Drug overdose calls come in thick and fast to the specialized paramedic designed to combat overdose deaths in Vancouver’s Downtown Eastside.

Save one life, and it’s on to the next case just minutes later here, in ground zero of Canada’s opioid crisis.

“I think it’s as bad as it can get. I’ve never seen it like this. It’s non stop,” said paramedic Brian Twaites during a ridealong with W5.

“There’s been shifts where I’ve done 26 responses in a 12-hour period. And that’s just my vehicle,” he explained.

Twaites is one of the frontline workers W5 profiled in a new documentary called "48 Hours."

The epidemic’s death toll is rising, largely caused by cheap synthetic drugs such as fentanyl cut into the black market supply. Last year at least 1,400 Canadians died of an overdose. 

In B.C., nearly 1,000 people died in 2016 of an overdose. W5 went to Vancouver to learn the lessons of the authorities – the community – and the users here.

It’s the worst health crisis in memory, killing three and a half times more people than AIDS did in B.C. at its peak in 1994.

An overdose call usually comes in as a cardiac arrest. That means the dispatcher sends all first responders, which includes firefighters.

In Vancouver, firefighters are now able to carry and dispense the opioid antidote Narcan, which is the trade name for Naloxone. It’s a simple injection and it can bring someone back from the brink.

And it happens multiple times a day for any crew member. The workload has Captain Darren Fairburn wondering when it will end.

“It’s frustrating, it’s scary, and it’s an eye-opener for me even after 22 years,” he said. “It’s pretty sad. It’s not sustainable and it can’t keep going on like this.”

His crew doesn’t spend much time fighting fires any more. Seventy per cent of the calls are medical, which includes overdoses.

Paramedics have also changed how they do business in the face of mounting overdoses.

“The crisis really hit us back in October,” said Joe Acker, BCAS director of patient care delivery. “Up until then, we were managing the overdoses as we’d seen them in the past, since the 1980s.”

Typically, the B.C. Ambulance Service would see about 40 to 50 overdoses each day across the province. But in November, that jumped to 135 overdoses a day. It’s stressful for the crews, but also the dispatchers, he said.

“Our dispatchers are essentially telling people how to save the life of someone who’s had an overdose, and that’s a very difficult job, especially when you’re doing it, sometimes literally, dozens of times a day,” Acker said.

BCAS added new paramedics to the road, but also created specialized units like Twaites’s to be able to go out independently. They added bicycle crews as well to navigate alleys and get directly to users.

He says there is some good news: the death toll is dropping, and so is the call volume for his crews. In December, 5 people were dying a day. In February, that’s down to 3.

“The call volume for us is actually going down, which is incredible,” he said.

Narcan is also in the hands of people in the community, which can be a volunteer in a overdose prevention site or a drug user using it on a friend. That could be behind the drop – but there could be risks that remain.

“I think the system’s done so well in educating people and providing home naloxone kits, that people are actually taking risks and not calling the ambulance, and that’s really dangerous,” he said.

Twaites says the people who are using with friends are much safer – because then they can call 911.

But if someone is injecting alone, then that’s much more risky, he says.

“There’s a lot of time where we’re not called in time, you know, people are alone, and it’s just too late,” he said.