The rise of fentanyl in Alberta, and in the local area over the course of the past winter, is a serious cause for concern for the executive director for the Alberta Paramedic Association.
“Overdose is one of our most frequent calls; it’s increasing this winter,” said Mark Moebis, who is also the supervisor for Prairie EMS’s Elk Point division. Crystal meth and cocaine usage continues to be an issue in the communities his division serves, including Elk Point, Dewberry, Kehewin, Fishing Lake, Frog Lake and the rural areas in between, but usage of those drugs hasn’t changed, he said.
“What we’ve noticed is the addition of fentanyl being used with those drugs.”
What frightens Moebis is how much more dangerous fentanyl is than drugs like cocaine, as even an amount as small as two small grains of sand is enough to lead to an overdose.
Fentanyl, a fast-acting narcotic analgesic and sedative that is up to 100 times more potent than morphine and roughly 50 to 100 times more toxic. In 2014, 120 deaths in the province were associated with fentanyl, almost doubling in 2015 with 213 overdose deaths from January to the end of September, prompting health authorities to call it a public health crisis.
Overdoses can lead to a range of symptoms, whether it’s a slow heartbeat, severe sleepiness or cold and clammy skin, but the most severe symptom is the inability to breathe, said Moebis.
Unlike fentanyl prescribed or used in a hospital setting for potent pain relief, fentanyl produced in the street is “produced more recklessly,” with each pill having varying levels of concentration of the drug. In fact, the concentration of the drug may not even be uniform through a pill bought on the street, said Moebis, explaining that if a person cuts one sliver of the pill to ingest, they may end up consuming all the fentanyl in the pill. This means even first-time users trying the drug or another drug cut with fentanyl can overdose.
In response to the growing crisis and lobbying efforts by the Alberta Paramedic Association, Alberta’s health minister has moved to having EMTs, as well as paramedics, now being able to administer naloxone, also known as Narcan, which is a drug that can reverse a fentanyl overdose. Last June, the government also provided $300,000 for take-home naloxone kits, which people can apply to get if they are at high risk of opioid overdose.
While he said the division hasn’t seen any confirmed deaths from fentanyl, Moebis said emergency medical responders have used Narcan to get people breathing, which has helped prevent deaths from fentanyl use.
Like Moebis, Louis Cardinal, who works with National Native Alcohol and Drug Abuse Program (NNADAP) in Saddle Lake, says that he had not seen local use of fentanyl until recently.
“We’ve never seen it before. This past year, 2015, we’ve had a few clients who say they’re experimenting with it,” he said, adding users seem to be in their 20s and 30s. Last year saw several deaths of young and middle-aged people from the reserve, and Cardinal believes that deaths from suicides and accidents, in some cases, can be linked to general alcohol and drug usage.
“The things these gangs are interested in is making a profit, selling their poison to our people. As long as they’re making money, they don’t care who they hurt,” he said.
NNADAP works with users to try and get them into medical detox, with Cardinal estimating the program helped 300 plus clients last year. However, he pointed out that was a drop in the bucket.
“We’re a community of about 6,000. If we’re only helping 300 people a year, there’s a lot of people that aren’t getting the help they need,” he said.
Cardinal and Moebis both say they suspect times of economic hardship go hand-in-hand with drug and alcohol use as well.
“I suspect the increased amount of drug activity we are responding to, I suspect (is a) result of lack of work,” said Moebis.
He wants people to be aware of the prevalence of fentanyl and its harmfulness, the fact, for young people, that experimenting with fentanyl or drugs cut with fentanyl even one time could lead to an overdose.
“I like to think this is a crisis that’s going to start and end, but I fear fentanyl is going to be the next cocaine or methamphetamine - we see it come in and spike but the usage is always there.”
