Toxic drug supply and COVID-19 measures increase overdose risks

·3 min read

WATERLOO REGION — Last week, following a string of suspected overdose deaths, public health issued an alert about new strains of fentanyl. Experts say that an unregulated toxic drug supply, compounded by COVID-19, is to blame.

According to Waterloo Region’s Overdose Monitoring Alert and Response System, as of Nov. 3 there has been a nearly 30 per cent increase in overdose-related deaths since 2018. With 239 overdoses in September and October alone, this doubles the number of overdoses compared to the same time last year.

Joanna Han, co-ordinator of the Integrated Drugs Strategy, said that questions about new strains of fentanyl will remain unanswered without rapid drug testing services like in Toronto.

“All we know is that it’s extremely toxic.”

Han said that Waterloo police regularly send samples of drugs they find for testing, but because it takes months to get results back, “it’s not really useful for us because a new batch will be circulating by then.”

Violet Umanetz, site supervisor at the Consumption & Treatment Services site on Duke Street West, wrote in an email that fentanyl has been used pharmaceutically for many years. “If people were accessing pure fentanyl or standardized doses, the risks would be manageable and the effects over time would be somewhat predictable.”

Fentanyl enters the Canadian illegal drug market by import from other countries, illegal laboratories in Canada, and theft of medical fentanyl products.

The last decade has seen more potent strains of fentanyl and its analogues popping up across North America. Models developed by Public Health Canada project that the 2020 opioid overdose crisis “may resurge or surpass levels seen at the height of the opioid overdose crisis in late 2018” and that the level of fentanyl in the drug supply will impact the rate of fatalities.

Umanetz wrote that what drug users are told is fentanyl may be something else entirely.

“We don’t have access to rapid drug testing … we have no way of knowing what people are actually buying or using in ‘real-time’ — no way to warn people about what the effects may be of using that particular substance.”

Instead of pure fentanyl, people are getting drugs cut with caffeine, sedatives, veterinary pharmaceuticals, Benefiber, benzodiazepines, and other random agents.

“The restriction on travel, particularly cross-border, has significantly impacted on the availability of many drugs,” Umanetz wrote, “which makes it harder to find, more expensive to purchase, and more likely to be ‘cut’ with unwanted substances.”

Han agreed and said that with borders closed because of the pandemic, people who make illicit drugs are relying on new supplies and materials, increasing the risk of drugs being more toxic and unreliable.

A report published last Tuesday from the Ontario Drug Policy Research Network, Ontario’s chief coroner, Public Health Ontario, and the Centre on Drug Policy Evaluation reveal how COVID-19 and the response to the pandemic have exacerbated the opioid crisis.

Preliminary data show overdose-related deaths increased by 38 per cent in the early months of the pandemic, and that Wave 1 COVID-19 emergency measures enacted by provincial and municipal governments resulted in “a reduced capacity for pharmacies, outpatient clinics, and harm reduction sites providing care to people who use drugs.”

Ruth Cameron, executive director for AIDS Committee Of Cambridge, Kitchener, Waterloo & Area, said that the issue now is not a lack of research.

“There comes a time where more studies aren’t warranted, and the moral and ethical thing to do is to act with the evidence you have.”

A Freedom-of-Information request from the New Democratic Party revealed that from Jan. 1 to Oct. 2. there had been no email correspondence between Ontario’s health minister and top officials regarding the opioids crisis this year.

Cameron said that, in order to save lives, the federal and provincial governments need to act. “We have a wide range and a number of proven tools at the ready, all we lack is the funding to implement them at the municipal level."

Fitsum Areguy, Local Journalism Initiative Reporter, Waterloo Region Record