MONTREAL -- Advocates who work with Montreal's homeless community and on reducing harm among drug users are concerned about the major increase in overdoses in the city since the COVID-19 pandemic began.

On Friday, several social media posts highlighted the death of a young woman named Flo, who apparently overdosed outside the Hotel Dupuis, which has been housing homeless people during the pandemic. 

Welcome Hall Mission CEO Sam Watts (who runs the Hotel Dupuis site) said she was not the first overdose victim in recent weeks.

Ambulances, he said, show up at Place Emilie-Gamelin across the street regularly, and overdoses have spiked during the pandemic.

"It's a very vulnerable clientele," said Watts, who said the hotel receives about 360 people per day. "These are people who are struggling with a variety of issues that could be mental health, could be drug or alcohol addiction, or a variety of other behavioural disorders. And so, from time to time we will see people who who end up in a situation where they either have overdosed or look like they could be in some sort of medical trouble. And I think that's a concern."

Liz Singh works on the front lines with the Head and Hands Overdose Prevention Project (HHOPP) and saw the effect first hand when Montreal Public Health reported in July 2020 that the city was witnessing the highest number of overdose deaths since monitoring began in 2014.

"We were officially in an overdose crisis as of last summer so it has always been on the horizon for us," she said. "You can feel it. There's people passing away on a regular basis. So it's pretty apparent."

TAINTED SUPPLY

A major issue support workers have seen is the quality of the drugs people are using in Montreal.

"It looks like what happened is the border closure affected and made the market even less predictable," said Singh. "Because their substances are illegal, they're buying them off the black market (and) the black market is not regulated in the way that a market is, which means that you can be buying something, and it's either not the potency that you hoped for, or it's not even the thing that you hope for."

Fentanyl, both Watts and Singh said, has been turning up in more and more drugs leading to predictably dangerous situations.

"There's been a disruption to the drug supply as best as we can determine," said Watts "There are some tainted drugs that are out there, so we've seen more people die from overdoses than exposure or anything else."

ACCESS TO SERVICES LIMITED

Both Watts and Singh said it is clear the city needs more safe injection sites and other services where users' drugs can be screened and they can use in a safe environment.

"Harm reduction is an area of considerable concern today in the community," said Watts. "Not that it's the ultimate answer, but it's part of a series of answers that are necessary. We have always held sobriety as the gold standard, and it still is, but at the same time, if the person isn't alive any longer, you really can't work on sobriety with them, and so often the first step is harm reduction."

CACTUS Montreal, the safe injection site located near the Berri-UQAM metro station, provides safe injection services, but Singh said the requirement to bring the drugs in during opening hours is not always ideal or realistic for users, especially during the curfew.

"Obviously there's people all around the city using substances and they're not all going to be able to travel every time to CACTUS," she said.

Singh and other front line workers would like to see more locations across the city.

Organizations are also working to develop dope alerts for when there's a dangerous mix of drugs going around, so they can flag it.

"An organization will put on Facebook, or the city will put out an alert being like, 'Watch out for this,'" said Singh. "So we're trying to get more organized with that and get more organized about the drug tracking. Maybe experimenting with benzodiazepine testing strips, to see if that's the way that people can check their substances for benzos, but it's a scramble, and we're working with limited information and resources that helps with that."

What is key, Singh said, is being able to check drug supplies.

Watts said work was being done to improve harm reduction services prior to the pandemic, but since March 2020, those projects have stalled.

He said a plan needs to happen soon, and it has to involve a combination of health-care professionals and those on the ground working with the vulnerable populations.

"The services and so on are not equipped to be able to run anything related to services for vulnerable people," said Watts. "So they have to work with people like us because we understand what goes on on the ground."

Singh added that part of the solution is in treating drug users like people who need help and not targetting them by making it hard to provide services and support for them.

"The drug war is intentionally targeting certain people. This is a way that we're killing people," she said. "If you were really trying to help people this is not the system that you would build. This is a system that reflects your hostility towards people who use drugs."

COVID-19 CASE DROP AMONG HOMELESS

Watts added some good news, however, about the progress of the novel coronavirus among the homeless population.

"There has been a notable reduction in COVID-19 cases in the broader community of people experiencing homelessness, and we've got 1,000 people who've been vaccinated," said Watts. "I think that is a huge step and a good news story... Generally what was a problem around Christmas time, has been diminished."

He said the COVID-19 centre for homeless people in Montreal had just nine beds occupied Thursday night.

"That's the good news," said Watts. "The bad news is, we're seeing more of the drug problem."