Fake fentanyl patches have become a lucrative business in Ontario as addicts and dealers find ways to fool pharmacists into handing over the highly toxic drug that sells for big bucks on the streets.
Illegal sales of the dangerous opioid became so problematic, the provincial government last fall mandated a policy that prevents pharmacists from refilling fentanyl patch prescriptions, unless patients return their used ones.
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But dealers have learned how to skirt around the new program by making increasingly convincing replicas of used patches, which they use to get refills. Each patch can sell anywhere between $500 and $700.
As police services around Ontario encounter the phony replacements, they often turn to Det. Brad Reaume in North Bay, where the patch-for-patch program took off well before provincial legislation made the program mandatory.
That city's police force has become the go-to experts on fake fentanyl distribution.
"The first generation of counterfeit fentanyl patches were very sloppy. They were getting detected almost immediately by pharmacy staff," Reaume said.
But the quality has become much more sophisticated and prescription drug dispensers are increasingly reporting the forgeries, putting the issue square on the doorstep of the Ontario College of Pharmacists. The situation is alarming, particularly because of the opioid crisis sweeping the province and the country, a college spokeswoman explained in a statement.
"We are aware there have been issues with fake fentanyl patches showing up at pharmacies and we are very concerned about this issue and the diversion of opioids," wrote Charlotte Burchett.
Lucrative patch business
Someone holding a prescription for fentanyl patches can fetch between $4,000 and $5,000 a month, if they peddle their entire supply. In order to do that, they need to skirt the patch-for-patch program, which finds its roots in Ottawa and later blossomed in North Bay.
"It's ruining human lives. It's ruining families," Reaume said of the fentanyl addiction. "It destroys communities."
Reports of patch forgeries have trickled into the southern-most reaches of the province in recent months, showing up at store counters in Windsor. The arrival has prompted police to work with pharmacists and teach them how to spot the fakes.
"It's something we want to stay ahead of and it's going to take a lot of vigilance on behalf of pharmacists," said Windsor police spokesperson Sgt. Steve Betteridge.
Without knowing what to look for, the phony patches can fool just about anyone, according to Dr. Tony Hammer, an addiction specialist with the Erie St. Clair Local Health Integration Network, which oversees health spending for the southernmost portion of Ontario.
"It would be very easy indeed for a pharmacist, even a conscientious one, to take a look and go: 'Yep, looks alright to me,'" Hammer told CBC News.
It didn't take long for the forgeries to hit the market, even in North Bay. Shortly after police adopted the return policy for all pharmacies, the phonies — although crude in their early design — started showing up.
But the quality improved rather quickly. Police busted a one-man patch production operation that sold counterfeits for $200. Even at that price, the patches remain attractive to anyone who can dupe a pharmacist and sell their real patches for much more.
Some of the subtle signs of the counterfeits include a slightly blurry font and a small difference in the curves of the patch corners. Hammer suggests counterfeiters could be using a credit card to model the corners, which are slightly sharper than the mould used for patches.
"Any pharmacist who doesn't carefully look at them, match them up and take measures to detect fake patches is — in my opinion — not meeting the standard of care," he said.