Sean LeBlanc first caught wind of people using fentanyl as a street drug in Ottawa three years ago. The synthetic opiate had been around for decades, but until it became available as a wearable patch, it hadn't caught on with street drug users.
LeBlanc said nothing prepared him for its overpowering intoxication.
"I'm a previous opiate user myself and have a lot of experience with it but fentanyl really, really terrified me. I used it one time and then never, ever again," said LeBlanc.
He blames fentanyl for the death a year later of a close friend whose body was found in his supportive housing apartment three days after he had overdosed.
LeBlanc, who now chairs the Drug Users Advocacy League, a group that aims to improve the safety and education of and towards drug consumers, said he has a simple solution for fentanyl.
"I would like to see it wiped off the face of the earth," he said.
Police, health officials and treatment groups in Ottawa and across the province are sounding the alarm over fentanyl, which has fast earned a reputation as one of the deadliest drugs in the province and the city.
Developed in 1959, fentanyl is a synthetic drug that acts like an opiate such as morphine or heroin. It has primarily been prescribed to manage acute pain, including for palliative care patients, and its patch is designed to slowly release the potent drug over 72 hours.
A history of fentanyl
1959 | Fentanyl synthesized
1970s | First illicit use of drug appears within medical community
1992 | First fentanyl patch (Duragesic) marketed in Canada
1996 | Duragesic added to Ontario Drug Beneﬁts formula
2006 | Generic version of fentanyl patch added to Ontario Drug Beneﬁts formula
2007-2009 | Fentanyl first noticed as street drug in Ottawa
Sept. 2010 | First patient approaches The Royal with fentanyl addiction
Fall 2011 | Series of break-ins in Manotick area later connected to fentanyl addiction.
August 2012 | Manotick resident Tyler Campbell, 17, dies of fentanyl overdose.
(Sources: The Royal, Ottawa police, CBC News)
In 2006, a generic version of the drug was added to the Ontario Drug Benefits formula, and it wasn't long before drug users discovered the prescription drug could be chewed, smoked, injected or otherwise consumed all at once. The results, according to health officials, can be disastrous, particularly for first-time users.
From 2009 to 2011, an estimated 253 deaths in the province have been linked to fentanyl, according to Ontario's Office of the Chief Coroner. That's more than three times the number of deaths linked to heroin. During that time frame, only the far-more widespread oxycodone was connected to more deaths.
80 to 100 times more powerful than morphine
Fentanyl has already been blamed for the deaths of at least two youths in eastern Ontario, according to Ottawa police, and it is suspected as a likely cause of death in a number of other deaths in the National Capital Region, including the death of two men at a Booth Street apartment last year.
"The risk of overdose is very high, particularly among new users," said Dr. Melanie Willows, the clinical director of substance use and concurrent disorders at The Royal.
"It's 80 to 100 times more potent than morphine and a higher risk than a drug like Oxycontin," she said.
As with oxycodone products, fentanyl is legal with a prescription, so when it started to appear as a street drug it took health and safety officials by surprise.
Drug linked to Manotick school
Police didn't learn about the drug until early 2012 when they arrested a young offender charged with over a dozen residential break-ins in the Manotick area.
The young offender told police he was committing the break-ins because he was hooked on fentanyl.
"At the time we didn't know very much about it, we had heard that there was a new drug being experimented with in some of the schools," said Staff Sgt. Kal Ghadban with Ottawa Police's street crime and break-ins unit.
Ghadban said after working with school officials in the Manotick area, police learned more than a dozen teens in one school were addicted to the substance.
The drug can now be seen citywide, said Ghadban.
"It's not what I'd call an epidemic and it's not something that's very rampant but people who do use it come from all walks of life and all parts of the city," he said.
Doctors, nurses among first users
The rapid appearance of fentanyl comes as no surprise to Ottawa doctor Mark Ujjainwalla, who has been treating fentanyl addicts for more than 20 years.
The signs of fentanyl
What others observe in users of fentanyl and other opioids:
- Drowsiness or "the nod."
- Constricted or pinpoint pupils.
- Slurred speech.
- Impairment in attention or memory.
Opioid withdrawal signs:
- Dilated pupils.
- Anxiety, irritability, anger (drug craving).
- Agitation (cannot sit still).
- Appears to be ill: nausea, vomiting, diarrhea, sweats and chills, watery eyes, runny nose.
- Yawning and Insomnia.
(Source: The Royal)
Ujjainwalla said fentanyl wasn't a street drug back then, so many of the addicts he treated were doctors and nurses who first had access to the drug.
"Fentanyl is a highly potent, highly addictive opiate, and it wouldn't take long before the average person using the drug would be addicted, and unfortunately most of them would die," he said.
Ujjainwalla runs a methadone clinic in Ottawa to help get people off the drug. He said the lack of treatment options in Ottawa, particularly for adolescents, has been one the most frustrating parts of his job.
"The times to treatment are unacceptable, to be honest shameful, and as a taxpayer and parent I feel like our government is letting down our community," said Ujjainwalla.
Willows said at The Royal wait times for people asking for help with addictions is typically four to six months.
She said telling people who say they need help now is the most difficult part of her job.
"Everyone on our waiting list is in crisis," said Willows.