This Back Alley ‘Harm Reduction’ Tent in Vancouver Isn’t Asking Permission to Operate

Clean needles, chairs, naloxone, a couple people trained in CPR, and shelter from the rain. These are the basic elements of a do-it-yourself supervised injection site, so says the operator of a back alley "harm reduction tent" recently opened in Vancouver's Downtown Eastside.

One of the tent's founders, Sarah Blyth, told VICE the site is a response to the neighbourhood's opiate overdose epidemic. Blyth, who also helps run the weekly Downtown Eastside street vendor markets, said she and other frontline workers wanted to set up something more consistent and street-level after hearing calls for help in the streets.

"You're in the middle of it, you're seeing people ODing, and you just can't believe that there isn't more help," she told VICE.

"At our market, you would hear people screaming from the alley," Blyth said, recalling a race to track down the opiate-blocking drug naloxone, which the province recently deregulated, and get it to the ODing person. "We would scramble to get everything together, we didn't want to be late for this kind of thing."

The tent is covering gaps left by Vancouver's safe injection site Insite, which Blyth says is "packed" and unable to respond to street-level emergencies. "It's not Insite, it's not supposed to function as Insite," she said.

Vancouver Coastal Health has pledged to open two new safe injection sites by next year, but Blyth isn't waiting for the government to step in. "When you're dealing with emergencies like this, there's no time to wait for the government bureaucracy to do its job."

Blyth set up the tent with Vancouver Area Network of Drug Users (VANDU) founder Ann Livingston last Wednesday, and so far city and health authorities haven't given them any trouble. Even as the royal circus passed down Hastings Street a half-block away, with a heightened security presence at the street market, Blyth continued her harm reduction project uninterrupted.

Blyth and Livingston have been supervising injections and handing out harm reduction supplies from 10 AM to 4 PM every day since, with between 25 and 40 people stopping by each day—some shooting up, others taking rigs for the road. On the day social assistance cheques went out, they stayed open until 9 PM.

The same day it opened, British Columbia's coroner released new stats that showed fentanyl is showing up in recreational drugs, as well as street-level opiates. The super-potent synthetic opioid has caused over 60 percent of overdose deaths across the province in 2016. So far this year, overdoses have killed nearly 500 people.

Read More: Cocaine Is Detected in Almost Half of BC Fentanyl Overdose Deaths

Blyth says fentanyl has made overdoses more deadly, requiring frontline workers to respond quicker. When a batch of bad drugs is in circulation, she says the back alleys around Hastings can turn into a "warzone" where many people in a row go under, sometimes within minutes of each other.

"They go down a lot harder, and it's harder to get them out of that. You need more Narcan [the trade name for naloxone], a lot more," she told VICE. "A few minutes can mean everything—they could end up in intensive care or in a way worse situation."

"With heroin you would get them Narcan and some air and they're fine, but this is two, three Narcans later and they're still down."

With the opiate crisis across the country showing no signs of slowing down, Blyth suggested the pop-up response tent could be replicated in other hard-hit communities.

Follow Sarah Berman on Twitter.