A surge in drug overdoses that has spread across several provinces has prompted Vancouver firefighters to redistribute re-sources and place limits on shifts to ensure first responders on the front lines of an opioid crisis aren't overwhelmed.
Vancouver's Fire Hall No. 2, which serves the Downtown Eastside, has long been one of the busiest in North America. It used to average roughly 650 calls a month, but soaring overdose rates – largely from the growing prevalence of illicit fentanyl in street drugs – have pushed that number up to more than 1,000 in both July and August.
"We certainly are registering that it's taking a toll," Fire Chief John McKearney told city council Wednesday during an update on the fentanyl crisis.
In Vancouver, firefighters are stationed in the Downtown Eastside fire hall for 18 months at a time – a much shorter term than the standard three- to five-year terms usually worked at other halls. But Chief McKearney said the department is now looking at reducing that further, to 12 months, to avoid burnout.
Fentanyl has been blamed for a significant spike in fatal overdoses in several provinces, including British Columbia, Alberta and, more recently, Ontario. B.C. declared a public-health emergency earlier this year, while the federal government is working on a national response.
Chief McKearney's assessment came as the B.C. Coroners Service released new statistics on the growing death toll of illicit drug overdoses, particularly fentanyl.
As of Aug. 31, 488 people in the province had died of drug overdoses so far this year, an increase of 62 per cent from the same period last year, when 505 died. B.C. is expected to record the highest number of fatal overdoses this year in nearly 30 years of record keeping.
So far this year, fentanyl has been detected in about 60 per cent of all illicit overdose deaths, compared with 30 per cent in 2015.
Vancouver also confirmed the locations Wednesday of two additional supervised drug consumption sites, both in the Downtown Eastside. Vancouver Coastal Health has said it wants to add three to five sites, in addition to Insite, which was the first in North America, and a smaller site at an HIV/AIDS clinic that had been operating for years but was finally given federal approval earlier this year.
At the centre of that increase in overdoses are first-responders, including firefighters, paramedics and police officers – many of whom are now armed with the lifesaving medication naloxone, which can reverse the effects of an opioid overdose.
The fire department recently decided to borrow units from less busy halls in the city on the busiest days of the month, the week when welfare cheques are distributed.
Similarly, during particularly busy periods of the day, some units from Fire Hall No. 2 will be swapped out with units from a less busy hall – as a requirement – to get some downtime.
"We're trying to be as dynamic with this as possible," Chief McKearney said. "We have seen the mental health strain on the department."
In the six months since equipping firefighters with naloxone, members at Fire Hall No. 2 have used it 32 times. The two other fire halls that have administered it most are in Yaletown (six times) and Strathcona (five times). Vancouver firefighters have reversed a total of 51 overdoses since February.
The Vancouver firefighters' union has posted updates on Facebook, logging the number of calls received by Hall No. 2 with a plea to its management, the city and province to do more to help.
Firefighters say that, without more staff and trucks, responding to the increasing volume of overdoses is causing other parts of their service – such as business inspections, training and fire response – to take a hit.
Robert Weeks, head of the union, says he hasn't seen a proportional increase in resources to meet the city's increase in needs, especially in the Downtown Eastside.
Also at City Hall on Wednesday, Patricia Daly, chief medical health officer at Vancouver Coastal Health, confirmed the locations for two of the proposed supervised consumption sites. They are 528 Powell St., which will soon become a mental health and addictions drop-in centre, and the yet-to-be-opened Heatley Integrated Health Centre.
Applications for these two sites are expected to be submitted within a month. If approved, both sites would require significant renovations before opening.
On Tuesday, B.C. became the first province in Canada to deregulate emergency-use naloxone, meaning it can now be sold at locations beyond pharmacies, such as health-care sites, treatment centres and community agencies.
The drug, available in both intramuscular and intranasal form, reverses the effects of an opioid overdose within minutes. Naloxone administered in the absence of opioids produces no effects, meaning there is no abuse potential.
Toward the Heart, a B.C. government harm-reduction initiative, has also distributed more than 13,700 take-home naloxone kits to people who use drugs, free of charge, since it launched in August, 2012.
With a report from Wendy Stueck