A tranquilizer for large animals and a drug similar to those used to treat anxiety and sleep disorders have seen recent upticks in B.C.'s illicit drug supply.
The resurgence of carfentanil, intended to immobilize large animals such as elk and moose, and the introduction of etizolam, which is chemically similar to benzodiazepine medications but is not prescribed in Canada, serve as a snapshot of the volatility in B.C.'s unregulated drug supply as the province marks three years since declaring a public-health emergency due to overdoses.
Carfentanil was seized by border agents in Vancouver in early 2016, but B.C. did not have any reliable tests for the drug until the following year. An overdose death in November, 2016, was confirmed through Health Canada laboratory testing to have been linked to carfentanil – the first known carfentanil overdose recorded in B.C.
From June, 2017, to December, 2017, the powerful opioid, which is many times more toxic than fentanyl and not intended for human use, was detected in at least 71 illicit drug overdose deaths in the province, according to the BC Coroners Service. That number fell to 35 in all of 2018, but is now climbing again. There have been more than 50 carfentanil-related deaths in the first three months of 2019, according to preliminary data.
Data from LifeLabs, a Canadian company that specializes in diagnostic testing and sends bimonthly reports to B.C.’s Ministry of Health and the BC Centre for Disease Control, also confirm it has been on the rise again since August, surging over the winter.
LifeLabs tests urine samples from patients who are screened for fentanyl, usually at drug treatment centres. In December, it found that 3.1 per cent of fentanyl-positive tests also contained carfentanil; by early March, that figure climbed to 15.6 per cent.
Earlier this month, The Globe and Mail reported that etizolam, a drug chemically similar to a benzodiazepine, had entered B.C.'s illicit market and was being cut into fentanyl and heroin, resulting in overdoses that leave some drug users unconscious for hours at a time.
LifeLabs began testing for etizolam in June, 2018. In September, seven samples tested positive for the drug; in October, 11; in November, 17. In the first three months of 2019, 169 samples tested positive for etizolam.
Drugs seized by law-enforcement agencies and sent to Health Canada for laboratory testing also provide an idea of what is circulating in the unregulated market.
In all of 2018, the federal department’s Drug Analysis Service confirmed the presence of etizolam in 107 samples submitted by law enforcement. In the first three months of 2019, it confirmed 50.
Maryse Durette, a Health Canada spokeswoman, cautioned that these statistics may not be representative of the market, and that no correlation can be made between the number of samples received by the DAS and the volume seized by police.
Benzodiazepines act on the same receptors as alcohol and produce similar effects, such as memory loss, slurred speech and difficulty walking. When mixed with opioids or alcohol, the risk of overdose, or death, increases.
It has been challenging to measure the scope of etizolam’s reach in B.C. as drug checks offered locally do not detect it.
These latest trends come as B.C. marks three years since then-provincial health officer Perry Kendall declared a public-health emergency due to overdoses.
In an interview this week, Dr. Kendall said the path forward must include: building a comprehensive, evidence-informed addictions treatment system; decriminalizing people who use drugs; and providing a regulated, pharmaceutical-grade supply of substances as an alternative to contaminated street drugs.
“The big difference between now and 10 years ago is that we have a really, really, really toxic drug supply,” he said. “And while interdiction – criminalization and prohibition – never worked very well, its role in pushing the criminal enterprise to develop more and more potent, hence more and more toxic drugs, has actually made it much more dangerous for people who use illicit drugs.
“The danger isn’t stopping people from using these drugs so, pragmatically, we want to stop people from dying from poisonous drugs."