VANCOUVER -- Trey Helten has known almost every one of the 50 or so people he has treated for overdoses on Vancouver's Downtown Eastside since February.
As a former heroin and methamphetamine user who lived in the neighbourhood for three years before getting clean and returning "to do something positive," he's one of many peer support volunteers and workers playing a vital role in stemming the overdose crisis that has devastated the province.
Unlike professional workers such as paramedics and firefighters, Helten and many peer support volunteers are dealing with the loss of their friends, with no formalized supports in place.
"It would be nice if we had regular access to some sort of 24/7 counselling down here. I just knew one participant who came back from his tent and found his girlfriend dead from an overdose. And he didn't really have anyone else to talk to. It just encourages the cycle (of drug use)," he said.
Helten himself had a tough day recently when a drug user reverted to childlike state, asking his mother why she didn't protect him from his stepfather, but Helten said he managed to avoid relapsing by phoning his Narcotics Anonymous sponsor.
"I walked off shift that day feeling like my eyes were vibrating," he said. "It had really upset me and I felt like I had a contact high."
Ryan McNeil, a researcher at the BC Centre on Substance Use and an assistant professor at the University of British Columbia's department of medicine, said he has been involved in studies interviewing 200 drug users since December 2016.
Consistently, he has heard that peer support workers and volunteers are more trusted by drug users because they have shared experience. He has also heard they need more support than they're getting.
They are often drug users themselves and are being traumatized again by the scope of loss in their community, he said.
"We've spoken with a number of peers who've subsequently left peer positions or moved on from them just because they can't cope with the stress they're experiencing," McNeil said.
"They're both dealing with the stress and hazards of doing the work that they do while also losing people in their community -- friends, family members and so on."
The BC Coroners Service said 1,451 people died of illicit drug overdoses last year in the province.
Helten said he wouldn't be alive today if it weren't for safe-injection sites and the peer support workers who helped him. So he wanted to return to the Downtown Eastside after getting clean to do his part.
"I was an IV heroin and crystal methamphetamine user, covered in scabs, 160 pounds, jaundiced, yellow eyes, very sickly," said Helten, 35.
"Peer support workers were the only people who treated me like a human being while I was in my addiction."
Helten spends at least five hours a day volunteering with the Overdose Prevention Society and receives a daily $10 honorarium for his work.
While he doesn't expect full pay, Helten said more recognition of the role that peer support volunteers play would go a long way.
For him, the ideal would be a scholarship fund or education support. He'd like to be a social worker someday.
In the meantime, he's adding the work he does with the Overdose Prevention Society to his resume.
Sarah Blyth, executive director of the Overdose Prevention Society, said peer volunteers are often the first people on the scene, reviving drug users with naloxone and other emergency measures.
"They're the unsung heroes for sure in this crisis," she said.
The Overdose Prevention Society provides them with training, a certificate that will hopefully help lead to future employment and connects them with counsellors when needed. Support is often arranged on an ad hoc basis and the society might help volunteers find housing or veterinarians for their animals.
"We do what we can. We get concert tickets, everything else that they deserve, we try to get them time off and we fundraise for them," she said.
Blyth said she'd like to see peer workers recognized in a more formal way.
"I think making sure that people have, when everything is said and done, support and opportunities to move up and move forward into employment. Because there's nobody better, nobody more qualified in this crisis than these front-line workers."
There are some supports in place. In June, for example, the provincial government said its mobile response team had provided critical incident support and training to more than 6,000 people working on the front lines.
The 13-member team includes counsellors, psychologists, trauma experts and first responders and it has travelled to 57 communities in B.C.
"Workers being exposed to frequent traumatic events may be susceptible to compassion fatigue, trauma, and other stress-related harm. The MRT helps people proactively address the cumulative stress of their jobs during the overdose crisis," the Provincial Health Services Authority said in a news release.
The B.C. government has committed $1.7 million for two years for the team.
McNeil said initiatives like the team may fill some gaps, but not all of them. Existing supports tend to vary by organization and by the level of employment the peers have, from volunteers to full-time staff.
"We just need more resources."
