FENTANYL AND BEYOND
Fentanyl use and distribution has exploded in Canada over the last couple of years, and it’s going to get worse before it gets better, and fentanyl seems to be just the tip of the iceberg.
Increasing access to naloxone, safe injection sites, and increased opioid reporting and early-warning systems will help, but won’t stop the market for the drug from increasing.
The practice of drug producers and traffickers cutting their product with supplemental substances is not new. But the use of fentanyl and other opioids to do so is not only uncommonly deadly, it can also clearly trace its roots to the “the national crisis of prescription painkiller abuse, and associated medical prescribing practices.”
“Anchored between domestic criminal entities and those based in China, 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.”
Not Fit For Human Consumption
Carfentanil, a synthetic opioid so deadly police say as little as 20 micrograms would be fatal to the average person, with one microgram being smaller than a grain of salt.
Carfentanil is more commonly used in zoos and by wildlife workers as a tranquilizer for elephants and other large animals. Parts of the U.S. have recently seen an alarming number of carfentanil overdoses. Ohio, for example, had 25 overdoses in just a three-day period in July.
“It’s 10,000 times more powerful than morphine, 100 times stronger than fentanyl,” “It’s not for human consumption. It’s for large animals.”
In many cases of overdose, the carfentanil has been mixed into heroin, at times without the drug user’s knowledge. Police in East Liverpool, Ohio, said they suspect carfentanill was involved in the case of a couple who were photographed overdosing in their car and whose photos were posted online by police as a way of attracting attention to the drug problems officers are dealing with.
“It wouldn’t surprise me at all to know that we got more and more bionic opioids responsible for mortality on our streets,” said Dr. Hakique Virani, medical director at Metro City Medical Clinic, an addiction treatment centre in Edmonton.
W-18 is 100 times stronger than fentanyl and 1,000 times more powerful than morphine.
Part of the “W-Series” of opioid compounds, W-18 was developed at the University of Alberta in 1982. The drug proved to be the strongest of the 32 compounds in the series and for that reason, W-18 was deemed unsafe.
“Typically things move from west to east and we saw that with fentanyl. We’re continuing to see that with fentanyl and we imagine that probably we’ll see the same thing with W-18.”
What’s worse, officials with the College of Physicians and Surgeons said so little is known about W-18 – it’s unclear if naloxone will reverse its effects in the event of an overdose.
Yet Another Unregulated Substance
A research chemical called U-47700, an opioid painkiller developed by chemists at an American pharmaceutical company in the 1970s, appears to have recently turned up at a Calgary emergency room. The patient told doctors that he bought the powder over the Internet and snorted too much, triggering an overdose, said Dr. Mark Yarema, medical director of Alberta’s Poison and Drug Information Service.
Physicians who treated the patient contacted Yarema asking what he knew about U-47700, which is not regulated by drug laws. They wanted to know how long they needed to keep the patient for observation. The assignment required some background research.
“The patient ended up getting several doses of naloxone and needed to be on a naloxone infuser for several hours in the emergency department,” he said, referring to medicine that reverses the effects of opioid overdoses.
It was the first case of U-47700 Yarema has seen in Alberta, but the drug has cropped up across the United States. The Drug Enforcement Administration has found that U-47700 can be acquired from online vendors of research chemicals for as little as $70 per gram and delivered in less than a week.
Resources: CBC News, Calgary Herald, Global News
Any comments would be greatly appreciated – Jeff Dibble