White Coat, Black Art

'I couldn't live with myself if I didn't go respond': Vancouver tenants take lead in overdose prevention

The Tenant Overdose Response Organizer (TORO) non-profit is a groundbreaking harm reduction program taking opioid overdose treatment out of the clinic and into many of Vancouver's single-room occupancy hotels by recruiting residents and drug users as caregivers. 

'People really want to become part of the solution,' says community organizer of Downtown Eastside program

Jeremy Bell prepares harm reduction kits for tenants of single-room occupancy (SRO) hotels as part of the Tenant Overdose Response Organizer (TORO) group. (Brian Goldman/CBC)

Jeremy Bell goes door-knocking in a decrepit hotel on Vancouver's Downtown Eastside.

If a tenant answers his knock, he offers food, the anti-overdose drug naloxone, and a harm reduction kit.

He strikes up conversations, encouraging tenants to take naloxone training. Those living in these impoverished downtown hotels — many of them drug users themselves — will then be able to administer the life-saving drug to people overdosing.

"There's a lot of very private people in Vancouver that — you know — you knock on their door enough times offering doughnuts and eventually they come out," he said.

Bell is a Tenant Overdose Response Organizer (TORO) on Vancouver's Downtown Eastside. It's a groundbreaking harm-reduction program that recruits residents of Vancouver's single-room occupancy (SRO) hotels as educators and first-responders to overdoses.

Over the past six months, the program has distributed 2,000 naloxone kits into private SROs, 13,000 needles, and thousands of sterile drug-use supplies, such as needles and crackpipes, to prevent spreading disease. 

Bell knocks on single room occupancy (SRO) doors in Vancouver's Downtown Eastside. (Brian Goldman/CBC)

Bell, 41, lives in a single room, much like the one he is canvassing on this day. 

He keeps naloxone in his room, and is called upon to give it on a regular basis. 

"I couldn't live with myself if I didn't go respond to an overdose when I heard about it," Bell told White Coat, Black Art's Dr. Brian Goldman.

Since joining in 2017, he estimates that he has saved over 750 people from an opioid overdose, and trained some 1,500 people on how to use Narcan kits.

A used needle bin sits next to an emergency overdose kit. (Jeff Goodes/CBC)

Becoming part of the solution

TORO, funded by the Vancouver Coastal Health Authority, started as a six-month pilot program in 2016, but three-and-a-half years later, it is still running. The program runs out of a small office on the top floor of a rundown mall on Keefer Street. 

Samantha Pranteau, a longtime resident of the Downtown Eastside, is the community organizer who supervises the TOROs.

WATCH I How to assemble a safer drug use kit

How to assemble a safer drug use kit

2 years ago
Duration 0:52
Samantha Pranteau, head of Tenant Overdose Response Organizers, demonstrates how a safe drug use kit is assembled. 0:52

"It's a really beautiful thing to witness these miracles that happen every time in SROs, where people, when they are empowered and educated, you really see that spark. People really want to become part of the solution."

While TOROs like Bell are out knocking on doors, Pranteau is in the office, loading up backpacks with kits containing the anti-overdose drug naloxone. 

According to Government of Canada data, there are more opioid deaths in B.C. than in any other Canadian province. The B.C. Centre on Substance Abuse found that 88 per cent of the province's illicit drug overdose deaths in 2017 happened inside of buildings.

The B.C. Coroners Service reported that there were 981 suspected illicit drug toxicity deaths last year. While still the highest number of opioid deaths in any province, it's a 36 per cent decrease from similar total deaths in 2018. 

'Conductors of change'

TORO's goal is to keep those numbers on a downward trend by trying to ensure people have the resources they need "because there's really nobody looking out for the folks that are in private SROs except the neighbours themselves looking out for each other," Pranteau said. 

A backpack filled with anti-overdose medication kits and drug use paraphernalia. (Brian Goldman/CBC)

According to Housing Vancouver, there are over 8,200 single-occupancy rooms spread across 172 hotels in the Downtown Eastside. Thirty to 40 per cent of occupants identify as Indigenous and they are disproportionately low income and male. 

Pranteau says that for safety reasons, TOROs work in pairs while going into the hotels to knock on doors. Sometimes they will bring residents food like pizza or bannock, or offer Indigenous cultural services, such as burning sage and sweetgrass in the rooms to help nurture healing. 

Pranteau says many of the people TORO serves are suffering multiple layers of trauma.

If people living in single rooms are given opportunity in their lives and "a little bit of space to get out of survival mode," then they can become the "conductors of change within their community."

Pranteau says 'people really want to become part of the solution' when tackling drug overdoses. (Brian Goldman/CBC)

Pranteau​​​​​, who had been coming to the Downtown Eastside since a child, says the area feels like home. 

"I feel safe here. I feel loved and welcome. I can be myself. And really, there's just nothing like the Downtown Eastside."

Prior to TORO training, Bell had taken it upon himself to walk the neighborhood's streets and alleyways to check for people who might have overdosed. 

"At the same time, I was taking care of working girls, making sure that they were safe and stocked up with condoms and whatnot."

The response to giving someone Narcan for the first time was "breathtaking," Bell said, but after years of distributing the life-saving drug he had become "numb to the experience."

"It's exponential, the amount of lives I've touched just by being part of TORO," Bell said.

Produced by Jeff Goodes, Written by Adam Jacobson

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