Pubdate: Sat, 12 Aug 2017
Source: London Free Press (CN ON)
Copyright: 2017 The London Free Press
Author: Jennifer Bieman
Page: A1


As deadly fentanyl fuels a public health crisis, Free Press reporter
Jennifer Bieman reveals what you should know about common London
street drugs

Forget the old adage that what you don't know, can't hurt you. When it
comes to street drugs, what you don't know can kill you.

That was the thrust of a rare public health warning - three health
agencies and London police joined in its release - last week in
London, when authorities stressed that the latest villain in Canada's
opioid drug crisis, deadly fentanyl, is turning up in other illegal
street drugs.

Critics scoffed at one suggestion that fentanyl is even showing up in
marijuana, a conclusion drawn from urine tests on recovering drug
users. But the wider message - that too many people are taking street
drugs without knowing what's in them - was quickly underlined when
three drug overdoses in mere hours killed one person in Sarnia and
left two others in hospital.

Cocaine laced with fentanyl is suspected. Cutting other stuff into
drugs is a practice that's gone on for years - sometimes, to fatten
drug dealers' profits; sometimes, to make drugs more addictive.

Taking the public health message to heart, The Free Press took a
closer look at some of the most common street drugs in London, how
they're used, what else might be lurking in them and the risks of using 


What: A fast-acting synthetic opioid, up to 100 times more powerful than 
morphine, it has sparked a public health crisis across Canada, 
implicated in growing numbers of overdose deaths. As little as two 
milligrams of fentanyl, the equivalent of about four grains of salt, can 
kill you. That should be an eye-opener for other illegal drug users, 
since fentanyl has been detected in street drugs such as crystal meth 
and heroin. How used: On the street, gel from prescription patches, used 
to manage chronic pain, can be smoked, ingested or dried into a powder. 
Illegal powdered fentanyl has made its way into Canada from overseas 
labs and can be pressed into tablets made to look like prescription 
drugs like oxycodone.

Toll: Fentanyl is the leading cause of opioid-related deaths in Ontario, 
killing 220 people in 2015 alone. Contaminants: It's difficult to trace 
the exact ingredients in the illicit fentanyl from overseas labs. As for 
street fentanyl, derived from prescription gel, it's not clear what 
might be in it. "(Users) are drying out the fentanyl patches, and then 
making it into a powder and cutting it with other things," said Jim 
Dean, a London criminal lawyer. Effects: Shortness of breath, dizziness, 
drowsiness, lethargy and euphoria.

Quote: "Any chemical substance that's in powder form can be mixed with 
anything, even pressed pills," said Dean.

"People just get pill presses, mix the chemicals together, and put
them in and make the pills."


What: A narcotic painkiller, sold under the brand name Dilaudid, it has 
run second in Ontario only to fentanyl among opioid deaths.

How used: It's available in injectable liquids and oral solutions, but
Andrew Sharpe, a nurse practitioner at the London InterCommunity
Health Centre, said hydromorphone pills - taken orally or crushed,
melted, made soluble and injected - are the most common form on the

Toll: Hydromorphone was responsible for 207 deaths in Ontario in 2015. 
Prescription opioids, including hydromorphone, are the runner-up problem 
that substance-abuse clients seeking treatment at Addiction Services of 
Thames Valley report, second only to alcohol. Contaminants: Some 
hydromorphone users mix the drug with heroin, says Narcanon, an 
international drug education and treatment group.

Effects: Drowsiness, relaxation, euphoria, trouble concentrating, dulled 
perception of pain and lower respiratory rate.

Quote: "Entry-level users will take the pills," said Sharpe, adding 
longer-term drug users often turn away from swallowing tablets in search 
of a more intense high. "Lots of times they crush them up, heat them up 
and then inject them and then they get a much bigger high."


What: A powerful stimulant, also known as ice, speed and crystal meth, 
it's made in secret labs with relatively cheap but often dangerous 

How used: Made popular by biker gangs in the 1960s, the drug can be
crushed and snorted, swallowed, smoked or injected. Compared to other
street drugs, it's cheap - averaging $10 to $20 for a tenth of a gram,
said Karen Burton, needle and syringe program co-ordinator at the
Regional HIV/AIDS Connection in London.

Contaminants: Over and above the toxic chemical ingredients used to make 
methamphetamine, including antifreeze, battery acid and drain cleaner, 
Burton's needle-exchange and harm-reduction program has seen crystal 
meth laced with fentanyl for a while.

Effects: Crystal meth is a stimulant, giving users an erratic high that 
can keep them awake for days. "The behaviour that comes with it is 
unpredictable. It generally keys people up, makes them a little more 
aggressive, a little more stimulated," said Sharpe. If the drug is laced 
with fentanyl, even a single dose can be fatal.

Quote: "The purity of it changes from batch to batch, so that's always a 
concern for us," said Sharpe. "You can take basic chemicals, make it in 
your garage and you have crystal meth as long as you know the right 


What: An addictive opioid, found in powder and tar forms on the street, 
it's made from morphine that's been chemically processed. First 
introduced in the late 19th century as a painkiller and cough 
suppressant, street heroin can be injected, snorted or smoked. It's not 
inexpensive, averaging $30 to $60 for a tenth of a gram, said Burton.

Contaminants: Regional HIV/ AIDS Connection harm-reduction co-ordinator 
Blair Henry said heroin is often laced with fentanyl. "The heroin, if 
it's cut with fentanyl, makes it more powerful and more attractive to 
the end user," he said. The RCMP also have warned of heroin cut with 
carfentanil, a synthetic opioid 100 times more powerful than fentanyl.

Effects: Surge of euphoria, followed by sedation and drowsiness. New 
users report sometimes feeling nauseous. If laced with fentanyl or 
carfentanil, a single dose could be deadly.

Quote: "What we're hearing from the street is that it never was a really 
huge thing in London, but it's definitely getting a little worse," said 


What: Its recreational use headed for legalization by the federal 
government next year, marijuana is the most commonly used illegal drug 
in Canada, the Centre for Addiction and Mental Health reports. 
Forty-four per cent of Canadians admit they've used pot at least once in 
their lives.

How used: The buds of marijuana plants can be smoked or processed into 
oil. Contaminants: The London warning that pot could be laced with 
fentanyl was based on urine tests of recovering drug users who reported 
only using other drugs, not fentanyl, fuelling doubt by many. Neither 
the RCMP nor Health Canada has reported any confirmed cases of 
fentanyl-laced pot.

Effects: THC, marijuana's main psychoactive substance, mildly distorts 
perception and can make users feel relaxed and mellow or lively and 

Quote: "It's a pretty cheap drug. In terms of mixing or lacing it with 
other things, I'm not sure," said Sharpe, skeptical of the health unit's 
warning and the accuracy of self-reporting. "In our experience, people 
don't just use one drug."


What: An illegal drug that goes back decades, exploding onto the scene 
in the 1970s and '80s, made infamous by pop music and Hollywood films, 
it's a highly addictive drug derived from coca leaves. Typically, it's 
snorted in its white powder form, giving users an energetic and euphoric 

Contaminants: Though fentanyl has been mixed into cocaine, London police 
also have seized other drugs used as cutting agents, including 
phenacetin, a U.S. Food and Drug Administration-banned painkiller, pain 
relievers benzocaine, procaine and lidocaine, caffeine and levamisole, a 
drug used to treat parasitic worms in humans and animals. The department 
also has snapped up creatine and inositol, supplements used as cutting 

Effects: Cocaine can make users feel talkative, alert and euphoric. It 
also can cause erratic behaviour, panic attacks, increased heart rate, 
paranoia or hallucinations.


What: The highly addictive narcotic, known by its brand name Percocet, 
killed 179 people in Ontario in 2015. The prescription opioid pills are 
used to treat pain, but on the streets they can be crushed, snorted and 

Contaminants: Fake oxycodone pills, actually illicit fentanyl formed 
into tablets, have been detected by police, especially in Western Canada.

Effects: Sedation, reduced anxiety, relaxation, pain relief and 
euphoria. Counterfeit oxycodone pills made with fentanyl can be lethal.
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