Pubdate: Fri, 04 Mar 2016
Source: Province, The (CN BC)
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.theprovince.com/
Details: http://www.mapinc.org/media/476
Author: Nick Eagland
Page: 3

NEW DEADLY PERIL LOOMS FOR DRUG USERS

Painkiller W-18 Is Up to 100 Times Stronger Than Fentanyl - and It's 
Heading Here

Drug experts fear B.C. won't be ready to deal with the devastating 
impact of the powerful painkiller W-18 when it inevitably hits the 
streets here.

Already, health officials and first responders are scrambling to 
combat a surge in overdoses from the potent, synthetic opiate 
fentanyl, which was detected in 146 illicit drug deaths in 2015, up 
from 91 in 2014, according to B.C. Coroners Service data.

After Calgary police recently seized pills containing W-18 - which is 
up to 100 times stronger than fentanyl - drug experts began bracing 
for its arrival in B.C.

Vancouver police and the coroners service haven't yet seen W-18, but 
Mounties believe "it's likely just a matter of time" before it 
reaches B.C., said Staff-Sgt. Rob Vermeulen.

Hugh Lampkin, board member of the Vancouver Area Network of Drug 
Users (VANDU), said he's "expecting a lot of trouble" from W-18.

"Let's be real about it, the same thing's going to happen here (as in 
Calgary)," Lampkin said. "I think B.C. has ... a larger population of 
drug users, so we can expect a lot more overdoses."

Lampkin said it's possible those behind the distribution of W-18 
tested it in Calgary "to get it right" before introducing it into 
Vancouver's opiate supply.

He doesn't believe illicit-drug makers intend to harm users, but 
they're mixing inconsistent batches and pressing pills containing 
"hot spots" capable of providing lethal doses.

In preparation for W-18's arrival, VANDU has focused on educating 
opiate users by reminding them not to use alone, to test their drugs 
in small doses and be wary of W-18 "coming down the pipeline," Lampkin said.

He said it's vital they have access to naloxone, a drug that reverses 
opioid overdoses. More than 400 VANDU members are currently trained 
to administer it.

Ron Moloughney, president of the Surrey Area Network of Substance 
Users (SANSU), said W-18 is expected to be a "serious" problem when 
it arrives in the city, where firefighters responded to more than 200 
calls for overdoses in January.

SANSU is working on its response with RCMP, Fraser Health Authority 
and the Lookout Society, he said.

Moloughney said 50 to 75 SANSU members are trained to administer 
naloxone, but he doubts that's enough to curb W-18's expected impact.

"Personally, I don't think naloxone will be the key to this situation 
because it will be too late by the time they get some naloxone into 
their system," he said. "This stuff kills you instantly." Mark Haden, 
adjunct professor at the University of B.C.'s School of Population 
and Public Health, said naloxone needs to be made more widely 
available but is a "Band-Aid" on a bigger problem.

"If you really think about the fentanyl problem and the W-18 problem, 
essentially, these are problems of drug prohibition," Haden said.

"The fact we criminalize drugs and do not allow people to access 
these drugs in a controlled and regulated way - based on a 
public-health model - results in absolutely uncontrolled drugs on our 
streets that have unknown purity, unknown strength and unknown concentration."

Dr. Keith Ahamad, a clinician scientist at the B.C. Centre for 
Excellence in HIV/AIDs, also said harm reduction through naloxone is 
important, but not the solution to the problem posed by W-18.

"A huge component of the problem, really, is untreated opiate-use 
disorder, and without a real, concerted effort to engage with this 
population in an evidence-based way, we're really ... missing the 
boat here," Ahamad said.

"Right now we have a treatment system in British Columbia that's 
operating outside of best evidence-based guidelines. We have a 
physician population here that (is) not appropriately trained to both 
recognize and diagnose, and to treat addiction, in an evidence-based way."
- ---
MAP posted-by: Jay Bergstrom