Whether nightclubs like it or not, illegal drug use is a very real part of the nightlife scene in Vancouver. And as the overdose crisis continues in Vancouver and across the province, it means there's a chance the drugs being used in nightclubs could be deadly.
The overdose crisis has taken more than 1,000 lives since January of last year, and while there are no confirmed opioid overdose deaths in clubs so far, the B.C. Coroners Service says it is investigating at least one suspected overdose death in a Vancouver club.
The reality is there could be more.
According to the latest numbers from the coroners service, cocaine was the most common drug to accompany opioids in people who died from illicit drug overdoses between 2012 and October of last year.
So, if fentanyl or carfentanil or W-18 can be present in almost any street drug, it means casual drug use inside of clubs could be a dangerous proposition.
Some nightclubs have taken proactive steps to keep their patrons safe from potential overdoses by purchasing naloxone kits and training their staff to use them, but those pockets of harm reduction seem to be oases in a desert of denial, stigma and fear of liability.
Too many clubs refuse to act.
At a time when naloxone kits are available in high schools in some B.C. school districts, pharmacies and funeral homes, it seems puzzling there is no consistent approach to harm reduction on the nightlife scene.
And so far, governments and industry associations have done little about it.
Stigma and Denial
Munroe Craig is an addiction expert and owner of Karmik, a nightlife and event harm reduction organization contracted by promoters to set up sanctuary spaces at events.
"The people that are considering this something that's not happening, or they don't believe this is happening in their space, they're misinformed and they're wrong," she said.
"We've responded actively to situations that could have been fentanyl overdoses. Thankfully they weren't."
Some club purveyors simply don't see supplying naloxone kits or other harm reduction services as part of their purview. Tania Richards, the director of sales and marketing for the Granville Entertainment Group, which owns The Roxy, Doolin's Pub and others, says it's neither her company's responsibility, nor within its area of expertise.
"The simple answer is no we don't. We are not trained or authorized to administer this medication. We have strict protocols and guidelines given to us by the industry and our insurance coverage," she said.
"Currently, our protocols are to call Emergency Health Services and/or 911 in case of medical emergencies as no authority has mandated we are even allowed to do this."
And it's not only a lack of action at the club level.
Industry association Barwatch represents about 35 venues in the city and was originally formed to help fight gang activity. It has since expanded its focus to include sexual harassment, sexual assault and harm reduction.
Curtis Robinson is the chair of Barwatch and a former Vancouver police officer. He said Barwatch has sponsored an information campaign on the overdose crisis, and while some members have taken steps on their own, it has not considered an overarching policy for naloxone kits or other harm reduction.
But that doesn't mean he's not open to it.
"This fentanyl thing is brand new to the conversation and we haven't been asked to do [harm reduction] yet ... but I'm sure we can probably put that on the agenda for discussion," Robinson said.
Calls for government action
Both the City of Vancouver and the province issue licences for liquor serving establishments, but so far, there is nothing in that process requiring clubs to have naloxone kits and trained personnel on hand. Craig would like to see the city add something to its licensing process.
For Paul Stoilen, operating partner with the Donnelly Group, in charge of Republic and Bar None nightclubs, the idea of including harm reduction in the province's Serving It Right training would be an easy starting point.
"It's now part of society, unfortunately, so I think this kind of training could easily be implemented into some liquor control board requirements for Serving It Right," he said.
"If you're serving alcohol, there's things that they train us to look out for and this could easily be added to that."
While government regulation on harm reduction seems like a pragmatic step for the nightlife scene, there's no sign of any movement on that front.
The City of Vancouver won't say if harm reduction will be part of its updated liquor licensing policies this spring, and on the provincial level, there's nothing in the current licensing legislation about illicit drug harm reduction.
When asked if it had any such plans for nightclubs, the ministry responsible for liquor distribution didn`t directly address the question but issued the following statement instead:
"The province does not require liquor licensed establishments to have overdose harm reductions processes or have their staff trained on administering treatment for overdoses."
Even if changes are made, advocates say regulators have been too slow off the mark, dragging their feet nearly a year into a provincial health emergency.
Without leadership on harm reduction from governments and professional associations, it appears as though pubs and clubs will have to act independently on the issue.
And for casual drug users not fully aware of the consequences of their actions in the context of an overdose crisis, the lack of a harm reduction plan could,create a life or death situation on the nightclub dance floor.