The rise of fentanyl in the US and Canada
According to an El País article, this drug is a powerful medical painkiller. Originally designed to relieve acute pain in cancer patients. When mixed with drugs such as heroin, it is causing an epidemic of overdose deaths in the United States and Canada. According to the US Department of State, the fentanyl problem is described as “the worst drug crisis in the history of the United States.”
Mireia Ventura, a Doctor of Pharmacy and researcher at Energy Control in Barcelona, states that fentanyl’s entry into the North American market is due to the fact that it is a cheap and very potent drug. And because the supply of heroin does not meet demand in these countries. “In general, it is adulterated when a substance is not available,” she sums up.
Nearly 2,300 Canadians died last year from an opioid overdose. The situation continues to worsen, as deaths linked to illegal drugs increased by 50% in the first quarter of 2017 compared to last year in the province of British Columbia. For the first time, deaths from heroin surpassed those from firearm homicides in 2015.
Canada’s Minister of Health, Jane Philpott, comments that “this crisis is one of the greatest public health challenges in our country, and we cannot even quantify it accurately.” Philpott placed fentanyl at the centre of her opening address for the 25th International Harm Reduction Conference. The minister announced an emergency plan that includes opening new supervised injection sites. And also commissioning an epidemiological study to help understand and tackle the crisis.
Fentanyl testing in drugs
Between July 2016 and March 2017, the team led by Mark Lysyshyn, an epidemiologist and professor at the University of British Columbia, analysed more than 1,000 drug samples from users of Vancouver’s supervised injection site, Insite (North America’s first supervised injection site). Nearly 8 out of 10 contained fentanyl. 82% of what they bought as methamphetamines was adulterated with this substance. And in 83% of the samples believed to be heroin, this dangerous opioid was also found. In 40% of the cocaine analysed, fentanyl also appeared, which is 100 times more toxic than morphine. Those who discovered through the test that what they had bought contained fentanyl did not stop injecting. But the likelihood that they reduced the dose was 10 times higher.
“The study shows that the state of alert we are living in is fully justified,” says Rick Lines, Executive Director of the conference organiser Harm Reduction International. “If drug checking can help users at an injection centre, a controlled place where there has not been a single overdose death, imagine what it can do on the street. These types of interventions can save many lives,” he added during the presentation of Lysyshyn’s study.
The test used in Vancouver produces results in seconds. It is adapted from reactive strips used to analyse urine. A small amount of the drug is diluted in water, heated, and the strip is inserted. If there is fentanyl, a line appears. Lysyshyn notes that, for now, the system only detects this substance and not the amount, nor its many analogues.
Fentanyl enters the United States illegally from China, according to the Department of State report. The Trump Administration has just announced that the United States will toughen penalties for possession and drug trafficking. And Canada already has a bill in Parliament to decriminalise cannabis use. It is also committed to harm reduction in the form of needle exchange programmes and supervised injection sites.
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