Keys, phone, naloxone: In downtown Ottawa, the antidote to opioid overdoses has become an item some people won’t leave home without

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As the seconds ticked by, one terrible thought crossed Moira Alie’s mind: Am I watching someone die?

That morning, a man burst through the doors of St. Albans church in downtown Ottawa, like a bolt of lightning through an otherwise quiet Sunday service, shouting, “Someone’s overdosing!”

Ms. Alie, who is neither a doctor nor an expert in overdoses, jumped to her feet and rushed outside carrying six doses of naloxone, the drug that works like an antidote to opioids.

“I was thinking, ‘Oh gosh Moira, you’re actually going to have to administer,’” she recalls. “I had to pep-talk myself a little bit. ‘You can do this. You know what to do, just do it.’”

The man was lying in an alley. He wasn’t breathing and his face was turning blue.

Ms. Alie and her fellow parishioners had recently taken lessons on how to bring a person back from the brink; how to administer life-saving naloxone to someone overdosing on opioids. It was like CPR training, she figured. Good to have, but unclear when she might need it.

The answer came sooner than she thought.

The area around St. Albans, a 10-minute walk from Parliament Hill in Ottawa’s Sandy Hill neighbourhood, has become the epicentre of the city’s drug and homelessness crisis. Just a few months ago, rat poison turned up in the toxic supply of fentanyl changing hands on the streets outside the church.

Drug users who frequent a drop-in centre in the basement of St. Albans began arriving not just incapacitated from the opioids, but also bleeding from the mouth. It took a while for social workers and police to figure out what was behind it. More recently, horse tranquilizers have found their way into the mix, adding to the already deadly sedative powers of the opioids.

The opioid crisis comes to Ottawa

As Ms. Alie called 911, two other people began administering her naloxone to the unconscious man, using small dispensers designed for spraying it up the nose, for fast absorption.

Dose one had no effect. Dose two also did nothing.

From her training, Ms. Alie knew multiple doses were likely needed. As the street supply of opioids grows increasingly powerful, one or two bottles of naloxone are not nearly enough anymore.

They gave him a third dose. Then a fourth. The seconds ticked by. Still nothing. By the time they unwrapped the fifth tiny bottle, Ms. Alie was terrified they were running out.

“You’re watching someone slip away,” she says.

The fifth dose took. The man’s eyes opened, he sucked in air. The naloxone disconnected the opioid high, if only temporarily, but enough to bring him out of the comatose state.

He rose to his feet. She asked him to wait for the paramedics since the naloxone ultimately wears off, giving the opioids a chance to regain control. But he refused, disappearing down a side street. He looked to be in his 50s and possibly homeless, but she couldn’t tell. Ms. Alie never forgot the man, though. She helped save his life, but she never got his name.

At St. Albans, they’ve coined a term for these incidents: revivals. And these days, the revivals are happening with chilling regularity.

Since the congregation took naloxone training in March, there’s been seven outside St. Albans. But that number is quite modest. At the drop-in centre beneath the church, where some of Ottawa’s most afflicted seek daytime refuge once the overnight shelters close, they’re doing at least one revival a day.

In a neighbourhood overrun with addiction and homelessness, St. Albans has become a bulwark against the rising tide of a crisis. The church sometimes stocks enough naloxone that paramedics will borrow kits when official supplies run dry.

People like Ms. Alie are now thrust onto the front lines. Leaving the house prompts a new mental checklist: keys, phone, naloxone. Just to make sure it’s never left behind.

Leah Seabrook did her first revival on Easter weekend. As she was walking up Daly Avenue that Saturday afternoon, she came across a man slumped against the red wooden door of St. Albans. She could see a few white pills on the ground. He’d collapsed while taking them.

It took two doses of naloxone to bring him back, a small amount compared to other revivals, and it was like watching someone wake up suddenly. “He was like, whoa, what happened?” she says.

He was young, maybe 25, possibly a student. He left in a hurry, still groggy but unwilling to stay.

Like many in the congregation, Ms. Seabrook took the training fearing if she didn’t, someone could die on their steps. “Just a matter of time,” she says.

She carries the naloxone in her purse and wonders whatever happened to the man she helped.

“I do think about it,” she says. “Was this the moment that changed his life? Was this the moment that just kept him alive a little bit longer until the moment that changed his life? Or is he, you know, one of the statistics?”

When she found him, his backpack and a few pieces of mail were scattered at his feet. One of the envelopes had a name on it.

“Whether it’s his name or not, I don’t know,” she says. “But that’s the name I associate with him.”

She won’t say what it is. That she keeps to herself.

As Ms. Seabrook walks around Sandy Hill, she sometimes spots the empty plastic wrappers for naloxone lying on the ground. The doses are handed out by nearby drug stores and used by those who frequent the area. It’s very specific packaging; hard to miss if you know what you’re looking at.

Some people see litter. But to her it’s something else.

“Whenever I see them, I think, okay, somebody’s life was saved here.”