugs on the street, and Wright says that’s problematic. She doesn’t see a time when users will be able to purchase drugs at the safe injection sites, she says.
“This isn’t about making money, it’s about saving lives,” she said.
Tuesday, February 21, marked the National Day of Action on the Overdose Crisis, and about 150 people marched through downtown Toronto to demand all levels of government take immediate actions to prevent overdose deaths.
Wright attended the march. She wondered why Toronto hadn’t had a rally like that before.
“Some dealers, even with seeing my tracks, would not sell to me,” Wright explained. “When I first came back to Toronto in 2011, while off heroin, I still struggled with injecting pill forms of opiates. I had found myself in a bare apartment, trying to convince two women that I wasn’t a cop. I didn’t know if they were gonna sell to me or kill me. Thankfully, I was able to convince them through listing names of dealers and street peeps I knew.”
Leigh Chapman is a registered a nurse in Toronto, whose brother, Brad, was an opioid user and died of an overdose 18 months ago. Brad died alone in a alleyway on Walton Street about 400 metres away from Toronto Public Health’s The Works.
Brad was a regular client there several times a day, and Chapman said he would have benefitted from having a harm reduction shelter. Brad overdosed using a needle exchange kit from Toronto Public Health.
Brad was taken from the emergency department to the intensive care unit where he stayed for eight days.
But he suffered from irreversible brain death due to lack of oxygen, something he couldn’t recover from.
About 20 years earlier, Brad had been prescribed OxyContin to help battle pain from a brain tumour.
It took a two years for doctors to diagnose him with a brain tumour, but by that time, Brad was already addicted to opioids. In response, doctors stopped prescribing him OxyContin, and he sought other opioids, such as heroin or street OxyContin.
“Because there is no harm reduction shelters in Toronto, which mean that if you’re homeless, like he was, and you don’t have a place to stay and you’re high, you don’t have a place to go. Which mean that you sleep on the street,” Chapman said.
Brad had tried methadone after being diagnosed and undergoing brain surgery, but he still suffered from acute pain. However, it helped him fight his opioid addiction. But there was no counselling or emotional support for him to explore why he was using it in the first place.
Chapman considers drug overdoses to be a epidemic, adding that 18 months ago fentanyl wasn’t on the radar in Ontario. And because of that there was no investigation into fentanyl being a factor in Brad’s overdose.
Brad was able to access some harm reduction services, but not harm reduction shelters or supervised injection sites, Chapman said.
Chapman said Brad would still be alive if he had access to a supervised injection site, as well as treatment and resources to be able to minimize his drug use.
A 28-year-old Indigenous, homeless man suffered a fatal overdose on heroin that may have been laced with fentanyl earlier this year. At about 7 p.m. on February 15, the man went to St. Felix Centre, which is one of the two warming centres that operates 24 hours a day.
The shelter was 10 people over its limit when the man arrived. The man was offered a referral to another location, but declined.
After being turned away from the downtown drop-in shelter,the man was found dead inside a KFC washroom in the Queen Street West and Bathurst area. Police suspected the drugs were laced with fentanyl.
Ward 27 councillor Kristyn Wong-Tam said the man’s death was avoidable for many reasons.
“If we were able to provide some additional support to him early on, maybe it would have led to different choices,” she says. “If we were able to supervise his injection and be on site with naloxone, if he needed it, we would have been able to resuscitate him. If he was on the street for a very long time and not being able to pull himself out of the trench, than we need to find out what we could have done differently.”
Accessibility Outside the Downtown
Wong-Tam said she’s been hearing from drug users who don’t live or work in the downtown core and whose first language isn’t English. They tell her that they will never come downtown to use any of the facilities the City is proposing because the downtown is not accessible to them.
“Where they need support, which is culturally and linguistically appropriate for communities, are Scarborough, North York, and Etobicoke,” Wong-Tam said. “I’ve heard this loud and clear from advocates who’ve worked in those communities who say, “Councillor, it’s great that you’re getting supervised injection sites centres in the downtown core, but that’s not going to help the South Asian community that is living in Malvern, and that’s certainly not going to help the community that’s living in Rexdale.”
Haran Vijayanathan, executive director at Alliance for South Asian AIDS Prevention (ASAAP), said that while having supervised injection sites are needed in Toronto, having all of the sites only available in the downtown core may make it difficult for people who are living in areas such as Scarborough, who can’t afford to access transit systems to come down downtown to inject safely and then go back home.
“There is a fear for them to access the service because drugs are illegal,” Vijayanathan said. “There’s a lot of thinking behind what would it do to their family, what will that do to their immigration status…if they’re not a Canadian citizen or permanent resident. They feel unsafe going into clinics and hospitals to access services because they feel that they’re going to be turned away or judged for their use. There’s a huge mistrust between racialized communities and systems.”