It’s Christmas 2019, the first one since Sara-Jane died.

Everyone gathers around a candlelit buffet where steam wafts from platters of meat, vegetables and gravy. The room fills with the scents of a holiday feast — butter and garlic, burning wax and a hint of red wine.

Her ashes rest on a red tablecloth next to a porcelain Santa Claus at the edge of the table. A wooden chair where Sara-Jane would have been is empty, sitting under her portrait. She looks stunning: a perfect smile, piercing eyes and shoulder-length hair off to one side.

Just a few months earlier, while studying at the University of Ottawa, Sara-Jane was in her dorm, alone, when she took a drug spiked with fentanyl.

“That first Christmas without her, it was important for us to create a ritual,” said Isabelle Fortier, Sara-Jane’s mom. “The first one is almost always the hardest. So we got everyone together and we raised a glass to her. We spoke to her, shared memories of her, bought her and her brother Gabriel Christmas decorations with the year inscribed on them.

“Just like when they were kids.”

With the latest variant of COVID sweeping across Quebec, Fortier’s Christmas ritual will have to be stripped down to the bare essentials. She said she’ll spend it alone “with Netflix and a bottle of wine.”

‘Family and the holidays are a big trigger’

Fortier is one of hundreds of Quebecers who will grieve for a child lost to the fentanyl crisis, which kills more than one person every day in this province.

Some 923 people have died of an opioid-related overdose since the COVID-19 pandemic began nearly two years ago, according to the Institut national de la santé publique du Québec. And that’s not counting the months of October, November and December, which the coroner’s office have not yet recorded.

“There’s no way around it, the holidays are a motherfucker,” said Alexandra de Kiewit, who has lost her share of friends to the crisis. “My first serious boyfriend died in Jonquière recently. That was a lot. I’ve lost people in Montreal, one of our volunteers died, it feels like an everyday thing now.

“It’s hard on the survivors but it’s just as hard on those who still use drugs.”

The only Christmas she ever spent away from her family was when she was living on the streets and getting high.

“I was ashamed, I couldn’t face my family all banged up like I was,” she said. “I spent Christmas Eve with my dealer. For a lot of people who started using to begin with, family and the holidays are a big trigger. Whether it’s that shame or whether it’s because someone in your family abused you, there are lots of reasons to want to keep using.

“The other problem with Christmas is that services start to shut down. When you add social distancing and safety measures, a lot of people are at risk of using alone. And that’s when you die.”

When the pandemic arrived at our shores last year, it interrupted the supply chain of heroin, cocaine and amphetamines from the United States and overseas. Fearing a supply shortage, major suppliers started cutting their product with fentanyl — a synthetic drug that is 100 times more powerful than heroin.

One of the only solutions to stop people dying is for them to test their drugs and use a safe injection site, where a medical professional can intervene during an overdose. Before the pandemic, most of these sites would see one or two overdoses a week but a nurse or street worker would step in and administer the life-saving drug naloxone.

Now, most sites have gone from seeing an overdose per week to multiple overdoses a day. Still, no one has ever died while using at a safe injection site in Quebec. But with the pandemic back in full swing, these facilities have to reduce capacity, and that increases the risk that someone will use alone on the streets.

‘They send you into the wilderness’

“Last winter, when the government imposed a curfew, we saw a spike in overdoses too,” said Hugo Bissonnet, who works at Le Dispensaire, a harm reduction clinic in St-Jérôme.

“People didn’t want to be caught outside and fined so they didn’t use safe injection sites, they didn’t have a friend watch over them while they injected themselves.

“This time around, workers are burned out, a lot of the resource centres are short-staffed and the government response is practically non-existent.”

Funding for harm reduction has flatlined under the Coalition Avenir Québec government. And that’s despite a 30 per cent increase in overdose deaths last year. Federally, the process of having Health Canada sign off on drug testing programs is also stalled.

Le Dispensaire has had new lab equipment gathering dust in its basement since last winter. Staff can’t legally use it until Health Canada gives the clinic an exemption from the Criminal Code that would allow workers to handle street drugs without fear of being arrested.

“I haven’t heard back from (Health Canada) in months,” Bissonet said. “It certainly doesn’t feel like the hundreds of people who die of an overdose every year are a priority.”

De Kiewet knows both sides of the fentanyl crisis. As a peer intervention worker, she is a recreational user of hard drugs and someone who helps counsel people who use drugs.

Earlier this year, she woke up on a friend’s living room floor after nearly dying of a fentanyl overdose. But just a few months prior, she climbed into the backseat of a sports car with her naloxone kit in hand, ready to save someone who was going into respiratory failure after shooting dope spiked with fentanyl.

There are few in Canada with such an intimate knowledge of why people use, how they use and why they die using. Her fear, with Christmas just days away, is that the holiday will trigger risky behaviour from people in emotional distress.

“People tend to mix drugs more during the holidays,” she said. “You drink a bit of liquor to numb the loneliness, throw in a few benzos to take the edge off and you might wind up accidentally killing yourself.

“I remember getting kicked out of the hospital on Christmas Eve when I lived on the streets. I asked to stay for supper, to experience some sort of human warmth and have a warm meal. But a lot of people don’t consider your humanity when you’re a drug addict in the public health system. So they send you into the wilderness to fend for yourself.”

Reach out

There is some light at the end of the tunnel. While people continue to die every day, more and more of their loved ones are speaking out and enlisting allies in provincial legislatures and parliament.

After De Kiewit’s friend Sam Moro died of an overdose on Dec. 5 in Drummondville, he was honoured by a politician from his home province.

Green Party MLA Kevin Arseneau stood in the New Brunswick legislature last week and paid tribute to the fallen 36-year-old.

“To all of those who feel bad, who feel alone, who fight demons and who fight a system that abandons them, you’re not alone,” Arseaneau said. “To all the rebels, the dissidents, the anti-conformists, to the punks, I ask you to send a greeting to our friend, Sam.”

When Sara-Jane died, her mother took her grief and poured it into harm reduction. Fortier sits on the board of a safe injection site and community clinic in Montreal and lobbies politicians on behalf of Moms Stop the Harm — a network of thousands of parents who have lost a child to the fentanyl crisis.

“When you lose a kid to poisoned drugs, it often isolates you from the rest of your family,” Fortier said. “There’s a lot of shame, a lot of stigma attached to that kind of a death. So people would rather not talk about it and that tears families apart. I’m lucky our family has been strong but for those who have experienced that isolation, there are groups like Moms Stop the Harm.

“What I would say to anyone who knows someone struggling this time of year is reach out. Get over your anxiety or fear of talking about it and reach out. It can make all the difference.”