Saturday , May 15 2021

Egan: Five have died of drug overdose in four days. What now?



If five pedestrians died on a pedestrian crossing in 72 hours, or five people died a week of toxic salad, clocks would stop, as the poets say, the authorities would gather, everything left aside.

But five sons or fathers or mothers dying of drug overdose in three or four days are quite statistically significant, a sad number of self-correction. Maybe five more will die next week, for everything we know, for everything we do today differently.

(Indeed, it was in London, Ottawa – not Ottawa – where five more men just died in the six-day period, all suspected of overdose, which led the chief of police to call in public.)

The overdose group that hit Ottawa at the end of March was frighteningly happening across North America. The most interesting aspect of drug-type drug abuse is "regular" cocaine, as it exhibits the entire population of casual users with deadly opportunities. The death of the promising musician and the middle-aged HVAC operator testifies to a scary, new area.

Experts tell us that these are people who would not normally have an opioid overdose antidote. And the reason is simple: Typically, fentanyl, a synthetic opiate that can slow elephants, was added to boost other opioids, like heroin or other morphine drugs. Cocaine, meanwhile, is not opiate, but is equally targeted.

"We believe most of the drug market is currently being infected with fentanyl," says Andrew Hendriks, Ottawa Health Care Director, and the head of the work group for the prevention of overdose.

Andrew Hendriks, Director of Health Care Public Health in Ottawa.

Jean Levac /

Postmodern news

At the moment it is unclear what drugs have killed five individuals at the end of March, but history is a travel guide to the most probable scenario where dozens of local residents were overtaken in a few hours-a "complete ruin," the words of an experienced worker on the street in the city center.

In the summer of 2016, in the four-day period in July, there was a dramatic increase in the number of patients who came to the emergency department at the Surrey Memorial Hospital outside of Vancouver – a total of 43, mostly men. Due to the rapid administration of naloxone, 35 patients were treated and soon released, but three ended in intensive care. One died.

Because of the extraordinary nature of the event, health authorities have separated the time for toxicology. The conclusion was that it was probably one trader responsible for distributing crack cocaine with furanyl-fentanyl, a so-called "analogue" that had not been seen in Surrey before.

"This is the first reported cluster of cases of overdose caused by cocaine contaminated with furanyl-fentanyl in North America," said a report delivered to Centers for Disease Control and Prevention.

That would not be the last. Late one night in September of that year, nine young people in Delta, BC, won cocaine. In about 20 minutes, all nine of them overcame and needed help from a nurse or hospital for respiratory disturbances.

Why? Cocaine was linked to fentanyl or his relatives, and occasional users are not accustomed to the use of opiates, which sounds ghastly like Ottawa in March 2019. (In short, cocaine is "up" and opiates are "lowered" and opioids are "down" to points the respiratory system may stop.)

In June 2018, about 20 people in Philadelphia – regular cocaine users from a part of the city – were taken to a hospital with overdose in what a physician described as the first wave of cocaine-fentanyl that hit the city. Two users died.

While Ottawa police refused to talk about what might have been last week – was it a source, for example? "We know something about the use of unauthorized drugs in the city.

Sites for supervised injection at the Sandy Hill Health Center used mass spectrometer for drug testing for up to 18 substances before use. The process is voluntary and takes only a few minutes. In December, of the six samples of cocaine, one contained fentanyl, the other two had another opioid. In November, out of eight samples, four had fentanyl or similar drugs.

"It's amazing how the speed of drug delivery increased with all these different types of cocktails," said program director Rob Boyd, and fentanyl appeared in much of the "stimulus stimulus".

Rob Boyd, Program Manager for Oasis Damage at Sandy Hill Health Center.

Wayne Cuddington /

Postmedia

The next step is to collect data on the amount of each drug in the blend, he added, referring to safe practices among those who use cocaine, even occasionally.

Dr. Dan Ciccarone is a doctor and researcher at the California University of San Francisco. He watched many overdose waves that hit North America and talked to many drug dealers.

"These clusters make everyone in the public health world shake their heads," he said on Wednesday.

His best explanation is that random contamination is probably a culprit – in delivery and packaging – not deliberately mixing the drug "up" (cocaine) with "down" (synthetic opioids), although fentanyl is relatively inexpensive and easy to mix.

"At the first level, you have to ask why (mix). I must tell you that there is no good answer. Fentanyl and its analogues appear almost in all, including meth, he said.

"All drug streams now suddenly have a new level of paranoia in them."

Asked about the stigma of drug use, Ciccarone said that the mysterious death of racing horses in California gets more media coverage than the "historical" opioid crisis.

"In the United States, it's so big that it increases the mortality rate. Yet, at this level of crisis, that is not welcomed. I think it is because of stigma and fear, "he said, and then pointed to the slow public health response to the AIDS crisis in the 1980s.

"It takes a long time to develop a response to fentanyl because we are afraid of it."

nUMBERS:

Fifty-five so-called "purple" samples (sold as heroin, "down" or fentanyl) contained fentanyl and its derivatives from September to December, in the safe place of injection of Sandy Hill.

50 Percent of cocaine samples containing synthetic opioids in November, December, in limited Sandy Hill tests.

14 hours between the six overdoses attended by nurses on the same day, including three deaths.

40, 5: Emergency, Death, Ophthalmic Causes in June 2018, Ottawa.

$ 80,000 / $ 1.6 million: Cost of one kilogram of trimmed fentanyl, a potential payload of the same pounds, according to the New York Times.

$ 0 or $ 1: An expense (antidote) naloxone kit in many pharmacies and a limited-use test strip of fentanyl.

To contact Kelly Egan, please call 613-726-5896 or email [email protected]

Twitter.com/kellyegancolumn


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