Law-enforcement seizures reveal fentanyl's creep into heroin and now cocaine

While the portion of cocaine contaminated with fentanyl remains low, it is growing; meanwhile, heroin is being entirely replaced

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      On March 19, Vancouver Coastal Health used its drug-contamination-alerts system to issue a rare warning about cocaine.

      “Powder cocaine tested at Insite found to contain cocaine and fentanyl,” the text message reads. “Sold in East Van as white powder with brown chunks.”

      According to federal data supplied at the Straight’s request, in 2018, the dangerous synthetic opioid fentanyl appeared in 3.3 percent of cocaine samples that law-enforcement agencies sent to Health Canada’s Drug Analysis Service (DAS). That’s up from 2.5 percent the previous year, 0.94 percent in 2016, and 0.31 percent the year before that. The numbers are low but rising.

      Heroin, meanwhile, is being entirely supplanted by fentanyl and, more recently, an even more potent synthetic opioid called carfentanil.

      In 2017, DAS for the first time found more heroin samples contained fentanyl than did not. In 2018 the trend continued, with 2,571 heroin samples containing fentanyl compared to 1,217 recorded as straight heroin.

      Jenny Kwan is the NDP MP for Vancouver East, a riding that is often described as the epicentre of Canada’s overdose crisis. On the phone from Ottawa, Kwan said B.C. needs to continue with harm reduction and expand existing services with more radical initiatives.

      “Dead people don’t detox,” Kwan told the Straight. “We need to take every measure possible to save lives.”

      She suggested Canada look to Portugal, where, in 2001, the government eliminated criminal penalties for the personal possession of drugs and invested heavily in treatment options for addiction.

      “We need to address this as a health issue, truly, and not a criminal-justice issue,” Kwan said. “And until we decriminalize, I don’t think we’re going to get there.”

      Decriminalization is a policy suggestion that’s gaining traction in B.C. It’s received support from top provincial health officials and former Vancouver mayor Gregor Robertson, among others. But Prime Minister Justin Trudeau has repeatedly said a Liberal government will not consider decriminalizing hard drugs.

      Kwan also called for Ottawa to declare the opioid epidemic an official public-health emergency, something else that she noted the Liberal government has repeatedly declined to do.

      Travis Lupick / Health Canada

      Another idea that Kwan described as deserving of public debate is regulated supply. She referenced a February 2019 report by the B.C. Centre on Substance Use that lays out a legal framework for people addicted to opioids to obtain prescription heroin from a pharmaceutical company as opposed to from dealers on the streets.

      “People are putting their heads together, saying, ‘This might work and might save lives,’ ” Kwan said. “Any initiative that could achieve those goals is worth exploring.”

      The same day as VCH’s alert for fentanyl-laced cocaine, the health authority released its latest monthly report on overdose deaths. It revealed that in 2018, the province for the first time surpassed 1,500 fatal overdoses in a single year. Fentanyl was associated with 87 percent of those deaths, up from 15 percent five years earlier.

      To receive bad-drug alerts from the B.C. Centre for Disease Control and Vancouver Coastal health, B.C. residents can text “alert” to 236.999.3673.
      Travis Lupick

      Dr. Mark Lysyshyn is a medical health officer with Vancouver Coastal Health. In a telephone interview, he noted the extent to which law enforcement has failed to curb fentanyl’s infiltration of illicit-drug markets.

      “The more we try to enforce [prohibition], the more potent the drugs become in order to evade enforcement action,” he explained. “That’s the pattern.”

      Similar to Kwan, Lysyshyn argued that it is time for Canada to begin real discussions about regulating supply.

      “We know that street drugs come from a completely unregulated market, and…each time a substance passes hands, it can be adulterated or errors can be made,” he said. “So I’m in support of all proposals that seek to provide people with safer alternatives to the drugs they are using now.”