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Hey there, time traveller!
This article was published 04/12/2016 (2692 days ago), so information in it may no longer be current.
Authorities and community leaders have found themselves in a desperate battle against a new drug crisis, with two powerful opioids at its centre.
Authorities and community leaders have found themselves in a desperate battle against a new drug crisis, with two powerful opioids at its centre.
Times
Winnipeg police say fentanyl and carfentanil are commonly available in white powder form and are usually misxed into OxyContin, cocaine, crystal meth and other street drugs.
The opioid medication fentanyl, used clinically as a sedative, and its derivatives are at the heart of several overdose cases which have proved fatal in recent weeks.
On Nov. 20, police officers handled two cases at which drug paraphernalia was seized, and fentanyl is suspected as the primary cause of overdoses leading to two deaths.
On Nov. 16 in the Maples area, three adults died after overdoses believed to be linked to the deadly drug. Police found white powder in the house, which was seized and sent for laboratory testing.
Early in September, police seized 1,477 blotter tabs of carfentanil — a more powerful form of fentanyl, which itself can be 100 times stronger than morphine — from a hotel room in the city and, since then, Winnipeggers have continued to hear new reports of deaths and near-death cases linked to the two opioids.
In October, two men were found dead in a parked car on College Avenue, and a baby was rushed to the hospital after being carelessly exposed to carfentanil. He has been treated and placed in care.
Supplied photo
One of the naloxone kits that have been distributed to Manitoba RCMP
officers to treat opioid overdoses.
In November, Manitoba health minister Kelvin Goertzen told the provincial legislative assembly that 24 Manitobans had died in 2016 with an opioid in their system. Of those, fentanyl was considered a primary cause or contributing factor in nine deaths.
According to Winnipeg Police Service spokesperson Const. Jason Michalyshen, fentanyl and carfentanil are commonly available in white powder form and are usually mixed into OxyContin, cocaine, crystal meth and other street drugs.
Michalyshen also warned that although police still haven’t found opioids in marijuana, “It doesn’t mean it’s not present.”
Michalyshen also said it’s hard to determine if a powder is fentanyl or carfentanil other than through laboratory testing — which is one of the reasons people are using the drugs without knowing they are.
“You’re not going to see it, you’re not going to smell it, you’re not going to taste it certainly, regardless of what your drug of choice is.
“If it’s contained within and you don’t know it, it can kill you, bottom line.”
Michalyshen said police, community partners, families and friends of those who have died are seeking for answers.
“Why are they using the drugs that they are? And why, despite the fact that we’ve put out some pretty strong messaging as of late, (are) individuals still willing to take that risk?” he said.
“It is mind-boggling, it’s concerning but we all know that there are individuals that are dependent.”
Drug use on the rise: Bear Clan leader
Bear Clan Patrol leader James Favel refers to opiods as “scary things.”
He said the number of people on drugs has risen, and that he’s personally seeing an unprecedented level of intravenous drug use. During Clan patrols last year, the group picked up 10 to 25 needles in total. This year they have found as many as 70 in one week — all in areas frequented by children.
“As a community member and a parent, I am worried about it on many different levels,” Favel continued. “I’m not sure where they are getting it from, I don’t know why they are using it, and I don’t know how they are using it. This thing is so strong I don’t know how they get access to it. It doesn’t make sense.”
Emergency services first responders have reported they receive daily calls of fentanyl overdoses. Recently, 67 Bear Clan Patrol members received kits of the fentanyl antidote naloxone and were trained to use it in case they come across someone who has overdosed.
Dr. Joss Reimer, the Winnipeg Regional Health Authority’s medical officer of health said naloxone could be very useful in the short term. The challenge is the dose of fentanyl or carfentanil that someone has ingested.
“If you can get naloxone into someone’s system it will be effective. The challenge of that is that, especially with carfentanil, depending on the doses, you need higher doses of naloxone,” she said, adding medical help must not be dismissed.
“(Naloxone is) short-acting and potentially the (opioid) starts acting again after an hour or so.”
Reimer said much of the WRHA’s testing of fentanyl and carfentanil was not done using human subjects. Carfentanil is not made for human use and is commonly used as a sedative for elephants. Therefore, it’s hard to determine exactly what amount could be fatal but Reimer said, based on what researchers have seen, as little as two milligrams can be deadly.
Michalyshen said although police and other community organizations have worked hard to make people aware of the dangers of opioids, there are still drug users willing to take the risk they may be using something contaminated with the killer medications.
“Individuals who are engaged in this, they’ve heard the message, they know what’s going on; they know that there’s that risk. Sadly, they are individuals who are willing to take that risk,” he said.
“It’s frustrating but it’s even more concerning when we see this mentality where we have individuals who are willing to put themselves at such risk, knowing what we know.”
Michalyshen said a major concern of police is that fentanyl is present in other drugs and it’s well-disguised, most times being sold as cocaine or meth.
“This isn’t all about the drug dealer or the individual who uses drugs on a regular basis. This could be that 17-year-old who has never used drugs before, who goes out with friends and is curious. ‘I’m going to try that tonight’ and doesn’t wake up tomorrow,” he continued. “This isn’t about fear-mongering or creating this absolute fear, although the results, I think, should be quite fearful.”
Reimer shares Michalyshen’s concern that people are using opiods without being able to control the dosage or are using them unknowingly.
“Opioids are designed as painkillers. As you take higher dosages, they not only block pain sensations, they also start to slow your heartbeat down, and they slow your breathing,” Reimer said.
“They trick your brain into thinking that you don’t need any more oxygen, so you don’t breathe as much and eventually stop altogether.”
Addressing the problem in the classroom
Nick Davis-Peters, the Addictions Foundation Manitoba (AFM) school addictions counsellor for Seven Oaks School Division’s high schools, said students are curious to learn more about fentanyl but not many students have told him they’d tried it.
Students have some questions about the potency of the opioids, and he said there has been some apprehension about fentanyl.
“It feels like, or hopefully, it’s an opportunity to be more proactive, provide information,” he said. “There have been reports from people who have tried it in the past and have had ‘scary experiences’ and that deterred them from doing more drugs.”
Davis-Peters said parents, caregivers and teachers should have ongoing honest and non-judgmental conversations with teenagers and children concerning this crisis that has affected many Winnipeggers. He said while fear tactics might work with some youth, there are groups of teenagers that won’t listen.
“If you are judgmental of people who are making these choices and they look for help and are met with this judgment, that’s one less person they’ll reach for information,” he said. “As adolescents, this is a normal time of curiosity and rebelliousness and risk-taking. But based on all the information this is not a risk they want to take. And perhaps there’s that belief that it won’t affect me, and somehow I’m different than others, or somehow I can handle my substances.”
The Winnipeg Police Service and AFM are working together to have students attend workshops where they explain the dangers of fentanyl, carfentanil and other drugs, what an overdose looks like, and what strategies can be used in case of an overdose.
“We need to dig deep and continue those conversations and provide those supports with respect to individuals who are continuing to put themselves and others at risk with this lifestyle,” Michalyshen said.
Favel thinks the only way to save the youth is to engage with them. The Bear Clan Patrol has organized mock patrols and invited young people to walk with them.
“Engaging with our youth is the only path. We have to be more responsible and responsive to the needs of our youth. It takes a village to raise a child, and it does,” he said.
National opioid summit leads to action plan
Last month, Kelvin Goertzen Manitoba’s health minister, attended the National Opioid Summit at which the federal and provincial governments, together with health professionals from across the country, met in Ottawa to discuss and develop a co-ordinated national response to the opioid crisis.
At the end of the two-day conference, Manitoba committed to improving data collection to target interventions better; to expand access to Manitoba’s provincial naloxone distribution program; to improve prescription-drug monitoring to prevent prescription drug misuse; and to provide specialized education for service providers and parents.
“Our goal has been to reduce the impact of opioids through the distribution of naloxone on an expanded basis but also to aggressively warn parents and all Manitobans of the dangers of this drug, its presence in drugs where users cannot know it is hiding, and the dangers it poses to unsuspecting and vulnerable children and to our first responders — police, fire and paramedics,” Goertzen said in a statement.
On Nov. 24, the RCMP and the Chinese Ministry of Public Security partnered to combat illegal importation of these opioids, which according to Michalyshen, most of it is coming from overseas.
“There are no known illegal labs in the province or none identified as of this time. Much of what’s being brought forward into Manitoba is likely, and some point comes from overseas,” he said.
The next day, Goertzen and provincial justice minister Heather Stefanson announced a new social media campaign to inform and educate youth about the dangers posed by these drugs to both users and non-users and their presence in common recreational illicit drugs.
The province is also developing a program to distribute naloxone to high-risk injection opioids users and is seeking federal restriction on pill presses.
Although many strategies will be taken place from now on, authorities say this crisis won’t go away too soon and numbers will continue to rise.
“This is going to stick around for quite some time because it’s easier and cheaper to transport and get across borders. That makes it very appealing to drug dealers,” Reimer said.
“I think the reality is that it’s going to take time and it’s going to take all of us having the conversations with people who are engaged in this type of behaviour before there are any significant changes,” Michalyshen said.
Responding to a fentanyl overdose
When opioids attach to opioid receptors found in the brain, spinal cord, gastrointestinal tract, and other organs in the body, they reduce the perception of pain.
Abuse of opioids can produce euphoric sensations because they affect the reward centres of the brain by flooding the circuits with dopamine — the effect sought by people abusing these substances.
However, according to Dr. Joss Reimer of the Winnipeg Regional Health Authority, high doses of opioids can slow a person’s breathing during an overdose until it stops, causing death by asphyxiation.
Reimer notes a few signs of a opioid overdose:
• Sleepiness;
• Slow breathing;
• Trouble speaking and walking;
• Skin becomes cold; and
• Awkward, shallow breathing and snoring.
Naloxone, the opioid antidote now carried by police and emergency responders, blocks opioid receptors to reverse the respiratory effects which lead to death. Rescue breathing can also help save a person’s life. Reimer said it’s important to make sure the person going through an overdose continues to breathe.
Although these strategies may help, medical assistance must not be dismissed.
Reimer counselled that people avoid doing drugs by themselves, that they stick to what they are using and with the same dealer.
WAYNE GLOWACKI / WINNIPEG FREE PRESS
Const. Jason Michalyshen said police are concerned with the well-being of Winnipeggers who are buying drugs on the streets.
Police officers
Ligia Braidotti
Nick Davis-Peters, AFM school addictions counsellor for Seven Oaks School Division, said students have been curious about fentanyl and carfentanil’s potency and that they’ve been apprehensive about the opioids.PHIL HOSSACK / WINNIPEG FREE PRESS
James Favel, Bear Clan Patrol leader, said they’ve collected 70 used needles in one week, a record number since they’ve started patrolling the North End.RUTH BONNEVILLE / WINNIPEG FREE PRESS
Health Minister Kelvin Goertzen announced several strategies the province will be taking in response to the opioid crisis.
