Province working on measures to stem the problem
The Alberta Law Enforcement Response team has deemed the drug fentanyl “the biggest drug trend of the year.” According to the Canadian Centre on Substance Abuse, there were at least 1,019 fentanyl-related deaths in Canada between 2009 and 2014.
Almost all Canadian provinces have experienced a rise in Fentanyl use in recent years, with fentanyl addiction in Alberta increasing more than any other. In Alberta alone, the number of fatalities involving fentanyl between 2011 to 2014 increased by a factor of 20, resulting in 221 deaths.
According to Alberta Health Services (AHS), young adults in the province between the ages of 20 and 30 are most deeply affected by the opioid epidemic.
Fentanyl is a powerful medical anaesthetic synthesised from opioids; opioids are chemicals generally used for surgeries and for treating severe chronic pain.
According to AHS, when used for an extended period of time, fentanyl causes individuals to develop a tolerance that can lead to mental and physical dependency on the drug. Further, AHS has found that fentanyl is 100 times stronger than morphine, heroin, and oxycodone.
Dr. Ernest Hilderman, a physician and anaesthetist at the Smith Clinic in Camrose, said that there is no oral version of fentanyl and that it was never intended to be an oral medication. He also said that in the case of fentanyl overdoses, it is hard to determine the strength of fentanyl because it is generally mixed with other drugs.
Drug traffickers often sell fentanyl as fake oxycodone. Consumers may think that they are buying oxycodone, but instead are sold a lethal drug.
According to the RCMP, fentanyl is finding its way into Canada’s illicit drug market in several ways: Firstly, through the diversion of pharmaceutical fentanyl products (primarily transdermal patches) from domestic supply channels. Secondly, through the smuggling of pharmaceutical or analogue versions of fentanyl into Canada from abroad, notably China.
In January 2016, CBC reported that although the province had more than 200 fatalities in 2015, the Conservative Government turned down over $1.4 million from the federal government for drug treatment programs.
Alberta’s current Minister of Health, Sarah Hoffman, said that the government is currently working to get some of that funding, and is investing $600,000 to review substance abuse programs in the province.
In 2015, the co-chairs of the Alberta Mental Health Review sent a letter to Minister Hoffman to take immediate action in response to the spike in fentanyl abuse. The recommended actions included the distribution of naloxone kits, the implementation of educational and training programs, and setting aside funding for public awareness campaigns.
According to AHS, naloxone is a drug that can reverse the effects of a fentanyl overdose, as long as it is taken by the subject immediately.
In May 2016, the Alberta Government reported that it had tripled its supply of naloxone kits. Presently, Alberta has more than 700 naloxone distribution sites, including community pharmacies, walk-in clinics, and harm reduction agencies.
The province has also focused on raising public awareness about the dangers of fentanyl, improving access to treatment, and reducing the supply and trafficking of fentanyl.
Kevin Friese, executive director of the University of Alberta Wellness Services, confirms that naloxone kits are available with a prescription from the University Health Centre Clinic and Pharmacy.
Friese said that although there have been no inquiries or requests for the naloxone kits, he’s hopeful that the provincial prescription requirement will be removed to make them more accessible.
Dr. Hakique Virani, a professor in the faculty of medicine at the U of A and a public health and addiction medicine specialist, said that fentanyl use has increased because it is easy to traffic. “It is dirt cheap when it is ordered off the Internet.”
He also stated that although naloxone is the best response to fentanyl use by the provincial government, it does not serve as a treatment for addiction.
“If you look at your circle of people in a university environment, one of them is struggling with a substance use condition,” said Virani. “While they might not be ready to get definitive evidence-based curative treatment, they might be willing to use it in a place where they’re less likely to die, and that gives them a chance at treatment when they’re prepared.”
Virani endorses the idea of medication-assisted treatment for addiction. However, he has expressed criticism of the Alberta government’s recent pledge to increase the number of detox beds as a response to the fentanyl crisis.
He noted that abstinence-based interventions can be dangerous for people with opiate addictions given the possibility of post-treatment relapse.
Although the situation is being addressed, new derivatives of fentanyl have entered the Alberta market. These derivatives include, carfentanil, an element used in elephant tranquilizers, and W18, a psychoactive drug with no known medical purpose. W18 is a hundred times more potent than fentanyl.
It remains to be seen how well the current measures will stem the problem.