Healthcare worker collective Care Not Cops: A regulated drug supply is the only way out of the toxicity crisis
Healthcare worker collective Care Not Cops: A regulated drug supply is the only way out of the toxicity crisis
VPD raid and arrests of Drug User Liberation Front leaders symbolic of shameful government investments in drug user deaths
By Care Not Cops
On the evening of Oct. 25 2023, the Vancouver Police Department (VPD) executed a raid in three locations, including the homes of two people, who they also arrested as part of the ongoing public relations campaign against the Drug User Liberation Front (DULF). The VPD drew attention to the harm and disruption they caused the next morning via press release.
DULF has been one of the few groups, publicly or otherwise, doing the labour to undercut the poisoned drug supply that the BC government, nonprofit and health authority executives, and police departments have worked to ensure continues to kill an average of six people per day in BC.
“Government, health and social service leadership are deeply invested in the status quo. They have failed to adequately address the crisis that is killing six people each day. DULF actually tried to undercut the toxicity of the supply, and these institutions likely saw that as a threat, ” says Jenn McDermid, an outreach-based social worker in Vancouver and PhD student in UBC’s Interdisciplinary Studies program.
Numerous organizations and individuals in British Columbia have generated revenue and wealth off the people who have died from the drug toxicity crisis, by promoting issues adjacent to the crisis through marketing campaigns. This includes funding initiatives, such as unregulated, private “treatment” sites with no evidence of net positive outcomes (and which put people at risk of overdose upon discharge), and ensuring that prescribed replacements are limited to biomedical settings. Prescriptions are done either via physicians, who have long systemically upheld harmful prohibitionist policies and stigma toward drug users, developing labels like “drug seeking,” and ensuring urine tests can be billed for extra income; or from nurse practitioners (NPs), who are under surveillance from governing bodies whose mission and responsibilities are to ensure that practice reflects evidence and protects and promotes the health of communities being served, but which have done very little to encourage NPs to address the toxicity of the supply.
Workers providing overdose response have reached a breaking point as the government approach continues to funnel a social crisis and public policy issue into the healthcare system with limited prescribers. Harm reduction interventions are estimated to have saved hundreds of lives per year during the crisis and prior, but the root cause of the crisis has yet to be addressed.
“In the seventh year of a toxic drug public health crisis, the health authority cuts vital funding for frontline overdose prevention. It is like they’re asking us to fight a forest fire with a garden hose and then taking back the hose,” expresses longtime Downtown Eastside (DTES)-based outreach worker Blake Edwards.
Receiving and writing prescribed alternatives is an intensive process, with limited outcomes. Even if someone can somehow connect to a prescriber (when few are accepting new patients), people are not prescribed a therapeutic dose until after a number of surveillance-oriented visits. The provision of care is heavily regulated, generally subtherapeutic, and mostly limited to opioids, and therefore inappropriate and inaccessible to the vast majority of individuals. The healthcare system will never have the tools to fully solve this crisis, and it is alarming that what little regulated supply exists continues to only be accessible this way.
There will be even less access now that DULF is defunded and shut down.
As a collective of direct care workers, Care Not Cops is deeply concerned about the more than 40 participants in DULF’s program who have been cut off from their reliable source without notice, as multiple levels of government colluded to do abruptly. This is despite DULF being public in their activities for years, including running a compassion club since 2022.
This is shameful theatrical politics that may directly result in people dying, in addition to potential indirect loss of life, as fear resulting from this action could drive some communities away from a compassion club model that saves lives.
As outlined by Tara Myketiak, MSW, an outreach social worker in Vancouver and former safe consumption site worker, “A non-prescribed, regulated and predictable supply is the only way out of this crisis. A number of stakeholders previously stood behind DULF in absence of appropriate public policy. Now they are silent or worse, while the VPD arrests founders, shuts down operations and jeopardizes the lives of more than 40 people relying on a predictable supply from DULF.”
Death is the most acute harm caused by drug toxicity — the number of people who have been killed by the poisoned supply is tragic and significant. We grieve them all. The death toll is the easiest way to get the point across when addressing the significant harm of drug toxicity.
Other harms and violence are also linked to prohibition, the continuous expansion of carceral relations, and the illegal drug market drives wide-ranging social issues and violence. For example, the unpredictability of sedatives and benzos can increase risks of gender-based violence, as well as making withdrawal and ceasing use or prescribing appropriate alternatives more complex. Survivors of overdoses likewise endure the trauma of near-death experiences, and the constant worry of overdose. Many of us must manage the never-ending grief and trauma of significant loss in our communities.
“People coded as drug users experience exclusion in almost every setting, which drives shame and isolation. This organized abandonment is preventable, although historically, it seems intentional. If we aren’t excluded from life itself, we are relegated to second class citizenry,” says Jake Seaby Palmour, an outreach-based social worker in Vancouver, “Drug users wear the wounds of settler colonial indifference. It is a nightmare scenario.”
The crisis also tends to be painted as a DTES only issue, despite the odds of fatal overdose being lower in the neighbourhood compared to other parts of the province. This is attributed in part to community care, expansive naloxone administration knowledge and training, and the proximity to some harm reduction-based services. In 2022, more than 86% of deaths by overdose in BC occurred outside of the DTES, according to BC government statistics. Rural and remote communities without harm reduction services continue to endure extremely concerning rates of people dying from overdose.
The formal response to the drug toxicity crisis has been characterized by piecemeal projects; a decriminalization framework that ensured a law enforcement presence in the lives of drug users, in part by creating a resource card distribution role and setting a low possession threshold for charges, where some forces previously used uncapped discretion; few public health emergency measures taken; a concentration of overdose prevention services in only one neighbourhood despite a ministerial order saying it should be otherwise; and little has been done to adapt to long-known trends of increased inhalation use.
“Horrific that different branches of government worked together to defund and create spectacle off DULF’s courageous, serious work,” says Tyson Singh ਤੈਸੋਨਂ ਸਿੰਘ Kelsall, a social worker in Vancouver and PhD student in Simon Fraser University’s Faculty of Health Sciences. “Many of us who use drugs don’t even meet eligibility for medicalized access, nor would it be reasonable for the system to be used that way. A regulated supply is necessary social infrastructure. If I die from a fatal overdose, I wonder if those individuals that stood down in these institutions will feel comforted by the excuse of just having done their jobs.”
From the start, it has been clear that the drug toxicity crisis is driven by an unpredictable supply — and that the supply is made unpredictable by prohibitionist policies and their enforcement without a regulated replacement, despite people having always used drugs since prohibition was imposed here. To reduce deaths and make the drug supply predictable, the drug supply must be addressed.
DULF’s compassion club has been one framework communities and movements have called for and should be scaled up. DULF’s work provides a vision for an alternative future where people can access a reliable supply of drugs, removed from the healthcare system, and led by those who have been impacted by the toxicity crisis.
Care Not Cops joins the Vancouver Area Network of Drug Users in expressing support today for DULF, who should be praised for burdening intense risks to save lives in our communities, particularly by the institutions that have participated in the organized abandonment of all people who use drugs.