Ann Livingston's July 9 presentation for the BC Humanist Association on the Overdose Prevention Society.

1. Overdose Prevention Society:
Compassion, Action &
Civil Disobedience
in the Face of a Crisis in
Vancouver’s
Downtown Eastside
Ann Livingston annlouiselivingston@gmail.com

2. In September, 2016, three women were so
concerned about the growing fentanyl
overdose crisis that they set up a tent &
table in an alley behind the DTES Market
they managed.
In potential violation of the law, they set
up a drug injection/ consumption site in
Vancouver's Downtown Eastside to
combat the many overdose deaths.

3. Why do volunteers break
the law to provide life
saving care to their
neighbours & friends
using drugs outside?

4. Sarah Blyth & Ann Livingston

5. Police Tolerance in Vancouver a Myth?
• Higher police activity & more arrests than ever DTES
• Undercover “buy & busts” cause ~18 court
appearances per charge
• VPD get drug users “red zoned” away from OPSs &
their support networks even for bylaw tickets
• Pretrial Jail time is common for procedural crimes
(fail to appear, going In red zones & bail & release
conditions).
• Non-addicted drug dealers are not arrested.
• Bylaw tickets result in warrants

6. VPD “mine” the DTES for “crime”
DTES Vancouver Bylaw Tickets in red – 90% in DTES

7. There are citizens who go to jail for 3 - 6 mo at a time & are
re-arrested for failing to comply with community conditions
“Doing life in 3 mo. bits.”
When
discharged from
prison, receive
NO welfare,
NO housing or
NO medical
coverage.
Creates chaotic,
reckless drug
use & despair.

8. Over 70% of arrests in the DTES are for warrants
for “failure to comply” with court orders

9. Challenging Police & Prosecutors
• Police crackdowns on drug
users are frequent & are
called‘sweeps of dealers’.
• VANDU protested 1200
jaywalking, vending &
urinating tickets given in 2
months. Because these
tickets result in jail time; we
escalated a campaign & 800
tickets were dropped.
Eventually a DTES street
mart was funded to ensure
people had a place to vend

10. We put on markets for over 5 years before getting
funding, permits & a space. Persistent Civil
Disobedience!

11. 
DTES Market at lot at 62 East Hastings

12. Public drug use increased & increased in the DTES.
Market Members disagreed about a safe drug use
tent & users being barred. We were reviving ODs in
front & behind the market with kits.

14. The son of
our beloved
Janet
Charlie died
of OD in
Aug/2016.
We bought a
tent & set
up on the
back of our
lot. Janet
approved &
she had
opposed

15. Opened 10 am - 10 pm everyday. Teensy funding from market &
Go Fund Me page for volunteer stipends. Scrounged everything
including power. Recruited people using the facility. Experts!

17. From the Vancouver Sun Editorial Oct. 2016: quotes
• But VCH says they do not support or condone it, noting
that, “It’s not legal.”
• The City of Vancouver has also washed its hands of the
back-alley facility, saying it is not connected to nor
sanctioned by the city.
• …police have not moved to shut down this illegal
operation. …
• There is a fine line between harm reduction and enabling
addiction. InSite represents the former; the pop-up drug
tent the latter.
• The illegal drug site should be shut down immediately,
• …More harm-reduction sites like VCH’s InSite and
addiction treatment clinics like Providence Health Care’s
Crosstown Clinic are desperately needed.

18. BC Drug OD Deaths & Deaths/100,000 1989 -2015
In this graph we may be seeing the effects of Fentanyl 2015
Note that the 1990s OD epidemic rate is reached in 2015

19. Opened OPS in Sept. In Nov 2016 ODs spiked. Carfentanyl?

20. Sarah Blyth “We cannot sit
around & have this happen
on our watch… & we don’t
have to wait for red tape or
the government &
bureaucracy… We knew
that no one could stop us,
because we were doing the
right thing.”
Nov 2016 - DTES Market Drug Use Tent

21. 80% of dead are men – 20% women.
Most deaths between 19 – 59 years old.
Death rates are evenly distributed in BC

22. 85% of fatal ODs in Vancouver in “residences” or “other
residences”. Most non-fatal ODs are outside!
Non-addicted people seeking pain meds are unable to get
them from MDs. When they buy fake percocets, they die
alone in their rooms. BCCP&S new rules are killing people.

23. Terry Lake Minister of Health BC
visiting illegal site.

24. On December 8, 2016, B.C.’s Minister of Health
announced a policy shift changing how
supervised-injection sites are established.
• Sites opening do not have exemptions from the
Controlled Drugs and Substances Act that were
previously required to open.
• TERRY LAKE BC Minister of Health: “I’m assured
that we’re not contravening the federal law,”
“Under the Emergency Health Services Act, I can
make this kind of order in the face of a public-
health emergency.”

25. On inspiration for the plan, Lake gave partial credit to an unsanctioned
program that’s operated in the Downtown Eastside since mid-
September. In two back alleys, former parks commissioner Sarah Blyth
and her team established a pair of pop-up injection tents where staff
give addicts a safer place to use drugs.
“I woke up yesterday at 4 o’clock in the morning and was thinking about
the pop-up tent,” Lake recounted. “And the real challenge that we see
is the cold weather. People have a combination of overdosing and
hypothermia, so I know we had to do more.” “The goal here is to keep
people alive,” he added.

26. Strengths of community models of drug consumption sites;
• Empowers people to come together to act in urgent health crisis or
emergency - users, non-users, parents, off duty nurses, MDs
paramedics, civil rights lawyer etc
• Sites set up & run with smaller amounts of funding
• No need for exemptions from Controlled Drugs & Substances Act.
• They are a non-medical model so do not need licensing.
• No line ups as we make room by setting up additional tents
• With outside venues, they can encourage safer inhalation of heroin,
crack cocaine & crystal methamphetamine.
• Toilets are cheap to rent & set up & are essential
• Keep citizens from despairing while watching their friends die
• Community run drug consumption sites are an important place to
attract people using drugs who might otherwise die using alone to
socialize, to hang out & use drugs safely, to love themselves

27. Area 62 Overdose Prevention Site (OPS)
Our project represents an inspiring example of
citizen action in a public health emergency.
We are an innovative & collective solution to
our issues in community health.
Our peer-based services are beneficial to
• the health authority;
• to the community; &
• to the participants themselves.

28. Area 62 OPS ensures excluded, vulnerable &
marginalized people are welcomed to a safe
place where they can use drugs &/or
participate as a volunteer.
Non-drug user volunteers are welcomed &
strengthen our ability to cover busy days
when more drugs are consumed & volunteers
need a break.
We work with Karmik, a west coast Harm
Reduction organization which provides
pragmatic harm reduction services to festivals
& nightlife events across BC.

29. Our Overdose Prevention Site educates peers in:
• civil disobedience & advocacy;
• safer drug use & OD prevention
• community governance;
• innovative strategies;
• health determinants ;
• facilitators & barriers for scaling up innovations;
• improving health outcomes thru empowerment:
• opiate replacement therapy
• welfare rights
• self love
• OD first aid

30. We have much to do. These undercover VPD are
arresting people for crack in front of VANDU’s
OPS. She was charged with possession of 1 rock –
the VPD claims they never do this.

31. In the alley by the OPS, the VPD are searching
people & taking their $ with no charges. This is
evidently legal as they can go get their money
from the police station but must show ID which
they do not have. Who knew?

32. Super bright lights were put up in the alley
behind the OPS. Lights attract people selling
drugs & encourage crowds. Bob Rennie, the
Condo King owns this building.

33. The task of injecting
naloxone into someone
who has overdosed is
attractive to some. But it
is only effective to
befriend people & help
them get welfare,
housing, healthcare,
meaningful work &
resolve criminal charges.
There is a disagreement
about our broader
purpose.

34. It will take a persistent, well organized, social
justice movement to change our drug laws.

35. Drug users’ groups can be organized with relatively small
funding to end the criminalization of people who use drugs.

36. Law Enforcement Action Partnership (LEAP) is an
international, educational organization comprising
former & current police officers, government agents &
other law enforcement agents who oppose the current
War on Drugs.

37. Despite 10s of
thousands of
Take Home
Naloxone kits
being
distributed to
100’s of
community
agencies &
opening ~20
OD Prevention
Sites, OD
continues to
kill 4 people a
day in BC.

38. Funded by
Community
Donations – Run
by unpaid
volunteer MDs &
RNs for a few
months.
FIXERUM in Copenhagen Denmark.
Civil Disobedience.

39. Maia Szalavitz, Scientific American, May 2016 "The final
major risk factor for addiction is economic
insecurity & poverty, particularly unemployment
& the hopelessness, social marginalization & lack
of structure that often accompany it.” “...heroin
addiction rates among people who make less
than $20,000 a year are 3.4 times higher than
people who make over $50,000.”
“To those who study the effects of inequality on
health, it is no coincidence that the collapse of
the white middle class has been accompanied by
a rise in all types of addictions, but especially
addiction to opioids.”

40. Maia Szalavitz, Scientific American, May 2016
“Many people would prefer it if we could solve
addiction problems by busting dealers & cracking
down on doctors. The reality, however, is that as
long as there is distress & despair, some people are
going to seek chemical ways to feel better. Only
when we can steer them towards healthier—or at
least, less harmful—ways of self-medication, &
only when we reach children before they develop
this type of desperation, will we be able to reduce
addiction and the problems that come with it."

41. How do we witness the anguish
of people who use drugs?
By giving a voice to those people who use
drugs who are most vulnerable to
oppression &:
• to harassment from the police,
• to neglect from healthcare providers,
• to incarceration,
• to apprehensions of their children &
• to hatred from society.

42. We bring justice and healing when
we:
• invite the rejected,
• give voice to the silenced ,
• include the excluded, &
• bring unity & peace to those
who are divided

43. In a world hungry for:
• healing & forgiveness,
• reconciliation & most of all –
• unconditional love –
we are called to alleviate that
hunger.

44. "The trouble is that once you see it,
you can't unsee it. And once you've
seen it, keeping quiet, saying
nothing, becomes as political an act
as speaking out.
There's no innocence.
Either way you're accountable."
Arundhati Roy

45. annlouiselivingston@gmail.com
https://www.youtube.com/watch?v=Z4K1PN8NeJA
http://www.vancouversun.com/health/Part+Many+addicts+still+shooting+Vancouv
er+alleys+with+video/9901387/story.html
http://www.terry.ubc.ca/2014/10/15/the-four-pillars-revisited/
http://kcts9.org/reel-nw/fix-story-of-addicted-city
https://www.youtube.com/watch?v=9mCTnMDPWKs
https://www.youtube.com/watch?v=9bswoE3QQxI&list=PL18y1vgsGPLZ1r5qjhq7Gj
Ch12y24ykDq&index=11
For more information on Unsanctioned User-Run
Initiatives to Save Lives: