FEARS OF FENTANYL ABUSE
Next killer drug epidemic looming
What we’re seeing now scares the hell out of me.
A few days after Byron Klingbyle obtained his free naloxone kit, he was already jabbing a needle of it into the thigh of a lifeless man, bringing the downtown Windsor overdose victim back from the brink.
A harm reduction specialist with the AIDS Committee of Windsor, Klingbyle and others have begun seeing a growing number of local fentanyl abusers. A potent opiate, the synthetic painkiller is many times more powerful than morphine or heroin.
Ottawa has declared fentanyl abuse a national health crisis, and British Columbia this year declared it a public health emergency. It was only last month when Ontario announced pharmacists could now supply anyone with naloxone, a fast-acting antidote in opiate overdose situations.
Klingbyle said he had his kit only eight days when a panicked client rushed into his Pelissier Street office. The client and two companions had been smoking fentanyl in a car at the Windsor Water World parking lot and now one of them, his lips and fingertips blue, was slumped motionless in the back seat.
Klingbyle said it was lucky timing that he had the life-saving drug on hand, supplied after a half-hour training session with one of 44 Windsor-Essex pharmacists currently distributing them. A jab into the thigh and, an agonizingly long three minutes later, the unresponsive man’s eyes fluttered open. After a period of shallow breathing, “he took a big breath at about four minutes.”
“A life is priceless,” Klingbyle said of his life-saving intervention.
Illegal use of fentanyl, a fast-acting synthetic opioid pain medication, began its street popularity after the makers of OxyContin, under public pressure, created a tamper-proof version of the painkilling pill, heavily abused by addicts.
“The problem is, this stuff is very, very, very, very powerful, and if you look at the dollar-to-dosage potency, fentanyl takes it to another level,” said Dr. Tony Hammer, who treats drug addicts at his Erie-St. Clair methadone clinic in Windsor.
“We’re holding our breath ... but we assume (fentanyl, and its even more potent cousin, carfentanil) are headed our way,” Hammer said. The clinic has been increasingly detecting traces of fentanyl in the urine of clients when they’re tested.
“There’s growing concern ... about the inevitability that it will be here,” Windsor police Supt. Ted Hickey said of fentanyl. Property crime, he said, “goes hand in hand” with drug abuse.
As in other cities, Hickey said one of the biggest worries is that dealers are mixing fentanyl with other street drugs to give them an extra kick.
“John” said crime is usually the only way addicts can support a habit that can cost hundreds of dollars a day. A Windsorite now enrolled in a methadone program to kick his fentanyl habit, John, who wouldn’t give his last name, said he dealt drugs to pay to get high.
Concern about “whether I was gonna survive another night” was a big motivation to seek help, said John, adding he had overdosed on several occasions but always recovered. What makes fentanyl “very dangerous,” he said, is that users have “no idea” of the dosage they’re getting.
“I definitely feel fortunate to still be among the living,” he said.
“Mark” is another Windsorite who got hooked on fentanyl after it gave him the best high he’d ever experienced.
“I call it a hug from God when you get that rush — your house could blow up and your dogs could die, that’s a bummer, but this euphoric feeling, it’s everything,” said Mark, who asked that his real name not be divulged. The inevitable flip-side, however, was just as extreme: “Cold sweats, clamminess, you can’t eat, you can’t sleep, the nausea waves — even my hair hurts.”
Fentanyl, said Mark, “destroys everything around you.”
Much of the current problem is the illegal diversion of the 72hour time-release fentanyl patches prescribed to cancer patients and those suffering intense, chronic pain, who have grown tolerant to less-potent opiates such as morphine. Mark was prescribed his during recovery from a motorcycle crash — when the doctor ended the prescription, he took his fentanyl hunger to the streets.
Chinese chemical labs and Mexican drug cartels are among those now manufacturing and distributing fentanyl in white crystalline powder or pill form. Carfentanil — 100 times more potent than fentanyl — is being sold online in very small, difficult to detect quantities and as a cheaper and more plentiful substitute to heroin. It is a synthetic opioid so toxic it’s used to sedate elephants. Two salt-grainsized flecks can kill a human.
“What we’re seeing now scares the hell out of me,” Chuck Rosenberg, administrator of the U.S. Drug Enforcement Administration told top government officials at a U.S./Canada Border Conference in Detroit last week.
He said the return on investment for criminal organizations is “a hell of a lot more than heroin,” and that the potency of what’s now hitting the streets is “crazy stuff.”
In B.C. and Alberta, the rate of fentanyl overdoses is being called a public health crisis, with 42 deaths in 2012 ballooning to 418 last year. Calgary saw a fentanyl overdose death every four days on average in 2015, and the B.C. Coroners Service reported an average of two fentanyl overdose deaths per day in the province during the first four months of 2016.
Hammer said those who were addicted to OxyContin before it was sold in tamper-proof tablet form are the ones switching to fentanyl.
Klingbyle, whose job as a harm reduction specialist is to be supportive and to gently encourage addicts to kick their habits, said fentanyl is “definitely a problem here now” and that carfentanil has already made its way onto Windsor streets.
Experts warn the deadly new opioids — cheaply manufactured and obtained by dealers — are increasingly being mixed in with other drugs (fentanyl is sometimes even passed off to customers as heroin or other opiates).
Klingbyle urges anyone with friends or family members who are drug users to obtain one of the free naloxone kits.
Those three fentanyl smokers at the former Windsor Water World parking lot initially called 911, said Klingbyle, but when the emergency operator told them that police had to be alerted, they skedaddled. “They were panicked, scared,” he said of the two who raced their comatose pal to his office for help.
“It’s scary for sure,” John said of fentanyl on Windsor streets. Added Mark: “We’re not talking about this enough.”