The Groupe de recherche et d’intervention psychosociale (GRIP) runs a free drug testing service out of a van. PHOTO: Courtesy GRIP
Inside a black van illustrated with white hexagons driving the streets of Montreal is a laboratory.
There, people who bought drugs can find out exactly what they’ll be consuming. It’s a free, anonymous service set up in the wake of the toxic drug crisis.
“I like doing this because I know I would have needed this type of service when I was younger. I have tried many things, and I wasn’t always cautious,” said Louif Philippe Laviolette.
Laviolette works as a harm reduction intervention worker and analyst for the drug-checking team at GRIP — Groupe de recherche et d’intervention psychosociale —one of the many organizations in Montréal that works to support drug users by providing harm reduction and prevention services.
GRIP’s black van is equipped with a green counter with a laptop and a medium-sized grey box with a silver tube similar to a tap. This is the FT-IR, a machine used to check substances such as heroin, cocaine, methamphetamine, MDMA, fentanyl, and benzodiazepines, among others. Only 10 mg of a sample — the size of a sunflower seed — is enough to determine the components of a substance.
“We don’t find worrisome results that often. It doesn’t mean there’s nothing else. But if I can only find cocaine in your coke, it’s kind of good news to me,” said Laviolette.
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GRIP shares the results monthly with public health authorities. They also have a partnership with Health Canada.
“When we have some suspicious samples or if we find something we’re not sure about, we send them a sample, if the person who owns the drugs allows us to take a little bit,” explained Laviolette.
In our daily lives, harm reduction is a set of practices we do to minimize risks when doing an activity, like buckling a seatbelt before driving a car or wearing a helmet when riding a bike. In the context of drug use, harm reduction is an umbrella term for practices that seek to reduce the risks of drug consumption, like educating people about consent and sexual harassment in a festive context, or encouraging them to check the substances they are going to use and learn more information about potential risks.
“We could find fentanyl in some substances, but we won’t find it in everything. It’s not that common to find it in party drugs, like MDMA or coke. It has happened once or twice in the past two years. In the downers, it is more common because it’s a contamination thing.”
The “downers” Laviolette mentioned are depressants like opioids (heroin, codeine, and OxyContin), sedative-hypnotics (Valium, Xanax, and Halcion), and tranquilizers (benzodiazepines).
From 2010 to 2015 there was an increase in diverted or illegally produced opioids in Canada. These supplies became contaminated with more potent opioids, like fentanyl and other substances, causing overdose-related deaths.
When the COVID-19 pandemic forced Canada to close its borders, it disrupted the supply chain of heroin, cocaine, and methamphetamines used by organized crime. To avoid a drug shortage, wholesalers began cutting their substances with fentanyl, which worsened the overdose crisis.
According to the Public Health Agency of Canada, there were 5,975 apparent opioid toxicity deaths last year, which means an average of 22 deaths per day — 8 per cent higher than in 2022. More than 40,000 people have died from opioid-related deaths since 2016, which is when the federal agency began collecting such data.
Across the province, Naloxone kits — a fast-acting drug used to temporarily reverse the effects of opioid overdoses — are distributed for free at pharmacies and organizations like GRIP.
“It has become normal to have it,” said Laviolette while looking at the black naloxone kits hanging from the ceiling of GRIP’s van.
Naloxone kits hanging in GRIP’s van. PHOTO: Courtesy GRIP
Advocates for a safe supply of drugs
For Félix-Antoine Guérin, Coordinator of the Community Intervention Program at L’Anonyme — another organization in Montréal that focuses on harm reduction — not having a safe and stable supply of drugs is one of the main issues in the overdose crisis. He explained the supply is changing fast to more potent substances.
“People have access to drugs that are much stronger for a set period before it changes again. We see that people overdose when these switches happen,” said Guérin.
A safe drug supply is “a legal and regulated supply of drugs with mind/body altering properties that traditionally have been accessible only through the illicit drug market,” as the Canadian Association of People Who Use Drugs says.
This is also considered a harm-reduction strategy. There are already a couple of drugs that are being distributed through safe supply, like cannabis and alcohol. For example, at a liquor store, it is possible to see where the product came from on the label, and the degree of alcohol it has.
Guérin drives around Montréal in a white van with his team connecting with people who use substances, sex workers, and unhoused people.
L’Anonyme offers a safe consumption site for drug users to prevent overdose deaths from toxic drugs PHOTO: Courtesy L’Anonyme
“People come with their own substances, which could be prescription pills that people choose to inject or could be illegally bought substances,” explained Guérin. In Safe Consumption Sites, like L’Anonyme’s van, they are able to help people when they overdose.
One of the main harm-reduction principles is to avoid using drugs alone because, according to Montréal’s Public Health Department (DRSP), 77 per cent of overdose deaths occur in homes.
The group most affected are men aged 40 to 59, a generation that has not learned to talk about their pain and take care of themselves, as Chantal Montmorency, the director of the Association Québécoise pour la Promotion de la Santé des Personnes Utilisatrices de Drogues (AQPSUD), said in an interview.
Community and compassion
A big blue pair of glasses stands out on Dr. Jean Robert’s face. He has a big nose, thin lips, and white hair surrounding the crown of his head.
He is an 86-year-old doctor at Le Dispensaire, a community health centre in Saint-Jérôme, Québec. In his eyes, harm reduction means to be accompanied with compassion. “Prevention involves very simple things in which we have to trust people who are using drugs. They don’t want to suffer, they don’t wish to die,” said Dr. Robert.
At Le Dispensaire, people can check the substances they are going to use, have anonymous STI screenings, job search support, and housing assistance, among other services. The majority of patients come from word-of-mouth. At the clinic, they use this communication system to share information that could be helpful for their patients. “When we do a test with someone who sells drugs or who has a new batch and there is Valium or benzos, it takes five minutes for everybody to know.”
Dr. Robert remembers his first patients. They were mostly unhoused women and used to gather in downtown Montréal. They called him “Médecin de Rue” — the street doctor. He chose that name as the title of a book he wrote about his experiences and reflections while working as a community doctor.
Inside L’Anonyme’s van is a safe consumption site to prevent overdose deaths. PHOTO: Courtesy L’Anonyme
Quebec’s network of community service clinics (CLSCs) was created in the 1970s to offer a range of health and social services to the people of the territory they served. After getting his degree in medicine and specializing in microbiology and infectious diseases, Dr. Robert was invited to participate in developing this network of community service centres.
He set up the Community Health Department at Saint-Luc Hospital, which he led for 20 years.
“Unfortunately, the system, capitalism, and corporatism destroyed the community health system. The first people who contributed to this were the doctors because they think they know everything, they have an answer for everything,” said Dr. Robert.
After the closure of his department at Saint-Luc Hospital, he implemented this community approach in Saint-Jérôme at the Centre Sida Amitié, now Le Dispensaire.
For Dr. Robert, community health care is based on addressing people’s needs rather than focusing on naming problems.
“A community, in the Québécois sense of the word, is a group of people from any social sector who share the same suffering,” says Dr. Robert. He thinks the official structures tend to name problems, like mortality, overdoses, or drug addiction because they are unable to satisfy the needs of the people, like having a shelter, “un abri”, as Dr. Robert said.
To him, drugs are not the cause of drug addiction. Systemic issues that obstruct people from having their needs fulfilled are the cause.
“Some people need to be cared for, but the system is not listening. The system operates on the basis of power and gives orders. The system doesn’t know what it’s like to be hungry. The system doesn’t know what it’s like to suffer.”
