Category Archives: pandemic

about what’s happening

on the july coroners update
on overdose deaths in BC.

i want to give people some information about this update from the provincial coroner on tuesday. it’s your information, actually, and sometimes facts are hard to come by. i’ll do separate posts because nobody likes one that goes on forever.

first here’s a few things the coroner said.

“The number of people dying in B.C. due to an unsafe drug supply continues to surpass deaths due to homicides, motor vehicle incidents, suicides and COVID-19 combined,” said Lisa Lapointe, chief coroner.

175.

or 5.6 deaths every day. average.

july was the third month in a row when there were 170+ Illicit Drug Toxicity Deaths -> using “illicit” to mean that they *socially* not permitted, so people use alone – and not just illegal. different. and toxicity -> poisoned, not overdose. because you use what you use but there’s not way of knowing this.

this is from the coroner’s service statement:

“Once again, post-mortem toxicology testing data published in this report suggest an increase in the number of cases with extreme fentanyl concentrations (exceeding 50 micrograms per litre) in April, May, June and July 2020 compared with previous months.”

how concentrated is that? compare smooth peanut butter vs crunchy. but you can’t see the crunchy bits.

those tiny numbers at the bottom of this are number of deaths per 100,000 – a measurement to compare. right now what matters is that we’re at 30.5/100,000. in 2018, we were 31. remember 2018?


Housing

the next thing the update looks at is the location of death. this is one thing where the vancouver region is really different from other parts of the province.

the red slice in the two pie charts is for supportive/social/SRO housing.

Private Residence – includes driveways garages, trailer homes and either decedent’s own or another’s residence.
Other Residence – includes hotels, motels, rooming houses, SRO (single room occupancy, shelters, social/supportive housing etc.)
Medical facility – includes hospitals, community care facilities, etc
Occupational site – includes locations where the decedent was at their place of work.
Public buildings – includes restaurants, community centres, businesses, clinics, etc.
Outside – includes vehcles, streets, sidewalks, parking lots, public parks, wooded areas, and campgrounds

so, there were DOUBLE the % of overdose deaths in supportive, social, SRO, and hotels, shelters etc in the VCH region than province-wide! Doesn’t that seem like something that could be directly addressed? Instead, operators lie to the public and to funders about “community” and “looking out for one another” and meanwhile abuse their staff who in turn abuse the residents. demolition by neglect.

And “meeting people where they’re at” or even “wrap-around supports” is obviously not identical single-resident units. when homeless people refuse to live in such housing, it is clearly a signal that the housing is not adequate.

if you are living in an encampment and managing ok, and use drugs, and prefer living to being dead, it’s the rational choice.

but obviously these are shitty choices.

just to make the shittiness clear, here’s the two articles from late last year about how no one even bothers to keep track of how many people die in vancouver’s supportive housing, numbers are going up, an its super fucked up.

No one is monitoring Deaths in Supportive Housing – Travis Lupick, Georgia Straight, Dec 2019

“If it were daycares or hospitals or prisons, and if there were one or two or three deaths, we would have reached a stage that triggered an investigation,” Gagnon argued. “People are dying in these spaces, no one is doing anything about it. No one is even looking into it.”

Deaths Rise Amid Conflicting Rules – Travis Lupick, Georgia Straight

continuing on the housing problem (no one wanting to live in the housing/ everyone being dead)

as i’m finding, there isnt A Solution to this: there are many, and “the solution” is always for People to Have Real Choices, which is very simple and outrageously revolutionary at the same time. you should see the looks i get – i might change my name to WTF.

(also whenever someone who has any power at all says “this is how it is down here” – tells you to accept the unacceptable and get used to it – they are not On Your Side, and now you must fight even harder, often alone, because its real.)

on average, 20% – 40% of regular drug users prefer to / will only use alone: it’s their thing. should they be prioritized for safer supply access?low-income/supportive housing needs to have harm reduction built right into it – not be the same as ever, now! with naloxone.

harm remains a feature of operation: how power is deployed when someone has even a tiny bit.such housing must have using rooms, units for couples, units for street families, drug checking and ☑️ dealers.

housing that acknowledges that drug users exist, in design and policy.formal accountability structures and a complaint process THAT IS DOCUMENTED, and collaborative management between operators and residents. resident committees. yeah low-income co-ops and resident self-management

did you know that not everything needs to become a total clusterdumpsterfire before you can try to fix it? or do something else?

we must dump this idea that 100% shelter rate is only housing worth working for. i would very much prefer to live in the world. what do you think? people out there have often never met people like any of us. i have found that if you give them a chance, most of the time everyone is surprised. and frankly we’re not going to change things any other way.

its like we’ve been behind a wall for 20 years.


Poverty Cycling

the next part of the coroner’s report is on the day/week when the most overdose events occur. let’s talk about what to do about cheque week.this chart is of deaths per day for the province – cheque day is the same day everywhere, but the supply is local. or in transit, from one market to others. as you can see, cheque day seems to be starting to look like other days by the end of 2019 – or was it?

it definitely was not.

the peaks in the lines are cheque week. this chart is of 911 calls for ODs.in 2019, deaths were down by 1/3. calls for serious overdoses were almost exactly the same. as ive said before, it was the changing supply – the benzos. people were very messed up and some will never be ok, but they didnt die.

in the last three months, calls have increased dramatically.

from the gov’t release:

“Paramedics are responding to and reviving overdose patients about 80 times a day, every single day in B.C.,” said Jon Deakin, paramedic practice leader with BCEHS. “It’s a lot. It’s the highest number of daily overdoses BCEHS has ever seen.”

This graph is from the BCCDC – the blue line at the top represents 911 calls throughout the province and the five line nearer the bottom represent the five health regions.

Oh here’s a chart of the % of benzo content in the local down, week by week, since january.

here are those two charts on top of each other. the blue Xs are cheque week.

we can’t have cheque day, or cheque week like this anymore. we don’t have time for another study to find out if people who use drugs prefer being alive. also, fuck the British Columbia Centre on Substance Use and their useless exploitative ‘research’.

we can’t allow the government to continue dumping all the legit money on all the poor people in the province on the same day. when you think about it that way, it’s ridiculous.

so here’s my idea: what if you could decide yourself when and how you’d get your assistance on the regular? work it out, depending on what you want to be doing. twice a month, every week, twice a week, thirty bucks a day, whatever. keep cheque day if you’re lazy. yes, you must get a bank account. do you like getting ripped off? yes, we need our own bank, if pigeon bank isnt working out for you.

the point is for you to make choices for yourself – which is all i hear from people everyday, that’s all they want.

this is the only way that i can imagine that would break this fucked up cycle for real. what do people think?

unnatural disaster

It is not an opioid crisis! The changes we seek are not about a class of drug. This about prohibition & racist drug policy that justifies its existence by punishing people already suffering under the conditions it has created; its a weapon of the structures that must be unmade.

In fact, saying people died from “opioid-related overdose” has profoundly negative effects on people who are prescribed these medications, pain patients. And it’s another way that the words we all use obstruct access to safe supply.

In any public forum, the comparison with COVID-19 is going to come up. It’s not about the number of deaths: it’s not a competition. Let’s step back and have another look, because these are really different, and here’s how. And i think this is the point that we need to get insistent about.

Contagious viruses like COVID-19 that become epidemics, which in turn become pandemics, are inevitable — they happen again and again throughout human history. They are natural disasters — terrible but natural. What illicit drug users have experienced these last years is an unnatural disaster in every way. It is the result of choices: choices that have been made by governments. And different choices could be made every day.

It is not about opioids. Definitely not anymore. Really never was. Calling it such distorts our goals. I’ve been correcting anyone from the media I speak to, anyone in government, and anyone in health care or drug policy who still speaks to me. I don’t need to speak with them, nor they to me. It’s the public we to talk to, not each other. Really. You may think I’m going too far, but it shocks people when i call it a Prohibition Massacre. And that’s what I want to do: shock people out of complacency, and stop them from saying ¯_(ツ)_/¯ what can we do? It’s the bad rugs! ¯_(ツ)_/¯

Try to shock people, however you can.

And stop saying the same thing again and again. Because it didnt work.

COVID amplifies

COVID amplifies systemic violence: increasing and accelerating the impacts of already existing policy, policy trends, and practices. the consequences, intended or not, immediately impact people exposed to risk, because they haven’t made any policy choices, and can only react. and these consequences collide and combine in unexpected ways, depending on local context.

so drug users are dying in large and increasing numbers. almost all of us will die, from many things – all of them consequences of injustice.

for example, the guest ban in SROs and supportive housing has directly led to a lot of deaths in the neighbourhood which would otherwise been prevented – and in multiple ways. obviously yes, overdosing because using alone. also, where is the “guest” now? living rough on the street, then dead from a stabbing. the ban prevents a resident with mobility issues from visiting their friend across the street, who would have insisted that they go to the hospital, but that didn’t happen, so they’re dead. lots of that. my own building was decimated in may. ten percent of my neighbours died.

and the supply is toxic. its all over the place in terms of potency, composition, and internal consistency, as has been noted.

there are so many stupid terrible ways that poor people die. sometimes it’s one little thing that goes wrong, and then everything falls to pieces. those are consequences, and not causes.

as is poverty, and its cycle (in lockstep with the illicit supply), which is also a killer. we have to stop having cheque day. people must be empowered to design their own assistance schedule, in consultation with an advisor. the government must stop dumping all the legal money on poor people once a month. this needs to stop. it can. it’s a choice.

these are excess COVID deaths. COVID amplifies.

i also discovered that this is happening everywhere, at least in canada, and even more so this US, which makes sense in drug policy terms. 30% -> 50% – 90% mortality, March – April – May, quite consistently. Everywhere I could find overdose data. Because it’s a pandemic, which means everywhere.

“Between March 15 and April 25, British Columbia recorded 372 more deaths than in any of the previous five years for those same weeks — but just 99 of those were confirmed COVID-19 cases.”

Excess deaths, june 19, cbc

so at this rate, by year’s end … well, my advice is to speak directly to users. for once. like we’re human. and say that at least 6000 drug users will almost definitely be dead by year’s end.

Overdoses – in this sense – are only the most dramatic in an overwhelming tide of death. and will continue to be for a little while. but they are not the cause of death. nor is COVID.

people say they hate drug use, and users, but that’s an excuse: that’s why the drug war is maintained- they need this reason to justify such hate. but as it turns out drug users are oppressed racialized minorities, Black and Indigenous people, people with disabilities, whether physical or mental or emotional, and queer and trans people, and other people denied or unable to access regulated medical care (undocumented migrants, injured contract workers, youth or teens fleeing abusive homes), and often a combination of these, and then add poverty. these are lived political contexts, these are lives lived in great pain, exposed to this system’s violence. and trapped in it. it looks like the people here. it hurts. a lot. drugs soothe that somewhat. for a time. it’s not the drugs, it’s drug policy.

that is why this is political and why it is about justice. because injustice is fatal.

prohibition and death

vancouver and forgetting

alcohol was prohibited in Vancouver during the 1918 pandemic. a lot of people died during prohibition, at the end of the war, in that pandemic

A LOT 

WAVE AFTER WAVE (Epidemic and Public Health : Influenza in Vancouver, 1918-1919 by Margaret W. Andrews)

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health services were already short staffed because many doctors and nurses had gone overseas, to serve in the war.

they couldn’t figure out how people were getting sick − it wasn’t the poor, the old, the weak − they couldn’t figure out how those who became infected were infected. they couldn’t make connections

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the majority of deaths were people between 20-39.

it was prohibition and if you wanted to drink, this was the legal route. you needed a prescription. it was rationed, and mild.

"there were long queues for prescription spirits"

it was pandemic safe supply.

otherwise you had no idea what you were drinking but people went to underground bars anyway. i know this; i was in the basement of old gachet on cordova, where there’s a tunnel to the old bar − people could enter it from down the block & around the corner. to not use alone.

to examine documents now, to be historical, is to wonder at how infrequently the pandemic is mentioned. once it was here.

"there was popular reluctance to admit that normal life was being disrupted"

it was understood very differently in in different places. and death rates tell only only a part of the tale. i wonder what it was by neighbourhood

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table from Margaret W. Andrews, Epidemic and Public Health, BC Studies 1977

if you can’t get social or physical distance, there’s always the historical option. step back, and look at us.

26.9 in 2020 for the whole province
but overdoses

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in the aftertimes people tried to forget it happened as quickly as possible and focused on recovering from the war and even called it Great and repealed prohibition and once again believed that everything was fine and nothing would ever change and the pandemic only lasted three years

and almost 800 people had died in the city, which had a population of 100 000

were they supposed to pretend that never happened? to forget that they ran out of flowers for funerals? they sure tried.

will we? did our deaths or lives ever happen?