A common joke told around the Downtown Eastside is that there is no heroin left in Vancouver, only fentanyl. Now a study out of UBC suggests that jest actually has some truth to it.
“The proportion of opioid users in the Downtown Eastside who tested positive for fentanyl jumped to 100 percent from 45 in just five months last year,” reads a UBC media release.
Researchers led by Dr. William Honer, head of UBC’s department of psychiatry, monitored 237 Downtown Eastside homeless people and residents living in the neighbourhood’s shabby hotels. Participants attended monthly meetings from March 2017 to July 2017, answered questions about their drug use, and provided urine samples that were cross-referenced with their responses.
“Fentanyl-positive urine samples increased rapidly during a 5-month period while opiate-positive samples declined,” reads a paper based on the study that was published in JAMA Psychiatry.
“By July 2017, all samples from participants reporting nonprescribed opioid use were fentanyl-positive.”
Honer is quoted in the release as calling attention to the speed with which participants’ drug supply changed.
“Our report shows how quickly things can change,” he said. “High-risk drugs can enter the distribution systems very quickly.”
The paper states that these findings raise questions about the effectiveness of opioid-agonist treatments for addiction, such as Suboxone and methadone.
It also notes that many participants who tested positive for fentanyl claimed that they had not taken fentanyl.
“The low concordance between reported fentanyl use and detection is consistent with unawareness of exposure,” it reads.
“Rapid and specific tests for fentanyl and related analogues are urgently needed, along with innovative treatments,” the paper concludes.
The project's key finding, that 100 percent of nonprescription-opioid users tested positive for fentanyl, is not surprising or far out of line with other statistics illustrating the extent to which fentanyl has contaminated B.C.’s illicit-drug markets.
The B.C. Coroners Service has reported that fentanyl was associated with 81 percent of more than 1,400 fatal overdoses recorded in 2017. In addition, Vancouver Coastal Health has reported that of the 1,500 tests conducted at Insite through 2017, 84 percent of samples that users believed to be heroin tested positive for fentanyl. For nonopioid drugs (methamphetamine and cocaine, for example), that number was 65 percent.