Rise of new opioid highlights unpredictable drug supply: expert
A national substance use research organization is warning about a new type of opioid that is increasingly being found in Canada's unregulated drug supply.
The Canadian Centre on Substance Use and Addiction said in an alert there is a rising presence in the drug supply of potent synthetic opioids referred to as nitazenes, which are often more potent than fentanyl.
Nitazenes usually appear unexpectedly in drugs assumed to contain other types of opioids like fentanyl, oxycodone and non-medical benzodiazepines, said the centre.
The rise coincides with an increase in prevalence of benzodiazepines, which are often used as sedatives and tranquillizers.
This type of substance was only detected in less than one per cent of samples analyzed by Health Canada in 2021, said the centre, while noting it was four times the levels detected in 2020.
"One of the purposes of these alerts is not necessarily to put them out when the house is burning down, but more when there's a spark that got out of the fireplace," said Sarah Konefal, research and policy analyst at the centre.
It is likely that the presence of nitazenes is underestimated, because some drug checking services in Canada don't have the tools to actually detect this type of substance, said Konefal.
"One of the concerns is that we're only looking at the tip of the iceberg."
Recalling when fentanyl first appeared in Canada in 2013, Konefal said the centre released an alert based on a handful of reports of its presence in communities across the country.
In 2015, prevalence of fentanyl in Canada's drug supply started picking up, she said.
British Columbia declared a public health emergency in 2016 based on the significant increase in drug-related overdoses and deaths, soon followed by a national public health emergency.
The centre has been monitoring the rise of nitazenes based on data from Health Canada, which analyzes drugs seized by law enforcement. In 2021, the majority of samples with nitazenes came from Ontario, followed by a quarter of samples coming from Quebec.
Since January 2020 when one type of nitazene had been detected, over a two-year period there has been a rise not just in overall counts but also in the types of nitazenes detected, the centre's figures showed.
"The fact that there's more different types that are showing up, that's one indicator that probably the reach of nitazenes is expanding," Konefal said.
Karen McDonald, lead for Toronto's drug checking service, said she is seeing nitazenes showing up unexpectedly in the city's supply.
Since the service started in October 2019, it lets people in the city anonymously submit a drug sample to see if what is in it matches what they expected it to be. Those results are then shared with the purchaser.
The service also combines the results from samples checked and shares information on trends in the Toronto drug supply.
When nitazenes were first identified by the service at the start of 2021, they were in only one per cent of fentanyl samples checked, McDonald said. By the end of that year, nitazenes were in about 15 to 20 per cent of the fentanyl samples, and in 2022 it is about 20 per cent.
Because newer opioids in the unregulated drug supply like nitazenes and benzodiazepines tend to show up in drugs with fentanyl, the risk of people overdosing increases, Konefal said.
Given that nitazenes are more potent along with the fact that they're in drugs that have the same effect, it will increase risk of opioid poisoning, she said.
Public Health Ontario said the risk of nitazenes is "likely moderate to high" in the province, according to an October 2021 brief.
Nitazenes have directly attributed to the death of four Canadians in Ontario, according to Stephanie Rea, spokesperson for the Office of the Chief Coroner. Nitazenes have been detected in the examination of other deaths, and the investigations are still underway, Rea said.
Overdoses involving nitazenes may be hard to reverse and might require extra doses of naloxone, the centre said.
"The biggest issue is just that folks who are using these drugs don't actually know that they're using them," said McDonald, noting there is no dosing information for what people purchase on the street.
It is impossible for people to make safe choices when they don't know how much of a drug they are using, on top of the fact that they are also using a lot of other drugs they aren't even aware they are using, McDonald said.
The emergence and rise of new substances is the reality of a drug supply that is not regulated, said McDonald.
"The supply just continues to get more contaminated, more toxic, less predictable."
Since 2016, more than 9,000 Canadians have died from apparent opioid-related causes, according to the Public Health Agency of Canada.
"Canada recognizes that the overwhelming majority of overdose deaths have been due to the contamination of the illegal drug supply with substances such as fentanyl," said Maryse Durette, spokesperson for Health Canada.
Health Canada is aware of the increased presence of nitazenes in Canada and is analyzing emerging information on them, she said.
Since 2017, the government has committed more than $800 million to address the opioid overdose crisis, she said.
One or two doses of naloxone have successfully reversed nitazene overdoses, said Durette.
This report by The Canadian Press was first published May 21, 2022.
This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.
MORE HEALTH NEWS
CTVNews.ca Top Stories
The U.S. Supreme Court has ended the nation's constitutional protections for abortion that had been in place nearly 50 years in a decision by its conservative majority to overturn Roe v. Wade. Friday's outcome is expected to lead to abortion bans in roughly half the states.
Canadian politicians are responding to the U.S. Supreme Court's decision to end constitutional protections for abortion, with Prime Minister Justin Trudeau calling the news 'horrific.'
Canadian advocates are cautioning against complacency regarding abortions protections in place in Canada, after the U.S. Supreme court voted to overturn Roe v. Wade on Friday.
With the U.S. Supreme Court’s decision to end constitutional protections for abortion, 26 states are likely to ban abortions; 13 of which are expected to enact bans against the medical procedure immediately.
A Member of Parliament from rural Alberta went live on Facebook Friday to celebrate a United States Supreme Court vote to end constitutional protections for abortion.
Two people were killed and around 10 wounded on Saturday in a shooting at a nightclub in Norway's capital Oslo, Norwegian police said.
Miners working in a gold field in Yukon have uncovered what is being called the 'most complete' mummified woolly mammoth found to date in North America, officials announced on Friday.
An Ontario driver is speaking out after a shovel struck her windshield while she was driving on the highway.
Ontario Premier Doug Ford has unveiled his cabinet for the 43rd Parliament and there are some big changes to the front bench.
'It’s in shambles': RCMP 'architects of own demise,' says criminologist after complaints in N.B. and N.S.
After a week of criticism and anger at the Mass Casualty Commission in Nova Scotia, and outcry in a rural area of New Brunswick, there are questions about the RCMP’s role in community policing.
'Everything's on the table': Vancouver police tight-lipped as they investigate Indigenous teen's death
Vancouver police insist there's not much they can say publicly about their investigation into the death of missing Indigenous teen Noelle 'Ellie' O'Soup, but 'everything's on the table' as they work to determine how and why she died.
Soaring grocery prices are making it hard for some Canadians to feed their children, as families lean on food banks and donations for support.
Woman slashed in neck with machete in Vancouver stranger attack says she thought she was going to die
A woman who was attacked by a complete stranger armed with a machete on the streets of Vancouver is sharing her story.
The federal government has announced improvements to the passport processing system in an attempt to address continued backlogs, but Canadians continue to endure long lineups.
A year ago in the middle of the night, a 12-storey oceanfront condo building in Surfside, Florida, came down with a thunderous roar, leaving a giant pile of rubble and claiming 98 lives -- one of the deadliest collapses in U.S. history.
After weeks of ferocious fighting, Ukrainian forces have begun retreating from a besieged city in the country's east to move to stronger positions, a regional governor said Friday, the four-month mark in Russia's invasion.
An aftershock took more lives Friday and threatened to pile even more misery on an area of eastern Afghanistan reeling from a powerful earthquake that state media said killed 1,150 people this week.
The former Minneapolis police officer who fatally shot an unarmed woman who called 911 to report a possible sexual assault in the alley behind her home is scheduled to be released from prison next week, months after his murder conviction was overturned and he was resentenced on a lesser charge.
President Joe Biden will sign a bipartisan bill to address gun violence into law Saturday before departing for Europe, the White House announced Friday.
Abortion bans that were put on the books in some states in the event Roe v. Wade was overturned started automatically taking effect Friday, while clinics elsewhere – including Alabama, Texas and West Virginia – stopped performing abortions for fear of prosecution, sending women away in tears.
Now that the House and Senate have adjourned for the summer, CTVNews.ca breaks down what key pieces of legislation passed in the final days of the spring session, and what key government bills will be left to deal with in the fall.
The inquiry investigating the Nova Scotia mass shooting wants to know why the federal Justice Department withheld notes written by a senior Mountie for several months -- and if there's more revelations to come.
The Ontario Brain Institute is playing a key role in open science and brain health research with the release of new clinical data that will help scientists around the world advance investigations into pediatric neurological conditions.
German lawmakers voted Friday to end the country's ban on advertising abortions, which has in the past led to doctors being prosecuted for providing information about the procedure to potential patients.
Thirty-three countries have reported 920 probable cases of severe acute hepatitis in children so far, a jump of 270 from May, the World Health Organization said on Friday.
A team of biologists recently hauled in the heaviest Burmese python ever captured in Florida, officials said.
Coinciding with unrelenting cyberattacks against Ukraine, state-backed Russian hackers have engaged in "strategic espionage" against governments, think tanks, businesses and aid groups in 42 countries supporting Kyiv, Microsoft said in a report Wednesday.
NASA's first spacecraft designed to study a metallic asteroid won't be launching this year as planned, according to an announcement made by the agency on Friday.
Tennis star Osaka and her agent and business partner, Stuart Duguid, are forming a media company called Hana Kuma in partnership with The SpringHill Company, which was created by NBA star James and Maverick Carter.
Several celebrities including Viola Davis, Bette Midler and Stephen King reacted after the Supreme Court on Friday voted to overturn Roe v. Wade, which guaranteed a woman’s constitutional right to abortion.
Flowers, art, and Dior's world-famous ateliers collided on Friday for a sweet-smelling explosion of creativity. The house's Paris Fashion Week show was an homage to late British painter Duncan Grant and celebrated member of London's Bloomsbury Group, who died in 1978.
Statistics Canada says the number of job vacancies at the beginning of April hit just over one million, up more than 40 per cent compared with a year earlier.
Despite record low levels of unemployment, many sectors are suffering from labour shortages in the second quarter with restaurants and hotels continuing to be amongst the worst hit, a new Statistics Canada survey finds.
After the U.S. Supreme Court ruled on Friday to overturn Roe v. Wade, corporate giants from a range of industries pledged to provide support and financial assistance for employees — and, in some cases, their dependents — seeking abortions in states that outlaw the procedure.
A new painting of the Duke and Duchess of Cambridge was revealed to the public on Thursday. The painting – the first official portrait of Prince William and his wife, Catherine, together – is on display at the Fitzwilliam Museum in Cambridge, U.K.
Mounties in Coquitlam are appealing to the public for help tracking down two pieces of artwork that were allegedly stolen from a high school art display.
A bloodhound named Trumpet won the Westminster Kennel Club Dog Show on Wednesday night, marking the first time the breed has ever snared U.S. dogdom's most coveted best in show prize.
Canadians Bennedict Mathurin and Shaedon Sharpe took very different paths to the NBA, but their pro dreams were realized just minutes apart on Thursday.
A former professional football player who was convicted of killing his ex-girlfriend will not be eligible for parole for 14 years.
The Trotz Watch in Winnipeg appears to be over.
Toyota is recalling 2,700 bZ4X crossover vehicles globally for wheel bolts that could become loose, in a major setback for the Japanese automaker's ambitions to roll out electric cars.
A majority of Canadians who intend to travel this summer say high gas prices are affecting those planned getaways, a pair of recent surveys show.
Two people involved in testing for the electric car brand NIO died when one of its vehicles fell three stories from a Shanghai parking structure, the company said Friday.