Eight minutes

Ontario is in the midst of a deadly overdose crisis, which claims an average of seven lives every day. The accounts that follow were written by two volunteers at St. Stephen in-the-Fields, Toronto, who reversed an overdose behind the church. The diocese’s social justice vestry motion for 2025 urges the Province of Ontario to reverse the planned closure of safe consumption sites in Ontario, and to lift the ban on the creation of new sites, to expand life-saving harm reduction services to Ontarians. Without supervised consumption sites, the number of fatal overdoses will only grow.

Cera’s story

Compared to the constant rush of guests that we’d had visit us until a few weeks beforehand, this particular Sunday at St. Stephen in-the-Fields’ weekly breakfast program felt calm. There was time to catch up with regulars, sharing one another’s grand plans should we win the $80 million lotto jackpot that had yet to be claimed. Would an apartment in Rome do, or should the imaginary winnings be spent on gaining solitude on the far-off island of Skellig Michael?

Some new faces had appeared in the encampment outside the church, which had recently been under greater scrutiny from the city due to an accumulation of residents’ belongings that had been placed to block wind in the cold. As the parish hall began to quiet, Tucker and I had the chance to get some fresh air and introduce ourselves to the new neighbours while checking in with long-term residents. Taking orders for triple-triple coffees and sharing a chocolate bar found in the church kitchen, all seemed well.

Suddenly B, the youngest of the current encampment residents, called us over, his face panicked. “Someone needs your help over there – he overdosed,” he said, pointing to the narrow path tucked between the church and the neighbouring fence. We ran over to the figure who was lying face down in the mud.

I arrived first and was horrified to see that the individual, who I initially mistook for another encampment resident, was deathly pale. I crouched down beside him and tried to turn him onto his back, immediately thinking that our chances of reviving him were slim. His lips were blue, and his body provided no response to my efforts to rouse him. My right arm was in a cast past my elbow, causing me to mentally assess what I was physically capable of doing to assist Tucker, who had joined me with naloxone. CPR? No. Filling syringes with naloxone? Unlikely.

Tucker was checking for a pulse as I asked B for help filling the first syringe. Tucker administered the first nasal dose – the first of four doses before firefighters would arrive to take over the response. We waited with bated breath to see if the naloxone would reverse the overdose. After a minute and half, B passed the syringe to Tucker, and he administered the second dose while I was calling 911. It looked like the person had a nasal infection, so we hoped the injected naloxone would work better. We waited.

After a minute or two, the man took a rattly, choking breath, though his eyes did not open, and his lips and nails remained tinted blue. Feeling tentative relief, we rolled him into recovery position before administering another dose of naloxone. As I waited on hold with 911, the thought crossed my mind that this situation was only going to become more frequent should the Ontario government’s Bill 223 – The Community Care and Recovery Act – be enacted. Tucker and I had received significant amounts of training on how to respond to an overdose. Once 10 of the province’s 17 supervised consumption sites (SCSs) were forced to close, how many others would be required to be in our position? In addition to the obvious consequence of a devastating increase in the loss of life of some of our society’s most marginalized and vulnerable members, and the accompanying demand for already thinly stretched emergency response resources – as predicted by the government’s own internal reports – there would also be an increased need for community members to provide lifesaving care for one another.

It took eight minutes from the first dose of naloxone for medical personnel to arrive on scene. While the gentleman we supported ended up recovering from his near-death experience, what would have happened if we hadn’t had been there? Or if we carried only the standard two-dose naloxone kit provided by pharmacies? Or if B hadn’t seen his limp body in the cold, dark passage on the other side of some raised stairs? We were only maybe 10 meters away, but we were oblivious to the crisis until it was almost too late.

These are the sorts of questions that have been weighing on my mind. In the days that followed, I replayed the image of the man’s lifeless body frequently, recalling just how convinced I was that it was too late to save him. When I was alone, I wanted to be with others. But when with others who didn’t consciously engage in spaces where there was the potential for someone to overdose, all I wanted to do was be alone. I was angry and sad and scared. That’s not to say that I wasn’t proud of how we’d handled the situation. I was, and I feel much more confident to respond to an overdose in the future. But the awareness that the successful outcome was as much a result of luck as it was preparedness terrified me.

In its most basic form, community care consists of individuals recognizing one another as equal human beings who are understood to be holders of basic human rights. These rights include the rights to life, liberty and security of the person, as outlined in section 7 of the Canadian Charter of Rights and Freedoms. While the Government of Ontario may not currently have this understanding of care, Ontarians can choose to demonstrate care for one another. This can take form in many ways, including by carrying naloxone, supporting unhoused neighbours and notifying political representatives that you support evidence-based harm reduction policies.

We are in the midst of several colliding crises. Regardless of our differences in lifestyle, we have no choice but to live together, ideally with some sense of harmony. Do you have the skills and supplies to maintain the life of a neighbour who has overdosed for eight minutes? How would you respond if you couldn’t? These are the questions one should be asking themselves as we enter an era in which drug users’ access to healthcare becomes even more limited. Choosing to side with the oppressed and vulnerable is difficult and necessary. There will be days where it seems like the weight of the uphill battle is too heavy. But what other choice do we really have?

Tucker’s story

The first time I responded to an overdose, the person came to with one dose of nasal naloxone. This time, we required two doses to get some consistent breathing back, three for them to no longer appear hypoxic, and four for them to regain consciousness.

That pause and wait between doses – that, for me, is the stressful part. During the first one, you can hope for a quick response. As that doesn’t work, the thoughts of wanting oxygen for the person, and people who can do more, come to mind.

Thinking on it afterwards, I reflect that through my volunteering I have access to people to talk to afterward, and that this isn’t my usual day. The people who work at supervised consumption sites, I hope, have access to supports through work, along with professional distance. But B and others don’t have supports, and these are their neighbours – possibly strangers, possibly friends. With the closure of SCSs I expect there to be an increase in overdoses outside, where it will be other residents or the public that needs to respond. And that’s a better outcome; the other is that people are found too late.

Learn more about this year’s social justice vestry motion at www.toronto.anglican.ca/vestry-motion.