More than 80 per cent of drugs sold as heroin on the streets of Vancouver don’t contain any heroin at all, while nearly all of them contain the powerful synthetic opioid fentanyl, according to the findings of a pilot project led by the B.C. Centre on Substance Use (BCCSU).
The centre gave local users the opportunity to check their drugs not only for the presence of fentanyl, but a wide range of substances. The final results, to be published in the September edition of the Drug and Alcohol Dependence journal, show that fentanyl has overwhelmingly supplanted the local supply of illicit opioids, and heroin in particular. Stimulants and hallucinogens, meanwhile, are much more likely to contain the substance they are sold as.
Mark Lysyshyn, a medical health officer at Vancouver Coastal Health (VCH) who co-authored the paper with Kenneth Tupper, Karen McCrae, Ian Garber and Evan Wood, said the findings provide insight into just how contaminated the local drug supply is.
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“Something like 60 per cent of the drugs that we check are not what people think they are,” Dr. Lysyshyn said on Tuesday. “We’ve always had the idea that drugs could be something different, but right now [the contamination rate] is really high.”
The pilot ran from November, 2017, to April, 2018, at two VCH-operated supervised-consumption sites in Vancouver’s Downtown Eastside. Drug checks involved both fentanyl test strips and an infrared spectrometer, purchased by the BCCSU and the City of Vancouver. In all, 1,714 samples were tested.
The majority (58.7 per cent) of samples that clients volunteered were expected to be opioids, according to the paper. Of 907 samples expected to be heroin, only 160 (17.6 per cent) contained any heroin at all, while 822 (90.6 per cent) tested positive for fentanyl.
The most common composition for a drug purported to be heroin was caffeine, a sugar alcohol and fentanyl, the paper stated.
The next most common types of samples were reported to be stimulants. The checking found that 87.9 per cent of 256 samples purported to be speed or crystal meth contained some amount of the expected substance, while 91.4 per cent of 140 samples purported to be crack or cocaine did. Fentanyl was detected in 5.9 per cent of the speed or meth samples and 2.1 per cent of the crack or cocaine.
Of 141 samples loosely categorized as “psychedelics” – MDMA, LSD, mushrooms – 86.5 per cent contained some amount of the expected substance, and zero contained fentanyl.
Dr. Lysyshyn noted that the results of the pilot – which used samples offered voluntarily by clients of the Downtown Eastside supervised-consumption sites – are not necessarily representative of broader illicit-drug markets.
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An earlier VCH drug-checking pilot project which used only the fentanyl testing strips found that people who were informed the synthetic opioid was in their drug were 10 times more likely to reduce their dose. Those who reduced their dose were 25 per cent less likely to overdose.
Dr. Lysyshyn said the checks serve not to prove the safety of an illicit drug, but to provide people who use drugs with more information about the substances they choose to ingest.
“I don’t think the purpose of drug checking is to say, ‘These are safe; take them recklessly.’ That’s not what we’re trying to do,” he said.
“We’re saying, here’s a bit more information about these substances; they still could be risky. Because even if you find out there’s no fentanyl in your heroin, heroin causes overdoses, too. We don’t want people to forget all about the other harm-reduction advice that we’re giving; this is just additional information that we think could be helpful.”
The infrared spectrometer is at the Insite supervised consumption site on Mondays, Wednesdays and Thursdays from 2 to 8 p.m. Drug checking will also be available at the Health Initiative for Men from 6 to 9 p.m. this Friday in advance of the Vancouver Pride Festival and at August’s Shambhala Music Festival in Salmo.