British Columbia has expanded a program allowing people to check their street drugs for fentanyl before using, becoming the first jurisdiction in Canada to facilitate the experimental testing on a wide scale.
Health officials have also purchased a device that detects both the presence and quantities of deadly adulterants and can provide a more detailed analysis of not just fentanyl, but other chemically similar drugs being cut into the local supply.
"Today's announcement is part of our mandate to save lives and prevent the needless suffering of people, of families, from all across this province," B.C. Minister of Mental Health and Addictions Judy Darcy said at a news event announcing the expansion on Friday. At her side were Vancouver Mayor Gregor Robertson and representatives from Vancouver Coastal Health (VCH) and the BC Centre on Substance Use (BCCSU).
"As I've said many times before … tackling this overdose crisis takes a whole province."
Fatal overdoses have soared in B.C. owing to the local drug supply being poisoned with highly toxic adulterants. More than 1,100 people died in the first nine months of this year and powerful synthetic opioid fentanyl was a factor in 83 per cent of those deaths.
The fentanyl-checking program began in July, 2016, as a pilot project at Insite, Vancouver's first public supervised-injection site. Last summer, it expanded to four overdose-prevention sites and one other supervised-injection site in Vancouver; it is now available at all 18 overdose-prevention sites and seven supervised-drug-use sites in B.C.
To use the tests, which are adapted from urine tests, users mix a few grains of their drugs with water in a cooker and then submerge a test strip into the solution. A result appears within seconds: One line means it contains fentanyl; two lines mean it does not.
Early data from the VCH pilot last fall showed that people who found fentanyl in their drugs were 10 times more likely to reduce their dose and, as a result, were 25 per cent less likely to overdose.
The City of Vancouver has also used $60,000 from its opioid contingency budget to purchase an infrared spectrometer, which can identify multiple components of a drug mixture – and their quantities – in seconds. This means it not only detects the presence of fentanyl, but of chemically similar drugs along with anything else that could be harmful.
VCH medical health officer Mark Lysyshyn said officials will be using the spectrometer in combination with the test strips to ensure the highest degree of accuracy. The device will be used alternately at Vancouver's Insite and the Powell Street Getaway supervised-drug-use sites.
"We see drug checking as another piece of the puzzle to address the overdose crisis. The experts here at the table. … Certainly, lives can be saved this way. We have lost far too many people and we have to take every step that we can to save lives," Mr. Robertson said.
Long-time drug user and outspoken activist Dean Wilson encouraged both drug users and drug sellers to test their supply – "so you don't sell us your poison."
Mr. Wilson said he has wanted to see drug tests developed since B.C.'s last overdose epidemic, in 2001, and is convinced that the initiative will save lives.
"We don't want to die," he said. "Any knowledge that allows us to make sure that we know what's going into our bodies is helpful."
The BCCSU will study the spectrometer's effectiveness and the potential to expand its usage elsewhere.
Dr. Lysyshyn said VCH is looking at distributing the fentanyl testing strips more widely, although their manufacturer does have some reservations. In an October, 2016, interview with The Globe and Mail, BTNX Inc. president and chief executive Iqbal Sunderani said that while having the option to test is better than nothing, he is worried that a drug user could misinterpret the result, or not take appropriate precautions if the test turns up negative for fentanyl.
"It's a difficult question. It's one that is, ethically, very difficult to answer," he said. "I personally don't think we should be handing these out like Smarties to everybody, and giving them a false sense of security. It should be handled with care, responsibility, by the right professionals."
Dr. Lysyshyn said a possible solution would be to partner with an organization such as Karmik, which offers harm reduction services at B.C. music festivals and events.