'Tranq dope' making dire situation worse on the streets of Alberta, outreach workers say
179 poisoning deaths due to opioids in April, the deadliest month on record
Troy Bevans and Lauren Cameron know better than most about the realities of drug use — they've seen it from both sides.
And as the two outreach workers set out for their shift in downtown Calgary on a recent afternoon, they say it's never been this bad or this dangerous.
"Tranq dope" is taking a toll, they say.
"It's really scary out there," said Cameron, a former "chaotic" drug user trying to help people living on the city's streets.
The numbers bear it out.
Alberta poisoning deaths in April due to opioids hit 179, the highest number since the province started collecting data in 2016, according to the province's substance use surveillance system. The numbers were updated on Monday.
Weekly EMS responses to opioid-related emergencies have also been growing in frequency this year.
The weeks of June 5 and June 12 were the third and fourth highest on record, with 261 and 250 responses, respectively.
Bevans and Cameron are with the Calgary chapter of AAWEAR, which stands for the Alberta Alliance Who Educates and Advocates Responsibly.
Before they head out, they fill their backpacks with new meth pipes and straight shooters — which are mainly used for crack cocaine — along with basic necessities like hygiene kits, clothing and water.
What becomes quickly clear is there's more to this than cold, hard statistics. Real-world impacts are playing out on the streets of Calgary's downtown every day.
'If you can do it, I can do it'
Street outreach — involving face-to-face work with people living on the streets — is challenging and emotional. The workers hear stories, like from one man living on the streets who said that in the last week and a half, he knew of five people who had died.
On this afternoon, flanked by a new grocery store and the Central Library in the East Village, Bevans and Cameron approach a group of people who have gathered at the bottom of a parkade. For outreach, they often stick to two people in a group, so as not to overwhelm people.
They introduce themselves and ask what harm reduction items are needed. One woman, going through a difficult time, recognizes Bevans.
One of her friends recently passed away from an overdose, and Bevans gives her a hug.
"Troy, we came a long way, and I feel like, if you can do it, I can do it," the woman said.
"Of course you can," Bevans said.
"But it's really hard," the woman said.
Along with the gear, Bevans and Cameron have also brought with them their personal experience.
Bevans was out on the street for more than 20 years, struggling with addiction. He remembers the moment when things shifted.
"One day, I just thought about my mother, and her coming to my funeral," he said. "That started my change."
On Aug. 1, Bevans will be 13 years out of "chaotic" drug use, referring to consumption of drugs that has grown out of control. He still remembers what it was like on the street — people walking by, pretending they didn't see him.
Cameron used to live in Vancouver, where she was a chaotic user of heroin. Ten years ago, she would buy the drugs off people on the street.
"It was a lot safer 10 years ago. I wouldn't be alive right now if I was doing that now," she said.
Things have grown more complicated in recent months.
Animal tranquilizer in opioids
Increasingly, jurisdictions across North America have been monitoring the spread of adulterants — including benzodiazepines and xylazine, an animal tranquilizer — being added to opioids, like fentanyl and heroin. The U.S. Office of National Drug Control Policy designated xylazine as an "emerging threat" in April.
Xylazine isn't approved for human use but has been detected in opioids like fentanyl. Not all people who use drugs necessarily want these drugs. But having an addiction means they may be the only ones they can get at the time, which may seem preferable to being "dopesick," Bevans said.
Dopesick is a colloquial term that refers to the intense withdrawal symptoms an individual can experience when quitting opioids — physical symptoms like vomiting and seizures, and psychological symptoms like depression and paranoia.
Users who come into contact with the tranquilizer can fall into blackout states and develop agonizing wounds or "rotting flesh," sometimes requiring amputation.
"The xylazine is causing, like, these horrible wounds on people. Their skin is coming off," Cameron said. "And it's every week … there's people with these … it looks like their skin is, like, falling off of their body."
Making things worse, the effects of xylazine are not reversible by naloxone, the life-saving, overdose-reversal medication.
"People are vulnerable. They're passed out on the streets, and they get taken advantage of. Often they get raped or robbed. They're just in such a precarious situation, and so, so vulnerable," Cameron said. "It's scary."
WATCH: 'Tranq dope': Dangerous animal tranquillizer spreading in Canada's street drugs:
EMS calls close to peak levels
Bevans and Cameron head north. Soon, they meet two young men, and Cameron offers to show them a drug testing kit.
"You put a really tiny amount in it. Like a couple grains of salt, right?" she said.
Testing drugs, of course, is of increased consequence given the toxicity being measured right now. Bevans and Cameron have been seeing more people passed out on the street, hunched over, prompting the pair to sometimes give rescue breathing — something that doesn't always work because of how toxic the supply is right now.
They are also calling EMS more and more these days to revive people on the street.
While EMS calls are close to peak levels at present, provincial data on mortalities is posted only up to April 2023.
A spokesperson with the province's ministry of mental health and addiction said data on mortalities is posted after it is received by the Office of the Chief Medical Examiner, which generally takes around two months.
Still, the EMS data tends to track very closely with mortality data, according to Elaine Hyshka, an associate professor and Canada Research Chair in health systems innovation at the University of Alberta School of Public Health.
"Obviously, we have highly toxic drugs circulating right now that are causing a recent spike in overdoses causing deaths. But what exact substance or chemical is causing that spike is still an open question," Hyshka said.
"If we were taking this issue seriously, we would have public health officials out regularly, at least monthly, telling us what's circulating, what the impacts are on people, and how people can keep themselves safe."
Hunter Baril, a spokesperson with the province, said the rate of EMS responses right now "is something we are monitoring closely and demonstrates how important addressing the addiction crisis is."
"Just as we have the past four years, Alberta's government will continue to ensure that those in crisis are receiving the help and support they need," Baril said.
Back on the street, Bevans and Cameron continue their shift. The people come from all backgrounds, but Indigenous people are disproportionately affected, in Cameron's experience.
"[Due to] intergenerational trauma, due to colonial harms, not having enough cultural supports and services," she said. "It's really sad to see that."
It's clear to Bevans and Cameron that anyone could find themselves out here, and everyone out here is someone's son, someone's mother, someone's sibling.
Near the end of their shift, a man approaches the pair, who says he recently was staying at the Drop-In Centre.
The man says he used to be in the navy but fell on some hard times. However, he says he once made $90,000 a year.
The night prior, he says he saw a young man overdose near the Central Library, and by the time EMS arrived, he was gone.
"He was in major distress," the man said. "It's tough to see a man die."
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