Pubdate: Mon, 15 May 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Andrea Woo
Page: S1


A pilot project operated by Vancouver Coastal Health has found success
with a simple detection strip for the notorious opioid

Drug users who test their drugs and discover fentanyl are 10 times
more likely to reduce their dose, raising the possibility that making
such tests widely available could reduce overdoses.

That is one finding of a drug checking pilot project at Insite,
Vancouver's supervised-injection site, operated by Vancouver Coastal
Health (VCH). Launched last July, the initiative offers drug users the
option of testing their drugs for fentanyl using a simple test strip,
which produces results in seconds.

 From July to March, Insite clients checked their drugs more than 1,000
times. In all, 79 per cent tested positive for fentanyl, including 83
per cent of drugs reported to be heroin, 82 per cent crystal meth and
40 per cent cocaine.

Of those who tested their drugs before using them, the ones who
discovered the presence of fentanyl were 10 times more likely to
reduce their doses - and 25-per-cent less likely to overdose.

"It shows that this is a potential way to reduce harm," said Mark
Lysyshyn, medical health officer for Vancouver Coastal Health.

To use the tests, which are adapted from urine tests, users mix a few
grains of their drugs with water in a cooker and then submerge a test
strip into the solution. A result appears within seconds: One line
means it contains fentanyl; two lines mean it does not.

But the tests have their limitations. For one, they only test for
fentanyl - not any of its numerous analogues, some of which have been
confirmed to be in B.C. And, they don't test for the quantity of
fentanyl present.

Dr. Lysyshyn said the health authority is now having discussions with
partners about how best to expand the initiative, but cautions there
is still much research to be done and "this is only the very beginning
of drug-checking."

The manufacturers of the test strips are working on new strips that
can also detect fentanyl analogues, Dr. Lysyshyn said. It's not yet
known when those might be available.

Fentanyl has been detected in a growing percentage of illicit-drug
overdose deaths since 2012, the first year the BC Coroners Service
began testing for it and keeping detailed data.

The synthetic opioid was found in around 5 per cent of overdose deaths
in 2012, compared with more than 60 per cent now.

More recently, several stronger analogues have been detected in B.C.
Carfentanil, for example, is suspected to be the cause of a surge in
overdose deaths from November through January. Overdoses on these more
powerful opioids can require up to eight doses of naloxone to revive a
person, compared with one or two doses for a heroin overdose.

Provincial Health Officer Perry Kendall noted there exist dozens of
types of fentanyl and it's expected that more will arrive in B.C. He
had called for the decriminalization and regulation of drugs, noting
only so much can be done to respond to a toxic drug supply.

"Trying to chase one analogue after another in real time is not a real
fruitful exercise," Dr. Kendall said. "There are dozens of fentanyls
and we have no ability to test for [them all]. And even if we did, I
don't know if it would change our reaction to it."

About 90 per cent of overdose deaths happen indoors. Patricia Daly,
chief medical health officer for VCH, said for those who insist on
using alone, such drug tests have the potential to save lives.
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