The coroner’s office is investigating two more deaths as possibly linked to a batch of heroin circulating in the city that is so lethal it prompted police and public health to issue impassioned warnings about it last month.

Officials are now looking at a total of five deaths as linked to this particular batch of heroin, regional coroner Dr. Jack Stanborough confirmed Wednesday.

“There are five that we’re tracking to see if they’re related to the deaths reported in the media,” Stanborough told CBC Hamilton. “The concern is if there’s something different in the composition of these drugs that is causing these specific deaths.”

Other people have died in the city from heroin overdoses in the same timeframe as those being investigated, Stanborough says, but they aren’t being actively looked at as connected. “I always have heroin and cocaine deaths in the area,” he said.

Hamilton police and public health both issued warnings about a more powerful and lethal batch of heroin in Hamilton last month, after Stanborough said his office was investigating three deaths as possibly linked to the drug.

It’s impossible to say what exactly was in the heroin that killed those five people until toxicity screen reports come back, and that still hasn’t happened, Stanborough says. Results likely won’t be available until mid October.

Fentanyl and heroin mix popping up in other cities

One former opioid user told CBC Hamilton that a batch of heroin mixed with the powerful prescription painkiller fentanyl has been circulating in the city. Both police and public health mentioned fentanyl in press statements about the overdoses, but could not say for sure without a formal toxicity report from one of the people who had overdosed.

Bus shelter overdose kits Hamilton

These posters advertising overdose prevention kits on bus shelters have started popping up around Hamilton in recent weeks. (Rick Hughes/CBC)

Police had hoped to coerce members of the public to hand over heroin samples with a drug charge amnesty in an effort to chemically analyze what is being used in the city. But no one has handed over any drugs, Police Const. Debbie McGreal-Dinning told CBC Hamilton Thursday morning.

"When police respond to drug overdoses/sudden deaths where drugs are involved, those drugs continue to be sent ... for testing," McGreal-Dinning said. "This is to see if there are any similarities between the drug mixture and to determine if there are any similar components in the mixture to link separate cases." 

Mixing or lacing fentanyl with heroin is an emerging problem in other places, too. Montreal’s fatal overdose rate was four times the average in June, which public health officials tied to heroin laced with fentanyl. Six people died in one day alone that month.

Reports of fentanyl-spiked heroin have also popped up in Boston and Pittsburgh in recent months. The New York Times reported in January that 22 people died in Pennsylvania from overdosing on a potent mix of heroin and fentanyl earlier this year.

City offering overdose prevention kits

The city’s public health unit has also been pushing new overdose prevention kits containing the drug naloxone, which helps keep someone who is overdosing alive –  but it hasn’t seen a rise in people accessing them. Here are the number of kits that have been distributed each month since the program began:

  • 15 in May
  • 14 in June
  • 23 in July
  • 17 in August

The majority of drug deaths in Hamilton are still being caused by opioid overdoses.

About 40 people in Hamilton die each year from drug overdoses, and from 2010 to 2012, about three quarters of those deaths were caused by opioids like heroin, oxycodone or fentanyl.

That’s up from 2008 and 2009 when only about half of all drug deaths were caused by opioids.

In 2011, 43 people died from acute drug toxicity in Hamilton, and 34 of those died from opioids.

In 2012, 39 people died from acute drug toxicity, and 28 of those died from opioid overdose.

Drug and Opioid deaths in Hamilton