An Ontario-wide plan to reduce the use of OxyContin could have inadvertently led to a spike in the use of fentanyl.
Both are prescription opiates, but a recent manufacturing change prevented OxyContin from being crushed for snorting or smoking, said a spokesman for Alberta’s ALERT integrated policing unit.
The tamper-resistant formulation, called OxyNeo, was introduced to the Canadian market in early 2012.
“There’s definitely a correlation between the decline of Oxy and the rise of fentanyl,” said Const. Chris Auger of the Ontario Provincial Police drug diversion unit, Maclean’s magazine reported.
In a five-year span, there were at least 655 fentanyl-related deaths in Canada. That’s one death every three days and that’s likely an underestimate, the Canadian Centre on Substance Abuse wrote in a study.
The agency looked at figures from 2009 to 2014 but warned that there was a sharp increase in the last two years, in 2013 and 2014. That increase may be because of the sudden drop in OxyContin abuse.
Both legally-prescribed and counterfeit versions of fentanyl have flooded the country’s streets since OxyContin abuse fell off.
In another twist, Fentanyl is often sold as “fake Oxy,” even though it’s much more potent. Raw powder is imported into Canada and illegally mixed with blue or green dye, then pressed into pills that resemble OxyContin tablets.
Users, not knowing what they’re getting, often overdose. Fentanyl can produce a euphoric high and pain relief. However, overdosing can cause blood pressure to plummet, slowed breathing, deep sleep, coma or death.
“In its liquid and powder form, fentanyl increasingly being used to cut cocaine and heroin, dramatically boosting their potency, often with fatal consequences,” Maclean’s reported.
Again, users who believe they are getting one street drug are instead getting another, and they may be dying because of it.
Typically, fentanyl is prescribed as a patch, though it can also be sold as a lozenge, nose spray, tablet or pill. Black-market users sometimes squeeze the liquid from the patch and eat it, while others chew patches that have already been used.
They still get high due to the potency of the drug: Experts say fentanyl is 100 times more powerful than morphine.
Each patch is meant to provide 72 hours of pain relief. One user told Maclean’s he took two patches a day, either chewing them or scraping out the gel and injecting it into his body.
The solution to the crisis might be familiar to OxyContin users: make fentanyl more difficult to obtain.
In North Bay, which has a population of just 55,000, there have been 16 overdose deaths since 2007. To put it in perspective, the city only had one murder over the same period, Maclean’s reported.
Pharmacists in North Bay now require those with a prescription to bring back every one of their patches before the prescription is refilled. One pharmacy said it saw a 20 per cent drop in refills and the street price of the drug skyrocketed.
But what, then, will take its place?