Stats staggering in fentanyl-related drug deaths

Sixteen fentanyl-related overdoses all in the evening of Aug. 9 in Vancouver have brought national attention to an issue the Blood Tribe has been tackling head-on.

In March, the First Nation in the Blackfoot Confederacy in southern Alberta declared a local state of emergency in response to 13 deaths over four months due to drug overdoses.

“We can’t associate all of those (deaths) to the fentanyl. We believe they’re overdoses but until the toxicology comes back from the medical examiner’s office we can’t say they were fentanyl,” said S/Sgt. Joseph Many Fingers with the Blood Tribe Police Service.

In response, the BTPS instituted an Oxy-80 tip line, created a crime reduction unit with two dedicated police officers, and began educating the public. Declaring a local state of emergency, which is still in effect, also allowed the First Nation access to more services and support for the community, including Naloxone, which can be administered immediately – although not self-administered – to counter the initial effect of a fentanyl overdose.

Deaths have decreased on the Blood reserve because of the education and awareness campaign, said Many Fingers.

The tip line has yielded results as well. But also frustration. As quickly as the police get the drug dealer off the street and out of the reserve, there is someone else to take his place. And after the dealer has paid his fine and served his sentence, he is back in the community selling drugs that are cut with fentanyl. Dealers from other reserves are also trying to get a foothold on the drug trade on the Blood reserve. But Many Fingers says there are also local sources for the illegal drugs. The profit is too great for a fine and insignificant jail time to be a deterrent, he said.

“We’ve just got to stay on them,” said Many Fingers, who points out that all the law enforcement agencies are working in cooperation, whether they’re tribal police or RCMP.

On the street, fentanyl is commonly called Oxy-80 or fake Oxy (as there is little oxycodone in it) or “greenies.” Fentanyl is 50 to 100 times more potent than morphine and 750 times stronger than codeine. Fentanyl is cut into the mix with prescription drugs or used to lace illegal drugs.

Often times, users either don’t know how much fentanyl their drugs include or that their drugs do include fentanyl. Fentanyl taken with alcohol can be lethal. The drug is extremely addictive and “the high they get from it is apparently greater than morphine,” said Many Fingers.

While Many Fingers hasn’t heard of any other First Nations that have declared a local state of emergency because of fentanyl, he said, “Pretty much all of Canada is having problems with itÖ. I know western Canada, Saskatchewan, Alberta and B.C., lots of problems, lots of overdoses, lots of deaths.”

Recent numbers provided by the Canadian Community Epidemiology Network on Drug Use indicate that deaths in these three provinces have increased significantly since the network put out its first alert on fentanyl in June 2013.

Many Fingers blames organized crime for making fentanyl a cheap, popular and easy-to-access commodity.

According to the RCMP, fentanyl is making its way to the illicit drug market as either a diversion of pharmaceutical fentanyl from domestic supply or through smuggling, primarily from China, where fentanyl comes in to the country in powdered form and Canadian-based organized crime produce illicit fentanyl products.

On July 22, a joint investigation by the Calgary Police Service, the RCMP and Alberta Health Services resulted in the arrest of a Calgary resident and seizure of 122 grams of fentanyl, worth an estimated $348,000. The investigation began a week earlier when an officer at the Canadian Border Services Agency’s Vancouver International Mail Centre intercepted a parcel from China. Upon investigation, the officer discovered an unknown white powder she suspected was fentanyl.

So far this year, Calgary police have had 34 incidents involving fentanyl seizures compared to only 12 incidents in 2014. Data provided by Health Canada’s Drug Analysis Services indicates that seizures of fentanyl had increased over 30 times from 2009 to 2014.

Figures provided by the Epidemiology Network are staggering. Between 2009 and 2014, at least 655 deaths in Canada were either fentanyl-caused or contributed. In that same time frame, there were at least 1,019 drug poisoning deaths in Canada where fentanyl was indicated in post-mortem toxicological screening; more than half of these deaths occurred in 2013 and 2014.

Dr. Matthew Young, with the network, says no figures have been gathered specific to Aboriginal populations, either off or on-reserve.

Dr. Jennifer Melamed, who operates out of Alliance Clinic in Surrey, B.C., says fentanyl is impacting anybody who uses heroin, whether it’s the suburban “recreational user,” the working class or the homeless. The Alliance Clinic treats opioid addicts providing them with methadone or suboxone.

While fentanyl is only now coming to the public’s attention, Melamed says it has been an issue for years.

“I asked a patient if she was scared about fentanyl out there. She said, ‘No, it’s been out there for three years,’ and she’s right…. For the last three years we’ve been seeing it in the urine and nobody’s changing their behaviour,” said Melamed. “When you’ve got the disease of addiction and all you can think about is the next high … nobody learns because everybody believes it won’t happen to them and they’re the next one that gets caught in it,” said Melamed. “It’s a horrible problem, but it’s not going away.”

Many Fingers agrees, saying fentanyl is only the latest in drug-addiction fads.  A few years ago it was OxyContin. When law enforcement finally gets a handle on fentanyl, it will be replaced by something else.

“I don’t think …we’re going to say we’re ever going to stomp out the drug trade,” he said. “It’s a lucrative business. That’s why we have so much trouble in today’s society. There’s so much money to be made and it’s easy money.”

Photo caption: “Whether you’re a recreational user popping a pill, or an entrenched user shooting heroin, you won’t see, smell or taste fentanyl, but it could very easily kill you,” said Dr. Nicholas Etches, Alberta Health Services Medical Officer of Health. AHS has launched a public campaign.