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Some Dealers Are Checking Their Drugs to Keep Clients Alive

A new study shows how drug dealers can play a crucial role in harm reduction during the overdose crisis.
Needles are seen on the ground in Oppenheimer park in Vancouver's downtown eastside on March 17, 2020.
Needles are seen on the ground in Oppenheimer park in Vancouver's downtown eastside on March 17, 2020.  Photo via The Canadian Press

A new study provides a rare glimpse into the mindset and operations of some drug dealers as they navigate an increasingly toxic illicit drug supply and the potential risks faced by their clients. 

“I couldn’t live with killing one of my friends, or anybody. Anybody’s kid,” one man who sells meth in Vancouver’s Downtown Eastside told the authors of a new study released last month in the International Journal of Drug Policy. “A lot of us just don't want to die. A lot of us just want to get out of our own heads for a couple hours, right?”

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Based on a small sample size of 26 people who got their street drugs tested at an overdose prevention site in Vancouver, the study’s researchers conclude that those who sell drugs are often overlooked in the crucial role they can play in harm reduction efforts, and are instead assumed to be necessarily malicious and morally bereft, as they are often perceived by law enforcement and the general public.

The study comes as some jurisdictions across North America are embracing the decriminalization of drug possession as a means to tackle soaring overdose death rates—as Vancouver and Oregon did recently—and the movement calling for a safer legal drug supply is gaining momentum. But at the time same, more low-level dealers are facing criminal charges such as manslaughter or murder if their clients die of an overdose, something public health and drug policy experts say is harmful and misguided.

“Rather than the caricaturized villains portrayed in the media, sellers desired the capacity to keep their clients safe,” the study states. “Stronger enforcement of drug laws at the expense of low and mid-level drug sellers who are attempting to mitigate harm to the best of their ability is counterintuitive to the goal of reducing overdose deaths.” 

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Results of a drug checking test in Vancouver. Photo via International Journal of Drug Policy.

The researchers, who spent time at the Vancouver site from 2018 to 2019, observed that these drug sellers didn’t just swoop in and out to make sales, they lived and worked in the community and often sold drugs as a way to support their own use. They also built levels of trust with their clients.

“These people who are selling drugs are people who use drugs, and they’ve been ravaged by the overdose crisis and are taking the steps they can within what’s available to them to try to keep people safer, while frankly have very little control over that,” Ryan McNeil, the study’s lead author and director of Harm Reduction Research at the Yale University School of Medicine, told VICE World News.

The drug checking services at the site utilized test strips that detect the presence of fentanyl, LSD, and benzodiazepines, in addition to more sophisticated drug-checking technology that provides a breakdown of the approximate percentage levels of various substances in the drugs, including cutting agents. 

For McNeil and his team, the ways sellers used the test results challenge commonly held stereotypes around people who deal drugs and the dynamics between them and their customers. “The logics of how drug selling is operating aren't too far from what you'd see in a lot of other businesses,” he said. 

The study describes how the dealers used the drug-checking program at the overdose prevention site as a way to figure out what exactly is in the drugs they’re selling and consuming. With that knowledge, especially if the drugs involved higher levels of fentanyl than anticipated, some dealers responded by tailoring which drugs were sold to clients, and even returning especially dangerous batches to their suppliers for refunds or in exchange for a more suitable one. 

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“Participants reported that knowing the potency of their product allowed them to tailor their drug-selling approaches so as to avoid accidentally killing customers, particularly those with heightened overdose vulnerability,” the study says. “The positionality of drug sellers within the drug market make them an effective target for drug-checking-related harm reduction interventions, as information for street-level drug contents could inform selling and communications strategies with buyers.”

While the drug market in Vancouver’s Downtown Eastside is unique from other drug markets across North America, in particular due to its high levels of poverty, harm reduction advocates say that rethinking the potential role of dealers would be helpful in other contexts.

For Guy Felicella, a peer clinical adviser at the B.C. Centre on Substance Use who spent decades living in the Downtown Eastside and sold drugs to pay for his own heroin addiction, people who sell drugs should be supported by being provided complete access to services to get their drugs tested without fear or arrest or repercussions. 

“They don't want to put out a bad batch, just as much as we don't want to see a bad batch out there,” Felicella said. “If you're going to vilify them then they're not going to access possible services of harm reduction that could exist that could keep people alive.” 

Ultimately, Felicella and the study researches say the solution to the overdose crisis lies in broad safe supply programs that would provide a proper alternative to the street supply. 

While a number of safe supply programs, often for a limited number of participants, have popped up across Canada, many provincial governments oppose them, and physicians are generally hesitant to undertake it themselves with their patients.”

“Some drug sellers play an important role in regulating the drug market in lieu of effective state regulation of drugs,” the study concludes. “Unless safe supply is implemented, and the structural barriers that require one to sell drugs are addressed, drug checking can provide an effective harm reduction tool for addressing some of the dangers of a volatile drug market.”

Follow Rachel Browne on Twitter.