Bootleg fentanyl creating overdose crisis in town
The number of calls to paramedics for overdoses in the city has more than doubled since 2012, and one drug, fentanyl, is the main suspect behind the surge.
And things might get even worse.
“I definitely think it is a crisis here,” says Rob Boyd, director of the Oasis clinic at the Sandy Hill Community Health Centre and a leader in the harm reduction field in Ottawa.
“I said going into the summer that I had a bad feeling about it. I really try hard not to be alarmist when it comes to this stuff, but I think powdered fentanyl is a real game-changer.”
The worrisome thing about fentanyl, first widely used in patch-form as a painkiller, is its potency. Described as 50 to 100 times more powerful than heroin, only a few grains can cause an overdose, sometimes fatal.
In some jurisdictions, police officers have overdosed just by handling the powder, among the shocking stories popping up all over North America.
Just last week, nine young people in a Vancouver suburb overdosed almost simultaneously after sharing cocaine that was spiked with fentanyl, with eight of them ending up in hospital.
The problem today is that fentanyl is widely available in powder form and is being mixed — in uncertain dosages — with all kinds of street drugs.
“From one dose to the next, you don’t know what the concentration is,” said Boyd.
Added Catherine Hacksel, a member of the addictions support group, DUAL, and the co-ordinator of a weekly drop-in program:
“With fentanyl, you can buy enough to kill you in a dime bag.”
Boyd says data from the paramedic service suggests there may be as many as 1,400 calls for overdoses by the time 2016 is over, up from 1,027 in 2015, while the use of naloxone, which neutralizes the overdose effects, has doubled.
Once sourced via the medical route, availability is now wide open. In an investigation published last month, a Toronto newspaper illustrated how easy it is to order variations of fentanyl online, mostly from China.
“It’s quite frightening really, when you think that all you need is a mailing address and you get (fentanyl) shipped to you from China. You don’t need an elaborate supply chain to get it,” said Boyd, who has worked in the harm reduction field for more than 25 years.
If there was any doubt about how widely it is being mixed with other drugs, a recent sampling at the safe injection program, Insite, in Vancouver found about 90 per cent of heroin tested positive for fentanyl.
At Oasis, the clinic has two key pieces of advice for intravenous drug users: don’t use alone and make sure a naloxone kit is available to someone who knows how to use it.
The kits are now available over the counter and are offered free at a number of Ottawa pharmacies.
Boyd and others are worried, too, that drug users are often reluctant to call 911 when an overdose occurs for fear of criminal repercussions to the illegal activity.
Last week, Health Canada announced it is making it more difficult to import the constituent ingredients that are blended to make fentanyl. But, like so many other regulatory prohibitions involving drugs, there are questions about how effective this step will be.
“It feels very daunting about how you combat this,” said Boyd. The situation is made more difficult because Canada, per capita, is one of the biggest consumers of legal opioids in the world, so misuse via traditional prescription routes is common.
There are an estimated 1,500 to 2,000 intravenous drugs users in Ottawa, and hundreds would be using fentanyl, Boyd estimated, sometimes unknowingly.
Overdose deaths have soared in just about every major Canadian city in the past five years. The Canadian Centre on Substance Abuse, in a bulletin last year, reported there were 655 deaths linked to fentanyl from 2009 to 2014. The number of police seizures over that same period jumped 30 times. The drug is sometimes bootlegged in pill form and disguised as a legal, safe product.
The centre also reported that a fentanyl death occurs in Ontario every three or four days but admits those figures are probably low.
Boyd and others see the fentanyl scourge as just one more reason why Ottawa needs a supervised injection site. An application to Health Canada is expected to be submitted this fall.
By Kelly Egan
Source: Ottawa Citizen