There's something particularly agonizing about these deaths, even for a funeral director.
"It's the senselessness of it," John Romeyn said.
It's the father who sobbed as he sat across from him at a table in his funeral home near Vancouver, British Columbia. It's the look on the father's face as he realizes that instead of picking an outfit for his daughter to wear to graduation, he's choosing an outfit for her to wear in her casket.
Years ago, John Romeyn hardly ever heard about local residents dying from overdoses of the synthetic opioid fentanyl, he said. Now days, he sees about four fentanyl deaths a month in his funeral home.
"We're getting tired of dealing with these people dying needlessly," Romeyn said in an interview with The Washington Post. "It's definitely on the increase, there's no question about it."
The deaths are happening so frequently that some funeral directors are supplying their premises with naloxone kits to reverse possible overdoses among grieving loved ones or the staff who handle the bodies of opioid overdose victims. The British Columbia Funeral Association sent a bulletin to its members last month urging funeral directors to carry the kits, the Vancouver Star reported.
The overdose crisis playing out in each local funeral home is a microcosm of the fentanyl epidemic raging across British Columbia, Canada's westernmost province and the epicenter of opioid deaths in the country. In the first 10 months of 2016, 622 people died from apparent illicit drug overdoses in British Columbia, compared to 397 during the same period in 2015. About 60 percent of the deaths were linked to fentanyl, according to the British Columbia Coroners Service.
In April, the provincial health officer declared a public health emergency in British Columbia due to the alarming increase in drug-related overdoses and deaths. It was the first time he had exercised his emergency powers. By late September, 13,000 life-saving kits had been distributed across the province to sites such as hospitals, jails, and health centers, the Canadian Press reported.
Many public servants who work at the forefront of the crisis - particularly police officers - have begun issuing naloxone nasal spray to front-line officers and support staff who might come in contact with the drug while responding to overdoses. In Vancouver, clandestine lab teams in hazmat suits that once specialized in dismantling crystal meth labs are now being called in to handle fentanyl seizures, the CBC reported. Several police officers in the region have suffered overdose symptoms when seizing fentanyl powder.
Similar measures protecting police from drug overdoses have been encouraged in the United States for years.
The DEA issued an alert last year identifying fentanyl "as a threat to public health and safety," The Post previously reported. In June, it created a "roll call" video to warn law enforcement agencies nationwide "about the dangers of improperly handling fentanyl and its deadly consequences."
"A very small amount ingested, or absorbed through your skin, can kill you," said Jack Riley, the DEA's acting deputy administrator.
But such precautions are also being taken in far less expected realms in British Columbia, including funeral homes. The funeral association is urging funeral homes to obtain naloxone in part to protect the safety of embalmers, who often treat the bodies of drug overdose victims and could encounter a trace of a potentially lethal drug left undiscovered on a corpse or on personal items.
Additionally, Charlotte Poncelet, executive director of the British Columbia Funeral Association, told the Vancouver Sun that by having naloxone kits on hand in funeral homes, staff can be better prepared to assist in case a grieving funeral attendee overdoses during services.
Although Romeyn had not considered supplying his funeral home with naloxone, he considers it a logical - and potentially beneficial - precaution.
"There are people who do numb themselves before they come to a funeral," he said. In a time of intense emotional distress, the risk of an overdose could increase.
Many people don't realize the need for funeral directors to be well-versed in first aid, Romeyn said. "Some people say it's a bit too late for that."
But it's not the dead he's worried about. "It's the mourners," he said. Funeral directors often come across family members who experience fainting spells or even heart attacks, depending on their physical state and how they grieve.
Romeyn understands the magnitude of drug addiction in a deeply personal way - he was an addict himself for 27 years, he said. He's also seen the recent crisis affect his family directly. His son was at a party recently where his friend experienced a drug overdose and died. Witnessing the traumatic moment led Romeyn's son to leave his job at the funeral home.
"We have to deal with the final aspect of it," the funeral director said. Romeyn decided he needed to do something about the epidemic ravaging his community. For the past few months, he has begun working on a campaign with local schools, law enforcement, the coroner's service, and other agencies to build awareness of the dangers of fentanyl.
"The addicts know, they admit they take a risk," Romeyn said. "The focus is more on these young people that are going to pill parties and taking things that they have absolutely no clue about."
He has not looked into getting naloxone for the funeral home, but he plans to. At this point, it certainly couldn't hurt, he said.
"I need to do something," he said.
(c) 2016, The Washington Post · Samantha Schmidt