How Canada's opioid crisis is turning business owners into advocates

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Over the past year, Vancouver restaurant owner Brandon Grossutti has kept the anti-overdose drug Naloxone close at hand. Having run the chic Asian/French Pidgin Restaurant in the city's Downtown Eastside since 2012, Mr. Grossutti is accustomed to ongoing and open drug use in the neighbourhood. But with the spread of the ultra-potent opioid fentanyl, the rate and severity of overdoses in the streets and alleys near his business has gone up significantly.

"I've Narcaned six people in the last year," said Mr. Grossutti, referring to Narcan, the trade name for Naloxone, which is used to reverse the effects of an opioid overdose. "Luckily, in every case it looked like they survived."

B.C.'s Lower Mainland remains the epicentre of the Canadian opioid crisis, with nearly 700 people dying of drug overdoses in the region in the first nine months of 2017, according to the B.C. Coroners Service. But the crisis is spreading across the country, creating a new reality for street-front businesses in many cities. Employees, owners and customers are dealing with an increase in overdoses happening on business premises or nearby, as well as increased health hazards such as discarded needles.

"Businesses need to educate themselves on the opioid crisis. It's not just about selling your products. You need to be aware of the other things that could impact your day," said Mark Garner, executive director of Toronto's Downtown Yonge Business Improvement Area.

It's difficult to quantify the economic impact that the ongoing crisis is having on specific businesses or neighbourhoods, said Mr. Garner. But a number of neighbourhood business organizations across the country have noted a significant increase in discarded needles, homelessness and petty crime over several years. The fentanyl crisis, in turn, has added a sense of urgency to the need to tackle addictions and mental-health problems, and made the cost of inaction much more tangible.

In Toronto alone, paramedics responded to 69 suspected overdose fatalities and nearly 1,000 non-fatal overdoses between August and the end of October, most concentrated in the downtown area. An average of three people were dying of suspected overdoses every day in British Columbia in September, and fentanyl was detected in 83 per cent of fatal overdose victims in British Columbia in the first nine months of 2017, up from 68 per cent in 2016.

This has accelerated a change in attitudes among neighbourhood business organizations, which are feeling compelled to speak out, partner with other agencies and educate their membership on harm reduction. "Traditionally, BIAs have approached street-based issues with a focus on enforcement and limited interaction with social agencies," says the Downtown Yonge BIA in a newly released street safety strategy. This is becoming less tenable.

Leading the country in innovation is the Downtown Winnipeg Business Improvement Zone, which employs an eight-member community homelessness assistance team that walks the streets connecting people with social services, as well as a 25-member community watch team that keeps an eye out for people who are potentially in trouble. In Toronto, the Downtown Yonge BIA has developed and distributed guides which provide information on and directions to shelters and resource centres. In Vancouver, the Hastings Crossing BIA offers its member businesses de-escalation training.

"If someone comes into your store and is being erratic or demanding something they shouldn't be getting, causing customers to feel uncomfortable, instead of saying, 'I'll call the police,' you can learn their name, help them calm down, give them a few more options than just scaring them out," said Landon Hoyt, the BIA's executive director.

BIAs are also beginning to find their voices as advocates. In August, for instance, 22 Vancouver BIAs wrote a joint letter to the new provincial government imploring more investment in hydromorphone treatment programs.

"Sleeping in doorways, needles left in doorways, crime, these are all directly linked to the treatment options that people don't have access to," said Mr. Hoyt, whose BIA led the lobbying effort. "If we can get more people into the hydromorphone clinics and treatment programs, it's proven they cost taxpayers 50 per cent less in terms of policing, court costs, break-ins."

Because downtown small businesses are on the front line of the issue, they can be particularly effective advocates for the kind of systematic investment in housing and mental health needed to curb problematic drug use, said Mr. Hoyt. They also can also speak to politicians in the language of money. As the Downtown Yonge BIA puts it in its street strategy document, "this is not just a social issue. We believe social stability is central to economic growth, and reduces both the direct and indirect costs of street involvement to the district economy."

In the meantime, there are small steps individual businesses in areas struggling with drug use and homelessness can take, said Pauline Larsen, senior economic development manager with the Downtown Yonge BIA.

One of the biggest things is for street-front businesses to report incidents. That doesn't mean calling 911 every time someone is acting erratically, said Ms. Larsen, pointing out that there are a number of other numbers to call or ways to report online. But if issues go unreported, it becomes difficult to make a case for resources to be directed to a community.

"Police resources are incredibly stretched and if we have no data showing our challenges, it's hard to get more funding. If we don't report, we're disadvantaging ourselves as a business community," said Ms. Larsen.

Then there's just basic awareness and empathy. Not all employees will be comfortable using Narcan kits, but training in de-escalation as well learning about the causes of addiction can go a long way. And as Mr. Grossutti, the Vancouver restaurant owner, puts it, "be involved in the community and keep an eye out on your alleys."