British Columbia's coroners service is looking to improve its ability to test for the synthetic drug W-18, as police warn about its entrance into B.C., and officials in Alberta confirm the first fatal overdose in that province.
The Medical Examiner's Office in Alberta confirmed late last week that a man who died of a fatal overdose in south Calgary in March had heroin, W-18 and 3-Methylfentanyl, a drug chemically similar to fentanyl, in his system. W-18 has not been linked to any deaths in British Columbia.
Barb McLintock, spokeswoman for the BC Coroners Service, said the agency has "some capacity" for testing for the drug, but is "also exploring options to improve our ability to detect this substance at very small levels."
W-18's emergence in the recreational drug market is particularly troubling because it is many times more toxic than illicit fentanyl, which has been linked to a soaring number of overdose deaths.
W-18 and variations of fentanyl are being cut into other drugs for their low cost and high potency. Small quantities of W-18 can also be very difficult to detect in blood.
Also concerning: It is not yet known if naloxone, which can reverse the effects of an opioid overdose within minutes, is effective for a W-18 overdose, said Ashraf Amlani, a harm-reduction epidemiologist with the BC Centre for Disease Control.
"There is very limited information on the pharmacology of W-18 so we don't know if W-18 is binding to the same receptors in the brain that opioids, such as heroin and morphine, and opioid antagonists, such as naloxone, bind to," she said.
W-18 was developed and patented in Canada in the mid-1980s for its analgesic properties, but was never marketed commercially.
Three counterfeit oxycodone pills seized from a Calgary home last summer were later found to contain the drug; this was believed to be the first case of it being found in drugs meant for recreational purposes in Canada.
In December, police seized four kilograms of what would later be revealed to be W-18 powder from a clandestine lab in the Edmonton area. Last month, Kelowna RCMP said a Health Canada analysis of counterfeit oxycodone and Percocet pills confirmed the presence of W-18.
"Of particular concern is a green coloured oxycodone tablet marked CDN80," RCMP Corporal Eric Boechler said in a statement. "It was discontinued as a prescription tablet in 2012, so virtually any encountered on the street today are counterfeit and will contain fentanyl and/or other potent synthetic opioids such as W-18."
3-Methylfentanyl, which was detected in the Calgary death and can be hundreds to thousands of times more potent than morphine, is also in British Columbia; last June, a woman in Abbotsford died after using heroin that was laced with 3-Methylfentanyl.
The drug is thought to be manufactured in China and imported into Canada. It is not currently regulated under Canada's Controlled Drug and Substances Act; however, Health Canada is in the process of changing this. Graham Jones, chief toxicologist of Alberta's Office of the Chief Medical Examiner, noted that while some overdose deaths are obvious, many are multidrug deaths in which an opioid is present, but just one of several toxic agents.
"There is no easy 'cutoff' as to what is opioid-related and what is not," Dr. Jones said in a statement. "This can further complicate determining the specific cause of death."