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An alley filled with drug users outside the supervised drug-use tent in Vancouver’s Downtown Eastside.Rafal Gerszak/The Globe and Mail

A tent erected by volunteers off a Downtown Eastside alley as a temporary measure to deal with a surge in overdoses has become one of the busiest supervised drug-consumption sites in the province nearly 20 months later.

Downtown Eastside activist and city council candidate Sarah Blyth established the bare-bones medic tent in October, 2016, as a temporary hub to distribute naloxone kits – kits that reverse the effects of opioid overdoses – with volunteers trained to use them.

At the time, Vancouver was several years into a harrowing overdose epidemic and the back alley, behind a street market that Ms. Blyth manages, was particularly busy with injection-drug users.

“It was the most bizarre thing to see people overdosing everywhere, like ‘Is this really happening?’” Ms. Blyth said in an interview on Wednesday. “There was really no expectation [for the tent]. What it came down to was: ’Where’s the [naloxone]? Who has training?’ It was ridiculously crazy, and you can’t really run around looking for those things when someone’s having an overdose.”

Today, the site has moved indoors and receives an average of 377 visits a day, according to data released on Wednesday.

It also set the groundwork for dozens of other overdose-prevention sites to open across the country just as communities were fighting the red tape imposed by the previous federal Conservative government on opening sanctioned supervised drug-use sites.

In December, 2016 – the worst month on record for overdoses to date, with 162 dead – B.C.’s Ministry of Health not only gave Ms. Blyth’s overdose-prevention site a government stamp of approval, but ordered health authorities to open nearly 20 more across the province.

Ms. Blyth’s tent was replaced by a trailer the same month and began receiving funding from Vancouver Coastal Health. This past December, it moved indoors, into a storefront owned by BC Housing next door. The site maintains an outdoor tent for those who smoke their substances.

The overdose-prevention site has logged 180,437 visits since receiving government approval in December, 2016. During that period, there were 431 overdoses, 403 naloxone administrations and zero deaths. There have been an additional 60,000 visits by smokers since April, 2017.

In comparison, Insite, the first supervised-injection site set up in Vancouver, logged 175,464 visits in the 2017 calendar year. There was an average of 415 injection room visits a day, 2,151 overdose interventions and 3,708 clinical treatment interventions such as wound care.

Ms. Blyth said she is hopeful her overdose-prevention site can one day offer pharmaceutical-grade substances to clients rather than simply provide a supervised setting for them to use illicit drugs largely contaminated with fentanyl. A BC Centre for Disease Control pilot project to launch soon will offer the opioid hydromorphone to drug users to use as they please; it’s not yet known at which locations the drug will be dispensed.

Meanwhile, St. Paul’s Hospital in Downtown Vancouver this month opened the city’s first overdose-prevention site outside of the Downtown Eastside. Located on hospital grounds in a blue tent outdoors, the four-booth facility is open to inpatients and the general public seven days a week. It is funded by Vancouver Coastal Health and managed by the non-profit RainCity Housing, with a support worker onsite.

Overdose-prevention sites differ from supervised drug-use sites in that they are traditionally set up by volunteers through a quicker process as an emergency measure. Supervised drug-use sites tend to offer more robust services such as clinical care and counselling.

Overdose deaths have climbed dramatically in B.C. with the arrival of illicit fentanyl. At least 1,448 people died in 2014 – a six-fold increase from the average in the 2000s.

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