Pubdate: Sat, 17 Feb 2018
Source: Globe and Mail (Canada)
Copyright: 2018 The Globe and Mail Company


Earlier this month, front-line health workers in Toronto raised the
possibility that part of the city's cocaine supply may be tainted with
fentanyl, after a handful of drug overdoses were connected to users
unknowingly consuming the deadly opioid while smoking crack.

This dismal scenario is common in Canada. Across the country, illicit
drugs are being cut with the synthetic painkiller - which is up to 50
times more potent than heroin - because it is cheap and powerful and
saves dealers money. During a month-long period in the summer of 2016,
86 per cent of the street drugs tested at Vancouver's supervised
injection sitewere laced with fentanyl.

This has been a key factor in Canada's horrifying spike in
drug-overdose deaths. In 2016, there were 2,861 apparent
opioid-related deaths. In 2017, opioid deaths are expected to top
4,000 once all the numbers are tallied. So far, three-quarters have
involved fentanyl or its analogues, up from about half the year before.

Yes, some users take fentanyl deliberately, because of the powerful
high it provides. But many, if not most, related deaths seem to be
coming from the unwitting consumption of the drug, when the dose is

"There is a very toxic drug supply," said Dr. Theresa Tam, Canada's
chief public health officer, in discussing last year's figures.

Opioid addiction is a disease, and we are living through an epidemic
of it. fentanyl overdoses are part of that epidemic.

But we are also living through a crisis of poisoning. Those who have
overdosed and died after unknowingly taking fentanyl were victims in
an act of mass killing.

What else can you call the surreptitious sale of a fatally toxic
substance to thousands of people? A few grains of fentanyl can kill an
adult. All dealers know this by now.

So far, the federal response to the opioid crisis has focused on
emergency public-health measures, harm reduction, treatment and
prevention of drug abuse. Enforcement has been a relatively small part
of the picture.

That's more or less as it should be when it comes to drug addiction.
This is still largely a public-health matter.

But in this case, that approach has limitations. The fentanyl crisis
is fundamentally different from other drug epidemics, since hundreds
or even thousands of Canadians appear to be dying from overdoses of a
drug they didn't intend to take. If the poison were arsenic or
anthrax, which in sufficient doses it might as well be, we would have
no trouble seeing that we need more law enforcement, and fast.

This shouldn't be controversial. In a survey by The New York Times
about how to fight the opioid crisis in the United States, over
two-thirds of the experts polled said that, given US$100-billion, they
would devote some of the money to increased funding for police or
border screening, even while focusing on harm reduction.

If curbing the flow of fentanyl into the overall supply isn't a job
for police, then literally nothing is. To its credit, Ottawa has
already taken some enforcement steps, such as allowing border agents
to open packages weighing 30 grams or less, and stricter controls on
pill presses and the chemical ingredients of fentanyl.

But the government should also give the RCMP new funding and an urgent
mandate to bust fentanyl labs and arrest high-level dealers in a
co-ordinated, all-hands-on-deck national campaign.

One use for the funding could be more staff at international mail
centres and ports of entry. Another could be the creation of more
clandestine drug-lab teams, as border enforcement drives more domestic
fentanyl production.

In the justice system, dealers alleged to have secreted fentanyl into
other drugs should not be treated primarily as drug dealers, but as

A growing number of manslaughter charges against fentanyl pushers
suggest this is beginning to happen. Judges should augment the effort
by using their discretion to impose uncommonly stiff sentences on
fentanyl dealers, as at least one B.C. judge has already done.

So-called "tough" approaches to drugs have failed historically and
left vast collateral damage in their wake. Science and compassion are
much better tools.

But when drugs are being poisoned for profit, and thousands are dying
every year, trying to remove some of the poison is the compassionate
thing to do.
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