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People gather along East Hastings street as the local health unit has started prescribing a 'safe supply' of opioid alternatives to combat overdoses in the Downtown Eastside of Vancouver, April 6, 2020.

JESSE WINTER/Reuters

Vancouver’s DOXA documentary film festival has been forced to go online again this year by COVID-19, but the pandemic isn’t the only health crisis on the organization’s mind as it prepares to mark its 20th anniversary this week.

Selina Crammond, DOXA’s director of programming, says the opioid crisis is a “second epidemic” that will be spotlighted in the festival’s War on Drugs program. The program, curated by the Vancouver Area Network of Drug Users, or VANDU, includes four films about drug users, community activism and drug policy, two of which are directed by local filmmakers.

“VANDU has a really rich history of being an advocate and voice for drug users in the Downtown Eastside,” Ms. Crammond said of DOXA’s choice to include the group.

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“In the news and media, we see a lot of experts – academics, doctors and health professionals – talk about the fentanyl crisis and about drug use and addiction more broadly. But it’s really important to engage the folks who actually live the reality of it.”

Last year was a record-breaking period for opioid overdose deaths in British Columbia: 1,723 people died from drug toxicity, a 74-per-cent increase from the previous year. This year is proving worse. The 158 suspected illicit drug toxicity deaths that occurred in March represent a 41-per-cent jump from March, 2020.

In an essay accompanying the program, VANDU’s board writes that it selected the four films as a way to represent its members accurately: “not as poor, downtrodden victims of drugs and addiction, but as a community [of] people struggling to survive, and people fighting back.”

“We wanted to select films that would raise important questions, not only about our oppression, but about our liberation,” they write. “How do drug users organize and fight back against the drug war? How are drug user movements woven into other movements of poor and oppressed peoples? What does liberation look like for people who use drugs?”

One of the films addresses these questions through a history of VANDU itself. B.C. filmmaker Nettie Wild’s 2002 documentary, Fix: The Story of an Addicted City, showcases the drug-user activism that led the organization’s pioneers to set up North America’s first supervised drug-use site: Vancouver’s Insite.

“I think it’s really necessary viewing for all citizens of Vancouver,” Ms. Crammond said.

“You see VANDU activists occupying City Hall and talking to the mayor, and you see how that sort of advocacy actually does lead to change. That’s a big part of the story that we don’t get to see on social media and in newspaper articles. It’s a great foundation for people who may not be familiar with these issues to learn about them.”

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Supervised drug-use sites are only one treatment strategy in the larger approach to substance use disorder. As opposed to the classic abstinence-based model, harm-reduction policies do not demand that drug users stop using, but rather offer more feasible and holistic alternatives, such as opioid agonist therapy.

Vancouver-based director Elle-Máijá Tailfeathers’s latest film, Kimmapiiyipitssini: The Meaning of Empathy, is also part of the War of Drugs program. Ms. Tailfeathers returns to her home in the Kainai (Blood) reserve in Alberta to document the struggle her community members have faced with the opioid crisis.

Ms. Tailfeathers follows, among others, her own mother, Esther Tailfeathers – one of the reserve’s only physicians – and her efforts to provide harm-reduction options for residents. The film highlights drug users who have chosen to pursue harm-reduction therapies and also support networks, such as culturally specific healing centres and overdose patrol groups.

“When the crisis hit several years ago, I would hear about what was happening in the community from my mom. Witnessing all the grief, I just felt that I had to do something,” Ms. Tailfeathers said. The project, which took several years to make, required in-depth research into harm reduction and resistance to it.

“I understand why people believe that abstinence-based treatment is the golden standard, and why that’s the model that is most widely accepted, especially in Indigenous communities. It comes from a place of pain, trauma and loss, and of knowing what it’s like to lose a loved one, primarily to alcohol-related addiction,” she said.

“When it came to trying to further the conversation around harm reduction, I had to position myself within that understanding, and show respect for the multitude of voices in my community.”

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She said she hopes that by centering the experiences of Kainai’s residents and showing that harm-reduction strategies do actually work, she can increase understanding of the approach, as well as people’s empathy and respect for drug users.

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