Pubdate: Fri, 04 Mar 2016
Source: Vancouver Sun (CN BC)
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Nick Eagland
Page: A9

B.C. BRACES FOR ARRIVAL OF W-18

New synthetic opiate is up to 100 times stronger than fentanyl

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
province's streets.

Already, health officials and first responders are scrambling in
response to 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 B.C. Coroners Service haven't yet seen W-18.
Mounties believe "it's likely just a matter of time," Staff Sgt. Rob
Vermeulen said.

Hugh Lampkin, board member of the Vancouver Area Network of Drug
Users, 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)," he said. "I think B.C. has ... a larger population of drug
users, so we can expect a lot more overdoses to hit this province."

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

He doesn't believe illicit-drug makers intend to harm users, but
they're mixing inconsistent batches and pressing pills with "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 trained to
administer it.

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

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

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

"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 only 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 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," he 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."
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MAP posted-by: Matt