WHAT EXACTLY ARE OPIOIDS?
HERE IS A LOOK AT SOME OF THE SUBSTANCES BEING USED IN LETHBRIDGE
To better understand the extent of the opioid crisis in Lethbridge, it is important to understand some of the substances involved and how they came to be so prevalent.
In terms of “the opioid crisis,” opioids are painkilling drugs which come in a number of forms. Common types include codeine, oxycodone, methadone, hydromorphone, fentanyl, and carfentanil.
Some of these drugs can be pharmaceutical-grade and prescribed by physicians and surgeons.
Prescription opioids can end up for illegal sale on the street and be “cut” or tainted with other compounds, including fentanyl.
Fentanyl is a strong, odourless, and tasteless synthetic narcotic which can be 50 to 100 times more potent than morphine.
Non-illicit fentanyl is typically prescribed to control severe pain.
Carfentanil is a fentanyl analogue that is 10,000 times more potent than morphine and 100 times more potent than fentanyl.
Carfentanil is used to sedate large animals, such as elephants, and is not intended for human consumption.
Fentanyl and carfentanil are also being illegally produced and imported mostly from China and purchased online.
The drugs are shipped in decoy packaging and in small enough packages that Canadian Border Services Agency is unable to open it without the supplier’s permission (under 30 grams).
Fentanyl and carfentanil can be diluted with fine powders, added to other drugs for an additional kick, or made into counterfeit Oxycontin pills— so-called “Oxy 80s.”
When thinking about the amounts of these drugs being used, police often use a chocolate chip cookie analogy. If fentanyl and carfentanil are thought of as the chocolate chips, a counterfeit Oxycontin pill can be thought of as the entire cookie.
In come cookies, there may only be a few chocolate chips. In others, there are many chips. Unfortunately, as grains of fentanyl and carfentanil are similar in size to a grain of salt, there is no way of knowing how much of the drug is present in each pill, and it can vary wildly from one pill to another.
Three or four grains of fentanyl are enough to kill an average adult. One grain of carfentanil can kill an adult. One factor in the rise of opioid addiction has been legitimate prescription opioid use for pain. In the 2000s, there was a sharp rise in the number of prescriptions for opioids.
As a result, Canadians are now the second-highest consumers of opioids in the world after the U.S. It is a red flag that the drugs are being overprescribed.
Most people who use illicit substances do not become “problem” drug users suffering from chronic addiction.
Research indicates those users are often people who are self medicating due to physical, psychological, or emotional trauma they have suffered in their lives.
Opioid highs can involve a warm, calm, euphoria that can allow the user to ignore worries or personal issues.
Signs of opioid poisoning include confusion or delirium, vomiting, pinpoint pupils, excessive sleepiness or an inability to wake up, loss of consciousness, inability to wake up, breathing problems or arrested breathing, and cold, clammy skin or bluish skin around the lips or under fingernails.
According to Government of Canada statistics, there were nearly 4,000 apparent opioid-related deaths in Canada in 2017. About 92 per cent of those deaths were unintentional.
About 78 per cent of those unintentional deaths occurred among males. The actual rates varied province to province. About 72 per cent of those unintentional deaths were apparent opioid-related. Additionally, about 71 per cent of unintentional deaths also involved one or more non-opioid substances.
The primary treatment for opioid poisoning is a chemical compound called naloxone. It has proven to be a safe and highly effective substance that reverses the effects of opioids in the body.
It has been in use as emergency treatment for opioid poisoning for almost half a decade, and is listed on the World Health Organization List of Essential Medicines.
Chemically, naloxone is similar to an opioid, but has no effect if taken by someone not under the influence of an opioid.
Naloxone is often administered in two ways – either through injection or nasal spray. In Canada, naloxone is produced under the band name Narcan.
Injected naloxone can begin to work in two minutes or less, with similar responses in the nasal spray.
Naloxone has been made readily available in Canada and can be accessed in more than 30 pharmacies and walk-in clinics around the city.
Many also provide training in the proper way to administer the drug to treat opioid poisoning.