After two weeks in Royal Jubilee Hospital with a bad bout of pneumonia, Jared had stepped outside to smoke. Not a cigarette, but a hit of “down”—the term used in British Columbia to refer to the fentanyl-based street supply. Having recently come out of a medically induced coma, Jared was in withdrawal.
“I’ve never used inside the hospital, but I know a lot of people that do,” Jared told Filter. “What is the alternative?”
The morning of November 18, a pop-up overdose prevention center (OPC) appeared on the grounds outside Royal Jubilee Hospital in Victoria, and another outside Regional General Hospital in Nanaimo. Neither has been authorized by the BC Ministry of Health. If they’re not shut down, volunteers—around 50 social workers, outreach workers, doctors and nurses altogether—should be able to run the Victoria site for three days over the course of the week, and the Nanaimo site for five days. Though the canopy tents may be something of a surprise to the provincial government, patients who use unregulated drugs have been made aware of the services.
Dr. Jessica Wilder, a family and addictions medicine doctor spearheading the pop-up at Nanaimo, said that the hospital sees overdoses on a weekly basis. Without anywhere to safely manage their withdrawal on hospital grounds, people are using alone in the bathrooms, or leaving the hospital against medical advice.
“The only difference by having an overdose prevention site on hospital grounds is that there’s somebody standing by who’s trained to respond and provide lifesaving medication if something goes wrong,” Wilder told Filter. “For my patients who are in the hospital, it allows them a safe place to go to use [and still] stay in hospital and receive the care that they need and deserve.”
In 2023, BC had plans to open sanctioned OPC outside hospitals in Victoria and Nanaimo, as well as Campbell River. But in spring 2024, amid political backlash against harm reduction—including complaints about drug use inside hospitals by members of the BC Nurses’ Union—the province rolled back its decriminalization pilot. The sanctioned OPC never materialized. The BC Ministry of Health did not respond to Filter’s request for comment.
According to outreach workers, in the week prior to the pop-ups opening at least nine people in Victoria have died of overdose. Jared told Filter that he knows two people who died of overdose while he was in the hospital. He plans to use the Victoria pop-up while it’s open, and would use forensic drug-checking services if they were available too.
In the United States, the push to legalize OPC refers to highly regulated brick-and-mortar sites that will always offer on-site forensic drug-checking with Fourier transform infrared spectroscopy. Commonly known as FTIR, this method can indicate which substances are present in a drug sample, and give at least some indication of the overall composition, without destroying the sample so that the participant still has the option of using it.
In Canada, where harm reduction services are comparatively more established, well-resourced sites authorized by the federal government are known as “supervised consumption sites,” while the term “overdose prevention sites” generally refers to lower-barrier community spaces like outdoor tents. Some of the latter have received authorization from the provincial government, but they often begin as pop-ups operating without it.
“Let’s say you’re in hospital for leg surgery and you have a nicotine addiction. Of course, we give people nicotine patches, nicotine gum, everything possible to make it so that person doesn’t have to smoke,” Dr. Ryan Herriot, a family and addictions medicine doctor who is leading the OPS in Victoria, told Filter. “Nevertheless, some people have to smoke and so they go to the smoke pit. We’re honestly trying to just do that, except the difference is that people die if they can’t do this in the same way.”
These two sites won’t have forensic drug-checking, but Herriot said it’d be a great idea if a second iteration of the pop-ups were necessary.
Both Herriot and Wilder are hopeful that the government will recognize the value of the OPC and not interfere. They’re also well aware that the current political climate is not one that favors this.
“I would be really disappointed if there were negative consequences to my career,” Wilder said. “I’m really just hoping for a conversation to come out of this, so that we can continue to work together.”
Herriot expressed a similar sentiment.
“Our hope here really is to open up a dialogue with the provincial government such that they fund this and establish this,” he said. “In a prompt way, with paid staff and permanent infrastructure.”
Photographs via Brishti Basu