Angelina Ryan

The faces of fentanyl

Presence of the deadly opioid takes its toll on drug users and outreach workers on the streets of Whalley.



Her sixth child will be born in a month – if she and her baby make it that far.

But she doubts they will.

Angelina Ryan, 37, has died from fentanyl-laced heroin five times. In each life-threatening instance, she was rescued by naloxone, which reverses the effects of opioid drugs.

When Ryan ODs however, she stops breathing, starving her brain of oxygen. Every time it happens, she loses a little more of her cognitive abilities.

Her memories are damaged, her seizures increase, she passes out more often and her speech is further delayed.

She eventually reaches for the only comfort she knows – the very drug that puts her at risk of dying.

In addition to having five kids, Ryan has had 10 miscarriages.

She begins to sob when she talks about the arrival of her sixth child – due next month.

“Because of my pneumonia, I’m afraid I might not survive the labour,” Ryan says while standing outside the Front Room drop-in centre on 135A Street in Whalley on Wednesday. “They say I’m high risk as it is because of my previous pregnancies.”

Asked why she doesn’t stop using drugs, she says she did for seven years. But recovery didn’t stick.

“I quit speed, I quit heroin – to a point – but I haven’t been quite able to quit the street life,” she says, adding she’s lived on Whalley’s notorious “Strip” for 13 years. “It’s the biggest addiction, this lifestyle.”

Ryan is one of scores of desperate people on the morning of Nov. 23, Welfare Wednesday (government cheque day, when social assistance benefits are issued), who are huddled around a tent city that has become a feature of The Strip on 135A Street, between 106 and 108 Avenues.

Surrey bylaw officers conduct their daily sweep of the area, getting campers to dismantle their temporary dwellings, usually tents or lean-to shelters.

Several homeless people stand guard so their belongings don’t get taken away by authorities.

Paul Schlosser-MollerPaul Schlosser-Moller (left), 47, is one of those keeping watch over his temporary domicile and has recently taken heroin.

A fixture on Whalley’s streets, he looks like he’s aged 10 years in the last 24 months. Formerly a formidable presence in the tent city, he is now hunched over from a back injury and wears a weary expression.

With a raspy voice, he struggles to get out his words. He has overdosed four times on fentanyl-laced heroin.

“One time I was dead. I wasn’t breathing or anything,” Schlosser-Moller says. “I got Narcan (the brand name for naloxone) twice, and (a friend) slapped me in the face  and I still didn’t do anything until he said ‘cops’.”

RIP JesieHe knows there’s fentanyl in the heroin on the streets. He just hopes there isn’t too much.

“We’re lucky to find any real heroin out there, period,” he says.

Outside the front of his tent, the sidewalk is marked with coloured chalk that reads, “RIP Jesie, Nov. 19 2016,” for a friend who died of an overdose on Saturday.

“I’ve got a lot of friends that have died like that,” Schlosser-Moller says. “You never know when you’re going to get a strong batch, or even when it’s not mixed and sifted and put in properly, where you get some strong patches and weak patches in it.”

October saw the highest monthly death toll since April for drug overdoses in B.C., claiming 63 lives across the province.

The total deaths reported by the B.C. Coroners Service now stands at 622 for the year up to the end of October, up markedly from the 397 deaths in the same 10 months of 2015.

The powerful synthetic opioid fentanyl continues to be linked to approximately 60 per cent of fatalities this year.

WandaWanda (left), 48, has been living on the streets in Whalley for three years and she’s sick and tired of seeing friends die.

She feels safe from the recent spike in fentanyl-related overdoses because she doesn’t do heroin or cocaine.

However, she uses speed, and health officials are now saying fentanyl is being found in most, if not all, street drugs.

“I’m hoping it’s not on a level that’s going to make me overdose,” Wanda says. “I don’t want that to happen to me.”

Linda Fox, program manager for the Lookout Emergency Aid Society on 135A Street, carries naloxone with her at all times to respond to ODs on The Strip.

When asked if there is ever a day where responding to all the calls feels too much to bear, her answer is immediate.

“Yesterday,” she says, noting that Tuesday (Nov. 22) was a dark day in Whalley.

Service providers responded to 10 overdoses, one of which was a woman who lost her child the day before.

That followed a chaotic weekend, which also saw 10 opioid overdoses on Saturday and Sunday.

Fox has been with the Lookout organization for a few years, first in Vancouver, then on the North Shore, but arrived in Surrey last year.

Before she came to Surrey, she was never required to administer Narcan. She learned how – and hit the ground in a hurry.

Linda FoxLast year, Fox (left) heard a chain reaction of people on the street shouting “Narcan… Narcan… Narcan…,” with each call getting louder as people echoed the plea for the life-saving drug.

Without cellphones, it’ how those on the streets get the word out.

The calls led Fox to a grassy area behind the Ukrainian Orthodox Church on 108 street, where a man in his 30s or 40s lay in the grass.

His skin was a tint between ash-grey and blue, a sign of hypoxia. When Fox found him, he wasn’t breathing and had no pulse. Brain damage was likely already taking place.

Mouth-to-mouth resuscitation begins, alternating with chest compressions because his heart has now stopped.

Narcan is administered, however there’s still no pulse, and chest compressions continue.

More Narcan, still nothing.

The sequence is repeated.

An ambulance has been called and arrives on scene. More Narcan is given and compressions continue.

Finally, the addict sits up and is taken to hospital.

It’s a scene Fox and her colleagues see over and over, but she says it’s an experience that staff never really become accustomed to.

She says the street people are like family and the thought of losing them is hard. Critical incident teams are on hand for staff de-briefings.

Twice on Tuesday, Fox was overcome with emotion and had to call her superiors to vent.

When she was finished, she packed up her Narcan and went back out there.

Keir MacDonald, deputy executive director for Lookout Emergency Aid Society, says there are no easy answers to the escalating drug crisis, but without a multi-pronged approach to the issue, the future doesn’t look great.

“The sad part is, I don’t see it turning around,” MacDonald says.

Narcan

 

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