Pubdate: Sat, 04 Mar 2017
Source: Ottawa Citizen (CN ON)
Copyright: 2017 Postmedia Network Inc.
Author: Megan Gillis
Page: A4


AIDS committee hopes to use results for study

A project launched this week by the AIDS Committee of Ottawa is
offering urine test strips that reveal to people who have used drugs
whether they've been unwittingly exposed to the powerful opioid fentanyl.

"We're hoping to give community members a free and simple way to find
out whether or not they've been exposed to fentanyl through recent
substance use and we're also hoping, if we can, to collect a bit of
data on what those results might be," ACO harm reduction coordinator
Caleb Chepesiuk said.

"We also want to get a greater conversation going about drug quality,
drug use and the interventions to reduce those risks."

The Where's the Fent? project offers a free, anonymous way for people
to check if they've been exposed while trying to get a better idea of
the situation in Ottawa, where public health officials and first
responders have warned of the dangers of bootleg fentanyl in
counterfeit pills and street drugs.

ACO plans to collect the results of those people who are willing to
fill out a short form - no name is required - to create a report on
their findings.

If people who use the strips are "angry, scared, confused" about the
results, organizers of the project urge them to "talk to us first! We
strongly encourage people not to use these test results to accuse or
threaten someone you may have gotten the drugs from. Your safety is

Fentanyl has been found by Ottawa police lacing street drugs from
heroin to cocaine and in pharmaceutical look-alikes, such as the
counterfeit Percocets police believe were taken by 14-year-old Chloe
Kotval, who overdosed on Valentine's Day. Police are also
investigating the death of another west-end teen who they suspect also
consumed counterfeit pills.

The test strips and a urine cup are available at the ACO's Main Street
office, where users can take the test on the spot or take it home. It
works like a pregnancy test with results revealed minutes after the
strip is dipped in urine.

The test must be used within 36 hours of using the substance and the
sooner the better because some people's bodies clear fentanyl faster.

It only detects fentanyl and fentanyl analogues that our bodies turn
into a substance called norfentanyl. Organizers warn a negative test
doesn't rule out exposure to another opioid or adulterant. The test
doesn't pick up so-called novel opioids like the even-stronger
carfentanil or U-4770.

After a series of overdoses, Ottawa Public Health and city police
teamed up last month to warn the public about counterfeit pills that
look nearly identical to prescription opioids like OxyContin and
Percocet but contained fentanyl, which is 50 to 100 times stronger
than morphine. Users are getting them from friends, ordering them
online or buying them from dealers.

Ottawa police have also sent seized drugs to Health Canada's labs only
to find out that samples of what looked like cocaine or heroin
contained fentanyl.

The Where's the Fent? project can't prevent harm to people before they
use drugs but Chepesiuk hopes the project will provoke discussion
about drug quality testing. The conversation on opioids has focused on
alerting the public to the danger and distributing the life-saving
drug naloxone, which temporarily blocks the effects of an opioid
overdose, through pharmacies and clinics.

"We really need to start talking about pre-use interventions,"
Chepesiuk said. "Naloxone is great but it's after the fact. The issue
isn't just fentanyl, it's that people don't know the content and
strength of the drugs that they're consuming.

"That's where the analysis is necessary. We're seeing the public
health benefit from other jurisdictions."

ACO is one of the backers, for example, of a proposal to include a
spectrometer at a proposed supervised injection site in Sandy Hill.
The devices have been used to identify drugsat venues including music
festivals in British Columbia and through an outreach van in Spain.

A supervised injection site targets people who are "pathologized" as
drug users. But teens, university and college students and "otherwise
mainstream" adults are all at risk if they use recreationally.

"That's where we also have to look at putting services," Chepesiuk

Other jurisdictions have used the same urine test strips to test drugs
directly after diluting a small amount with water but ACO doesn't have
enough certainty of the reliability of the method and has no way to
supervise people taking drugs that may have been mistakenly cleared.

Vancouver's Insite, North America's first supervised injection site,
piloted using the urine strips to test drugs directly last year,
finding 90 per cent of tests in a single month last summer were
positive for fentanyl.

Meanwhile, the number of times nurses used naloxone to head off
overdoses rose eightfold in the first six months of 2016.

"We've heard from clients that they want to know what's in their
drugs," says Dr. Mark Lysyshyn of Vancouver Coastal Health in a press
release. "With the number of overdoses rising, it's critical to
empower people to learn about their risk of being exposed to this
toxic substance. We're hoping this will encourage them to use our harm
reduction services like take-home naloxone kits, consider undergoing
addiction treatment and take precautions like decreasing their dose or
not using alone."
- ---
MAP posted-by: Matt