Cumulative & Collective PTSD
On April 14th 2016, the province of British Columbia declared a public health emergency, due to the rise in opioid-related overdose deaths. While it is the only province to declare a public health emergency, provinces across Canada have been mired in an overdose crisis of their own. Activists, frontline workers, and people who use drugs have had to witness their friends, family members, and their community members die for years; COVID-19 has only made the crisis worse.
"There's this cumulative PTSD that the whole community is suffering together in. You know what I mean. It's a group of people that all have this stress disorder and the whole Downtown Eastside has this stress. It's not just an individual case of PTSD. It's like the whole goddamn city has it and it's sort of all integrated and that is making for a really really hard situation."
With multiple public health crises co-occurring, one of our members has referred to this incident as a 'syndemic,' an event where "multiple health and social issues intersect and interact to worsen or accelerate disease progression and social outcomes." Yet, other than the pandemic supply (of non-toxic drugs in BC), the public health response to COVID-19 has been completely at odds with the overdose crisis. This did not have to be the case (see our section on Acts of Resilience). Making matters worse, the response to COVID-19 has completely changed the local drug supplies of many places due to international lockdowns, leaving people with few options:
"I think there's a shift. I've seen people seem to be a little more irritable. That's one. People seem to be, you know, like you know, even some, a couple people I spoke to say...they told me, you know, like dope is harder to get for what they're looking for, so that depresses them. You know, then they say, 'if I don't do this, what's the other choice I have. Should I go to alcohol?' [...] the market is flooded with analogues. Since COVID, they have really gotten worse. It was there, but it wasn't as rampant. Now, it's so bad now. Wheras you have more analogues than anything else."
Novel fentanyl analogues, novel benzodiazepines (or 'benzo-logues') have disrupted an already volatile drug market. One member notes that the pandemic has created a "collective PTSD," where the pain and "fatalism" can be heard from the streets:
"But I hear at night, like people are scared. People are, people are angry and there's a lot of yelling and wailing, actually wailing and, you know, it's made it difficult. It's like, it's like a five-week welly month every night. It's like the end of a five-week welly month every night. That's what the noises are. It's just horrible."
The governments of various provinces have implemented some measures in response to the risks that people who use drugs and people who are houseless face. Many provinces sought to house people in the immediate first wave of the pandemic. Yet, there were fears that this would not last, as one member notes:
"it's like if you pose a risk to us, we'll lock you - we'll put you in a hotel somewhere and pay for it, and have no problem doing it. But, you know, as soon as you - that risk goes, like too bad for you. Find your own way again. Like so to me, what does that say to the individual, and to our society in general, that we just feel like a subset of our population is just not just worth our time, right? And being somebody that's in that population, and was for a large part of my life, living homeless and, you know, precariously housed, and, you know, I know that that, being in those hotels for people, is like oh, my goodness, it's probably a godsend for a lot of them. And now to just like be like, 'Sorry, bye.'"
News articles have been referring to the overdose crisis as "Canada's other health crisis," recognizing the continual deaths that have only been exacerbated since the beginning of the pandemic, while simultaneously marginalizing its devastating impact.
"Just that they, the overdose isn't getting the attention that it should be getting. Like I said, you know, it's all over the fucking news. Everything. We can have seven deaths in one week and not a fucking word on the news about the overdose and I believe, really believe that the overdose crisis is huger than the COVID. Still is. You know. Like and it seems that people have forgotten that unfortunately."
How do we deal with the cumulative and collective PTSD in a pandemic? In May 2020, one of our members suggested this solution as the first step:
"We can solve the problem in the Downtown Eastside really really quickly, between the Portland Hotel Society with all their outlets [offering access to supervised consumption and some non-toxic drugs], even if we just market up to Crosstown [a clinic which hosts an injectable diacetylmorphine program]. Dole it out at a different building so we don't have 2,000 people in front of the same building every morning. You know what I mean.
It would just, you know, the big thing that's going to be the hassle is the government's going to want some fucking kind of security around those drugs before they're handed out and that's the big hassle about getting a secure enough... or do you do that delivery every... you have them hotshot a delivery from a main place by someone every four hours or something, you know what I mean. They do their route and they drop off all places. So I don't know all the logistics yet in my own head but I think that anything can be overcome and as I say, once I get going, I'm going to want everybody on this. You know, even yourself. You want to add something to it, let's get everybody involved who can help to alleviate, you know, before November comes again and COVID fucking kills us all next year again."