The drug-dealers leading a public-health revolution

On a hot Sunday in July, a woman in her late 30s called Phoenix entered an unmarked shop in downtown Vancouver and approached the counter. “I’ll have a half gram of cocaine, please,” she said. The proprietor scanned a barcode: C$33 (around $24.50), a bargain for the drug at this purity. The packaging promised unadulterated coke – “no cut/no buff” – above a warning that the product is highly addictive, may impair driving ability and should be kept away from children and pets.

Phoenix then gathered complimentary supplies from across the room: syringes, needles, paper filters, tissues and a small cooking spoon. She carried them to a sanitised metal table, where she liquefied and mixed the cocaine with fentanyl – a powerful synthetic opioid she had bought from her usual dealer – to create the rush she wanted, and drew the solution into a syringe. She jumped up and down, twirling an invisible skipping rope to improve her blood flow. Then she sat down, inserted a needle above the knuckle of her index finger and injected.

Eris Nyx, one of the store’s managers, looked on from the cash point. She runs the shop with Jeremy Kalicum, who was in the back office weighing and packaging cocaine, heroin and methamphetamine. “The fact that we’re not in jail is unbelievable,” said Eris. “I think about that every day.”

In 2015, Eris was working at a bike-repair shop when she heard that staff at a nearby homeless shelter made twice her wage. She quit to pick up shifts there instead. The next year, the province of British Columbia, where Vancouver is located, declared a public health emergency. People were dying in large numbers from street drugs tainted with fentanyl, which mimicked the effects of heroin at a fraction of the price but could be fatal even at small doses. Eris observed the drug’s prevalence amongst the shelter’s residents: “You’d have ten overdoses on your shift,” she said. Nearly a thousand people died of overdoses in the province that year, often by contaminated street drugs. Within five years, more than twice as many were dying annually.

In response, a university-affiliated, government-funded research network called the British Columbia Centre on Substance Use proposed a plan for a “heroin compassion club”. It was modelled on buyers’ collectives that were formed during the AIDS crisis decades earlier – when patients pooled funds to acquire medicinal cannabis (to ease some of the symptoms) and as-yet unapproved medications. Today, Canadian heroin users can sometimes get opioid alternatives like hydromorphone from health-care providers. But many of the most vulnerable aren’t ready to submit to the programme’s requirements for supervision and emphasis on abstinence. Those that do engage often find it physically difficult to switch from their usual supply to prescribed replacements.

A growing movement among social workers and health-care professionals wants drug policy to focus less on interventionist measures and punishment and more on what’s called harm reduction, which aims to mitigate the negative physical and social consequences of addiction. The logical conclusion of harm reduction, some believe, is an affordable, accessible store for hard drugs. “Safe supply has to be as easy as calling your guy and getting the thing you want for the price you’re willing to pay,” said Phoenix, who is a regular at the shop and asked only to be identified by her first name. The drug store run by the Drug User Liberation Front (DULF) –?as Eris and Jeremy have named their initiative –?has been running for a year. No customer has yet died of an overdose.

Eris, 32, is dazzlingly fluent, to the point of sometimes being glib and unfiltered. She alluded to a difficult home life growing up, but groaned at any suggestion that it explains why she got into this work. “I think if you see the things I’ve seen, you would be doing the same thing,” she said of the drug crisis in Vancouver. “I open my front door and there’s dead people all over the street.” She met Jeremy while planning a safe-supply conference in 2019, the year the heroin-compassion-club report came out. “At that conference, we were like, ‘Somebody better step up and do this,’” Eris said. Both are matter-of-fact about how they came to be those somebodies. Jeremy, a wry and comparatively reserved 28-year-old, told me that, before starting DULF, he planned on becoming a doctor. “I showed a lot of promise,” he joked. His career in harm reduction began when he volunteered at a needle-exchange programme to bolster future medical-school applications. (He still hopes to take the admissions exam.)

Their shop was the culmination of a long experiment: how flagrantly could they traffic clean drugs without going to jail? At one of DULF’s early events, in the summer of 2021, they gave away free drugs in a police-station car park. Officers allowed the event to carry on. A sympathetic city councillor spoke to the gathered crowd about the need for a safer supply. Eris, dressed as Willy Wonka, stood beside her, cradling packages of meth, heroin and cocaine and grinning for the cameras.

Each month, on the day the province announced the latest overdose statistics – which were dire as ever – they would stage another giveaway. But media coverage dwindled over time. The press “want escalation”, Eris said. “They’re like, come back to us when you’re going to overdose in city hall or something.”

DULF did step things up. They applied to the Canadian government for a legal exemption to procure pharmaceutical supplies of illicit narcotics and test, package and sell them, at cost, to customers in a shop. They had letters of support from doctors, addiction researchers, local politicians and the regional health authority. In July 2022 Canada’s federal health department rejected their request. The next month, Eris and Jeremy opened the shop anyway.

DULF’s store operates out of a secret location in Vancouver’s downtown eastside. The neighbourhood is relatively untouched by gentrification, and homelessness and drug use is apparent on the sidewalks. Eris and Jeremy are not aware of anyone else in the world doing exactly what they do –?at least not as publicly –?so they’ve had to devise a bespoke set of best practices. They took membership applications from would-be customers, and accepted a small group who were at high risk of overdose and were already known to existing drug-user groups – given the amount of work involved, 50 members felt like their maximum capacity. Each member participates in follow-up surveys with DULF about how the shop has changed their health and habits; researchers from the Centre on Substance Use, the group that first proposed the heroin compassion club, are helping to collate that data. (Outcomes so far appear to be positive, but data are limited given the small number of participants.) With the help of volunteers, Eris and Jeremy keep a careful count of cash and inventory. Drugs are marked with test reference numbers and stored in a time-delayed safe; this protects against robbery by remaining locked until several minutes after entering the code, which only Eris and Jeremy know. Confidential member information is kept off-site.

Police have made few public statements about DULF. Jeremy said he’s had conversations with officers, who tell him the shop is “not a priority” for enforcement. Inspector Philip Heard of the Vancouver Police Department’s organised crime unit confirmed those conversations in an interview with me. “I fully appreciate their rationale and where their heart is,” he said, but warned that “if someone is doing something that they know runs afoul of the law, then they will always potentially be the subject of enforcement.” The police have taken an inconsistent approach towards unofficial “safe supply” initiatives. In May they arrested 51-year-old Jerry Martin for trying to sell purity-tested drugs out of a trailer in the same neighbourhood; DULF’s shop, in contrast, remains open. (Tragically, Martin died two months later from a suspected fentanyl overdose.)

Garth Mullins is an organiser with the Vancouver Area Network of Drug Users (VANDU), a user-led advocacy group that was founded in the late 1990s and that helped found DULF. “What DULF does is illegal, and we know that, and the police know it,” he said, yet “nobody’s been arrested because we’ve built such a huge group of people around it.” DULF is funded by the regional health authority as an overdose-prevention site, and by the Centre on Substance Use as a research project. A facility at the University of Victoria tests its substances. The shop has received drug-law exemptions for all these measures, except the essential bit: the buying and selling. “What’s crazy is the fact that we run a fucking heroin store with quasi-sanctioning, with all these letters that are like, you can do X, Y and Z, but don’t break the law,” said Eris. “It’s enough of an exemption that if you ended up in court, it’ll be a pretty kooky case.”

Despite the summer heat, Eris was wearing thick boots, heavy camo trousers and jacket, and an army-green T-shirt when we met. It was not a subtle statement for an organisation with “liberation front” in its name. As a pair, Eris and Jeremy are difficult to categorise – they’re scientists, they insisted, not drug-dealers. “We’re like Poindexter and…” Eris searched briefly for the perfect reference, then landed on it: Pinky and the Brain, mutant lab mice from a 1990s cartoon who plot misguided schemes of world domination. “One is a genius, the other’s insane,” she said, riffing on the theme tune. “But which one is which?”

Back at Eris’s apartment, she slouched over a laptop as she scrolled through listings: “Massive cocaine and ketamine blowout sale”, read one. These, she said, were typical posts on the dark-web marketplace where DULF buys its supply. Eris makes payments with cryptocurrency – their annual purchases are estimated to be in the hundreds of thousands of dollars – and picks up the packages at the post office.

Finding a reliable vendor took time. DULF needed large volumes at cheap prices; they had to be sourced from a seller in Canada, to avoid international drug-smuggling charges, and the drugs needed to be clean. It was a process of trial and error – buyers can seek refunds by opening a dispute on the site if they receive a tainted product – before they settled on a single vendor. “Whoever this person is obviously has an operation of some kind,” said Eris.? One justification for the compassion club’s model is that it would take money away from organised crime rings by selling medical-grade products from legitimate sources. Buying drugs on the dark web from an anonymous entity undermined that argument, as the health ministry noted in its letter rejecting the pair’s shop. But lacking the necessary permits, DULF would struggle to find a pharmaceutical alternative. “I don’t know, and I don’t want to know,” Eris said of their vendor’s identity.

Drug trafficking is, of course, illegal in Canada. But laws have stretched to accommodate harm reduction in British Columbia. The Canadian government decriminalised the possession of small amounts of hard drugs there in January, to encourage people to seek health care without fear of prosecution. Few now believe that decriminalisation has made much difference to the number of drug-related deaths; Vancouver police had all but abandoned arrests for simple possession anyway, and the street supply remained toxic. Fentanyl has largely displaced heroin, and drugs are increasingly tainted with benzodiazepines, a type of depressant that is resistant to the usual life-saving overdose medications.

The window for widely implementing harm-reduction measures in Canada may be closing. The leader of the opposition Conservative Party, Pierre Poilievre, has come out against safe-supply programmes of any kind. His motion in the House of Commons to redirect funding towards addiction treatment failed in May. Recent polling has his party ahead of Justin Trudeau’s Liberals. “Conservatives in this country are giving us some real old-school drug-war talking points,” said Mullins of VANDU. But community organising has got harder as drugs have become more poisonous – benzodiazepines can cause memory problems, which makes for more confused, less productive general meetings. And people continue to die: drug deaths in British Columbia are on pace for their highest year since the crisis was declared.

At VANDU’s community space, Mullins looked across a grey meeting room, where the board convenes. The group’s mission statement – which pledges to ensure that “drug users have a real voice in their community” – is painted on the wall. Farther along are photos of dead leaders. “I never used to believe in ghosts,” Mullins said. “But I think I do now. I know so many people that have died. I sit in this room, and somebody says something, and I just know that my friend is going to have this little cliché line he always says. And I turn.” Mullins turned. “And he’s been dead for six months. So the line doesn’t get said. But I hear it. I can almost feel the guy there. So, I guess I feel haunted.”

DULF’s shop was quiet, which was typical for a weekend. Then, shortly before closing, about a dozen members turned up. Monthly welfare cheques had gone out the previous week, and noisy customers had to queue for use of the three metal tables. The shop did over C$2,000 in sales that day. Like every day it had been open, no one overdosed in the space – and no one died.

Media attention felt important to DULF in the beginning, but it made their work harder. “People look up Drug User Liberation Front, and it’s like, ‘Look at this crazy transexual bitch handing out heroin to the homeless,’” Eris said. The organisation also had trouble opening a bank account. Eris suspects her manner might put people off. “I have a folder in my email called ‘death threats’,” she confided.

DULF’s focus now is more narrow: prove the model works, and establish its legality in court. It has appealed the health ministry’s rejection of its drug-law exemption request, and is preparing its case. Precedent may be in the group’s favour. After North America’s first supervised injection site, Insite, opened in Vancouver in 2003, it was challenged all the way to the Supreme Court, but survived. Insite, too, had been preceded by an illegal proof of concept. Eris and Jeremy hope that DULF will emulate that path: a criminal enterprise one day, a public-health success the next. ■

Sam Colbert produces podcast series for The Economist

PHOTOGRAPHS BY Jackie Dives