As a former drug addict, Byron Klingbyle knows all too well the dangers of addiction. In recovery for close to 20 years, the 59-year-old now counsels others dealing with substance abuse.
In his hometown of Windsor, Ont., the drugs of choice are opioids, such as oxycontin, morphine and fentanyl. But a new street drug, one so toxic it's primarily used to sedate elephants, has him worried.
"It's 10,000 times more powerful than morphine, 100 times stronger than fentanyl," Klingbyle said. "It's not for human consumption. It's for large animals."
He's referring to carfentanil, a synthetic opioid so deadly police say as little as 20 micrograms would be fatal to the average person, with one microgram being smaller than a grain of salt.
Carfentanil is more commonly used in zoos and by wildlife workers as a tranquilizer for elephants and other large animals. Parts of the U.S. have recently seen an alarming number of carfentanil overdoses. Ohio, for example, had 25 overdoses in just a three-day period in July.
In many cases of overdose, the carfentanil has been mixed into heroin, at times without the drug user's knowledge. Police in East Liverpool, Ohio, said they suspect carfentanill was involved in the case of a couple who were photographed overdosing in their car and whose photos were posted online by police as a way of attracting attention to the drug problems officers are dealing with.
"It wouldn't surprise me at all to know that we got more and more bionic opioids responsible for mortality on our streets," said Dr. Hakique Virani, medical director at Metro City Medical Clinic, an addiction treatment centre in Edmonton.
'Micrograms of a dosage of these opioids can kill — and have killed.' - Dr. Hakique Virani
"When we describe this as a superhuman drug, it's not to attract people to it. It's because it's literally what it is, where micrograms of a dosage of these opioids can kill — and have killed."
Virani, who is also an assistant clinical professor in the division of preventative medicine at the University of Alberta Faculty of Medicine, says that while addicts might live in fear that the next hit will be their last, that fear is not enough to curb demand.
"There's a demand driving this opioid crisis, and organized crime is meeting that demand with more and more toxic opioids, because they're easier to traffic," he said.
Calgary-bound package intercepted
Police say carfentanil is likely manufactured in China and shipped to drug traffickers in Mexico. From there, it enters the U.S. and, eventually, Canada.
In June, Canadian border officials intercepted a package in Vancouver containing a kilogram of carfentanil. It was bound for Calgary.
"We're extremely concerned about this, and it really takes an international collaboration to stop the importation of this," said Calgary Police Service Staff Sgt. Martin Schiavetta.
Last week in Winnipeg, police seized about 1,500 blotter tabs that they believe contain carfentanil.
"Typically, when police seize something, it's not the first shipment that's tried to make its way across the border," Virani said.
He says opioid addiction is a public health emergency.
"To deal with this problem, we require extraordinary measures, because clearly, our ordinary measures aren't working."
A game of whack-a-mole
He says a co-ordinated, all-hands-on-deck approach is needed from the health community, law enforcement and the justice system.
"I have yet to meet a police officer who has said they can arrest their way out of this problem, and I have yet to meet a judge who's said that he can incarcerate his way out of this problem, and I certainly hope that health isn't thinking [they can] ignore-and-wait their way out of this problem, because it is clear it is getting worse and worse and worse."
He says the changes that are needed include:
- Opening more supervised injection sites.
- Ramping up treatment for opioid addicts.
- Equipping first responders with naloxone, the medication used to reverse an opioid overdose.
- Improving measurement of morbidity and mortality rates for opioid-related deaths.
But Virani fears that until a comprehensive approach is developed, the opioid epidemic will continue to grow.
"[I] expect this to be much like a game of whack-a-mole, where you knock down a trafficker but something else will come up. History has taught us that the next thing that pops up will be more toxic and more frightening," he said.