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Fentanyl pills are shown in an undated police handout photo.The Canadian Press

The manufacturing equipment required to produce fentanyl-laced drugs for the street isn't much to look at: A tabletop pill press and a kitchen blender are enough to process an online order of opioids. The set-up fits easily inside a small utility trailer and can churn out 18,000 counterfeit Oxycontin tablets in one hour.

But the drugs produced in these tiny, mobile labs also pose a risk to police, firefighters, paramedics and other emergency crews. A couple of grains, which can be absorbed on skin contact, can be lethal.

At a workshop for first responders in Victoria on Tuesday, police demonstrated the equipment used to produce pharmaceutical-grade tablets that mimic prescription Oxycontin, and explained the hazards.

"There have been close calls right across North America," said Staff Sergeant Conor King of the Victoria Police Department, an organizer of the Justice Institute of British Columbia conference. "Because fentanyl is so lethal in such small doses – and in powder form can be distributed into the atmosphere – a first responder who walks into a fentanyl laboratory could inadvertently breathe in the fentanyl."

It can also be absorbed through the skin by touching something that is contaminated. "A very small dose, in the neighbourhood of two milligrams, is considered lethal," Staff Sgt. King said.

With ever-stronger synthetic opioids arriving in the country, the risk to drug users is growing, but the shift also means those attending a crime scene or assisting an individual who is overdosing face increasing danger.

A recent Globe and Mail investigation has found local traffickers can easily order the highly potent, low-cost drug online and have guaranteed shipment to Canada. It is then cut into street drugs such as heroin and oxycodone to make them go further and maximize profits.

The overdose death toll across Canada due to fentanyl is rising at an alarming rate – in British Columbia, drug overdoses are now the leading cause of unnatural death in the province, outpacing fatalities from vehicle crashes. Fentanyl has been detected in more than half of the overdose deaths so far this year.

Corporal Eric Boechler, with the RCMP's federal clandestine lab enforcement and response team, told the conference a dozen variations of fentanyl have been tracked in Canada.

Although there is no clinical analysis of the strength of the different variants, he said, "one of the scarier ones" now arriving in Canada is carfentanyl, which is believed to be as much as 6,000 times more potent than morphine. (Health Canada says more research is needed to determine the potency of such drugs, which are frequently obtained from unregulated labs overseas.)

Cpl. Boechler demonstrated how the pills are manufactured, and how easy it is for uneven distribution of the opioid to occur in whatever cutting agent is used as the base for the pill. Some pills end up with "hot spots" containing more of the opioid than intended.

"When I hear in the media there has been a huge amount of overdoses in one geographical area in a short period of time, I think to myself there was negligent mixing, with hot spots. Or maybe that drug trafficker had ordered fentanyl online but was supplied with a more potent, toxic analog. … The entire batch could be deadly."

British Columbia's top health officer has declared a health emergency in order to more accurately track drug overdoses, in the hopes that officials can more quickly issue warnings when bad batches of drugs appear on the street.

The coroner's office has tallied 308 illicit drug overdose deaths from January through May of this year, compared with 176 deaths in the same period last year.

"This is a crisis situation as far as the number of overdose fatalities," Staff Sgt. King said. "We are responding to this as we would to a disease, with law enforcement working hand in hand with the medical community because so many citizens are dying so rapidly."

Police are asking lawmakers to help curb distribution by banning the sale and possession of pill presses in Canada, he said. "These devices are being seized routinely in Vancouver; the end product is seen right across North America."

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