Il­licit drug sup­ply po­ten­tially more risky amid pan­demic

Calgary Herald - - CITY+REGION - ALANNA SMITH al­ Twit­ter: @alan­na_­smithh

Harm-re­duc­tion ad­vo­cates worry Cal­gary’s sup­ply of il­licit drugs may be more dan­ger­ous due to the COVID -19 pan­demic, while users could face fur­ther chal­lenges in ob­tain­ing cer­tain sub­stances.

Early in­di­ca­tions show travel re­stric­tions, bor­der clo­sures and mea­sures to curb the spread of the deadly virus are af­fect­ing sup­ply.

Kevin Blanchette is ex­ec­u­tive di­rec­tor of Al­berta Ad­dicts Who Ed­u­cate and Ad­vo­cate Re­spon­si­bly, a group of peo­ple with a his­tory of drug use who sup­port mem­bers of the drug-us­ing com­mu­nity through peer out­reach and ed­u­ca­tion.

“What we are hear­ing, see­ing and sort of ex­pe­ri­enc­ing is that cer­tainly drugs are harder to ob­tain,” said Blanchette. “Prices are el­e­vated as a re­sult of that, which is nat­u­ral de­mand and sup­ply, and they’re also us­ing more cut­ting agents be­cause of the lack of sup­ply.”

Drug cut­ting in­volves sub­stances, such as phenacetin, bak­ing soda and caf­feine, which are used to ei­ther en­hance the ef­fects of a drug or in­crease the vol­ume of a prod­uct.

With usual sup­ply routes likely dis­rupted, it means dif­fer­ent sup­plies are in stock. There are hun­dreds of dif­fer­ent cut­ting agents and users rarely, if ever, know ex­actly what they’re get­ting.

Ul­ti­mately, weaker prod­ucts mean users might take more, in­creas­ing the risk of over­dose and death — es­pe­cially con­sid­er­ing in­creased iso­la­tion amid the on­go­ing pan­demic.

“It’s a bit of a per­fect storm in terms of these vul­ner­a­ble folks at risk who are al­ready deal­ing with a toxic drug sup­ply, is­sues around men­tal and phys­i­cal health, and now home­less­ness and the chal­lenges with be­ing housed is sig­nif­i­cantly more for them,” said Blanchette.

With far fewer peo­ple in pub­lic, pur­chas­ing drugs is also more ev­i­dent and harder to do, he said.

Based on drug-re­lated ar­rests and seizures, Staff Sgt. Kyle Grant with the Cal­gary po­lice strate­gic en­force­ment unit said the COVID-19 pan­demic has had a mi­nor ef­fect so far.

“There has been a bit of price fluc­tu­a­tion in terms of metham­phetamine. That may be due to the (pan­demic) in get­ting high-qual­ity prod­uct from cer­tain sup­pli­ers, but at the same time it de­pends on who you are deal­ing with,” said Grant, adding prices can be found at their reg­u­lar al­lowance, too.

He said there’s also talk that more car­fen­tanil — a syn­thetic opi­oid that is ap­prox­i­mately 100 times more toxic than fen­tanyl — is in cir­cu­la­tion due to di­min­ished sup­ply of other prod­ucts. Il­licit drugs in Al­berta come from a va­ri­ety of places, in­clud­ing China, Mex­ico, the U.S. and within Canada.

But, at this point, he said it’s spec­u­la­tion. It’s too soon to tell what toll the pan­demic will have on drug prices, prod­ucts used and over­dose rates.

“The big thing to get across is you just can’t know what you’re get­ting,” said Grant. “Ev­ery­body’s bot­tom line is money in that busi­ness, and they will do and say what­ever it is to get that money out of your hands.”

Fur­ther am­pli­fy­ing the risks to drug users is reduced com­mu­nity sup­ports and ser­vices, such as the de-funded in­jectable opi­oid ag­o­nist treat­ment pro­gram and limited ca­pac­ity in shel­ters and sites in re­sponse to phys­i­cal dis­tanc­ing mea­sures.

Dr. Elaine Hyshka, as­sis­tant pro­fes­sor at the Univer­sity of Al­berta’s School of Pub­lic Health, said this is po­ten­tially the most dan­ger­ous time peo­ple who use drugs have faced in re­cent months. She said there needs to be phar­ma­ceu­ti­cal-grade al­ter­na­tives to il­le­gal drugs, such as hy­dro­mor­phone, to pre­vent the risk of over­dose and with­drawal, which could land peo­ple in the emer­gency depart­ment while health-care pro­fes­sion­als are deal­ing with COVID-19.

“It’s a very un­prece­dented sit­u­a­tion but we have to keep the work go­ing to sup­port peo­ple who are at risk of dy­ing an over­dose death,” said Hyshka. “It’s im­por­tant to not for­get the ex­ist­ing health crises while we are deal­ing with the pan­demic.”

Kyle Grant

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