It’s meant to be used in hospital to ease the pain of the very ill or sedate a patient during an operation, but drug users are getting ahold of it.
As the nightly news has recently tragically shown, some recreational drug users have died from ingesting fentanyl. The opiate killed a Squamish resident a year ago and the parents of a toddler in North Vancouver last month.
It has been used in hospitals for about 20 years, according to Dr. Mark Lysyshyn, a Vancouver Coastal Health (VCH) medical health officer.
Fentanyl belongs in the same family of drugs as morphine, heroin or OxyContin, but it is 50 to 100 times more potent than morphine, according to a 2014 B.C. Drug Overdose and Alert Partnership report.
A report by the Canadian Centre on Substance Abuse found between 2009 and 2014, there were at least 655 deaths in Canada – 152 in B.C. – where fentanyl was detected as a cause. That is an average of one fentanyl-linked death every three days.
Lysyshyn said while some people may be searching out the drug on purpose, many have no idea what they are ingesting is fentanyl.
About one-third of participants in a BC Centre for Disease Control urine survey tested positive for fentanyl even though 73 per cent did not acknowledge using the drug within the previous three days.
“That is how we know it is sort of a contaminant instead of people searching it out,” Lysyshyn said.
The biggest danger is to recreational drug users, he said. Regular drug users are usually aware of what is happening with fentanyl, but it’s the person who uses on occasion who is most at risk.
Fentanyl can be in pill form sold as fake oxycodone and other club drugs, in powder form as heroin and in powder form mixed into other drugs such as cocaine and crystal meth, according to Lysyshyn.
Too much of the drug is currently circulating for it all to have been diverted from hospitals, Lysyshyn said.
“It is actually very difficult to divert drugs directly from hospitals. There are lots of protections in place for that,” he said. While it is possible for most prescription drugs to be diverted, fentanyl is only prescribed in patch form. Therefore, there must be illicit labs manufacturing the drug, he said.
Squamish RCMP say they have not recently seized anything that they can confirm is fentanyl.
Lysyshyn said the drug was an issue in California in the 1990s and in Chicago and Detroit in the early 2000s.
“The Detroit episodes, they eventually linked that back to a drug laboratory in Mexico that had basically acquired the ability to make fentanyl and then started importing it into the States. So here, somebody has acquired the ability to make fentanyl, either in British Columbia or offshore, and it is coming into the drug market and it is probably cheaper than heroin, or cheaper than the alternative, so they are using it,” he said. “Until that supply chain gets interrupted, I guess we will continue to see it.”
Despite rumours to the contrary, Lysyshyn said there has been no evidence of marijuana being laced with fentanyl.
“That would be very concerning because so many people use marijuana,” he said.
But according to 99 North Medical Cannabis Dispensary owner Bryan Raiser, people who come to talk to him about medical marijuana are worried.
“They read the news and hear stories and are certainly concerned,” Raiser said.
There is an antidote, Naloxone, for drug users who are at risk of an overdose, Lysyshyn said.
Signs of overdose from fentanyl include tiny pupils, cold and clammy skin, slower breathing, inability to wake up, and blue lips or nails.
Squamish Mental Health Addiction Services, the clinic that helps local users, does not currently offer naloxone, but there are plans in the works to stock it, according to VCH.
In the meantime, Naloxone can be administered to opiate overdose victims in the Squamish area either by ambulance paramedics or in the emergency department of Squamish General Hospital.
Lysyshyn advises users not to use drugs alone, to avoid mixing alcohol with drugs and, if they are trying a drug, to only try a small sample first to see how the body reacts.
For more information go to towardtheheart.com/fentanyl/
