Over the past week chatter through social media demonstrates Sault Ste. Marie residents expressing concern about the incidents of drug overdose and overdose deaths in the community. In speaking with Desiree Beck, Chair of the Sault Ste. Marie and Area Drug Strategy Committee, Beck stated that the rate of overdose has reached epidemic proportions.
As explained by Beck, there is a challenge in approximating the exact number of overdoses in the community for various reasons including that often times an individual isn’t even aware that they have survived an overdose. Even local authorities struggle to acquire an accurate number of overdose deaths in the Sault. Police are not informed of every incident and the Office of the Coroner cannot provide information on sudden deaths that are not criminal in nature. Further, the stigmatization of people who misuse drugs shuts down the conversation about overdose and overdose deaths before it can even begin.
Beck also works as an Outreach Worker with the Hep Care Program at the Group Health Centre. Through her professional experiences as well as her work with the Drug Strategy Committee, Beck has an unfortunate lens into the serious problem of overdose in Sault Ste. Marie.
“In all reality I hear of five overdoses a week –but not everyone dies,” shared Beck who went on to elaborate that the past few weeks has seen an increase in those numbers. “First of all, we never hear about all of the overdoses. But this week I’ve heard of three overdose deaths and twelve overdoses in total. Over the past three weeks I personally know of six people who have died from overdose. The unfortunate thing is that this is not a spike.”
Acknowledging a significant concern with the misuse of crystal meth in the Sault, Beck added, “In our community the bigger crisis is synthetic fentanyl. There has been a massive increase in its use in the community and this is why we are witnessing all of those overdoses.”
Breaking it down into layman’s terms Beck provided an explanation about why synthetic fentanyl has been the catalyst to recent overdoses in Sault Ste. Marie. Synthetic fentanyl is manipulated by producers and mixed –blended up, with other substances like heroin and other fillers. The new product is sold in powder form or pressed into pills. However, the concentration of synthetic fentanyl is not consistently distributed in the final product.
“Synthetic fentanyl is more potent but the bigger danger is that it’s unevenly dispersed,” remarked Beck. “So if you and I each took a pill yours could have next to nothing and you might get a great high. Mine could be extremely potent and I could die instantly.”
Those at risk to overdose or those that are in regular contact with someone at risk –like family or frontline workers, are encouraged to pick up Naloxone through their local pharmacies. Note: Several pharmacies in Sault Ste. Marie provide this service. A prescription is not required and the drug is available at no cost. Training or administration of the drug will be delivered by the pharmacist.
Though anybody in Sault Ste. Marie can request a Naloxone kit, at this time paramedics are the only first responders mandated to carry Naloxone. It is unknown when or if other first responders such as the police or fire fighters will be approved to carry the life save drug while on duty.
“Naloxone is an opioid antagonist,” explained Beck. “Naloxone goes to the receptors in the brain and pushes out the opioids you’ve taken. The naloxone securely fits into those receptors and knocks a person into an immediate withdrawal.”
Naloxone will save lives but health professionals and police across the country have expressed concerns that the prepared Naloxone dosage is losing effectiveness in fighting more potent analogues of opioids that have recently presented on the street and in the mainstream –like synthetic fentanyl.
“If you were taking just heroin and overdosed you have a twenty to thirty minute window to get to secondary services,” remarked Beck. “The problem with synthetic opioids –especially synthetic fentanyl, is that time is knocked down to ten or fifteen minutes. In all Naloxone kits there are two vials but sometimes there are too many drugs on board to break the overdose. With all these synthetic variations of drugs it’s hard to know what the potency is or if you’ve taken too much. Sometimes it’s too late.”
A frightening variation of an opioid analogue has hit the mainstream. Not exclusive to hardcore users of drugs carfentanil is making its way into the hands of people who use illicit drugs recreationally or are experimenting for the first time. Typically injected, swallowed or absorbed through the skin via a patch, in Canada and the United States carfentanil is also cut into heroin, cocaine and other illicit substances.
Carfentanil is 100 times stronger than fentanyl and 10,000 times more potent than morphine. Carfentanil was first synthesized in 1974 and used to sedate large animals, like elephants. Carfentanil has never been approved for human consumption and the effects of less than one microgram –invisible to the human eye, can be felt by an individual. Just 20 micrograms, less than a grain of salt, can be fatal to a person. The risk to overdose is incredibly high and current doses of Naloxone are expected to be ineffective.
People who use illicit drugs in the Sault insist that carfentanil has made its way to Sault Ste. Marie.
Sault Ste. Marie Police confirmed that there have not been any seizures of the drug and the Office of the Coroner would not be able to confirm any recent overdose drugs to carfentanil owing to the fact that the Office has no test for the carfentanil compound. “But it’s on our radar,” wrote a spokesperson from the Office.
At this time testing for carfentanil is happening through Health Canada. A recent Global News report provides that “street drugs seized by Ontario police have tested positive for carfentanil for the first time and experts are warning the potentially fatal opioid could contribute to more overdose deaths across the province.” The green pills are being made to resemble OxyContin.
Beck was unsure if carfentanil has hit the community. “A lot of people trust and confide in me about drugs but I’ve had no one tell me about carfentanil. So chances are if people are using it they aren’t aware that they are.”
However, Beck expressed that frontline workers were alerted to a bad batch of something that passed through the Sault over the summer. “We saw a wave coming through and people that were using this stuff were od’ing or ending up in the hospital. Whatever they were using, they got so high it scared them.”
The challenge in identifying substances is partially attributed to the constant altering of compounds composing the drug. “There are dozens of ways to make the compounds found in fentanyl and the more that drugs are altered the more difficult it is to identify them,” remarked Beck.
Though challenges are myriad, Beck addressed two that the Sault presents around the issue of addictions and illicit drug use in the community.
The first challenge is a lack of accessible information and education.
“Our strategy is working really hard to make sure that we not only have enough information but that it is also clear, concise and continuous,” remarked Beck.
“We’ll never be in a position where we’ll be able to run up to every kid and slap drugs out of their hands before they are ever able to use it. But what we can do is make sure our community, our parents, front line workers and first responders have the right information about drugs. This is a problem that our community has which contributes to the continuation of drug use.”
Another challenge, as identified by Beck as well as many people in the community, is the issue of judgement and condemnation of people who use illicit drugs.
“It is our biggest problem. We are very ‘judgey’,” stated Beck. “If you look at the overdoses we have had this year alone –we’ve lost so many people in our community but we don’t talk about it. We don’t give families a space to grieve for the reasons their loved one died because we would rather judge them for their drug use and that’s a continuous problem. It all ties together.”
The Sault Ste. Marie and Area Drug Strategy Committee is aiming to provide ongoing information to the community in 2017. The Committee composed of seventeen agencies representing local authorities, school boards and health and service agencies are hoping to issue drug warnings to the community.
“When we hear of drugs that hit our community that have high potency rates or that have been related to significant deaths in other communities or any other drugs we are concerned about, we will release drug warnings from our community. It’s great that we can share information from Toronto or Ottawa or Montreal but when it comes from our own community people will pay more attention,” expressed Beck.
As a final point Beck added, “From the strategy point of view, we are working really hard to make our community proactive as opposed to reactive. I think that is one of our greatest liabilities as a community. We’ll never stop people from using drugs if they want to use them but I think we can make ourselves more prepared to support people to make sure that they have the right information. We’re trying to support our community as well as support the people dealing with drug use. And we’re doing it from a very real standpoint.”
For more information Desiree Beck can be reached by email at firstname.lastname@example.org or 705.541.2319 (office) or 705.941.8825 (cell).
Please check back in later this week for a difficult and in-depth look at the personal effects of drug addiction in Sault Ste. Marie.