British Columbia

New fentanyl types make overdose response tougher: Chief medical officer

Different fentanyl analogues are showing up on Vancouver streets, chief medical officer Dr. Perry Kendall says, and some are less responsive to the antidote naloxone.

Acrylfentanyl, a fentanyl analogue, might be on streets of Vancouver, Dr. Perry Kendall says

A few granules of sugar are used to demonstrate what a lethal dose of fentanyl would look like. (Rafferty Baker/CBC)

There are new types of fentanyl on the street that are proving to be tougher to treat with the antidote, naloxone, according to B.C.'s chief medical officer Dr. Perry Kendall.

Kendall, who also heads up B.C.'s opioid task force, said there are now multiple fentanyl analogues — chemical compounds that are similar to fentanyl and mimic its effects — on the streets of Vancouver.

These include the powerful carfentanil — which was detected in Metro Vancouver earlier this year — and now, acrylfentanyl.

"Acrylfentanyl — at least in mouse studies — is more toxic than fentanyl. It seems to have a longer duration in the human body," Kendall said.

Chemical analogues of fentanyl — like acrylfentanyl pictured here — can mimic the effects of fentanyl but might be more toxic or not respond to opioid antidote naloxone in the same way. (Aethyta/Wikipedia Commons)

The challenge, he said, is that some people who are overdosing require multiple treatments of the opioid-antidote naloxone in order reverse their overdoses.

"One treatment lasts for a little while and then they go down again because the pharmokinetic nature of some of these analogues are different and they last longer [than fentanyl]," he said.

Sarah Blyth, a community advocate with the Overdose Prevention Society, said it's scary to think what's out there.

"We really don't know what people are using. We know that sometimes a week will go by and it will be really strong and it will take a long time and a lot of narcan to get people to come back from the overdose," she said.

But attempting to detect which specific fentanyl analogue someone has used is difficult with existing technology, Kendall said, and he says it doesn't address the key problem.

"Focusing on any one particular analogue is a waste of time. I've got a sheet of paper in front of me that lists at least 44 fentanyl analogs," he said.

"We have an illegal drug supply that is really completely at the mercy at whoever is producing the product and shipping it into Canada."

High number of overdose deaths in April

The Vancouver Police Department reported 15 overdose deaths in the last week of April alone, bringing the total number of deaths in April to 41 — the second highest month on record this year.

VPD says there have been an estimated 141 overdose deaths in Vancouver in 2017.

The city also recorded the highest number of distress calls of overdoses in April. B.C. Emergency Health Services (BCEHS) says it responded to 130 suspected overdoses in the province on Wednesday, April 26.

The city has requested again for the provincial government to urgently scale up its response to the crisis, with Mayor Gregor Robertson saying, "the current government's approach is not working."

With files from The Early Edition