Every dose a potential killer
Users know the risk, but can’t stop
WATERLOO REGION — Sally has been taking drugs since her mother introduced her to them when she was 14.
Today, the 26-year-old Kitchener woman is on methadone to curb her cravings.
But Sally, not her real name, still does illicit drugs like crystal meth.
Her drug of choice is crack but last summer while looking for a hit, she bought a “point” of fentanyl and injected it (a point is onetenth of a gram). She doesn’t want to do it again but fears it could be laced in the drugs she usually buys.
Alex, not his real name, will do whatever he can to get his hands on some Percocets, which contain oxycodone and acetaminophen.
A few years ago he started swallowing the potent painkillers.
Then he began chewing them to get a faster rush. Now he crushes up the pill, dissolves it in liquid and injects it.
Alex says he has tried to quit but he can’t.
“You need a steady flow,” he says of the strong opioid. Alex continues injecting pain pills to avoid the painful withdrawal symptoms.
As soon as Alex gets out of bed he shoots up. Then he’ll do it again in the evening when the drug wears off.
“I don’t buy groceries, I buy drugs,” says Alex, who pays his rent and then spends the rest on drugs. He receives a monthly disability pension.
For Alex, a transgender man, life has been difficult. He’s been called names. He left his family behind and moved to a new place. He takes the drugs to make the pain subside.
“I just hope I don’t run into fentanyl,” he says.
Waterloo Regional Police say fentanyl is being cut with other drugs such as heroin, cocaine and meth and often users may not know how much they are getting. Some of the “hot spots” can be deadly, they say.
Jason has tried fentanyl a few times. He smoked the sticky, gummy residue from a used prescription patch once. Another time he mixed it up with vitamin C and injected it.
But the potent drug didn’t have much of an effect on Jason because he was also taking methadone at the time.
Methadone blocks the euphoric effects of other opioids, which is why it is seen as an effective treatment drug for addicts, according to the Centre for Addiction and Mental Health.
Jason, not his real name, says he used opioids while taking the treatment drug because all he wanted was to feel the euphoric high again.
“Opioids can really blindside a recreational drug user,” Jason says. “They can turn a recreational user into an addict overnight.”
He knows because it’s what happened to him.
When he was a teenager, Jason dabbled in hallucinogenic drugs like LSD and mushrooms.
He had never tried anything stronger until he moved to Waterloo Region with his mother and her boyfriend.
They all got hooked on pain pills.
“It wasn’t like I had to run off out of the house to do a drug,” Jason, now in his 30s, recalls. He would crush up various pain pills and snort them.
He didn’t inject drugs until he started taking methadone. He hoped taking the drug intravenously would help him get high again.
The urge to get high is what led him to injecting pain pills. It’s also what led him to fentanyl patches.
Up to 80 times stronger than morphine, fentanyl is typically prescribed in the form of slow-release patches that stick to the skin.
A decade ago, Jason says, addicts could buy used fentanyl patches on the street for about $20 a piece.
Now, they are not readily available. That’s because of new provincial legislation which forces patients to return used patches to pharmacies before they can get a new one.
Jason says he has heard of used patches selling for up to $200 apiece.
It’s actually cheaper to just buy heroin, he adds.
And now illegal powdered fentanyl is hitting the streets of Waterloo Region.
It’s a scary thought even to Jason.
“I can see the pure powdered fentanyl can very easily be dangerous,” says Jason, who used to sell legal prescriptions to users.
“How would you even measure it?”
As little as two milligrams of the stuff can be lethal, that’s the amount of a few grains of salt.
Jason says even if the drug is cut with other products to weaken its effect, there is no guarantee of what you’re actually getting.
Violet Umanetz with Sanguen Health Centre goes out with a mobile health van twice a week to help street drug users.
“It can be difficult to get information out to someone who isn’t housed or doesn’t have access to media, for example,” says Umanetz, an outreach worker with Sanguen, a health unit that provides support to vulnerable populations.
In addition to their focus on hepatitis C support and harm reduction, they also hand out naloxone kits. In three years, Sanguen has distributed more than 170 naloxone kits through its mobile health van and from its clinic in Waterloo. It recently switched to nasal naloxone, which is easier to administer.
Kits are also available at Region of Waterloo Public Health, Grand River Hospital and some local pharmacies.
Umanetz says there is a common misconception that overdoses are always fatal.
“A lot of overdoses go unreported,” she says.
That’s part of the reason why Umanetz says education is impor- tant so people who use drugs know what to do, how to spot an overdose and who to call if someone is at risk.
The stigma around drug use needs to change, she says. “People think, ‘If I’m overdosing I probably don’t want to call the police or EMS.’ Some people may think no one cares.”
Sanguen is constantly updating its approach to harm reduction. They speak to active drug users and give them flyers on how to administer naloxone and how to report an overdose.
“We need to continue to educate the community about drugs,” Umanetz says. “We can’t be everywhere at once.”