How Fentanyl Is Making Canadian Homeless Camps More Visible and Deadly

This article originally appeared on VICE Canada.

When talking about the immediate impacts of fentanyl in Canada, the place most of us tend to think of is the Downtown Eastside. Those few blocks of downtown Vancouver were already known for widespread opioid addiction, poverty, and mental illness, and so it's easy to confine all the death and suffering to those cold, wet alleyways.

But those who work in homelessness and addiction outreach tell a more complicated story, of increasing suffering stretching well beyond Vancouver's borders. Out in the wider Fraser Valley, political climates still reject basic harm reduction measures, and shelters are more scarce, which means users are much more vulnerable to homelessness and overdose. Just over a third of the province's 755 overdose deaths have been in the Fraser region.

What the province's housing minister has only hinted at, is how the fentanyl crisis has pushed more people onto the streets. To survive, many stick together in homeless encampments, to provide personal support and overdose response. The result is a noticeable growth in new tent cities scattered throughout Surrey, Maple Ridge, Abbotsford, and Chilliwack—all lasting well through the coldest winter in 30 years.

Michele Giordano runs a women's drop-in centre in Abbotsford, where there has always been some street homelessness. But she's noticed a shift, where instead of going along with "the Abbotsford shuffle" enforced by police, the city's homeless are increasingly hunkering down and sticking it out in camps for the winter. In one case a court challenge sided with campers.

"People who are out of sight in isolated areas are at more risk of danger from violent people, usually residents who are annoyed with the homeless people in their community," Giordano said. 'So what they've done, and this was starting a few years ago, is gathered together and created safety in numbers, for many reasons."

"More recently the fentanyl crisis has created a more urgent need for people to band together," Giordani told VICE. "If you don't have a safe place to use—a safe space with somebody watching—you risk dying from using alone. It doesn't matter if you're homeless or a wealthy person in a penthouse suite. The greatest risk to overdose is using alone, and people rectify that by moving in together, in close proximity, creating their own community for safety."

The same is happening elsewhere in the Fraser Valley. In Surrey, a special RCMP task force is now patrolling the makeshift shanty towns lining the street near homeless services like the Lookout Society. Over the last month they've responded to 52 overdose calls. In Chilliwack, more than a dozen homeless encampments in the fall have only partially been dismantled.

These areas don't have the same low-barrier housing and shelter system that Vancouver and Victoria have expanded in reaction to the crisis. Instead, a network of private recovery homes and sometimes-religious sober houses will send people to the streets in the grips of relapse.

"If somebody comes out of recovery, maybe because they've relapsed and been kicked out, they may be on the street," Giordano said. "That can move people into a place of despair—like that didn't work out, so why even bother? It's just one more letdown that leads people to more desperate places. Desperations sinks in and you just resign. You give up on yourself."

Two government-proposed safe injection sites could start saving lives in Surrey. But Chilliwack and Abbotsford communities continue to resist calls for harm reduction.

Tent cities across the province continue to be dismantled, over health concerns, and according to the housing minister to stop camps from reaching critical mass. "It would be good for the government to recognise that a drug addicted person is an expert in their own life. Instead of bringing in management with academic qualifications, they could focus on peers," said Giordano.

In the meantime, those tent city campers are just doing what they need to survive. "These are people that have been trained to apply naloxone to their friends. We need to give them credit for saving hundreds of lives."

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