St. Paul's OD prevention site is 1st in Vancouver outside Downtown Eastside

Kevin King guides a man through the fentanyl testing process in a blue tent in the alley behind St. Paul's Hospital.

After a brief wait, King, a self-described rocker with dyed blond hair and multiple chains dangling near his belt, shows the man a single line on the test strip, revealing that the tiny sample of drugs tested contains fentanyl.

The man says he's been using the same drugs for months and hasn't overdosed, but leaves the facility discouraged, without injecting.

King is a peer worker at the new overdose prevention site — the only such site connected to a hospital in the province, and the only spot in Vancouver outside the Downtown Eastside where drug users can inject using clean equipment under the supervision of trained professionals and peers.

Drug users can have their drugs tested for fentanyl at the facility, which opened in early May.

King has what's called lived experience — he used to smoke crack, but now describes himself as a "functioning addict" who favours meth smoking. He's on hand at the facility to work with people as they inject their drugs of choice.

"Actually, I've never used a needle during my whole time being an addict. I hate needles," said King, who estimates he's personally stopped more than 100 overdoses.

"It's a whole different story when you're saving someone's life. Putting a Narcan needle [into someone], for me, it's second nature almost," he said.

King said he's lost as many as 20 close friends to overdoses, and even overdosed twice in the last year himself — both times ending up at the St. Paul's Emergency Room.

According to Scott Harrison, director of addictions services with Providence Health Care, which operates St. Paul's Hospital, a big part of the new injection facility is engaging with drug users before the situation becomes an emergency.

The hospital handles many of the city's overdoses, and has developed a series of units that help people get addictions treatment. But Harrison said people only tend to engage after they overdose. And what was missing, he said, was the element of harm reduction.

"It's not just about enabling people to use drugs, this is [about] engaging people in healthcare, encouraging safer use and providing a safe space for people," said Harrison.

"It's a terrifying world out there for substance users currently, with the mass poisonings related to fentanyl," he said, calling the public health emergency "the new normal that isn't going away anytime soon."

A trickle of clients

Harrison said involving peer programming in the medical system — hiring people like King to work with clients and patients — is the biggest change to healthcare since antibiotics.

The facility is being operated by RainCity Housing, and for now, it's a three-month pilot relying on $50,000 from Vancouver Coastal Health.

The tent has four booths for people to use drugs — smoking anything is not permitted on St. Paul's property — and a few patio lounge chairs for people to relax and hang around afterwards.

Isaac Malmgren, who's managing the site for RainCity, said if it gets busy, people will be limited to 30 minutes in a booth. He said the facility can handle 50 visits per day and it's open from 11 a.m. until 11 p.m.

But only a trickle of people are finding their way to the discreet tent. Malmgren said about 10 or 11 people per day on average are using the facility, but he's pleased with the steady increase.

"We're seeing a lot of people come by who are really excited to be able to walk to something within their neighbourhood, close to their home, where they can feel safe using," he said.

"You can walk in off the street; you don't have to check in with any other staff. You just come straight to us and do what you need to do in the tent and feel safe doing it."

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