Out of the shadows: Illuminating Revelstoke's overdose crisis

In 2003, a man fell asleep in an easy chair and never woke up. He was discovered the next morning by his mother.

This was the first recorded fatal overdose in Revelstoke, according to the BC Coroners Service. He died from fentanyl, which was exceedingly rare at the time.

There were approximately 200 overdose deaths in B.C. in 2003. Since then, the numbers kept increasing, forcing the province to declare its first-ever public health emergency, in 2016.

Briefly, it seemed the province was succeeding as fatalities declined in 2019 for the first time in several years.

Then a pandemic hit and overdose deaths skyrocketed.

By the end of August this year, 1,068 people had fatally overdosed in B.C., which is more deaths than homicides, car crashes, suicides and COVID-19 combined.

Mercedes and her dad Kelly Kreschuk Loeppky. When Mercedes was 7 years old and visiting her dad in Vancouver, she asked to sleep in a cardboard box, like the people she had seen on the street. Kelly wouldn’t let her sleep outside, instead setting up the box to face the window. She said she remembers waking up in the middle of the night to find he had moved her to the couch and was sleeping in the box himself. (Submitted/Revelstoke Review)

Kelly Kreschuk Loeppky, from Revelstoke, died from fentanyl poisoning in Maple Ridge on Feb. 26. He had used at a safe consumption site and staff had attempted to save him using naloxone.

As an adult he came to Revelstoke regularly to visit his teenage daughter Mercedes.

“I was talking to my dad about what he was going to do tomorrow, and he never got to do anything because drugs took his life,” she said.

Kreschuk Loeppky had plans. He was going back to school. His three daughters were going to move in with him. He was going to be a mechanic.

He wanted to stop using, but couldn’t.

“I think at a certain point they might want a different choice, but that need is so strong that the drugs choose for them,” said Lynn Loeppky, Kreschuk Loeppky’s adoptive mother.

It took two weeks for Mercedes to really believe her dad was dead. Sometimes she thinks he is just on the run from friends who would steal, or a dealer.

“He acted like this big tough guy but he really wasn’t, at all. He seems really intimidating but he’s not,” Mercedes said. “He was definitely a good dad. He made me who I am today.”

Mackenzie Ave. at night. In the 2016 census, 7,547 called Revelstoke home. (Jocelyn Doll/Revelstoke Review)

In Revelstoke, there have been 12 overdose deaths since 2003, six of which were in 2018 and three this March. While Vancouver and Surrey have seen the lion’s share of fatal overdoses, the sudden flurry of fatalities in Revelstoke landed us on the list of cities with the highest per capita rate for overdose deaths in the province.

Jill Zacharias, who has worked as the city’s social development coordinator for 12 years, said it isn’t surprising.

“Drugs are a more embedded part of culture than we think,” she said. “They’ve always been a part of Revelstoke.”

Revelstoke RCMP say the majority of illicit drugs enter the city from Highway 1.

Zacharias added that the crisis in Revelstoke is related to people who have struggled with mental health for years.

Everyone who died by overdose in Revelstoke was a resident, according to BC Coroners Service, except one.

In 2007, a semi-truck driver travelling cross-country picked up a friend in Calgary. Just after midnight, the truck broke down at a rest stop east of the city. When the driver returned from making a call on a pay phone, he found his friend unconscious.

He performed CPR for 30 minutes until the ambulance arrived, but his friend died.

The coroner’s report concluded death was caused by poisoning from cocaine and its metabolites.

How did we get here?

In 1991, there was a sharp increase in overdose deaths following a rise in opioid prescriptions.

Almost 20 years later, increased heroin use triggered a second wave of deaths. Opioid prescriptions became harder to obtain and people turned to heroin, a cheap and potent alternative.

The third wave began in 2013 and by 2016 became a tsunami, mostly due to fentanyl.

Overdose deaths in B.C. since 2003
Infogram

Fentanyl isn’t new; it was invented in 1960 as an anesthetic for open-heart surgery. It’s 50 times stronger than heroin and 100 times more potent than morphine. Since its creation, it’s used commonly to treat all sorts of pain from cancer to childbirth.

However, when used improperly, even two milligrams can kill.

Illicit fentanyl is increasingly mixed with street drugs as it’s cheap but powerful. Illicit fentanyl is a street drug produced in clandestine labs, intended to mirror the regulated prescription variety.

Of the nine overdose deaths in Revelstoke between 2003 and 2018, four involved fentanyl, while the rest were a combination of other drugs including cocaine which was the most prevalent, methamphetamine, methadone and morphine.

Seeking treatment

Dr. Lora Cruise, a Revelstoke physician who provides opioid assistance treatment, said there are those that choose treatment and those that don’t – whatever the reason.

Dr. Lora Cruise in Revelstoke is the primary physician that provides opioid assistance treatment. (Liam Harrap/Revelstoke Review)

“Nobody signs up for opioid addiction. Nobody. It’s not something people do for fun.”

Most of the time, she said, it’s to cope with trauma.

John, a long-time Revelstoke resident, was sexually and physically assaulted by a family member as a kid. He spoke to Black Press on conditions of anonymity.

He was drinking and using cannabis by age 11. In his 30s, he discovered cocaine. He got into crack cocaine in his 40s.

He overdosed three times, once after waking up, pipe still in hand, and using again.

“It’s like loading up a revolver with bullets over the years, and playing Russian roulette – eventually the whole gun is loaded.”

It took John eight years before he made it six months without drugs or alcohol. He recently celebrated his 16th recovery anniversary.

He has regained custody of his son. His third marriage is sticking. He reconciled with the bank, having previously lied about renovations in order to remortgage and get money for drugs. He is also a sponsor for others in recovery.

Dr. Cruise said she has roughly 35 patients at a time seeking opioid assistance treatment, which usually involves prescribing buprenorphine to prevent cravings.

“It’s like how the nicotine patch may work for a smoker. People can turn it around,” she said.

Then a pandemic hit

John works as a welder in Revelstoke. He has been in recovery for 16 years. (Submitted/Revelstoke Review)

Two factors that are suspected of influencing the recent increase in overdose deaths in B.C. are COVID-19 restrictions and a toxic drug supply.

“COVID-19 really threw a ringer into everything,” said Chloe Sage, from ANKORS, an outreach and support society in Nelson that offers drug checking services.

“People that were already feeling marginalized and isolated were extremely marginalized and isolated.”

Due to lockdown, people began to use drugs alone, when there’s no one to administer naloxone, a medication used to block the effects of opioids.

With borders closed and fewer people travelling, moving drugs became much more difficult, said Sage.

Not only have drugs become more expensive, but the quality has plummeted.

Though COVID-19 has exacerbated the situation, people were always vulnerable to changes in the drug supply, said Dr. Mark Lysyshyn, from Vancouver Coastal Health. Vancouver sees the highest number of overdose deaths in B.C.

One reason why overdose numbers continue to skyrocket is because the province hasn’t changed the drug supply, he said. It’s unreliable, unpredictable and might have worsened independent of the pandemic.

List of municipalities in province with the highest level of overdose deaths from a BC Coroners Service August report. In June, Revelstoke was third. By August, it was 13. (Screenshot).

Dr. Bonnie Henry released a report last year calling for the decriminalization of people who use drugs. That would mean possession of illegal drugs for personal use would not lead to prison or a criminal record. Instead, it could entice people to seek help.

“Those who use drugs, come out of the shadows. We’re here to help you,” said Henry.

B.C. Premier John Horgan supports the province’s top doctor and urged Prime Minister Justin Trudeau to decriminalize illicit drugs for personal use. The Canadian Association of Chiefs of Police also backed Horgan’s request.

However, Trudeau said decriminalization isn’t the “silver bullet” solution.

Instead, he said the federal government will focus on providing a safer drug supply.

Some parts of B.C., such as the Cowichan Valley, have launched pilot programs that provide hydromorphone, a pharmaceutical-grade opioid, as an alternative to street drugs.

Another change this year is the instruction to federal prosecutors to criminally prosecute only the most serious drug possession offences and find alternatives outside the criminal justice system for simple possession cases.

The Big Eddy Bridge at night. Dr. Lora Cruise in Revelstoke said even though there have been no overdose deaths in the city since the spring, locals are still overdosing each month. (Liam Harrap/Revelstoke Review)

Revelstoke reacts

The city recently received a grant to address mental health and substance use and contracted Community Connections to further harm reduction services in Revelstoke.

Erin MacLachlan, a member of the team said they will be updating the city’s substance use strategy, including the development and implementation of anti-stigma resources.

Lifeguard, an app developed in B.C., also launched earlier this year. Just before a person uses, they load the app, enter the drug they are using, confirm their location and press start. This kickstarts a one-minute timer, which users can snooze if needed. When there are 10 seconds left, an alarm rings, getting progressively louder. If the user doesn’t tap the red stop button, an ambulance is alerted – but police are not.

Lifeguard information sessions were hosted by Interior Health in Revelstoke this summer, as was naloxone training. Take-home drug testing strips were provided, and a cell phone was even given to a resident so they could use the app.

Interior Health said they are working on plans that could expand access to safe prescription alternatives and add new outreach workers in Revelstoke.

ANKORS, an outreach and support society in Nelson that offers drug checking services uses a FTIR with infrared spectrometry to determine a substance’s spectra. “A spectra is like a thumb print,” said Chloe Sage. ANKORS can tell what a substance is within minutes. The equipment was bought through a GoFundMe campaign.ANKORS said it has plans to visit Revelstoke this fall to drug test. (Submitted)

Revelstoke does not have outreach workers on the street, which is something Dr. Lora Cruise said could help.

However, she said providing access to naloxone is probably the single best solution.

“It should be in every public building.”

There are currently naloxone kits in the Revelstoke RCMP building and fire station, but not city hall or the community centre.

In the spring at the start of the pandemic, pharmacists in Revelstoke said there was a shortage of naloxone due to a disruption in trade and production.

Regardless, solving the opioid crisis in Revelstoke will not be easy.

“You have to take the town, where it is and what it’s ready for. It’s a small town so it needs a small town solution. What works in Vancouver might not be practical here,” Dr. Cruise said.

Mayor Gary Sulz said if there is an appetite for a local drug testing and safe consumption site, it would have to be a community-wide conversation.

Words matter

Elaine has been in recovery for a year, after using heroin in Revelstoke for seven. She shared her story on the condition of anonymity.

Stigma is the hardest thing, she said.

“I felt like they all just wanted me to die.”

According to a 2019 report by Dr. Theresa Tam, Canada’s chief public health officer, stigma starts with labels and negative stereotypes, creating an “us and them” mindset.

The stigma around substance use is driven by the inaccurate belief that it’s a reflection of poor willpower or moral failure.

Elaine started using heroin in her 20s. That year she went to 10 funerals. She lost her cousin and best friend.

When her friend offered heroin she said accepted, recalling it made her feel invincible.

“If I could do heroin every day for the rest of my life and be okay, I would.”

But her life disintegrated. She lost custody of her child and lost her job. Yet, she managed to change her life. Now, she has her child back and the trust of her family, which she said has made all the difference.

Grizzly plaza in downtown Revelstoke. Since the start of the pandemic, the number of people using illicit drugs alone has soared. (Jocelyn Doll/Revelstoke Review)

What if another lockdown returns?

The B.C. government admits many of the measures introduced to combat COVID-19 also contributed to overdose deaths. However, it has not specified what would be different if another lockdown occurs.

Chloe Sage, from ANKORS, said if another lockdown was to occur in B.C., it could be catastrophic.

“None of us have a lot of resources to deal with a second wave, because we were here for the first wave. It was emotionally devastating to go to a funeral every week.”

While Revelstoke has not had an overdose death since March, BC Emergency Health Services said paramedics get an overdose call twice per month in the community.

Need Help?

There is a list of health and community services available at revelstokelife.ca

Community Connections: 250-837-2920 or info@community-connections.ca

Revelstoke Mental Health and Substance Use: 250-814-2241

BC Crisis Line: 1-800-SUICIDE (784-2433)

Mental Health Support Line: 310-6789

Revelstoke Women’s Shelter: 250-837-1111

Revelstoke Alcoholics Anonymous: 250-837-1958

With files by Katya Slepian

Do you have something to add to this story, or something else we should report on? Email:jocelyn.doll@revelstokereview.com

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