Community members are concerned about the future of a peer harm reduction education program that’s been running in its current iteration for the past year and a half on the Sunshine Coast and the future of the community that it has built.
On a sunny afternoon in mid-February, more than 30 local peers gathered for the penultimate meeting of the Sunshine Coast Street Degree program as run through BC Hepatitis Network. The program aims to empower peers working within the toxic drug emergency through education.
In the stuffy basement of Sechelt’s Rockwood Centre, a peer by the door fetched more folding chairs as people filtered in and new arrivals checked in with one another, calling greetings and some slinging jokes across the room.
BC Hepatitis Society was informed in January that the pilot project was ending and its funding would not be renewed. Vancouver Coastal Health (VCH), which funds the program in several communities, including the collaborative initial launch on the Downtown Eastside in 2017, has said the training offered through Street Degree will continue.
As of the mid-February meeting, the future of the program was uncertain and the frustration with the lack of information and consultation from the health authorities, palpable among participants.
Camaraderie
Harm Reduction Program Lead for BC Hepatitis, Jaylene Scheible opens the Street Degree session with a land acknowledgement, but it’s not the rote acknowledgement of traditional territories that’s become a corporate formality. It’s not only recognition of the shíshálh territories, but a detailed acknowledgment of the disproportionate impact of the toxic drug crisis on Indigenous people –– First Nations people died at a 6.1 times the rate of other B.C. residents in 2023, a legacy of centuries of colonial occupation, the Indian Residential School system and continued systemic racism.
The camaraderie in the room isn’t absolute; it’s realistic. You don’t leave your valuables unattended but there’s something more precious at play: life.
Anyone’s free to leave at any time to do what they need to do, says Scheible, and two people volunteer to be those who will check on folks to make sure they’re OK.
Within four months of its local inception, Street Degree was fully peer-led, fully peer-facilitated, according to Scheible. This session, led by Scheible who is herself a peer with lived experience and who worked front-line in the community, is less about skills and more about letting the community know of the defunding and for peers to ask questions and voice their thoughts. Other sessions cover skills –– such as, but not limited to, naloxone response. Everyone who attends gets an honourarium of $25 and facilitators are paid for all of the hours they work.
What is a peer?
“Peer” is a self-identity. “It's people who have lived or are in living experience with substance use, with mental health challenges, with experiences of being homeless or unsafely housed. And oftentimes it's all three of those,” Scheible told Coast Reporter.
In the room are peers who are living on the street, who are unhoused, who live in the tent encampment, who are in and out of the shelter, and peers who are in abstinence-based recovery who are still showing up in the community, there are members of shíshálh Nation and there’s space held for loss. Among the more than 130 peers who have attended Street Degree over the past 18 months, five of them have died.
Scheible names the five people who have died –– holding space for each, their family members and friends numbering among those gathered in the full room. “That's only people who have attended Street Degree,” Scheible later told me, there are more deaths within the community, including someone who died earlier that week. “We're always waiting, holding our breath, wondering who the next person is going to be.”
'Amazing' impact
John Kerpan is one of the nine peer facilitators for the Sunshine Coast Street Degree, having taken a course so he could teach the program. He has been coming to the Coast since he was two years old, went to high school here, returned in 2018 and worked on helping get a harm reduction site going.
Asked about the impact of the street degree program, Kerpan calls it “amazing.”
“Because all of a sudden we've got this momentum, and we've got so many people learning, and it's getting passed on and passed on,” he says. “We not only teach about naloxone and overdose prevention, but because they're putting benzodiazepines in [drugs] that naloxone doesn't help, we’re teaching people how to give oxygen and mouth-to-mouth to keep people alive.”
“Also, we have courses where we teach people how to help people that are having a psychotic break or maybe suicidal, so it's not just about the naloxone training,” says Kerpan. “It really is a broad scope of different courses that really help people to have tools in their arsenal to just help people on the street.
“You don't just walk by somebody that's lying there and obviously there's something wrong. The first thing to do – because naloxone can't kill somebody – so the best thing to do is give them a [naloxone] shot. And everybody should have a kit.”
Kerpan says he stopped counting at 75 people he’s saved with naloxone. “Sometimes three or four times.”
“The longest I've ever worked on somebody was 58 minutes before anybody could…I didn't have a naloxone kit, and I just kept on screaming, and finally, somebody heard me,” he says.
That person lived. But the toll is great for Kerpan. “It's really sad, and I've lost so many people.
“I actually got PTSD from it, whenever I would see people that I saved, their dead face, their purple face, would flash up,” he says. “So I had to stop for a while.”
“[Street Degree] helps people immediately,” says Kerpan. “This is something that people come into our meetings and learn, and it's something that then that night, they can save somebody's life because of what they learned.”
Peers at the meeting noted that they are often the first responders to the scene of an overdose.
“And now that we've had hundreds of people come through here, sure, it's helped, but it's not enough. It's only a start, and it's also brought a sense of community. It's brought a sense of people helping each other, looking out for each other.”
'You become friends'
Rei Sun, a 10-year veteran of security at music festivals who moved to the Coast three years ago from Vancouver says, “I'm blessed to be in a community where people are about community.”
As a caregiver, Street Degree gives Sun more understanding of the healthcare field. “This is one way to get to know the community better…and actually you become friends with some of these people…it’s very diverse in many ways.”
“Sometimes, if someone needs help on the street, I’ll go and help them, like volunteer my time,” says Sun. “I've seen a lot of people overdose in front of me, and I had to save them. I had to save them and take them home, take care of them, and do whatever I can to make sure they're breathing the next day.”
Without the program there would be a lack of skills, says Sun, “We need the skills to save lives.
“I've been doing this for a very long time but…without these courses, [we’re] learning the hard way on the streets…One small error can cause a family to lose someone.”
Learning Narcan
Cheryl McAllister moved to the Coast in 1978, and has been coming to the Street Degree program for about a year. With a longstanding opioid addiction, she’s recognized drugs were getting worse and worse over the past couple of years. She’s trying to reduce her own use so she can watch her grandchildren grow up. McAllister says she can’t count the number of times she’s had to use naloxone on someone. “My trauma’s through the roof right now, for people dying on me,” she says.
McAllister says she learned how to administer naloxone (Narcan) through the program. “If I didn't know how to do Narcan, I would have never known how to keep half these people alive.”
Should the program not be available, McAllister says, “People won't learn a lot. They won't know how to do it. I know there's a lot of people that don't know how to Narcan people."
Consultation
For Scheible the lack of consultation with the defunding rankles. “Harm reduction came and was born from the people,” Scheible later told Coast Reporter. “It was born from communities that were oppressed. It was born out of BIPOC communities, Black and Indigenous communities. And health authorities have taken harm reduction and turned it into this commodity that they think that they own.”
Scheible says while health authorities are doing public health initiatives, which is a part of harm reduction work, “what real harm reduction work is, is what we have been doing in those rooms, which is community building and relationship building.”
The camaraderie in the room wouldn’t be replicated in a non-peer led program, she said.
“We prioritize consent and self determination, and the work that we're doing is in response to injustice and stigma, and the realities of poverty, class, racism, social isolation, trauma, violence, unfair discrimination and all these social inequities affect a person's vulnerability and their capacity for dealing with drug related harm,” she added. “We change that all up in those rooms because we are breaking down our own personal stigma, our stigma within each other as a community.
“Institutions tend to operate from a fear of liability with policies and rules, and they're seeming to serve the needs of programs and agencies, not people.”
Program to continue: VCH
Coast Reporter asked Vancouver Coastal Health for an interview about the future of the Street Degree program on the Sunshine Coast. They provided the following written statement:
“VCH would like to extend our gratitude to BC Hepatitis for supporting the Street Degree in Overdose Prevention program for the past two and a half years. The program supports peers to build skills to work in overdose prevention services.
"Delivery of the program is changing from BC Hepatitis to the VCH Toxic Drug Response team. Through this change, the Street Degree in Overdose Prevention program will continue to be co-delivered by people with lived and living experience, and will continue to support peers in the lower Sunshine Coast region.
"The VCH Toxic Drug Response team originally developed and implemented the Street Degree model. The team will continue to work with community partners, including the Community Action Team, RainCity Housing, the operator of the Sunshine Coast Overdose Prevention Site, and the local VCH mental health and substance-use team to ensure the community’s overdose response remains robust.”
The Sunshine Coast Community Action Team, which disbanded more than a year ago, initially administered the Street Degree program locally. The Community Action Team is in the process of reforming, with a board and with the Sunshine Coast Resource Centre as a fiscal agent.
Closure
On March 17, this iteration of Street Degree is wrapping up with a final meeting, which is to include a closing circle and a community response video. “It's to have closure for ourselves the best way that we can, in a good way,” said Scheible.
