Cassandra Smith battles a crisis within the Black community where drug overdoses and poisonings are hidden in plain sight. There has been unprecedented overdoses deaths in Toronto in the last year. As a harm reduction specialist, she takes a client-centred approach to reduce the health and social harms connected with drug and substance use, without necessarily requiring people who use drugs to stop using them.
In this episode, Cassandra draws attention to the need within the Black community for more satellites sites . These are harm reduction sites run out of people’s homes, places where there’s overdose information, harm reduction kits, support and space to talk without judgement.
According to the Canadian Mental Health Association, overdose prevention sites have been known to reduce costs for the health care system, prevent blood borne illnesses such as HIV or Hepatitis C, helps individuals access support services and prevent overdose deaths. In addition, research shows that the existence of an overdose prevention site in a community does not lead to increased crime, and works to decrease public substance consumption. These facilities are helpful in reducing the harms related to substances, particularly opioids.
WARNING! This podcast episode contains discussions about drug use, overdose deaths and anti-Black racism which may be triggering to some audiences. Audience discretion is advised.
So as we're looking at spaces where harm reduction supplies and supports are provided, so there are agencies that are contracted as harm reduction distribution programs,and they'll have all the supplies and naloxone.L Lovell:
Naloxone is a medication used to reverse the effects of opioids. It's usually used when somebody stops breathing as in opioid overdose.Medication is part of a series of harm reduction practices happening throughout Toronto. As part of a series of community outreach programs kits are given to drug users. Some of these outreach efforts happen through satellites created and operated by people who use drugs.Welcome to facing addiction, I'm Lana Lovell, your host, just a reminder, this podcast contains discussions around racism, and drug use, which may be triggering to some audience members. We encourage you to care for your own mental health and well being. If anything you hear in this podcast is triggering for you. Please go to the website, workman arts.com for a list of mental health resources. For this episode,we're talking mostly about satellites.Cassandra:
So as we're looking at spaces where harm reduction supplies and supports are provided, so they're agencies that are contracted as harm reduction distribution programs,and they'll have all the supplies and naloxone. But what other people do is they have satellites in their homes. Some of them are funded. So they partner with organizations that are mostly located downtown,that have accessed funding for his harm reduction satellites.And it's a community member that will have their units available for folks that want to use in the space. They're trained in overdose prevention and response. They'll have, you know, a drawer in their house with some safe supplies, the food bank might stocked them up with some extra snacks, soups things because they know they'll have visitors. And those are satellite workers. So we have a few on Weston road. And there are also some houses that people work out of. And they've actually needed a lot more support during COVID Because they haven't been able to access condoms and other supplies as they needed them. So we actually stocked people up like whole overstock them, we'll make sure they have more than enough,right, we'll hear concerns about over the people sell them and,you know, you think about things that people do for survival.L Lovell:
It's West Toronto,late on a very cold winter night. But I've turned off the heater in the car because the sound with the fan interferes with our sound recording. I'm driving in my car with Cassandra Smith, Harm Reduction Specialist with Black Cap, the Black Coalition for AIDS prevention.She began this harm reduction work as a teenager,Cassandra:
I was an awkward kid,I don't like being the center of attention. And speaking to rooms of hundreds of people. That definitely just threw me out of my comfort zone. But I think the challenge also motivated me to see how far I can go. We weren't handing out safer drug use kits,we were handing out condoms, not knowing that that was harm reduction. AndL Lovell:
When you were 17?Cassandra:
When I was 17. But we built, we built the awareness into like, we could respond. And we can provide support awareness around the program through connecting with other youth. And I think that's a strategy that a lot of programs have strayed away from that they need to reintroduce themselves to.Because if the youth aren't listening to their parents so that aunties and uncles, me and my grown self going up to a group of them, they're just gonna look at me like, I'm another one of their aunties.They need to see people like them and teaching them things.It actually works. So my first job in harm reduction was when I was 17. Youth clinical services partnered with Davenport Youth -Perth Neighbourhood center and they built a squad of like youth outreach workers. And their area of focus was Jane and Finch, and what they wanted to do and this is the first time I ever learned about harm reduction. They came to us as us at the community center said look, we can train you will teach you how to do outreach to other youth because we're trying to go into Jane and Finch and we're getting shot at that's what the adults were telling us. They were wearing the wrong colors pulling up in the wrong color cars, and they saw us would have better chance of getting through to other youth which it was actually a successful program. We packed goodie bags and went to the gym program so I think Friday nights, they would have like ball night, and we'd go give out our goodie bags or have condoms,little inserts of information,some gum, and other little goodies for them. And that was a way of kind of giving them what they needed without telling them or teaching them or shaking their finger at them. And that approach worked. Now that was a pilot project, we see some programs in the city taking place that are similar, we'll see like a peer to peer project.But I've yet to see another youth outreach program. That's a harm reduction program. And I think that that's a really effective approach. So that was my first coordinator position.That's when I was 17. I came back to harm reduction, I would say, eight, nine years ago working in a neighborhood and Family Center. And that's how I started working at the satellite, too.L Lovell:
It's taken decades,and after some lived experience,Cassandra has created her own lane in the field of harm reduction. Cassandra knows Black people are suffering, and she's reaching out to them. Cassandra and I are now sitting outside a convenience store where a person who operates an independent satellite lives in the basement.I'm surprised, perhaps because the storefront basements I've visited over the years, usually,for the washrooms of a barber shop or bookstore or a restaurant have not been suitable for living. Anyway,we're here because Cassandra got a call asking to visit the satellite. So she wants to check in, they need support and more supplies, things like Naloxone,It's not a long wait.Cassandra:
So it's nice to see satellites, it's nice to see that people are kind of bringing that work home and providing it after hours when all the centers are closed. So I support a couple of them along the way,along actually, in my own community here. And some of the issues that have happened recently, someone was reported as a missing person. So you know, we're getting calls about that. And someone was revived.Well, thankfully, ever overdoses reverse today. But the satellite worker is really impacted by those experiences and losing a couple of people in the past couple of months, they feel like they can't do enough, they're not doing enough. So checking in with them is really important.L Lovell:
Cassandra takes a really positive outlook on a very complex situation, with no judgment, she helps people dealing with trauma, isolation and pain. People who are open to attack from all sides, like having the real apartment taken over so that they can end up in a convenience store basement or homeless. That can happen when a drug user that gets into debt with a dealer.Cassandra:
So apartment takeover is happening a lot. We we've supported housing buildings as well, where dealers will make some type of arrangement with the tenant. The tenant will have some kind of debt. And the dealer will say, Okay, I'll be here for a week until you pay off your debt. That week turns into two weeks into a month,maybe more folks are coming in.So these are issues that working groups and committees will address as well. Sometimes we do have to involve law enforcement,because we'll see human trafficking and other circumstances that we can't handle as a program, but we tried to do as much as we can,without involving the police.But that becomes difficult with satellite workers because they're vulnerable, right?They're not they don't have the supervision of any staff.They're pretty much, you know,doing things on their own under the guidance of a program, but,you know, evenings and weekends,they're, they're pretty vulnerable. So we try to provide that support as much as we can.And I'm encouraging people all over to have satellites as well,like, it's something that some people are intimidated by this concept of being a satellite worker, but some of them are in are doing it already and don't even realize, right. So I just think it's important that we all share have the same access to information. So promoting that within the African Caribbean and Black community is important too, and letting people know that they're satellites.We're gonna pass the harm reduction programs soon. It's close to the shoppers drunk man.So once we passed this light here, on the left hand side,there's a church right before the Shoppers, and you'll just see the center right there.That's not the satellite I'm going to but I'm just showing you a program. So you'll see them on the weekends lined up for a meal program Food Bank,and I like their food bank because when their truck comes they actually just hand it out right there. So people are lined up with their carts, their buggies and they're getting there. bag is filled with groceries, as opposed to making an appointment and coming on a designated day. So we'll see a lot of harm reduction supplies being picked up on days that people come to pick up their food as well, because we look at the attention that also brings and the stigma around substance use. So people don't like accessing usually they're not comfortable accessing or picking up supplies in front of others.So they'll ask for other things to kind of be added to the bag,which picking up a food bank camper is great because then you can throw some supplies in a black bag and give them to them too and no one sees. So this respect for privacy and confidentiality is really important too.L Lovell:
The accessibility of supplies is not about catering to obsession, it's about addressing service gaps that lead to overdose death.According to the Ontario Office of the Chief Coroner, an average of 328 suspected drug related deaths were reported each month during 2021. In downtown Toronto, the need for harm reduction kits is real.Cassandra:
Actually seeing New Dealers coming in with fentanyl,and pushing fentanyl pushing opioids on people who you know,crack smokers, right? That's the drug of choice, because you'll hear you know, cracks the the poor man's cocaine or whatever.But it actually literally is.You don't see people who are waiting on a check once a month really using cocaine on a regular basis. That might be a treat, or like a partying when they get a big check or, but the regular everyday drug wouldn't be crack because it's affordable. But unfortunately,the dealers, the newer dealers are cooking the crack and putting some dangerous things together. And because people don't know what they're taking what they're buying, that's what leaves them vulnerable to overdosing. So I could smoke crack for the last 20 years. But if my dealer gets locked up, I'm going to a new dealer. And what happens I'm, I'm vulnerable to whatever that new dealer is giving me so either my body has that tolerance or it doesn't.And I won't know until I take the drug. So that's the danger that we're seeing a lot. The north end side the 200% increase in overdoses and people were like, where? Yeah, that's all the areas that didn't have a supervised consumption sites and the overdose prevention sites.That's what it is. They need one out here.