Health officials are warning about a designer drug known as U-47700, after the powerful opioid killed four people in Halifax last year.
Toxicology reports show two of the fatal overdoses were caused by a mixture of U-47700 and fentanyl. The same drug cocktail was found in pills at Prince's estate last year after the music icon's death.
U-47700, also known as U4, is made in clandestine labs. It's typically sold online and sent through the mail, similar to illicit fentanyl.
'We're playing catch up'
Dr. Robert Strang, Nova Scotia's chief health officer, said he first heard about the drug a few months ago.
"They're highly skilled chemists so you know they're making a whole range of drugs," said Strang. "It's a growing issue that in some ways we're playing catch up on."
The introduction of more illegal opioids such as U-47700 has Strang considering the idea of prescribing heroin as a managed approach to dealing with addiction. He said it's part of the "growing conversation in Canada."
"It's driving us to think differently about what solutions we need to put in place in terms of access to safer forms of prescription-quality opioids," said Dr. Strang.
Popular with teenagers
Natasha Touesnard, who teaches Halifax drug users how to use naloxone — an antidote that helps reverse the effects of an overdose, has heard about U-47700 from young people.
"Even high school kids can order it, you know, if they choose," she said.
"There's been a lot of media coverage on how to buy drugs online and I think a lot of people now seeing that know how to purchase online."
According to Matthew Young at the Canadian Centre on Substance Abuse, the white powder can also be disguised as cocaine or other pills.
He said the biggest danger is that people have no idea what they're getting.
"Purchasing these pills is kind of like reaching your hand in a gumball machine, where the green ones will provide the effect — the intended effect or maybe no effect at all — and the red ones can potentially kill you," said Young.
Nova Scotia's Department of Health is currently working on a plan to tackle the opioid crisis, which Strang said has already led to improvements.
"We have a much better capacity now working with the medical examiner's office to actually do monitoring of overdose deaths," he said.
"EHS crews all have naloxone. Many of our frontline police officers now have naloxone and we continue to build on that capacity."
He said the next step is ensuring those adjustments are actually making a difference.
"If we're not seeing the right impact, we need to adjust those programs and make sure we're getting the outcomes we need from them," said Strang.