Below the Radar Transcript
Pandemic Conversations: Fentanyl Contamination Deaths during COVID-19 鈥� with Garth Mullins
Speakers: Fiorella Pinillos, Am Johal, Garth Mullins
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Fiorella Pinillos 0:06
Hello, everyone. Welcome to the eighth episode of our Below the Radar Conversation Series. Today we talk with Garth Mullins, the unitarian, community organizer, host and executive producer of the podcast Crackdown. Garth and Am Johal talk about how the Fentanyl crisis in Vancouver has been affected by COVID-19. And the positive effects that listening to drug user activists can have on the safety of the community.
Am Johal 0:36
Hi there, welcome to Below the Radar, really glad that Garth Mullins could join us the host and executive producer of Crackdown. Welcome, Garth.
Garth Mullins 0:47
Hey, thanks for having Am.
Am Johal 0:48
Hey, Garth, wondering if we can just start by maybe just introduce yourself a little bit?
Garth Mullins 0:54
Well, I've been an activist around Vancouver for a long time going way back, involved in a lot of different struggles and I've also been an opioid user my whole adult life. And so for the last seven or eight years, I've been involved in, you know, activism around the drug war and trying to stop the dying from the overdose crisis.
Am Johal 1:17
Garth, I think I first met you roughly about 25 years ago when I was on the Student Union at UBC and I think you were at UVic at the time. So it's wonderful to chat with you again and seeing you through so many different struggles. But I remember meeting you in and talking with you, in the mid to late 90s, when there were a number of overdose deaths that were happening, setting records at that time, the HIV AIDS rate and all of the organizing happening at that time. And here more recently, in BC, since the public health emergency was declared in 2016, there have been over 5000 deaths associated with drugs or oftentimes referred to as overdose deaths. But really, we've had a contamination of the of the drug supply and last month during this COVID period, where things have really turned in a really negative direction, there were 170 deaths in BC, which is a, which is a record. I鈥檓 wondering if you can speak a little bit to what you see happening on the ground?
Garth Mullins 2:28
Yeah, I mean, it's funny, going back to the 90s, you know, that was the first overdose crisis that was officially declared in Vancouver. You know, so this was the mid 90s, mid to late 90s. We also had an AIDS crisis, too, we had the highest rates of infection and transmission in the industrial world. So we had two, a dual public health emergency, you know, just like we do right now. And so I guess I've been through four or so far have survived, touch wood, four public health emergencies. And back then, you know, the,
Garth Mullins 3:05
The discussion amongst activists was how do we open the safe injection site? How do we get that started? And, you know, we had to do it without permission first. So we had to open these kind of underground, unsanctioned, safe injection sites to eventually embarrass the powers into letting us have a real one having an official above ground one. And you and me even had conversations back then, about what we now call safe supply, which was people were dying from very strong heroin back then, because sometimes the strength would change and, and people wouldn't quite know. And so we, I remember a conversation you and me and other activists talking about this would be solved by there just being a pharmaceutical grade heroin that people could access. And that that demand has continued for 20-25 years on to the current overdose crisis. And last month was the worst month ever recorded in BC for overdose deaths. And we're gonna see more bad months, we're gonna see more than 200 a month dying. If there's not like sort of a big change in government policy. Really, people have just been dying my whole life, like so there have been these crises, which are officially acknowledged and sometimes capture headlines, but it's just never really stopped. And so I just see it continuing, if we don't see a change.
Am Johal 4:37
And even at the time that the Insite, the supervised injection site, was opened, it wasn't the original demand of activists it was really to move towards a heroin prescription trial because what a safe injection site or supervised injection site does that it still required drug users to buy drugs on the street
Garth Mullins 5:00
which were never necessarily safe and, and either purity or things that they were cut with, and so although it brought a level of harm reduction, it didn't deal with the core issues and, and because of all of the medical trials and other pieces that were sort of placed on it, it couldn't really be opened as a public health intervention, because it was really caught up in the academic trials that were situated. And in terms of the attempts
Am Johal 5:35
that have opened up the past few months related to safe supply. I'm wondering if you can speak a little bit to that, and how you've seen it rolling out and how effective it's been?
Garth Mullins 5:48
You know, it's such a good, history is such a good teacher, because our vision was much bigger in the 90s. And then we get these incremental things that we have to fight for and defend for years, all the way to the Supreme Court. And so all of a sudden, you remember the vision, but you're just in the trenches defending the small wins. And we're seeing something like that, again, with safe supply in miniature. So we've been saying, 鈥淟ook, everything that people are wired to, that's killing people, right now, there's a pharmaceutical version of that available probably in most pharmacies or could be very easily.鈥� That's what we need. So the best substitute for heroin is prescription heroin, the best substitute for rock that's getting contaminated is cocaine. And the best substitute for fentanyl is pharmaceutical grade fentanyl. It's being able to know the dosages and manage them yourself and drug users, we're doing this every day. So we're very, we're very aware of exactly how much we need.
Garth Mullins 6:44
So the government was, you know, starting to respond to the COVID crisis. And big things were happening, like all of a sudden, borders were closing and economies were shutting down. And a doctor called me from, who works on the Downtown Eastside. And she said, "Oh, well, if drug users catch COVID, how can they quarantine? What do they need?" And I said, "Well, drugs, you got to give them prescription supply of drugs, because we're otherwise going to be going out and scoring every day. Quarantine doesn't work." So that discussion expanded into well, maybe people who want to social distance, who don't have COVID, but could be at risk of getting it like everybody in the province at that time.
Garth Mullins 7:22
Maybe they should be able to access this too. So originally, it was going to be for one, you know, a small set of residents of the Downtown Eastside, then the Health Authority, the Vancouver Health Authority saw it and they thought maybe we could do it and then BC saw it and said well, we could do it. So so this policy moved very quickly to be BC wide. And it allows for not direct substitutions of these drugs like I talked about, you know, heroin, fentanyl, cocaine, whatever, but sort of cousins of them like hydromorphone, or dexedrine, something like that, that don't exactly replace them. So it means that people are still going to be out trying to catch that itch that they're feeling. But it could reduce things, it could stop people from feeling so dope sick and all that. And so the province rolled it out. And right away, it hit the roadblock of, of doctors and the the self regulatory bodies of doctors, the College of Physicians and Surgeons and also pharmacists and their regulatory, their self administering body, the College of Pharmacists, the majority of most of them didn't like this idea, and so just refused to do it. So it right away, hit a brick wall, and you see an emergency response. Most places in the world when you have a declared emergency, you don't put 50 people in charge, you put one central authority that everybody answers to and they say, "Okay, there's a forest fire, go put water over there, go dump foam retardant from planes over there", not like 50 people debating what to do and modeling the wind direction for six months, right, you actually get on with responding to the emergency. Well not so for drug users. There is still this diffusion of responsibility amongst different government ministries, different levels of government, different agencies or bodies representing doctors. And so in the typical non emergency government as usual process that pretty much ground to a halt or ground to a very slow forward movement
Garth Mullins 9:20
because of that diffusion of responsibility because frankly, policy says cure people or not cure people, get them to abstinence like treat them they're sick, not like here, just let them have drugs, so they don't die. That's a completely off government policy approach. So the system balked, it just wasn't ready to hear that, it was inconsistent with other government messaging and so it's not worked out. And that meant that activists as we have done before, took it into our own hands. And earlier this week, we actually distributed tested drugs to people on the corner as a direct action which is completely illegal to go give out, you know, cocaine and opium to people. But we did that.
Am Johal 10:09
That's amazing. It reminds me a little bit of that time period in the 90s, where essentially, something similar was happening that predated government sanctioned interventions. And, you know, in BC, there have been these interesting trials that have happened over time that were met, that was meant to open up this space in terms of the research. So Naomi, was a prescription drug trial, there were a lot of issues with that, in terms of when the trial ended, there wasn't compassionate access allowed. So people who were kicked off the trial on the back end, had huge challenges. Salome, was almost going to be in a similar position when the Harper government at that time, was attempting to restrict it and ended up going to the courts, where at least the people who were on the trial were able to continue. But in terms of opening it up as a public health policy that could be opened up to a wider group of people. That's really where the challenge has been and as you rightly stated, you know, this is a public health emergency that was already declared. And now COVID is imposed upon it and we see how government can act in a mass way, in terms of how it's responding to COVID. Where do you see where the political opportunities might be to move public policy in this context, given that the context, the political context on the ground is so intense, where so many people are dying on a monthly basis?
Garth Mullins 11:37
I don't think the I don't think the figures from the coroner move government, you know, the figures from the coroner have been bad for years. And it hasn't really met with change. So I don't think our deaths rate for the government. I think that those of us who are still alive, have to arm twist the government, we have to make the costs of continuing the status quo so embarrassing and inconvenient for them, that they have to do something. But like, once we die, we don't mean anything to them. And our relatives, our mothers have organized themselves into groups, and pressured government and us working with those family members together is a stronger force. But we just have to make ourselves such a pain in the ass that they want to change it. Right? We have to be more organized and more forceful in the government than the people who want things to stay the same are.
Am Johal 12:30
Wondering if you can talk a little bit about the political action last week in a way that doesn't get you into legal trouble?
Garth Mullins 12:38
Oh, yeah, I will. And I don't have to even be tongue in cheek, I personally didn't handle any drugs. And I wasn't involved in sourcing or testing them. But uh, so myself, and a lot of activists from Vancouver, and BC, sort of got together. After those coroner numbers came out after we realized we had record deaths that month and said, "Well, this is it, this is time to remember the old tactics of civil disobedience and law breaking." And that this time means let's try to find a supply of drugs that people are actually using, test them to make sure that they're safer, you know, that they're not contaminated. And just give them out, just do the thing that we've been talking about for so long. And so we did that. And there were people from some of those groups that were involved in that. And, and to be honest, it's not that big a reach because activists have for a long time now been doing that to try and take care of their friends. So people who can get access to testing equipment or using test strips, have been trying to find sources, lines of supply of drugs that are non lethal, you know, and, and to test them and then to say, "Okay, let's get all our friends together and pool the money and get them and that's it." So people have been trying to do that in an underground way. It's very risky. And so we just brought a little bit of that above ground and set up a tent, you know, on Dunlevy and Hastings on Tuesday at Two. And we had a little march, had some speakers, you know, I was one of the speakers, people marched around. And then we said, hey, "If you need something, we got it in the tent." The original idea was that heroin was sold as down and cocaine. And unfortunately, we couldn't actually find heroin that we were all the everybody who was involved in the testing was happy enough with, you know, there was contamination from benzos and stuff. So we didn't do that. So we gave out opium and cocaine. And a lineup formed as you can imagine, you know, first of all people heard this and they're like, what, what, you know, a lot of rumors go around, and when someone says, Oh, yes, somebody is giving out cocaine up the street, you'd be quite right to go. That sounds like bullshit, you know, but people came and checked it out. And the lineup was usually about 30 people long.
Garth Mullins 14:59
They'd go in, people would say, you know, give a little readout of the mass spectrometer. So you could see what what was in what you were about to get, you know, you could see what it looked like, you know, like the little don't use alone, here's where the nearest safe injection site is, which was, you know, a 30 second, 15 second walk away at VANDU. And so people were going to VANDU to use the injection room. And the lineup was, like, if you imagine when people go to get a new iPhone, or there's a Black Friday sale on a new plasma TV or something, there's like these riots at the Walmart or at the Apple Store, whatever, nothing like that. So people were hearing about free drugs and there's just like an orderly lineup, no one needed to go and say, "Oh, stop pushing", or "everyone wait", or whatever. It was just, it was a community self organizing, and, and a little demonstration of what a drug user run service can really be like, and and you know, people who were letting people into the tent and serving people were watching, you know, and there's they were making sure if they would see someone who was really young or looked what they call 鈥渙pioid naive鈥� or you know, just wasn't a user something that they could just have a little chat with the person, but there was nobody like that. So it was pretty good.
Am Johal 16:21
Garth, I'm wondering for someone who might be listening, who is very new to this conversation, hearing about prescription supply of drugs, can you sort of explain in a very basic, straightforward way, the case for why this would be good?
Garth Mullins 16:41
Yeah, I mean, if someone is joining just now, and you just heard what I said, Thank you for sticking with us this far. Because I know what that sounds like, I know that I just said, we are giving out cocaine, our solution to the drug problem is to give out cocaine. That sounds ludicrous. I get that. And it's like, it needs to peel back a little further what's going on. So like, I think about myself, I used heroin for a lot of my adult life, I use methadone now. But, um, the things that really messed up my life were,
Garth Mullins 17:15
You know, when I couldn't pay for it, um, when the police got involved, when it got contaminated, and it gave me trouble, or when I couldn't find a syringe or something.
Garth Mullins 17:27
When I had a good job when I was, you know, a writer or something, and I had a great connection, and I could just get my heroin every morning and do it. And it was nice and you know, clean, predictable heroin, my check was coming in my life was really calm and normal, is was just like, unchaotic. The chaos came because of the fact that what I was doing was illegal. That's what was disrupting my life. So it's like, the laws around this thing Were really bad. And so it made this thing sometimes, you know, the police came and arrested the person who was supplying my dealer, and that threw my life into chaos, because then I couldn't get what I needed anymore. And you're dope sick. So you may think, okay, sure, sure. That'd be great. Change the laws, change the world. But why don't you just stop doing the thing if it's causing that much trouble? Well, of course, I tried. I tried a lot. I never could. And I still can't. It is really inexplicably difficult to anybody who hasn't, who hasn't really tried to stop, you know. So we have to have a health policy that figures people are just going to use drugs like this is just going to happen like we could have Nancy Reagan and everybody say just say no and programs in school, it doesn't work, it's shown to not work. In fact, the more traumatizing and alienating a society we create, the more likelihood we create of people who are going to be self medicating against the damage that comes.
Garth Mullins 18:53
So at one point, we have to realize, okay, maybe the biggest goal of everything around drugs shouldn't be to lock people up, it shouldn't be to get people into abstinence, it should be to not have people die, because nothing else happens if you're dead. So and and for, for me, like I've just seen enough of my friends and community members die that that's a priority for me too. And once you're able to take out those, those ruinous factors of something's illegal, something's too expensive you don't know what's in it, it could kill you, you get arrested and go to jail for it. Once you take those things out of the mix, you have your life back, all this noise and chaos isn't in it. And you know, maybe you're one of the people who is in the Naomi or Salome project and you go every morning and you know, you get your your prescription heroin, you do it you get on with your day, and all of a sudden, you're like, "Well, I can go to work again, I can remake the connections with my family again." And I think that other jurisdictions of the world have recognized this. You know, even in the UK, they used to have prescription heroin that you can get at the local pharmacy. You know, if you were registered and part of the program. So, it's not it's not as far out and ludicrous as it may sound at first.
Am Johal 20:06
Yeah. And what are some other jurisdictions where you see good drug policy happening? I know in Switzerland, there was a prescription heroin program, Portugal and places like that we're looking at broader decriminalization and legalization. But are there some programs in other parts of the world that you think are good places, in terms of Canadian drug policy could look to?
Garth Mullins 20:32
Sure, I think those two places are a great example. Right? And they have, they have pieces of it. So when it's criminalized, that means all the things that I said happen, like you have to, you have to get arrested and go to jail and be chased around by the cops and have trouble getting it. And then you have to do it quick and furtively and your whole life, you become underground. And that means underground and, and away from the medical system and everything too. So decriminalization is a great first step, it means just taking the police right out of all this would be a huge, huge benefit. Also, groups like the Vancouver area network of drug users, which I'm a member of, have been calling to defund the VPD and defund the drug war for a very long time. And that's what a lot of what police budgets get spent on is chasing around drug users and low level drug dealers, what's the point? So stop doing that, and, and Portugal kind of has. And so that's a really good step, and they kind of have for 20 years. So that's a big step in the right direction. In Portugal, though, drugs are still illegal. It鈥檚 just different things happen to you, when you're caught with a relatively small quantity, you know, you kind of you go to the principal's office instead of going to the police station.
Garth Mullins 22:05
that does allow people to get, you know, a known quantity of something. And I think it's the combination of these two things. It's the, it's the access to a known pharmaceutical supply, and removing cops from the equation. And if you want to add on, I would say, putting people who are drug user activists who are community builders in charge of these kinds of systems instead of doctors. So outsiders, people who aren't from the life are always going to get this kind of wrong, they're always going to be not trusted by people who've been criminalized and marginalized their whole life. So, why not put people who know this stuff in the mix? You know, and I think the combination of those three things, decriminalization legalization and a community drug user driven process, would, I mean, I could end the overdose deaths overnight, it would also have the effect of ending the organized crime illicit drug supply market. So if people don't like, features of that market, that it would it would work for them too.
Am Johal 23:13
Garth, is there anything you'd like to add?
Garth Mullins 23:17
Um, you know, I guess I talked a lot about what drug user activists can do. But I'm reflecting also that these big steps forward that we talked about in the 90s, or, or now, even even Tuesday, that, that involves allies as well, people who are not drug users, people who are
Garth Mullins 23:35
researchers, activists and community supporters, and people who are like, really just as much a part of our movement as anybody else is. And that coalition of people is very powerful. So we had a tent that was giving out cocaine and, you know, 10 feet away, there was a an academic speaking about policy, you know, a researcher analyst speaking about policy, and I, I think the combination of those things is really strong. So there's a role for the Academy here on the street. And not only will it help save our lives, it will make the research so much better, it will ground truth all what you're doing. So right before I went to that event, where we were giving out cocaine, I was in a meeting inside VANDU inside of the Vancouver Area Network of Drug Users, where a researcher was coming to report back to the group their findings, and they were saying, you know, we this was the sample size, this was sort of what some of the constraints of the research and so we had a really detailed discussion about how the findings might have been colored by the methodology a little bit, and they were kind of making notes for how they could tune in on the variable we were looking for a little further next time. I just think the collaboration is really good for both parties and so I recommend that.
Am Johal 24:58
Great. Garth Mullins, thank you so much for joining us on Below the Radar and thanks for all the great work you do out in the community.
Garth Mullins 25:06
Thanks, you too Am. Thanks and thanks for the podcast. It's a, this is great.
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Fiorella Pinillos 25:09
Thanks again to Garth Mullins for joining us on this episode of Below the Radar Conversation Series. You can learn more about Garth's podcast Crackdown by clicking the link in the description. Below the Radar is created by 丁香园AV's Vancity Office of Community Engagement and is recorded on the territories of the Musqueam, Squamish and Tsleil-Waututh peoples. Stay in the loop with Below the Radar by following us on Twitter, Facebook, and be sure to subscribe wherever you find your podcast.
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