BELLEVILLE, ON | Imagine that in a town barely larger than Shawinigan or Rimouski, 23 people overdose on opioids in 48 hours. Exaggerated, don't you think? But that's exactly what happened last week in Belleville, a small community of 55,000 people less than three hours' drive from Quebec, which had to declare a state of emergency because it cannot deal with this public health and safety crisis alone.
“It is out of control and we need help. I know it's a bit extreme, but you have to prepare for next time.
Belleville Mayor Neil Ellis sits in his office chair answering questions from the Journal and makes no secret of it: In February, he primarily drew attention to what his city is going through, which is why he declared a state of emergency on February 8.
Belleville Mayor Neil Ellis. Photo Olivier Faucher
Because in the previous two days, it was dropping like flies in front of the Bridge United Church, home to the only service point that helps the homeless and drug addicts, who are increasingly numerous in the community within less than 200 km of Toronto.
Bridge Street Church, home to Belleville's service center for people who are homeless or struggling with consumption issues. Every day a sad scene takes place around the building as several people take drugs. Photo Olivier Faucher
The overdose crisis, perceived as a problem in large urban centers in Quebec, has hit many medium and small Ontario cities hard in recent years, including Kingston, Peterborough, Thunder Bay… and Belleville.
Photo Olivier Faucher
Here the problem reached unprecedented proportions on the afternoon of February 6th.
“And another and another”
After four days in which no one could find drugs and many were in withdrawal, a new supply fell into the hands of opioid users that day, said Joshua Fox, a homeless man who regularly visits the service center.
“It started with Dan. He dropped his pipe and fell to the ground. Then another and another and another.
Barbara Boullata and Joshua Fox, a couple who frequently perform at the worship center at Bridge Street Church. Photo Olivier Faucher
Staff rushed to revive the victims with naloxone, but with little success because the drug contained a mixture of substances. “You have four staff members doing chest compressions, but there are seven people on the floor,” said JJ Cormier, director of the John Howard Society, which runs the day center at the church.
A large-scale operation by the emergency services then began, which, among other things, required ambulances from other cities, as Belleville only has four. Belleville Fire Chief Dan Smith compared the response to those used in mass shootings across the United States.
Belleville Fire Department Director Dan Smith. Photo Olivier Faucher
“Afterwards we went for another coffee and had two more [surdoses] in the church. Boom Boom! continues Mr. Fox. I had never experienced a day like this. […] It was crazy.”
According to authorities, who recorded a total of 23 overdoses in the 48 hours following this event, at least 13 people suffered an overdose in no less than an hour. One death occurred during this unprecedented episode.
In 2023, the number of opioid-related calls recorded by paramedics in Belleville exploded, reaching 307. In 2022, that number was just 112 and in 2021, it was 130.
“I don’t think we’re doing worse than other cities,” said Mayor Ellis, who, however, believes last week’s “very bad days” show his city lacks the resources to deal with the problem.
The mayor at the end of his strength
Neil Ellis was mayor for the first time from 2006 to 2014. When he left office after two terms in office, there was virtually “no visible homelessness” in his city. When he returned in 2022, an official count showed about 200 homeless people.
Many of them turn to drugs found on the black market for a variety of reasons, including chronic pain, whose effectiveness and poor quality make them extremely dangerous, says spokeswoman Hilary Thomas of the John Howard Society.
“A small town is even more vulnerable to the overdose crisis,” she believes. There aren’t the resources here like in big cities.”
Hilary Thomas, spokesperson for the John Howard Society. Photo Olivier Faucher
The state of emergency is serving as leverage for Belleville to seek funding from Doug Ford's provincial government for its “hub” project, which would allow the service center to have larger space and more resources to deal with the crisis.
“Without the support of our government, I see no change in sight,” summarizes Mayor Ellis.
A warning for Quebec cities
Quebec's small and medium-sized towns will not be spared from the overdose epidemic, warn experts who are already seeing worrying signs of an opioid crisis is moving forward with us.
“We should certainly expect that in Quebec,” says Jean-Sébastien Fallu, a professor at the University of Montreal’s School of Psychoeducation. Whether it’s an overdose crisis, crystal meth or fentanyl derivatives, here it always happens afterwards.”
Sandhia Vadlamudy, director of the Association of Dependence Workers of Quebec, agrees.
“We are not safe at all. The day such a substance is found in a small or large community, it will be sold and bought and we will be able to experience the phenomenon that we saw in Belleville,” she believes.
The Belleville case must “100%” be a wake-up call for Quebec cities. “If you ignore this now, you will fail,” said Hilary Thomas, a speaker at the John Howard Society in Ontario City.
Homelessness, a worrying sign
For more than a year, many cities in Quebec have been sounding the alarm about the increase in homelessness in their area.
Martin Damphousse, president of the Union of Municipalities of Quebec (UMQ), regrets that the problem continues to worsen. According to him, homeless camps are piling up everywhere.
Homeless encampments like this one photographed in Rimouski last September continue to proliferate in Quebec cities, the UMQ fears.
This creates a “very fertile” breeding ground for situations like the ones we saw in Belleville, Mr. Fallu said.
“The phenomena of homelessness and problematic drug use are closely related,” he emphasizes.
“The information I have on this is that it would not have happened in Quebec at this level, but seriously, no one wants it,” mentions Mr. Damphousse for his part. […] We’re definitely concerned.”
Materials that are too dangerous
As has been done on several occasions, Mr. Fallu and Ms. Vadlamudy propose the solution of public supply of safe medicines to prevent the overdose crisis from worsening.
“The crisis is caused by toxic and uncontrolled substances. It is organized crime that produces drugs and the goal is to make money and not to provide high-quality substances,” emphasizes Ms. Vadlamudy.
Mr Fallu believes we also need to address the social determinants of health, such as lack of access to housing and care, which drive people to turn to consumerism.
“It is certain that if we continue to pursue economic policies that create poverty and put people on the streets, this is fertile ground for all sorts of problems, including the overdose crisis,” he concludes.
Consumers who risk their lives
One user showed the Journal his medication, which was believed to contain fentanyl, before smoking it in a pipe. Photo Olivier Faucher
Users accustomed to overdoses feel condemned to play Russian roulette with the very dangerous drugs they can find to relieve their addiction.
At the beginning of November 2023, there was a wave of dozens of overdoses in Belleville. Among them is that of Leo Quinlan.
“This is the first time I almost died. I remember doing cocaine and then waking up in the ambulance.”
Leo Quinlan almost died in November 2023 when he took an overdose. Photo Olivier Faucher
Cases like this are common when speaking to people standing outside the Bridge Street Church worship center.
Michael, 39, leads our representative into an alley to show what he's going to smoke: a small orange ball that probably contains fentanyl, but also other substances he doesn't know about, he agrees.
Fentanyl, likely mixed with other substances, used by several people in Belleville. One user showed it to the Journal before smoking it in a pipe. Photo Olivier Faucher
“I’ve had at least 20 overdoses in my life,” he explains. He says he is trying to cope with methadone treatment, which replaces the effects of opioids and aims to stop their use.
“That’s not enough,” he said, however. He is still taking fentanyl, but in smaller amounts than before. He wants to have access to a safe supply of drugs that would allow him to stop risking his life by using black market substances.
Joshua Fox also nearly died after smoking a substance sold as fentanyl just days before the Feb. 6 overdose wave.
“The fact that it was mixed, that it was cut with something else, that was the dangerous thing. There’s other shit in drugs, and that’s what kills people.”
Overdoses in numbers
660%: This is the increase in the number of opioid overdose-related calls received by Belleville EMS when comparing 2018 (40) and 2023 (307).
Rate of deaths per 100,000 population related to overdoses in 2023:
- Quebec: 5.4 (compared to 3.2 in 2016)
- Ontario: 17.3 (compared to 5.2 in 2016)
Sources: Hasting Prince Edwards Public Health and Health Canada
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