V.I.

Deadly cocktail

Fentanyl citrate
Posted: March 5, 2016 at 11:08 am   /   by   /   comments (0)

Fentanyl citrateBy Benjamin Everett

Over 40 fentanyl-related overdoses have been reported in Victoria and Nanaimo since December 20, 2015, 12 of them fatal. The victims have come from all walks of life, but Paul Hasselback, Medical Health Officer for Central Vancouver Island, says that “it’s the younger ones that are the most tragic.”

Fentanyl is a synthetic opiate analgesic, most often compared to morphine, though its effects are over 50 times more potent. Typically used to treat severe pain, or to relieve pain after surgery in patients who exhibit a high physical tolerance to opioids, the drug has become a growing concern over the past couple years due to a rise in its illegal distribution.

“2013 is when we started to see a rapid increase of [fentanyl-related] overdose deaths, up almost 70%, where there was almost nothing in 2012,” says Hasselback.

2014 saw over 300 deaths reported as a result of illegal drug overdose in BC. Hasselback notes that “Fentanyl accounts for about one third of these overdose deaths provincially” — a startling increase from the estimated 5% reported in 2011.

But it’s not just the Island that’s fallen victim to this emerging trend. Ontario and Alberta have also reported a spike in fentanyl-related deaths in recent years, and the epidemic has reached the United States as well, with rural areas particularly hard hit.

Fentanyl in pill-form.

Fentanyl in pill-form.

The drug isn’t very difficult to acquire, either. A quick Google search brings up several websites offering guaranteed delivery.

“This is the situation right now,” says Constable Gary O’Brien of the Nanaimo RCMP. “There are street traffickers who sell straight fentanyl, and people know that if they take it, they could wind up dead within 20 minutes. But they do it anyways. Their addiction is so powerful that they’re willing to take that risk.”

However, it’s the mixing of straight fentanyl with other street drugs for added potency that has police and medical officials particularly concerned. In some cases, victims of overdose hadn’t even gone looking for fentanyl, but wound up with an unwelcome surprise when they thought they were only taking heroin or cocaine.

“Victims of overdose have been found to have a ‘drug cocktail’ in their system,” says O’Brien. “This ranges from anything from marijuana and cocaine to methamphetamines and fentanyl.”

But Hasselback says that “the real challenge is that concentration varies. It’s not like going to the pharmacy. You don’t really know how much you’re going to get.

“From toxicology reports, we’ve found that fentanyl is most commonly being mixed with heroin, though methamphetamines and cocaine are up there too.”

Early signs of overdose include severe sleepiness, slow heartbeat, trouble breathing, slow, shallow breaths, cold, clammy skin, and trouble walking or speaking. To combat the recent surge of fentanyl-related overdoses, Nanaimo RCMP and Island Health offer this advice for users of any drugs:

A patron receives assistance at a safe injection site in Vancouver.

A patron receives assistance at a safe injection site in Vancouver.

– Avoid using alone.
– Have an overdose prevention plan in place.
– Take a small sample of your drug first.
– Tell someone what you’re intending to use.
– Have a Take Home Naloxone Kit.
– Call 911 immediately if you experience any overdose symptoms.

Nanaimo RCMP and Island Health aren’t the only ones taking preventative measures, however. Nanaimo’s Vancouver Island University has made Naloxone kits available at their campus clinic in an effort to take a proactive approach in the wake of recent overdoses.

Some citizens in Victoria have also begun to take action, calling for supervised consumption sites like those found in Vancouver to provide users with a safe space to use, and supervision should an overdose occur. While critics argue that the sites encourage drug use and that the money would be better spent on treatment, one fact remains: addicts can’t be treated if they’re dead.

“You’ve got to deal with the root of the problem,” says O’Brien. “But the pros [of safe consumption sites] certainly outweigh the cons.”

Hasselback seconds this notion. The sites, he says, have “definitive value […] but it’s important that we promote preventative programming and detox environments as well, for people who are on the drug, but want to get off.”

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