Garth Mullins, a former heroin user, is now an advocate for drug users in his home of Vancouver
Opioid deaths have been rising again in the shadow of the pandemic, notably in the Canadian province of British Columbia, where overdose casualties have reached historic highs. Is enough being done to end this second public health crisis?
Every month or so, Garth Mullins has breakfast with his best friend. They go to the same place - an aging diner in downtown Vancouver with chipped wooden booths and neon signs. They always end up there around 1pm, talking through bites of bacon, eggs and white toast.
"And I always think, 'Is this the last time I'm going to get bacon eggs with him?'" Mullins said.
Mullins was an injection heroin user for more than a decade, before moving to methadone. He is now a journalist and advocate for drug users and harm reduction policies in his home of Vancouver - at the centre of the overdose crisis in the province of British Columbia [BC].
When the coronavirus hit the province in March, one public health crisis collided with another, and overdose deaths began to climb. Two months later they reached all-time highs: 174 deaths in May, then 177 in June, 175 in July. So far this year, 909 people have died of an overdose in BC.
Deaths from illicit drugs continue to eclipse deaths from homicides, suicides, car crashes and Covid-19, combined.
It's led to Canada's chief public health official - and the face of the country's coronavirus response - to warn of this second health emergency.
"Canadians should be seized with this particular crisis," said Dr Theresa Tam last month. It is "escalating as we speak".
The record-breaking figures reversed a period of relative stability in the province's battle with opioid abuse.
In 2019, three years after the province declared the opioid epidemic a public health emergency, the number of drug deaths fell by more than a third from the year before - an encouraging trend that continued into the early months of 2020. Then the coronavirus hit.
Experts say the necessary response to the pandemic laid the foundation for a spike in overdose deaths.
Deaths from illicit drugs continue to eclipse deaths from homicides, suicides, car crashes and Covid-19, combined.