Indian Time - A Voice from the Eastern Door

(September 27, 2016) Fentanyl use has become widespread in North America as well as in Akwesasne. The Akwesasne Mohawk Police Service is concerned about the use of this drug locally. The Akwesasne Mohawk Police Service would like to provide an educational piece to the community to forewarn of this hazardous and extremely dangerous drug.

Fentanyl is an extremely potent synthetic opioid prescribed for the treatment of chronic pain, usually in patients already tolerant to high doses of less powerful opioids such as morphine or oxycodone. Fentanyl is approximately 100 times more potent than morphine and 40 times more potent than heroin. Fentanyl used for non-medical purposes is most commonly encountered in the form of diverted prescription patches.

According to statistics from the Office of the Chief Coroner, deaths attributed to Fentanyl in Ontario doubled between 2008 and 2012 from 45 to 116. During this time frame, only the far more widespread oxycodone was connected to more deaths.

Fentanyl is sold under the prescription names Duragesic, Apo-Fentanyl Matrixe, Ran-Fentanyl Matrix Patch, Co Fentanyl, PMS-Fentanyl MTX and others. Non-Medical Use (or Illicit Use) Fentanyl is known by several street names: Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT and Tango and Cash.

Aside from using patches in a prescribed manner, users will extract the gel from patches and eat, smoke, inject and dissolve it under their tongues. Because fentanyl is highly soluble, users will soak pieces of the patch in alcohol and then infuse herbs such as basil with the mixture to smoke. Because the patch is made for a 72-hour slow release, scraping off the medication and smoking or sucking the drug out of the patch can make a single patch lethal.

SYMPTOMS

Users may experience slowed breathing, nausea, constipation, drowsiness, unconsciousness, coma and potentially death.

Street Prices (per patch) $150 - $220 in Central Ontario.

Up to $500 in First Nations communities in Northern Ontario.

GROWING CONCERN

In March 2012 Purdue Pharma replaced OxyContin with OxyNEO which is more difficult to misuse. Since that time many people who are addicted to opioids have migrated to using other opioids including fentanyl and heroin.

Fentanyl is obtained in a number of ways including the sale of legitimate prescriptions, theft of prescriptions, theft from institutions with drug inventories and fraudulent prescriptions.

ADDICTION

Younger people are becoming addicted due to the strength of the high;

People administering immediately when patches are acquired;

Experienced and long-term heroin users are alarmed at friends using fentanyl due to the dangers;

Police Confidential Informants reporting that users of fentanyl do not use it alone due to the high risk of overdosing.

METHOD OF INGESTION

Some medical professionals assumed their patients were using the patch as prescribed in a transdermal manner as opposed to smoking, chewing or injecting;

Fentanyl patches are being supplied illicitly by individuals possessing valid prescription for the medication who then divert all or a portion of their prescription.

A cottage industry to supply people who are addicted to opioids as opposed to organized crime groups has grown up across the province. Any gang involvement still sees the supply route as being from prescribed users selling patches;

Patches are being cut up for use resulting in inconsistent doses being consumed by users which increases the risk of overdose;

Patches that are properly used may retain 60% to 80% of the original dosage;

Because of the high street price in some communities, patients who are receiving the patch for appropriate clinical reasons may sell some of their patches, or be pressured to sell some or all of their patches, for additional income. If the patches are sold to people not familiar with the drug, significant harm or death can result.

Chief of Police Jerry Swamp states, “The use of fentanyl is alarming to all Police in Canada. Enforcement efforts together with public health initiatives and education are a critical part of controlling and eliminating this threat to our health.”