Outside the doors of a St. John's safe haven for the vulnerable, a deadly word isn't far from the minds or lips of those those who use the centre.
Two men having a cigarette outside the Gathering Place talk about the risk of fentanyl, the worry on the street, and the antidote that can reverse its deadly effects.
One man tells the other he picked up a naloxone take-home kit — one of 1,200 government-funded kits distributed provincewide. Before the second man walks back inside, he tells his friend to get off drugs.
In the last two weeks, paramedics have been called to the neatly painted refuge on Military Road, where three people have had suspected overdoses on site.
"I've never seen heroin here when I was an addict," said Robyn Byrne, who was visiting the centre Wednesday.
"It's apparently quite accessible, and that's where the fentanyl is mostly."
Byrne personally knows three people who have overdosed on what's suspected to be fentanyl. In one case, she said, fentanyl was mixed in with cocaine.
Eastern Health has counted 21 opioid overdoses that appear to belong to the same "cluster." At least two have been fatal.
Risk worth the high
Byrne, who has a teenage daughter, said she's been clean for nearly two years with the help of the methadone program. She's more grateful now than ever, given what's happening on the street.
"The sad thing is, where it is a new thing here, it's the thing that everyone wants to try, unfortunately," she said.
"For a lot of people, fentanyl is a top drug that people like here."
The risk of fentanyl is worth the powerful high it gives, she said — a different perspective from the warnings by health officials and police that drug users don't always know fentanyl is mixed in with heroin or cocaine.
It's estimated about 250 people pass through the doors of the Gathering Place on a daily basis. The centre provides a safe space, food, clothing, medical care and programs.
Many of those who visit are homeless or live in less-than-ideal housing conditions. Many are hungry, need a shower, or clean clothes. Many have mental illness and addictions.
"When we look at overdose, we certainly find that people will come here in their own crisis looking for assistance," said Joanne Thompson, executive director of the Gathering Place.
No access to naloxone until last week
On any day, an emergency could happen in the centre for one reason or another, said Dr. Mari-Lynne Sinnott, who works there part-time.
She remembers one day when she received a call about someone losing consciousness. Suspecting it was an overdose, they called 911.
"I have no other option … up until last week, we didn't have Narcan (naloxone) here," Sinnott said.
"We had nothing at our disposal other than, this looks bad, we better take them to the hospital."
The Gathering Place first spoke with Eastern Health in November about getting access to naloxone. Last week, Thompson said, they received the antidote, and are hoping to get take-home kits for guests of the centre.
In the last two months, there has been a "significant increase in the number of people who come in in crisis because they're in the throes of addiction and drug abuse," Sinnott said.
"Injecting opioids, yes, but also other prescription drugs, stimulants, and it's only getting worse."
Robyn Byrne would also like to see greater access to naloxone kits, and for police to move in on those who are selling fentanyl.
"I hope they get the people who are doing it and get them off the street," she said before walking away from the centre.
"They need to pay for what they're doing. They're causing people to lose their lives."