TEST STRIPS LET USERS SEE IF THEY’VE BEEN EXPOSED TO FENTANYL
AIDS committee hopes to use results for study
The issue isn’t just fentanyl, it’s that people don’t know the content and strength of the drugs that they’re consuming.
A project launched this week by the AIDS Committee of Ottawa is offering urine test strips that reveal to people who have used drugs whether they’ve been unwittingly exposed to the powerful opioid fentanyl.
“We’re hoping to give community members a free and simple way to find out whether or not they’ve been exposed to fentanyl through recent substance use and we’re also hoping, if we can, to collect a bit of data on what those results might be,” ACO harm reduction coordinator Caleb Chepesiuk said.
“We also want to get a greater conversation going about drug quality, drug use and the interventions to reduce those risks.”
The Where’s the Fent? project offers a free, anonymous way for people to check if they’ve been exposed while trying to get a better idea of the situation in Ottawa, where public health officials and first responders have warned of the dangers of bootleg fentanyl in counterfeit pills and street drugs.
ACO plans to collect the results of those people who are willing to fill out a short form — no name is required — to create a report on their findings.
If people who use the strips are “angry, scared, confused” about the results, organizers of the project urge them to “talk to us first! We strongly encourage people not to use these test results to accuse or threaten someone you may have gotten the drugs from. Your safety is important!”
Fentanyl has been found by Ottawa police lacing street drugs from heroin to cocaine and in pharmaceutical look-alikes, such as the counterfeit Percocets police believe were taken by 14-year-old Chloe Kotval, who overdosed on Valentine’s Day. Police are also investigating the death of another west-end teen who they suspect also consumed counterfeit pills.
The test strips and a urine cup are available at the ACO’s Main Street office, where users can take the test on the spot or take it home. It works like a pregnancy test with results revealed minutes after the strip is dipped in urine.
The test must be used within 36 hours of using the substance and the sooner the better because some people’s bodies clear fentanyl faster.
It only detects fentanyl and fentanyl analogues that our bodies turn into a substance called norfentanyl. Organizers warn a negative test doesn’t rule out exposure to another opioid or adulterant. The test doesn’t pick up so-called novel opioids like the even-stronger carfentanil or U-4770.
After a series of overdoses, Ottawa Public Health and city police teamed up last month to warn the public about counterfeit pills that look nearly identical to prescription opioids like OxyContin and Percocet but contained fentanyl, which is 50 to 100 times stronger than morphine. Users are getting them from friends, ordering them online or buying them from dealers.
Ottawa police have also sent seized drugs to Health Canada’s labs only to find out that samples of what looked like cocaine or heroin contained fentanyl.
The Where’s the Fent? project can’t prevent harm to people before they use drugs but Chepesiuk hopes the project will provoke discussion about drug quality testing. The conversation on opioids has focused on alerting the public to the danger and distributing the life-saving drug naloxone, which temporarily blocks the effects of an opioid overdose, through pharmacies and clinics.
“We really need to start talking about pre-use interventions,” Chepesiuk said. “Naloxone is great but it’s after the fact. The issue isn’t just fentanyl, it’s that people don’t know the content and strength of the drugs that they’re consuming.
“That’s where the analysis is necessary. We’re seeing the public health benefit from other jurisdictions.”
ACO is one of the backers, for example, of a proposal to include a spectrometer at a proposed supervised injection site in Sandy Hill. The devices have been used to identify drugs at venues including music festivals in British Columbia and through an outreach van in Spain.
A supervised injection site targets people who are “pathologized” as drug users. But teens, university and college students and “otherwise mainstream” adults are all at risk if they use recreationally.
“That’s where we also have to look at putting services,” Chepesiuk said.
Other jurisdictions have used the same urine test strips to test drugs directly after diluting a small amount with water but ACO doesn’t have enough certainty of the reliability of the method and has no way to supervise people taking drugs that may have been mistakenly cleared.
Vancouver’s Insite, North America’s first supervised injection site, piloted using the urine strips to test drugs directly last year, finding 90 per cent of tests in a single month last summer were positive for fentanyl.
Meanwhile, the number of times nurses used naloxone to head off overdoses rose eightfold in the first six months of 2016.
“We’ve heard from clients that they want to know what’s in their drugs,” says Dr. Mark Lysyshyn of Vancouver Coastal Health in a press release. “With the number of overdoses rising, it’s critical to empower people to learn about their risk of being exposed to this toxic substance. We’re hoping this will encourage them to use our harm reduction services like take-home naloxone kits, consider undergoing addiction treatment and take precautions like decreasing their dose or not using alone.”