Fight against fentanyl continues on city streets

By Joel Wittnebel/The Oshawa Express

Everything seems normal, or as normal as daily life can be in the life of a seasoned drug addict. They make their pick-up as normal, they process the drug as normal, they fill the syringe as normal, or lay out the line as normal and then shoot it into the vein; yes you guessed it, just as normal.

Everything seems normal until it isn’t.

Over the past year, this normal process has taken a deadly twist as more and more street drugs are being cut with fentanyl, an opioid 50 to 100 times more powerful than morphine, causing even the most seasoned of drug users to overdose. In fact, recent reports citing Health Canada numbers say that between 2015 and 2016, the amount of street drugs found to be laced with the deadly additive have increased by as much as 40 per cent.

And it’s happening here in Oshawa.

“I don’t know that I’ve seen a drug infiltrate, or being infiltrated into communities with the devastating carnage that fentanyl has caused, where there have been mass overdoses, high numbers of deaths right across the country,” says Paul McGary, director of the Pinewood Centre, an arm of Lakeridge Health dedicated to substance abuse and mental health issues.

Last year, The Oshawa Express reported on this issue following a rash of overdoses linked to fentanyl-laced drugs. Now, it’s clear: the fight against fentanyl continues.

The origins of a crisis

Durham police began to realize that fentanyl was going to become a serious problem in 2014. At that time, the powerful drug had been on the streets of Vancouver for some time.

According to information from the Canadian Journal of Addiction, the emergence of illicit fentanyl began with fentanyl patches. Placed on bare skin, the transdermal patch is used as a pain treatment, usually left on the user for as long as three days. However, in 2013, fentanyl began to appear in powdered and tablet form as well.

“You’ve got these super-charged pills that started appearing out west, so what’s happened, in a general sense, it’s sort of moved east now and now it’s across Canada,” says Dave Selby, a spokesperson with DRPS.

Another possible compounding factor for opiate users was the switch of Oxycontin to OxyNeo in 2012.

At that time, spurred by a crisis of Oxycontin addicts fuelled by high prescription rates, the drug was altered to prohibit users from manipulating the pill. The new drug, OxyNeo, became more gel-like and much hard to use once broken down – a shift from the formulation of Oxycontin, which could easily be broken down for injection. And while these changes stopped, in large part, people from using it illegally, it also had residual impacts.

“For our opiate-using population, who were not provided additional resources for treatment or anything else, they went searching for other drugs instead,” McGary explains.

Some users turned to heroin, but in Oshawa, there has never been anything more than small pockets of heroin users in the city, McGary says. It led others toward fentanyl and the patches as the source.

The battle begins

In 2014, in an effort to combat the use of illicit fentanyl patches following a rash of eight overdoses, seven of them linked back to heroin laced with fentanyl, Lakeridge, in partnership with DRPS, launched the Patch for Patch program.

The illicit use of fentanyl patches comes with its own set of dangers, the top of the list being the dosage is completely unreliable when scraping the remnants of the drug off the patch.

It was the emergence of fentanyl in pill form, and now within other drugs, that has really caught everyone by surprise, especially when drug users believe they are purchasing one drug, not knowing that a deadly amount of fentanyl is lurking inside.

“These were well-seasoned opiate users that had high rates of tolerance who were getting blown away and overdosing on this fentanyl. These were people who had incredible tolerances,” McGary says.

The most recent data from the Chief Coroner’s Office of Ontario shows that fentanyl has been the most deadly opioid since 2014, jumping from 86 deaths in 2010 where “the drug was felt to be a direct contributor to the death” to 162 in 2015.

And fentanyl is not the only problem, as numbers from the coroner also show that deaths linked to pain relief drugs such as fentanyl, percocet or morphine increased 242 per cent between 1991 and 2010.

It has drug users running scared.

“It’s created a huge fear among those who are users because there’s no quality control when it comes to street drugs,” McGary says.

“It’s become even less predictable. So now, in the last six months, it seems the speed has picked up even more so where the availability of both tablet and powdered fentanyl seems to be rampant, to the point where well-established users with well-established connections are all fearful about whats in the batch.”

In Durham Region, 2016 has seen police track down several batches of fentanyl-laced drugs.

A high profile bust in January saw police execute search warrants at an Oshawa townhouse and the East Toronto Chapter of the Hells Angels, resulting in the arrest of three suspects and the seizure of cocaine, marijuana, resin and 12 fentanyl patches.

More recently, police culminated a three-month investigation dubbed Project Explorer in which officers from the DRPS Drug Enforcement Unit and the drug unit of the Halton Regional Police focused on the trafficking of heroin laced with fentanyl.

Following a drug deal with undercover officers and a failed attempt to flee the scene resulting in damage to four police cruisers, a trio of suspects were arrested. The first batch of drugs sent to the lab confirmed the heroin was laced with the deadly additive.

“We’re starting to see that more and more,” Selby says. “As a result, we’ve seen people die in Durham Region and we’ve seen people die in many jurisdictions because they’ve taken a pill that ended up being something else.”

And that practice just doesn’t seem to make sense.

“Originally, people were cutting drugs so dealers would make more money,” McGary says. “In the case of fentanyl, fentanyl is not cheap, so why are you cutting a drug with sometimes what is a more expensive drug? Other then the fact that you want to create overdoses.”

Stopping it at the source

The Ontario Student Drug Use Survey found that in 2015, 10 per cent of students between Grades 7 and 12 admitted to using some form of opioid in the last year. The number was highest for those in Grade 12, where 13 per cent said they’d experimented with the drug, and lowest for Grade 9s at 6.9 percent.

Educating students and the general public about the dangers of these street drugs has always been a priority of the police, Selby says.

“We spend a lot of energy and effort trying to educate young people especially,” he says. “(They) are trying and experimenting with these drugs that there are no pharmacy guarantees. In fact there are no pharmacies. This stuff is being made in a dirty basement somewhere and you don’t know what you’re taking.”

And it’s not just a concern with students, but also for those who have been using the drug for years.

“We have so many clients who have lost friends, often times when you’re in the same room,” McGary says.

In an effort to combat the new dangers now facing the drug-using population, in June, the province announced the initiation of its Naloxone pharmacy program, making the potentially life-saving drug available off the shelf.

Naloxone, sold under the brand name Narcan, is an opioid blocker, and when injected is essentially a pause button on a potentially deadly overdose. EMS and emergency departments have been using the product for years, which can delay the effects of an overdose by as long as 60 to 90 minutes.

For McGary, getting this into the hands of drug users is step number one.

“It could save your life tonight, it could save someone else’s life tomorrow,” he says. “Then let’s talk about getting you engaged in stuff.”

The Pinewood Centre offers an array of services to those suffering from all forms of addiction and mental health issues. When it comes to their opiate recovery programs, the number of staff they currently have could be quadrupled to effectively respond to the demand. The long trajectory for recovering and the high rate of relapse make these addictions particularly extensive to deal with.

“In our business, you could literally always respond to a health crisis with better resources,” he says. “We do the best with what we have, but naturally you could always do more.”