An “astronomical” level of fentanyl in a drug sold as crystal methamphetamine shows the need for improved testing and harm reduction measures in London, a doctor specializing in street-level addiction says.
“This was a bright and shining example of why we need to keep doing what we’re doing, and do it better,” Dr. Andrea Sereda of London InterCommunity Health Center said Monday.
In one sample, the level of the deadly opioid was 77 per cent, compared to the usual four per cent level in drugs sold on the street, she said.
In four more samples from another batch, the levels of fentanyl reached 16 and 17 per cent in two samples and zero in the others.
“That really highlights the extreme unpredictability and volatility of the supply. The reason people die is they don’t know if they’re going to get the zero, or the four per cent, or the 17 per cent, or the 77 per cent,” said Sereda, family physician and manager of a safe supply program at LIHC.
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The health centre, Middlesex-London Health Unit and Regional HIV/AIDS Connection London issued a warning April 1 after preliminary tests showed there was fentanyl in drugs being sold on the street as crystal meth.
Crystal meth is a white, crystalline drug made in clandestine labs from toxic or flammable ingredients. The stimulant, which belongs to the methamphetamine family of drugs, can be snorted, smoked or injected.
Fentanyl is a hyper-potent opioid that is 100 times more powerful than morphine.
The drug Naloxone can stop a fentanyl overdose, but people using crystal meth may not carry Naloxone and may have no or low tolerance to fentanyl.
Preliminary tests and the warning came after people using the drugs and their friends began alerting others and notified health officials, Sereda said.
“The community really responded by choosing not to use that batch of fentanyl, letting all of their friends and peers know, by bringing in their drugs for testing. The community really, really rose to the occasion,” Sereda said.
“We need to work further to establish that so we can have this back and forth flow of information.”
Samples were sent to Toronto to confirm how high the fentanyl levels were, and that took several days, Sereda said.
“A two- or five-day turnaround is too slow to really give us the information that we need,” she said. “If we were able to obtain that type of technology in London, and we could do this on the spot, we could just keep people that much safer.”
While testing and communication can help in crises, the longer term solutions need to focus on harm reduction, Sereda said.
“We need an entire spectrum of options for people, which is not the unregulated street supply,” she said.
London has a 300-patient safe supply program at LIHC, but a recent study said it needs to expand to include more patients.
The city also has a safe consumption site, CarePoint, operated by Regional HIV/AIDS Connection London, but the pandemic and safe-distancing rules have hampered the operation.