Episode 31: Love, Death and Benzodope

Image: Laura Shaver and Martin Steward pose for a picture. Laura wears a backwards Christmas-themed baseball cap. Martin wears a baseball cap, camouflage t-shirt and a skull pendant on a cord around his neck. Martin has his arm around Laura’s shoulders. (Photo: Alexander Kim)

Can Martin and Laura's fairy tale love story survive benzodope – the next lethal era of the drug war?

British Columbia has seen a surge of unusual overdoses - including Martin and Laura’s. People are passing out for hours, losing their memories, and getting robbed and assaulted. And deaths have spiked. Again.

But our community is responding. Harm Reduction workers like Trey Helten at the Vancouver Overdose Prevention Society are coming up with ways to keep people OD-ing on benzodope safe and alive – all without adequate resources or space. You can donate to Vancouver OPS here. 

Benzo contamination of the drug supply continues to get worse. Almost half of the illicit opioids sampled in B.C. now have benzos in them. More than 100,000 of us depend on this street drug supply - including Martin Steward and Laura Shaver.

After withstanding so many other crises, now Martin and Laura need to survive benzodope – a scary new challenge confronting their decade-strong relationship and their work as drug user activists.

But what do we do now that so many of us are wired to benzos? How much longer can we wait for safe supply?

Transcript

A full transcript is available here.

Call to Action and Political Demands

• Prohibition has made the drug supply unregulated, unpredictable and potentially lethal. Drug users need a safe supply - that is, access to a safer pharmaceutical version of their drug of choice; coke, meth, heroin, fentanyl, whatever. A safe supply could end the overdose crisis overnight.

• Police must stand down and stop enforcing prohibition. Enforcement makes illicit drugs stronger and more contaminated. Drug war policing is what brought us benzo-dope.

• Doctors must start prescribing benzodiazepines and opioids in combination to substitute for the illicit and potentially-lethal street benzo-dope.

• OPSs should be expanded & funded to accommodate the longer duration of benzo-dope overdoses.

• Safe supply, substitution treatment and withdrawal management services must be made available to people who are wired to benzo-dope.

• OPS workers — especially peers — should have unionized jobs with benefits.

Learning Outcomes

Crackdown episodes are frequently used as educational tools by teachers and community organizers. Please let us know if your class or group listens to our work!

Episode 31 is especially useful for exploring the following themes:

• The outsized role of peers at overdose prevention sites in responding to the poison drug crisis.

• Ruptures and changes within the illicit drug supply.

• Romantic relationships and structural vulnerability.

• Public health outcomes of the benzodope crisis on people who use drugs.

Works Cited

News stories/journal articles:

• Crawford, Robyn. “Vancouver Overdose Prevention Society blames new drug for 16 overdoses in 2 days.” Global News. July 7, 2019.

• Daflos, Penny. “B.C. paramedics understaffed by up to 40 per cent daily due to burnout, injuries, vacancies.” CTV News, November 10, 2021.

• Harris, Magdalena, Kirsten Forseth, Tim Rhodes. "'It's Russian roulette': Adulteration, adverse effects and drug use transitions during the 2010/2011 United Kingdom heroin shortage." International Journal of Drug Policy, Volume 26, Issue 1, (2015): 51-58. https://doi.org/10.1016/j.drugpo.2014.09.009.

• Hennig, Clare. “Spike in overdoses reportedly due to opioid-sedative mix that acts like’ date rape drug.’” CBC News. July 8, 2019.

• Howard, Paul et al. "Benzodiazepines." Journal of Pain and Symptom Management, Volume 47, Issue 5 (2014): 955-964.

• Jones, Jermaine D et al. “Polydrug abuse: a review of opioid and benzodiazepine combination use.” Drug and alcohol dependence vol. 125,1-2 (2012): 8-18. doi:10.1016/j.drugalcdep.2012.07.004

• Laing, Matthew K et al., “An outbreak of novel psychoactive substance benzodiazepines in the unregulated drug supply: Preliminary results from a community drug checking program using point-of-care and confirmatory methods.” International Journal of Drug Policy. no 93 3:103169 (Feb 2021): 1-4, 10.1016/j.drugpo.2021.103169.

• Melnychuk, Mark. "New Varieties of Drugs Fuel Surge in OD Deaths; Fentanyl Containing Benzodiazepine Less Responsive to Narcan Antidote." Leader Post, Oct 27, 2021. 

• Ti, Lianping and Samuel Tobias, “‘Benzo-dope’ may be replacing fentanyl: Dangerous substance turning up in unregulated opioids.” The Conversation. August 11, 2021. 

• Vescera, Zak. “B.C. harm-reduction sites, doctors struggling with new type of overdose: Benzodiazepines don’t respond to emergency treatments such as naloxone.“ Vancouver Sun, July 9, 2019.

Reports:

• Kielty, Collin. “February 2022 Monthly Report.” Vancouver Island Drug Checking Project. March 22, 2022, https://substance.uvic.ca/blog/february-2022-monthly-report/. 

• BC Centre for Substance Use Drug Checking Report February 2022 which found 37.9% of opioids tested positive for benzos in Feb 2022. The report states that the true number may be higher because of limits on drug testing technology.

• Illicit Drug Toxicity Deaths in BC January 1, 2012 – January 31, 2022 states the number of illicit drug toxicity deaths in January 2022 equates to about 6.7 deaths per day.

• Illicit Drug Toxicity Type of Drug Data: Data to February 28, 2022 BC Coroners service report links benzos to 43% of last year’s deaths.

Additional Reading

• Betsos, Alex, Jenna Valleriani, Jade Boyd, Geoff Bardwell, Thomas Kerr and Ryan McNeil. “‘I couldn't live with killing one of my friends or anybody’: A rapid ethnographic study of drug sellers’ use of drug checking.” International Journal of Drug Policy Volume 87, (2021): https://doi.org/10.1016/j.drugpo.2020.102845.

• Bardwell, Geoff, Jade Boyd, Jaime Arredondo, Ryan McNeil and Thomas Kerr. “Trusting the source: The potential role of drug dealers in reducing drug-related harms via drug checking.” Drug and Alcohol Dependence, Volume 198, (2019): 1-6. https://doi.org/10.1016/j.drugalcdep.2019.01.035.

• Ivsins, Andrew, Jade Boyd, Leo Beletsky, Ryan McNeil. "Tackling the overdose crisis: The role of safe supply." International Journal of Drug Policy, Volume 80, 102769, (2020): https://doi.org/10.1016/j.drugpo.2020.102769.

• McNeil, Ryan, PhD., Taylor Fleming M.P.H., Samara Mayer M.P.H., Allison Barker B.M.A., Manal Mansoor B.A., Alex Betsos M.A., Tamar Austin M.A., Sylvia Parusel PhD., Andrew Ivsins PhD., and Jade Boyd PhD. "Implementation of Safe Supply Alternatives during Intersecting COVID-19 and Overdose Health Emergencies in British Columbia, Canada, 2021." American Journal of Public Health 112, 04, (2022): S151-S158: http://dx.doi.org/10.2105/AJPH.2021.306692. 

• Zawilska, Jolanta and Jakub Wojcieszak. “An expanding world of New Psychoactive Substances – Designer benzodiazepines.” NeuroToxicology. 73 (2). (2019). https://doi.org/10.1016/j.neuro.2019.02.015. 

Credits

Crackdown is produced on Musqueam, Squamish and Tsleil-Waututh territories.

If you like what we do, please consider donating to the show on Patreon.

Special thanks to Sara Blyth and Trey Helton for allowing us to record at OPS. If you’d like to provide them with a donation you can do so on their website here.

Thanks as well to Hugh Lampkin for helping us remember the details from Martin’s benzo overdose. 

Our editorial board is: Samona Marsh, Shelda Kastor, Greg Fresz, Jeff Louden, Dean Wilson, Laura Shaver, Reija Jean. Rest in Peace Dave Murray and Chereece Keewatin.

This episode was conceptualized, written, and produced by Sam Fenn, Alexander Kim, Alex de Boer, Jade Boyd, Lisa Hale and Garth Mullins.

Our academic director is Ryan McNeil.
Thanks also to Martin Steward and Laura Shaver for reviewing drafts so we could get this right.

Sound design by Alexander Kim.

Original score was written and performed by James Ash. 

Academic advising and direction for this episode was provided by Professor Jade Boyd. 

Additional research by Alex Betsos. 

Thanks to Brenda Longfellow and Darkfield Radio for additional project management and production support. 

Crackdown is funded in part by the Social Science and Humanities Research Council of Canada. Additional funding for this episode was provided by the Canadian Media Fund.