Canada’s Fentanyl Problem

By Frankee Wallace

It’s caused B.C to declare a public health emergency. Frequently cut into other recreational drugs – often without the user’s knowledge, it’s readily available online, cheaper and much more potent than other opiates. It’s fentanyl, and although you probably aren’t worried about it, you should be.

In September, police in a small B.C. town responded to nine overdoses within 20 minutes. Police say that the drugs seized, which the victims had believed to be cocaine, were suspected of having been tainted with fentanyl. This incident is only one of many; similar episodes have been occurring across Canada, from Vancouver, to Calgary, to Toronto.

In spite of the toxicity of the synthetic opiate, many Canadians see it as the perfect drug. Fentanyl is profoundly more accessible and less expensive than other painkillers. Largely sourced from China, fentanyl is then sent to Canadian dealers who access the illicit drug market online. The Internet – via the surface web and the dark web – continues to serve as “the main gateway for a thriving, open illicit opioid marketplace in Canada.” Black market fentanyl is usually used to cut other illicit substances. To put in perspective, a microgram of fentanyl can be more lethal than milligrams of other opiates. Side effects include fast-acting euphoria, but paired with nausea, vomitingsedation, with the kicker being respiratory arrest. Despite the dangerous side effects of fentanyl, Canadians are eating this stuff up.

The story of fentanyl epitomizes Canadian’s attitude towards drugs: enthusiastic and ignorant. The numbers don’t lie; we’re soaking up these drugs before we even know what they are, with over 1.25 million Canadians using opiates. Fentanyl is being mixed in, making the risk associated with these drugs much higher.

The drug isn’t new, but its popularity (deliberate or not) is, and it has the healthcare system tripping out. Just over a decade ago, the city of Ottawa had 100 emergency room visits related to accidental drug overdoses. In 2015, this number was 205. Ottawa Public Health explains this largely on the grounds of increasing presence of fentanyl in illicit drugs. Recent statistics from British Columbia show the problem is dire 488 people have died so far this year from drug overdoses, with 264 related to fentanyl. That’s more than half of the recent deaths, just in case the other numbers didn’t shock you enough.

Why now? Why Canada? Surely if similar substance abuse were happening in the United States, it would be plastered across Canadian news? Logistically speaking, Dr. Michelle Arnot, of the University of Toronto, says fentanyl has become more popular in Canada due to tougher access other opiates such as OxyContin and oxycodone. Doctors, concerned about abuse and addiction, are now writing fewer prescriptions for those drugs. This concern has not led to changes in opiate prescriptions in the United States; in Canada, however, people are looking elsewhere to get their fix. The drug is easily accessible, relatively cheap, and people don’t know of its side effects. Patches of straight fentanyl can sell for a mere $200 a patch, yet they are 40 times more potent than heroin.

In Vancouver, fentanyl has all but replaced heroin. This is because making fentanyl, as B.C. based doctor Samuel Gutman said, is a four-step process requiring easily available non-prescription ingredients. Thus, it’s incredibly tempting to cut it into other drugs to increase profits. Users, recreational or not, have no idea what they’re getting into. Fentanyl’s potency means it can easily be transported in small doses and even can kill you simply through skin absorption.

Responsibility falls on Canadian drug culture. As a nation, we mix a hands-off type of view on recreational drug use with poor education to prevent the abuse. Our response is still largely handled by law enforcement, and incredibly, e are still without a formal response and action plan for something that is and has been killing Canadians. Sadly, as NDP addiction-response critic Sue Hammell asserted, “were British Columbia faced with some other kind of deadly disease outbreak, there would be a fix right now.”

British Columbia’s provincial health officer, Dr. Perry Kendall, has declared a public health emergency due to the explosion of overdose deaths linked to fentanyl. We should expect an all-encompassing response from the federal government, or at least a cohesive response provincially in terms of rehabilitative remedies and institutions as well as education. Currently, Canadians have neither, apart from the arming of public officials with naloxone. Naloxone is used in emergency situations to stop the effects of opiate overdose, like loss of consciousness or impaired breathing. Emergency services are being armed with the antidote, in the event they inadvertently come into contact with fentanyl.

Recently, Health Minister Terry Lake said during an update on the opioid emergency that 13,000 life-saving kits have been distributed cost-free to nearly 300 sites across B.C., including emergency departments, public-health units, and provincial and federal correctional facilities. That may sound great, but what are we doing to stop Canadians taking from the drug in the first place? We need to do more: all of the provinces should take more preventative measures as well as implicate the antidote into their systems to make it more accessible, and.

An officer in the Ontario Association of Chiefs of Police, from the Waterloo Region Crime Prevention Council says Ontario has taken up a public education plan similar to B.C.’s system, which advises drug users to be extra cautious due to the possibility of unexpectedly powerful substances mixed into their usual doses, but ministers warning Canadians to be ‘extra cautious’ is not terribly effective. The fact that enforcement officers are using so much naloxone reflects the need for a structured and universal preventative education program. Being ‘extra cautious’ when ingesting poison only shows how Canada’s go-with-the-flow attitude isn’t working out. A more descriptive, structured take that reaches even the smallest of municipalities is necessary.

Yes, Canada is the frontrunner in North America for rehabilitative drug abuse care, boasting the only government funded safe-injection site on the continent. Wait a second, that’s still only one site in Canada, which means most fentanyl users are ending up dead before they could ever make it there. The ones that did make it are lucky; the site has released statistics stating that 90% of the heroin brought in by users in one month tested positive for fentanyl. Multiple accessible sites need to be created.

Education is the solution, but the Canadian government is finding that to be a hard pill to swallow. A total of $26.3 million, from the federal Substance Use and Addictions Program, is given annually to various institutions including school boards and universities to combat drug abuse across the country. These disassociated institutions have to reach out themselves for the funding, which makes it a system about as cohesive and trustworthy as that random drink concoction someone gave you at a party.

While it is understandable that education is under provincial jurisdiction and cannot be totally uniform, this does not mean that provinces are helpless. Recently, provinces have been eager to alter their education programs. For example, Premier Wynne overhauled Ontario’s education system in 2015, expanding courses in subjects like sexual education. If Wynne could create more extensive sexual education courses, than she should be able to expand drug education programs as well. Why shouldn’t she, or other Premiers, throw in a batch of programs designated to educate students about drugs? That way, Canadians, specifically youth, might be overdosing on helpful school programs and readily accessible information, not ‘fet’. Canada has a drug problem, and it’s high time for an intervention.

 

 

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