In the midst of an opioid crisis that killed 547 people across Quebec last year, the provincial government is sitting on a life-saving solution — and has been for months.

Despite a 30 per cent jump in fatal overdoses in 2020, the Coalition Avenir Québec budget released last week does not include new funding to fight the opioid epidemic. The CAQ government also allowed its overdose action plan to expire at the end of last year without replacing it.

“The government strategy right now is to just tell us to ‘do what you can’ while our people die,” said Jean-François Mary, executive director of CACTUS Montreal, a safe-injection clinic. “Last year was our worst ever for overdose deaths and the minister didn’t bother planning a new strategy to fight it. We also have no assurances we’ll get new funding this year.

“Without a public health strategy, you leave every regional health board to fend for itself. This is extremely dangerous.”

CACTUS and two other community groups have a plan and the resources to check street drugs for fentanyl before they can do harm. All they need from Quebec is an exemption from the Controlled Drugs and Substances Act to be allowed to have narcotics on site.

Outreach staff doing paramedic work

The groups sent their application to the health ministry five months ago but the government hasn’t given them any idea when the request will be processed. At this point in 2021, there is limited data on overdose deaths this year, but public records show 218 people died from opioid use in the final five months of last year.

A 2018 study published in the Harm Reduction Journal shows that a similar drug-checking strategy in Vancouver helped reduce overdoses while illustrating how prevalent fentanyl has become in street drugs. In roughly 1,400 checks, researchers found that 79 per cent of tested substances contained fentanyl — a synthetic and deadly opioid.

“This isn’t new or experimental. It’s a proven method that saves lives,” said Mary. “It helps us know what’s out there so we can warn users, it helps us know what to expect, how to adapt our services.

“Right now, things are so bad that our outreach workers are doing the work of paramedics 80 per cent of the time. We’re seeing overdoses every day, and their job isn’t to offer services or even guide someone toward getting sober anymore. They are there to make sure people don’t die. That’s how desperate it is.”

In a statement sent to Ricochet late Tuesday, a spokesperson for Quebec’s minister of health and social services said the province is in talks with Health Canada and Montreal’s public health department regarding the exemption.

And though funding for the opioid crisis was “not invoked” in the provincial budget, the statement says Quebec is identifying how to fund essential services ahead of a future action plan.
On the streets of Montreal, fentanyl is killing homeless Indigenous people every month. When Nogeeshik Isaac spoke to Ricochet in January, his hands shook as he described watching his adopted sister die of an overdose.

“She was still alive when the ambulance took her away,” he said. “One minute you’re hanging out, the next she’s having a seizure and you’re giving her chest compressions. It fucked me up. It made me not want to live anymore.”

Both Nogeeshik and his sister frequented the Resilience Montreal shelter on Atwater Ave.

‘We have a chance to use what they learned out west’

Last week, “Greg” travelled two hours north to Mont Tremblant to pick up the belongings of an Inuit woman who had just died of a suspected fentanyl overdose. The victim had come south for a better life but got mixed up with a boyfriend who used intravenous drugs.

“All she had left in this world was a few suitcases and a couple of Dollarama bags full of stuff,” said Greg, who did not want his real name published. “I agreed to drive up there and pick up her things so they could be flown back to her family in Nunavik.”

Greg, who is also Indigenous, has friends who live on the streets and he fears things will only get worse.

“I don’t want to have to keep hearing these stories and losing people but it really seems like there’s no end in sight.”

One street worker says the pandemic is making the crisis much harder to manage.

“People can’t get into detox without a two-week quarantine and, when you’re living with a 24-hour a day addiction, two weeks is an eternity,” said Matthew Biddle, the housing coordinator at Projet Autochtones du Québec. “One of the people we work with lost a family member in Nunavik. She had to miss the funeral because of the lockdown.

“That’s the sort of thing that will send a person spiralling.”

Many of the cultural programs in place to help with addiction and mental health issues have been suspended because of COVID-19, Biddle says.

That makes the need for a safe drug supply all the more crucial, said Mary.

“This is a public health problem that almost killed 600 people last year,” he said. “We have the equipment in place, the personnel in place, we’re trained to do the work. All we need is that exemption.

“This isn’t like Vancouver where they’ve been seeing this for five years. It’s just beginning here. We have a chance to use what they learned out west and avoid a worst outcome. But we’re waiting. And people are dying.”