London News & Search
Forget the old adage that what you don’t know, can’t hurt you.
When it comes to street drugs, what you don’t know can kill you.
That was the crux of a rare recent public health warning — three local health agencies and London police joined in its release — when authorities stressed the latest villain in Canada’s opioid drug crisis, the deadly painkiller fentanyl, is turning up in other illegal street drugs.
Critics scoffed at one suggestion springing from the urine tests of self-reporting drug users: that fentanyl is even showing up in marijuana.
But the wider message that too many people are taking street drugs without knowing what’s in them was quickly underscored when three drug overdoes in mere hours killed one person in Sarnia and left two others in hospital.
Cocaine laced with fentanyl is suspected in those cases.
Cutting other stuff into drugs is a practice that’s gone on for years — sometimes, to fatten drug dealers’ profits; sometimes, to make drugs more addictive.
Taking the public health message to heart, The Free Press took a closer look at some of the most common street drugs in London, how they’re used, what else might be lurking in them and the risks of using them.
What: A fast-acting synthetic opioid, 100 times more powerful than morphine, it has sparked a public health crisis across Canada, implicated in growing numbers of overdose deaths. As little as two milligrams of fentanyl, the equivalent of about four grains of salt, can kill you. That should be an eye-opener for other illegal drug users, since fentanyl has been detected in street drugs like crystal meth and heroin.
How used: On the street, gel from prescription patches, used to manage chronic pain, can be smoked, ingested or dried into a powder. Illegal powdered fentanyl has made its way into Canada from overseas labs and can be pressed into tablets made to look like prescription drugs such as oxycodone.
Toll: Fentanyl is the leading cause of opioid-related deaths in Ontario, killing 220 people in 2015 alone.
Contaminants: It’s difficult to trace the exact ingredients in the illicit fentanyl from overseas labs. As for street fentanyl, derived from prescription gel, it’s not clear what might be in it. “(Users) are drying out the fentanyl patches, and then making it into a powder and cutting it with other things,” said Jim Dean, a London criminal lawyer.
Effects: Shortness of breath, dizziness, drowsiness, lethargy and euphoria.
Quote: “Any chemical substance that’s in powder form can be mixed with anything, even pressed pills,” said Dean.
“People just get pill presses, mix the chemicals together, and put them in and make the pills.”
What: A narcotic painkiller, sold under the brand name Dilaudid, it has run second in Ontario only to fentanyl among opioid deaths.
How used: It’s available in injectable liquids and oral solutions, but Andrew Sharpe, a nurse practitioner at the London InterCommunity Health Centre, said hydromorphone pills — taken orally or crushed up, melted, made soluble and injected — are the most common form on the streets.
Toll: Hydromorphone was responsible for 207 deaths in Ontario in 2015. Prescription opioids, including hydromorphone, are the runner-up problem that substance-abuse clients seeking treatment at Addiction Services of Thames Valley report, second only to alcohol.
Contaminants: Some hydromorphone users mix the drug with heroin, says Narcanon, an international drug education and treatment group.
Effects: Drowsiness, relaxation, euphoria, trouble concentrating, dulled perception of pain and lower respiratory rate.
Quote: “Entry-level users will take the pills,” said Sharpe, adding longer-term drug users often turn away from swallowing tablets in search of a more intense high. “Lots of times they crush them up, heat them up and then inject them and then they get a much bigger high that way.”
What: A powerful stimulant, also known as ice, speed and crystal meth, it’s made in secret labs with relatively cheap and often dangerous ingredients.
How used: Made popular by biker gangs in the 1960s, the drug can be crushed and snorted, swallowed, smoked or injected. Compared to other street drugs, it’s cheap – averaging $10 to $20 for a tenth of a gram, said Karen Burton, needle and syringe program coordinator at the Regional HIV/AIDS Connection in London.
Contaminants: Over and above the toxic chemical ingredients used to make methamphetamine, including antifreeze, battery acid and drain cleaner, Burton said her needle-exchange and harm-reduction program has seen crystal meth laced with fentanyl for awhile.
Effects: Crystal meth is a stimulant, giving users an erratic high that can keep them awake for days. “The behaviour that comes with it is unpredictable. It generally keys people up, makes them a little more aggressive, a little more stimulated,” said Sharpe. If the drug is laced with fentanyl, even a single dose can be fatal.
Quote: “The purity of it changes from batch to batch, so that’s always a concern for us,” said Sharpe. “You can take basic chemicals, make it in your garage and you have crystal meth as long as you know the right chemistry.”
What: An addictive opioid, found in powder and tar forms on the street, it’s made from morphine that’s been chemically processed. First introduced in the late 19th century as a painkiller and cough suppressant, street heroin can be injected, snorted or smoked. It’s not inexpensive, averaging $30 to $60 for a tenth of a gram, said Burton.
Contaminants: Regional HIV/AIDS Connection harm-reduction coordinator Blair Henry said heroin is often laced with fentanyl. “The heroin, if it’s cut with fentanyl, makes it more powerful and more attractive to the end user,” he said. The RCMP have also warned of heroin cut with carfentanil, a synthetic opioid 100 time more powerful than fentanyl.
Effects: Surge of euphoria, followed by sedation and drowsiness. New users sometimes report feeling nauseous. If laced with fentanyl or carfentanil, a single dose could be deadly.
Quote: “What we’re hearing from the street is that it never was a really huge thing in London, but it’s definitely getting a little worse,” said Sharpe.
What: Its recreational use headed for legalization by the federal government next year, marijuana is the most commonly used illegal drug in Canada, the Centre for Addiction and Mental Health reports. Forty-four per cent of Canadians admit they’ve used pot at least once in their life.
How used: The buds of marijuana plants can be smoked or processed into oil.
Contaminants: The London warning that pot could be laced with fentanyl was based on urine tests of drug users who self-reported only using other drugs, not fentanyl, fueling doubt by many. Neither the RCMP nor Health Canada has reported any confirmed cases of fentanyl-laced pot.
Effects: THC, marijuana’s main psychoactive substance, mildly distorts perception and can make users feel relaxed and mellow or lively and energized.
Quote: “It’s a pretty cheap drug. In terms of mixing or lacing it with other things, I’m not sure,” said Sharpe, skeptical of the warning from Dr. Chris Mackie, London’s chief public-health official, and the accuracy of self-reporting. “In our experience, people don’t just use one drug.”
What: An illegal drug that goes back decades, exploding onto the scene in the 1970s and ‘80s, made infamous by pop music and Hollywood films, it’s a highly addictive drug derived from coca leaves. Typically, it’s snorted in its white powder form, giving users an energetic and euphoric high.
Contaminants: Though fentanyl has been mixed into cocaine, London police have also seized other drugs used as cutting agents, including phenacetin, a U.S. Food and Drug Administration-banned painkiller; pain relievers benzocaine, procaine and lidocaine; caffeine and levamisole, a drug used to treat parasitic worms in humans and animals. The department has also snapped up creatine and inositol, supplements used as cutting agents.
Effects: Cocaine can make users feel talkative, alert and euphoric. It can also cause erratic behaviour, panic attacks, increased heart rate, paranoia or hallucinations.
What: The highly addictive narcotic, known by its brand name Percocet, killed 179 people in Ontario in 2015. The prescription opioid pills are used to treat pain, but on the streets they can be crushed, snorted and injected.
Contaminants: Fake oxycodone pills, actually illicit fentanyl formed into tablets, have been detected by police, especially in Western Canada.
Effects: Sedation, reduced anxiety, relaxation, pain relief and euphoria. Counterfeit oxycodone pills made with fentanyl can be fatal.
London News & Search