Image copyright Kate Poitras
“I wanted to take a picture of each casualty,” Kate Poitras says, gesturing to the photographer’s entrance. “Every body had an ID number, and every person was recorded, for hours or days, in all the little records of that trauma.”
Image copyright Kate Poitras Image caption Kate Poitras was one of the first journalists to report on the overdose epidemic
Nine years after Ms Poitras started documenting fentanyl use in Ontario, the city of Markham, Ontario, now records its 10,000th death of a drug overdose every six weeks.
The surprising long-term number mirrors the largest-ever Canadian death toll from drug overdoses – last week, at least 87 people died of drug overdoses in Vancouver, more than in any other week in the city’s history.
Fentanyl remains the common thread running through all of the public health data going back to 2008.
More than half of all overdose deaths in Ontario are of a synthetic opioid, says Dr Nandita Bali, the provincial medical officer of health.
Image copyright Kate Poitras Image caption Toronto Star journalist Kate Poitras began documenting Toronto’s overdose crisis in 2008
Ms Poitras first reported about the drug spike in Toronto in 2008. She travelled to Markham for the first time on 8 October 2008, after her daughter’s teacher reported to her about a young girl in class who was acting strangely and had begun visiting friends’ homes with no memory of what had happened.
Image copyright Kate Poitras Image caption Kate Poitras has since documented overdoses in every Canadian province
“I don’t know how they got to the house, I don’t know what was in that bathroom, I don’t know anything about this drug, but I do know,” Ms Poitras says, inspecting a brown vinyl medicine cabinet.
She describes meeting a young man who lay next to a white sheet, sobbing. He leaned over and tugged on her sleeve.
Image copyright Kate Poitras Image caption She sits next to a drug abuser and tries to fight back her tears
“I keep walking in the street. This is why I need my fingers,” he says. “There is so much fear. They will take you down, turn you into a dog, what are you going to do?”
The drug first hit the scene in prescription painkillers such as Vicodin and OxyContin in the 1990s. As the US authorities cracked down on supply, drug users simply moved on to heroin.
In 2007, Canada started making its own prescription opioid-based drugs available under a strictly controlled licence.
“In many ways that was a blessing, because it recognised that it’s a public health issue,” says Melissa Ramsay, an expert on drug addiction and drug policy at Dalhousie University in Halifax, Nova Scotia.
“But it did so by keeping these pills behind the counter, with people forcing people to see the pill, driving drug use underground.”
Since 2008, Ms Poitras says, not much has changed, save that her reporting has grown increasingly critical.
Image copyright Kate Poitras Image caption Kate Poitras wanted to document the human aspect of the opioid crisis
She soon travelled to Vancouver to document the devastation being wrought by the burgeoning synthetic opioid epidemic. In 2013, she published her ground-breaking book about Toronto’s overdose crisis.
Ms Poitras says her work has forced officials to acknowledge the scope of the problem.
“I’ve been doing a lot of, you know, not the glamour stuff,” she says, but “keeping up with what is going on, being critical, knowing what is going on, because that is how you make things happen.”