Two days had gone by before anyone discovered that Neil Bakken was dead. 

The 53-year-old was an outreach worker at SOLID, a non-profit organization that provides services for drug users in Victoria. His colleague, friend, and neighbour Dave Keeler was the one who found him on Aug. 19. 

“It got to the point where my neighbour from downstairs said, ‘We haven't heard from Neil for two days,’” Keeler told Capital Daily. “And I went up to his window and got blown back by him being in a hot house for two days, passed away.”

Bakken’s life was taken by Victoria’s increasingly toxic drug supply. He is one of 80 people in the region who died between January and June 2022. Across BC, more than 10,000 people have died of drug poisoning since the province declared the crisis a public health emergency in 2016.

Wednesday, which marked International Overdose Awareness Day, saw about 150 people march from Centennial Square to the Ministry of Health building on Blanshard Street. Along with signs and chants expressing anger and demanding prescribed drug options as alternatives to the toxic street supply, the protest bore images of dozens who have died of an overdose or drug poisoning in recent years. 

Advocates from a number of local non-profit organizations also gathered in the 900-block of Pandora Ave on Wednesday afternoon to call for a range of supports they say are currently lacking: adequate safe supply, decriminalization, more drug checking services, and adequate detox and treatment beds for people seeking care.

Keeler and others say that while the toxic drug supply has been lethal for the past six years, the last two weeks have been particularly deadly in Victoria.

“Two weeks ago, we lost five people in one week,” Keeler said. This includes Bakken, another SOLID outreach worker, Paige Phillips, and Chris Schwede, who was found dead in his tent on Pandora Ave two weeks ago. 

While it remains unclear what’s causing this recent spike in deaths, Keeler and others believe that higher concentrations of xylazine—an animal sedative that can be fatal to humans in high concentrations—in the current street supply are to blame.

Irreversible overdoses

Keeler was around 13 years old when he first tried heroin, as a result of PTSD from a difficult childhood, and has been an addict since.

He says he was able to “get clean” for a while, at around age 30—he is now 46. At that point, the street supply of drugs in Victoria was less toxic. That’s what helped him stay alive long enough to wean himself off heroin. 

Then, he went through a breakup.

“I remembered what works, you know? I remembered what made me feel better [and] fell back into that again,” Keeler said. “So it's been a battle since then for me to get off medication. It’s very hard for me not to want to use and [to] work if I’m not using.”

Now, in addition to heroin, Keeler—and many other substance users in Victoria—also live with addiction to the analogs, like fentanyl and carfentanil, that dominate the street supply. After years of this tainted supply, many are now able to tolerate concentrations of up to 25% fentanyl, Keeler says. But adding xylazine to the mix makes it much more deadly.

“With xylazine, if you’re up to 0.5% [in a sample], it will be an irreversible overdose,” Keeler said.

According to Substance UVic, a program that offers drug checking services at their site on Cook Street, xylazine has been detected in the street supply for the past year. Their report for the week of Aug. 14 found six out of 36 drug samples contained xylazine, at an average concentration of 1.1%.

It’s this increasingly toxic and unpredictable drug supply that prompted Keeler and others downtown on Wednesday to urgently call for governments to offer safe supply.

Victoria city councillor Marianne Alto spoke at the Moms Stop the Harm rally, expressing her pride in the City of Victoria’s support for decriminalization and safe supply, but laid the onus for taking these steps on provincial and federal governments.

“Ultimately, we’re advocates like you and we have to depend on the provincial and federal governments to get off their duffs and work together and make changes we know have to happen,” Alto said.

In July 2021, BC committed $22.6 million over three years to funding safer supply services across the province, but drug users, experts, and advocates say those services are still not in place. An article in The Tyee from March this year found that only about 500 people have access to real replacements for the toxic street supply in BC. 

The consensus at the Wednesday rally in Victoria was clear, through chants that echoed across Centennial Square: there is no adequate safe supply, no adequate detox and treatment options, and no proper decriminalization.

A toxic cycle

A small, federally funded initiative in Victoria, called SaferVic, has been offering limited access to untainted fentanyl and prescription pharmaceutical alternatives since Spring 2021. There are no current options beyond this. 

Island Health says they are in the process of looking for service providers to deliver prescribed safer supply in Victoria, Nanaimo, and/or Comox Valley. No details on a timeline were provided, as the health authority says contracts have yet to be signed. 

“The services will provide life-saving pharmaceutical-grade medications (tablet and injectable opioid agonist therapies) as an alternative to the toxic drug supply,” Island Health said in a statement to Capital Daily. 

On the other hand, those who are looking to recover from their addiction are facing long wait times for detox beds—substance users need to go through a short-term detox process before they can apply to access the only publicly-funded long term treatment facility in the South Island region.

“People will be able to get dates into treatment quicker than they are able to get into detox, so detox ends up being the thing that’s keeping people from going into treatment,” said Jordan Cooper, director of services at Our Place Society. 

“We have an addictions worker who works in our drop-in space who does referrals for people that come in here for detox and treatment, and they're…seeing very long waits for people to get into detox.”

According to Island Health, there are 21 medically supervised detox or “withdrawal management beds” in the South Island, and 12 beds in Nanaimo.

“Occupancy fluctuates day to day,” the health authority said in their statement. “Staffing challenges as part of the Canada-wide shortage of health human resources, coupled with last-minute staff sick calls, client no-shows and early exits against medical advice contribute to not being able to use all the beds all the time.”

When someone voluntarily seeking treatment doesn’t get access soon, they go searching for the substance that will make their withdrawal symptoms go away, according to Keeler. He described what these symptoms can look like: dehydration, diarrhea, leg cramps and restless leg syndrome, cold sweats, nightmares, heavy sweating, and needing to urinate every few minutes.

“Essentially, they go back to searching for their crutch on the street there,” Keeler said.

That’s what happened to Helen’s son, who went looking for drugs after trying to find a detox bed and being told there would be a four to six week wait. Helen wrote about her situation in an email to Capital Daily and requested for her last name to be withheld out of respect for her son’s privacy.

“When your adult child comes to you and says, ‘Help me save my life,’ where do you go for help?” Helen wrote. “You call the number given only to be told, ‘Sorry, there is no bed for at least a month.’ Since then he has had a seizure from trying to detox himself… My son will die of his addiction before the province has a bed available, and it breaks my heart.”

An addict experiencing withdrawal has less of a tolerance for the stronger, toxic drugs they can find on the street, according to Keeler, which means they’re at higher risk of drug poisoning and death. This is how a lack of detox and treatment options, combined with a lack of safe drug supply, keeps people in a cycle of substance dependency that is leading to more and more deaths.

Recently, BC NDP leadership candidate David Eby proposed the idea of forcing people who overdose regularly into receiving involuntary treatment. It’s an idea that doesn’t make sense to drug users and advocates like Keeler.

“If there's space to be able to do that, then we should have space to be able to fit people in who want voluntary care as well, and we don't have that space,” he said.

‘We don’t always do it in such a vocal way’

Attendants at both the Moms Stop the Harm rally and the gathering on Pandora Ave on Wednesday had a common goal in mind: to raise awareness about the need for these interventions by being as loud as possible.

On the 900-block of Pandora Ave, workers from local non-profit organizations AVI, Peers, Indigenous Outreach Workers Network, and SOLID gathered to hold a barbecue for community members. Our Place Society set up a podium for speakers to use, in remembrance of the lives lost to the toxic drug crisis. 

Lacey Mesley, an AVI outreach worker and one of the orchestrators of the event, said the organizations typically work together to provide services, but this event was the first of its kind.

“We don’t always do it in such a vocal way. We don’t always do it in such a visible way,” Mesley said. “But we wanted to help take up space here for the people who access services down here, and we wanted to make it big and loud and proud so that people would have to ask questions and…continue to raise awareness for a war on people who use drugs that just doesn't seem to be ending.”

Mesley says they expect to have fed about 500 people on Wednesday. The event also included a harm reduction service table with naloxone kits available, a memorial wall for people to pay tribute to lost friends and relatives, Substance UVic drug checking services on site, and a cultural support tent for Indigenous people to access traditional medicines. 

She, like others, says there is no one fix for this crisis, and calls for more equitable systems of healthcare, both for people in active addiction and those seeking treatment. 

At the moment, Keeler takes three different prescription medicines to help him manage life without the stronger street drug supply he was used to. One of these is Oxycodone pills, which he has been prescribed by his doctor, and takes every few hours at night in order to sleep.

Keeler says he has been told by his doctor that he will soon lose his Oxycodone prescription, but was not told why. 

“I'm hearing that I probably will be cut off at the end of the summer, which is in a day or two,” he said. “Getting through the night is going to be a real problem. I’m probably going to work really hard not to seek something that will make me feel better again.”