University of Victoria chemistry professor Dennis Hore remembers the moment when fentanyl switched from the lacer to the supply.
Suddenly, paper dipsticks intended to test for the presence of fentanyl were obsolete. The question was no longer whether fentanyl was present in opioids, but in what potency.
The Vancouver Island Drug Checking Project began in 2018 with the goal of determining the full composition – all actives and all cutting agents – and potency of every sample brought in to them. Without a safe supply, offering a free, anonymous and comprehensive drug checking service is one the next best way to prevent overdose deaths, the project researchers say.
Reports aren’t available for 2018, but in 2019 the project tested 935 samples at its Victoria locations. In 2020, simultaneous with the pandemic hitting, that number jumped to 1,288. In both years, about 40 per cent of samples contained fentanyl, almost all of which were brought in by people who expected its presence.
The next most common samples were stimulants and psychedelics.
In the first four months of this year, 664 samples have been tested, with April seeing a record number of 213. The increase in drug checking mirrors the escalating overdose crisis. Last year was the deadliest year of the crisis with 1,716 deaths in B.C. and 122 in Greater Victoria, up from 986 and 61, respectively, in 2019.
Up until April 30 of this year, there had been 680 deaths provincewide and 53 in Greater Victoria.
In the last six months, the drug checking project has also seen the addition of benzodiazepines – benzos – in opioid samples. Benzos are prescription sedatives often used for anxiety, insomnia and epilepsy. Because opioids and benzos are both depressants that lower a person’s blood pressure and temperature and slow their heart rate and breathing, the combination of the two can quickly lead to an overdose. Benzos also don’t respond to naloxone, making saving someone harder.
In 2020, benzos or benzo analogues were found in 18 per cent of expected opioid-down (fentanyl or heroin) samples. That jumped to 50 per cent in January 2021, climbed to 59 per cent in March and 69 per cent in April.
The information provided by the drug checking services – Substance on Cook Street and and Lantern on Cormorant Street – can be life saving, but research assistant Ashley Larnder emphasizes they themselves are not saving lives.
“It is the clients themselves that are empowered to make their own decision. The client’s life is in their own hands,” she wrote for the drug checking project’s first blog post last September.
In her two years working with the project, first through a co-op position, then as a volunteer and now as a full-time employee, Larnder told Black Press Media her perspective on people who use drugs has completely changed. That terminology – people who use drugs, rather than drug users – is a big part of it.
“Though this subtle play on words may often go unnoticed, I feel that the underlying associations can cause a huge change in perception. It comes from viewing a person as an individual who may engage in the action of drug use instead of defining them by that action alone,” Larnder wrote.
The illicit drug supply is ever evolving and the composition and potency of any individual sample is impossible for a person to determine on their own. In any given month, the concentration of fentanyl in opioid-down samples going through the drug checking project could range from one to 25 per cent. So, even if someone is meticulous about their dose, one could be fine and the next could kill them.
“It’s really outside the individual’s ability to have stability in drug supply,” Larnder said.
The drug checking project aims to provide some peace of mind.
“Until we create the conditions for a safer and stable supply, and likely even after, drug checking services will be needed to provide quality control in a market that has little,” Larnder wrote in a May 2021 blog post.
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