Ontario’s top medical officials say recent statistics suggest a spike in the number of deaths related to the potent opioid carfentanil, as well as an increase in the presence of the drug in the province.

The province’s Chief Medical Officer of Health shared the information with local public health units in a letter last week, encouraging them to raise awareness of carfentanil in the drug supply in their regions.

Dr. David C. Williams says Ontario’s Chief Coroner reports preliminary mortality data show an increase in carfentanil-related deaths in the province for the first four months of this year.

His letter says carfentanil directly contributed to 142 deaths from Jan. 1 to April 29, which amounts to 50 per cent more than the total number of such deaths in all of last year.

It says that number will likely rise as more data from this period become available, since a large proportion of the death investigations from that time are still ongoing.

Williams also says there has been a “sharp” rise in urine samples from LifeLabs that have tested positive for the drug — from up to 100 per month in 2017-2018 to more than 700 each in April and May of this year.

He says the figures are not comprehensive since they only represent those who are getting tested. They also represent results from just one chain of labs, he said, noting that other community and hospital facilities conduct similar tests.

Williams says officials don’t know whether people are using carfentanil, a synthetic fentanyl analogue, intentionally or not.

“Data on carfentanil potency are limited, but best evidence suggests that carfentanil is significantly more potent than fentanyl,” Williams says in the letter.

“Intentional or unintentional carfentanil use could therefore be associated with increased risk of overdose and death compared with use of fentanyl or other opioids.”

The NYC Health Department is teaming up with Brooklyn nightclubs in Bushwick and Williamsburg to combat the continued surge of fentanyl and other opioid-related overdoses, officials announced last Thursday at Bushwick’s House of Yes.

Fentanyl, a synthetic opioid 30 to 50 times more potent than heroin, has been increasingly detected in cocaine, and health department officials warn that New Yorkers who use cocaine, even occasionally, may be at risk of an opioid overdose. 

“We want people who use cocaine occasionally to know that fentanyl may be mixed into cocaine and may increase their risk of an overdose,” said Health Commissioner Dr. Oxiris Barbot. “Bars and nightclubs are an important avenue to reach people who use drugs with potentially lifesaving information. We need people who use cocaine to know that they should use with other people, so someone can call 911 in case of an overdose, and always carry naloxone.”

Health department staff will visits bars and nightclubs in Williamsburg and Bushwick with coasters and posters to inform patrons that cocaine may contain fentanyl. All venues will be offered naloxone, the medication to reverse an opioid overdose, to keep on premises with first aid supplies, as well as training and kits for all interested staff.

“It is a no-brainer for us to support this outreach campaign that will help educate cocaine users about the dangers of fentanyl contamination and increase naloxone training for nightlife providers,” said Jacqui Rabkin, marketing and cultural director at House of Yes. ” We look forward to working closely with the Department of Health to keep our community safe.”

In 2016 and 2017, fentanyl was found in 37 and 39 percent of overdose deaths involving cocaine without heroin, up from 11 percent in 2015. According to the health department, this suggests that some people who died from overdoses involving cocaine and fentanyl may not have intended to consume opioids.

From January to September 2018, the city recorded 1,055 confirmed overdose deaths. Opioids were involved in 82 percent of the city’s overdose deaths last year, and fentanyl was the most common drug, involved in 57 percent of deaths. Fentanyl has been found in heroin, cocaine, methamphetamine and ketamine, as well as in benzodiazepines and opioid painkillers acquired from non-pharmaceutical sources.

Bushwick and Williamsburg were selected for the campaign, which is an expansion of a 2018 pilot that launched on the Lower East Side, because of the area’s high density of bars and nightclubs, officials said.

“Safety is always of the utmost importance when New Yorkers are enjoying a night out,” said Ariel Palitz, senior executive director of the Office of Nightlife. “This awareness campaign recognizes that nightlife spaces can actually provide an opportunity for people to look out for each other.”

When she died of an overdose inside the bathroom stall at the small Norwich restaurant where she worked, Carolyn de Wit’s death laid bare the reality that the powerful painkiller fentanyl had arrived in Southwestern Ontario.

It also signalled the opening of a new front in the justice system’s fight against the opioid drug crisis sweeping the region and Ontario. William Knapp, de Wit’s cousin’s husband, was charged with manslaughter in the January 2016 death of the 32-year-old mother of three.

Knapp had sold de Wit a single 50-microgram patch of the powerful painkiller from his own prescription. By pleading guilty to criminal negligence causing death, a conviction that sent him to prison for two-and-a-half years, he admitted he knew how dangerous the drug could be.

Since Knapp’s case, there’s been a spike in manslaughter charges laid across Ontario against people whom police allege supplied the drugs to overdose victims. Ontario has joined other provinces and several U.S. states looking to the courts to punish drug dealers pushing the drug, which is 100 times more powerful than heroin.

The movement of those yardsticks in the face of the deadly opioid crisis is no coincidence.

“The evolution of the trend has a lot to do with the evolution of the crisis,” said OPP Supt. Bryan MacKillop, the director of the provincial police force’s organized crime enforcement bureau.

“As increased numbers of overdoses occur, you’re going to see increased enforcement, increased number of charges and increased targeting of the people who are trafficking these drugs.”

The target, he said, is “on the people who are trafficking, selling, importing and manufacturing these drugs that are killing people.”

In Ontario, since de Wit’s death in her Oxford County town, manslaughter charges related to overdoses have been laid in Norfolk, South Simcoe, Lambton, North Bay, Perth, Huron, Bruce, York Region and the Sudbury area. Most of those charges were laid this year.

“We’ve got a responsibility to hold criminal offenders accountable,” said Greater Sudbury police Chief Paul Pederson, the incoming president of the Ontario Association of Chiefs of Police.

“From a policing perspective, we’re really getting our heads around the fact that people who are manufacturing (the drugs), the people who are then dealing in these illegal and deadly substances, have to be held to the highest level of accountability possible.”

The reasons are as plain as the skyrocketing statistics. Opioid-related deaths have been increasing since 2003, but took a huge leap in 2015 and 2016. Public Health Ontario reports that 1,394 people died of opioid-related overdoses in 2018, up from 2017.

The OPP say there was a 35 per cent increase in overdose deaths in the first quarter of 2019 compared to the same period last year. They note in a recent report that other areas of Canada have seen even greater increases in the number of deaths.

The spike in charges relates to the OPP and other police forces taking a new investigative approach. MacKillop said the police have embedded the definition of overdose – cited in Canada’s Good Samaritan Drug Overdose Act – into their policies and are embarking on “comprehensive and consistent investigations of all overdoses across the board,” with a clear eye on targeting the traffickers.

Pederson said any charges are laid in consultation with local Crowns. What’s necessary is “a clear line” from purchase to the consumption of the drug and a cause of death that is directly related to the opioid.

Fentanyl can kill a first-time user with as little as two milligrams. It’s dangerous enough on its own, but more troubling is the ease with which it can be mixed with other street drugs. Some of it comes from prescription medication, but a powerful illegal fentanyl from overseas labs, with unregulated dosages, is being smuggled into the country.

Added to the crisis is the introduction of carfentinil, a fentanyl-related opioid that’s 10,000 times stronger than morphine.

“It really is a deadly game of Russian roulette” for street drug users, Pederson said.

MacKillop said the ultimate goal is to tear down distribution channels both nationally and internationally. But fentanyl trafficking has unique features and has changed the definition of the typical drug dealer.

Related

The opioid crisis includes “cyber-enabled criminals who are able to order synthetic opioids over the dark web and have it delivered right to them,” he said.

“It’s a new type of drug dealer, who doesn’t necessarily have to take advantage of or be part of the larger drug distribution network we’re seeing in organized crime.”

Enforcement is only one prong in the approach to help the addicted and punish the pushers.

Since the OPP adopted its new policy in September, there have been more investigations “because we are trying to attack this from both sides.

“The overarching goal, as we deal with these investigations consistently and thoroughly across the province, is that they fuel larger-scale investigations,” MacKillop said.

Opioids have created “a whole new world,” and manslaughter charges are a logical offshoot given the number of deaths, one Southwestern Ontario expert says.

“It’s a killer drug,” said Brian Farmer, a retired Crown attorney and law professor. “This is no different than walking down Dundas Street with a loaded handgun, just shooting it off. You’re going to kill somebody.”

What the courts will have to sort out, particularly during the sentencing in such cases, is making “a distinction between the big-time dealers and the petty-ante, the little ‘I’m-going-to share-with-you dealers,’” Farmer said.

But there’s concern that the legal moves aren’t necessarily getting to the heart of the problem.

London defence lawyer Andy Rady, president of the London Criminal Lawyers Association, said the risk of charges may be an effective deterrent for law-abiding people, “but a lot of people who are involved in criminal activity aren’t deterred by much.”

Rady agrees “the plague of fentanyl” and “the way people are dying all the time, including in and out of jail, it’s been seen as: Something serious has to be done about it.

“There’s never really been a drug before, in my experience, that has been this deadly and has caused this much of a problem,” he said.

Already, some trends emerging.

In the Knapp case, and in cases in Lambton and Brant, there have been guilty pleas to criminal negligence causing death, a charge with the same legal construct as manslaughter. While the latter sounds more serious, for a conviction both charges require proof there was no intent to kill. Both also carry maximum sentences of life in prison.

Rady said the Crown can get convictions to manslaughter by proving criminal negligence, but not necessarily the other way around. The decision to accept a guilty plea to criminal negligence might come down to “legal esoterics.”

“In a lot of people’s minds, manslaughter is worse, when it isn’t,” Rady said, adding they’re two of the most serious charges in criminal law.

“Arguably, you’d rather plead (guilty) to criminal negligence than to manslaughter, and from the Crown’s point of view, they’re still getting a conviction for something that will result in probably a hefty jail sentence.”

When Knapp was sentenced a year ago, Superior Court Justice Thomas Heeney warned not to use his decision of two-and-a-half years in prison – a joint sentencing submission by the Crown and the defence – as the precedent in other drug manslaughter cases, because de Wit’s death came at the beginning of the opioid crisis when communities were just learning about the danger.

Since then, there have been sentences as long as six years in prison. The sentences will likely get even longer as the crisis deepens.

“The (sentencing) tariff, as we’re learning more and more about how horrible fentanyl is, is going to go up,” Rady said.

The police will leave that to the courts. They remain single-focused.

“The message to all people who are trafficking in these drugs is: ‘You’re killing people and we will try everything within our power to hold you accountable for that,’” McKillop said.

jsims@postmedia.com

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FENTANYL AND MANSLAUGHTER IN SOUTHWESTERN ONTARIO

April 2018 – Carolyn de Wit, 32, dies in a bathroom stall in the Norwich restaurant where she worked on Jan. 25, 2016, after her cousin’s husband, William Knapp, 37, sold her a single fentanyl patch. He was the first in Ontario to be charged with manslaughter at the start of the fentanyl crisis. In April, 2018, he pleaded guilty in Woodstock court to criminal negligence causing death and was sentenced to 2½ years in prison.

September 2018 – A judge sentences long-time drug dealer Andrew Earl Allison, 35, to 10 years in prison – one of the harshest penalties recorded for fentanyl-related deaths – for criminal negligence causing death and other drug charges. He’d been charged with manslaughter in the death of Anthony Micro, 46, in Brantford in September 2017. Allison had mixed up baggies of soft cocaine and fentanyl he had in his pockets when he sold drugs to Micro. Six years of the sentence was allotted to the criminal negligence conviction.

March 14 – Norfolk OPP charge Morgan Daniel Fick, 21, with manslaughter, possession of fentanyl and other drug-related charges in connection with the death of Ashley Gravelle, 35, of Port Dover, who died on March 2. On May 1, Carilyn Michelle Deming, 23, also was charged with manslaughter in connection with Gravelle’s death.

May 3 – Karen Edel-Savage, 59, pleads guilty to criminal negligence causing death in a Sarnia court after facing a manslaughter charge in the death of Daniel Lapointe on Aug. 9, 2017. She’d sold crack cocaine to Lapointe and his partner, calling the drugs “a real head-spinner.” Her sentencing hearing is slated for September.

May 27 – Terry Collins, 54, makes his first court appearance in Stratford on a manslaughter charge in connection with the Dec. 21, 2018 death of a 48-year-old Stratford man.

June 7 – Kayla Field, 27, of Central Huron and Brandon Weitzel, 28, of Goderich are charged with manslaughter in connection with the death of David Spies, 42, of Central Huron, who was found unresponsive at a home on Cut Line. More charges were laid June 14 against Stephen Feddes, 49, of Central Huron, who is facing accessory after the fact, and other charges. Field and Weitzel had additional criminal negligence causing death charges added.

Manslaughter charges have been laid in cases in Sudbury, Barrie and Collingwood.

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About opioids

• Highly addictive painkillers, also called narcotics, made from opium poppies or synthesized in a lab
• There are many different kinds of prescription and illegal opioids with varying strengths, including morphine, heroin, hydromorphone, oxycodone and fentanyl.
• Prescription opioid pills, often prescribed as painkillers, can be abused by patients or diverted to the streets, where they may be smoked, crushed and snorted or injected by drug users.
• Opioids have been implicated in more than 11,500 deaths nationwide since 2016.

Defense attorney Eric Miskell represented numerous drug dealers over the years, and by his account he was good at his job. He knew how to find loopholes and technicalities that would get testimony stricken, evidence thrown out and charges dropped.

But three months ago, he underwent a radical change of heart about his work when a former client named Nickie Martin was found slumped over on a motel room bed. She had died from a heroin and fentanyl overdose.

Miskell was stunned. He had seen Martin only a few hours earlier, and as far as he knew, she was doing well. She had gotten good reports from the center where she received treatment for her long-standing addiction and had recently regained custody of two of her children.

Her death was the kind of tragedy that has become commonplace in this small community 75 miles southwest of Chicago. LaSalle County had 39 fatal overdoses in 2018, which, given its population of 110,000, amounted to one of the highest opioid-related death rates in Illinois.

“It almost hit the community like a nuclear bomb,” said Brian Vescogni, a former drug prosecutor now in private practice. “We weren’t prepared for it, and it’s gotten worse. Without (the overdose-reversing medication) Narcan, you’d have 20 people dying a month, minimum.”

Martin, 31, wasn’t the first of Miskell’s clients to die of an overdose, but the futility of the work that went into her recovery angered him. He was furious at whoever supplied the fatal drugs to Martin, believing if the dealer were ever caught, the punishment prescribed by law would be insufficient.

Miskell vowed to stop representing accused drug dealers. Then, sitting in his law office after Martin’s wake, he went even further: He composed a three-page letter to Gov. J.B. Pritzker and President Donald Trump, arguing that the war on drugs hasn’t been tough enough.

“I am asking the State of Illinois and the United States Government to consider making the sale of illegal opioids an act of domestic terrorism with dealer terrorists punished accordingly,” he wrote. “All illegal sales of opioids should be a class X felony regardless of amount with a minimum sentence of 12 years as a first-time conviction.”

It was a remarkable proposal coming from a defense attorney. And as you might expect, it hasn’t been well received from others in that line of work.

“A large number of the (accused opioid sellers) I represent are addicts themselves; they’re generally trying to support their own habits,” said LaSalle County Public Defender Tim Cappellini. “Putting them in jail would go totally against the trend of trying to get treatment for many of these folks.”

But Miskell said opioids, which claimed nearly 50,000 American lives in 2017, are different from other drugs. Everyone in the illegal distribution chain, from foreign kingpins to street corner dealers, knows they’re selling a potentially lethal substance, and should be treated accordingly, he said.

“At what point do you get frustrated enough to say you’ve got to do something?” he said. “More people die every day of heroin overdoses in this country than die in the war zones in Iraq and Afghanistan. How the (expletive) does that happen?”

Familiar tragedy

Nickie Martin’s story is sadly familiar in the age of opioids. Her family said she was an honor student growing up in Ottawa — “She never had to bring a book home and she made straight A’s,” said her father, Don Martin — but went badly off track at 15 when a boyfriend introduced her to heroin.

From there, her life was a series of disasters. She was arrested again and again and spent two years incarcerated on a forgery charge. Her parents said she overdosed at least a dozen times, including when she was pregnant.

The family spent thousands of dollars on treatment programs, but nothing seemed to work, her father said.

“We had her down at one place for three months,” he said. “They said there was a 98% chance she would be clean, never want to do it again. Well, she must have been the 2%. She got back here and within two months, she met up with the crowd again and they got her using.”

Miskell met Martin in 2017 when she came looking for help on a child support case. He ended up representing her when she was arrested for driving under the influence of drugs, and came to view her as a “project” — someone deserving of extra assistance.

“I thought she was smart,” Miskell said. “She was well-spoken. She seemed so determined to beat it. … She was ready to step up, get better and become a mom.”

He kept her out of jail, mentored her and helped her reclaim two of her children (her third, a 3-year-old boy, remained in the guardianship of her parents). From what he could see, the help was working: In early April, he encountered her outside the LaSalle County courthouse when she was headed to see her probation officer, and thought she was in good shape.

She wasn’t. Her parents said she had resumed using heroin after months of abstinence, and had just returned to Ottawa from yet another treatment center. According to a police report, she told an acquaintance she was suffering from withdrawal symptoms after leaving a methadone program.

Martin never made it to her probation appointment. The department called police when she didn’t show, and that afternoon, officers found her body in a motel room.

The case file says officers interviewed someone who acknowledged selling Martin a few pills of clonazepam, an anti-anxiety medication. But no one has been arrested for providing Martin the heroin and fentanyl that killed her.

“Tracking that to (a specific dealer) is difficult to do after the fact — that’s the problem,” said Ottawa police Chief Brent Roalson.

Opioids as terrorism?

Martin’s death crystallized misgivings Miskell had harbored for months. When small-time drug dealers weren’t escaping punishment entirely, he said, they were getting probation, a sentence they regarded as the cost of doing business.

He had come to view the illegal opioid business as terrorism — an international, organized group of criminals intent on spreading death. He had little sympathy for any of the participants, even those who sell to feed their addictions.

“I’m talking about them all,” he said. “If you’re a little gangbanger that’s walking around selling to your neighborhood people, you go. You’re a terrorist. You’re part of the cell. At every level, each of these people should be held accountable.”

He sent his letter outlining the proposal to Pritzker and Trump four days after Martin died. The governor’s office returned a form letter — “I appreciate hearing from you about issues that matter in your life” — while the White House hasn’t responded.

A Pritkzer spokesman did not return a message from the Tribune seeking comment. The Office of National Drug Control Policy said the Trump administration “is prosecuting more fentanyl traffickers than ever before” and supports legislation that would toughen criminal sentences related to the drug.

William Banks, a law professor who founded the Institute for National Security and Counterterrorism at Syracuse University, said defining opioid trafficking as terrorism would be a stretch. By law, he said, terrorism is about “striking fear into the general population through the threat or actual delivery of violence,” and drug offenses wouldn’t appear to qualify.

Illinois’ terrorism law also appears too narrow to cover drug dealing. Chicago attorney Tom Durkin, who defended three men charged under the statute for allegedly plotting violence during the 2012 NATO protests, said it requires a political motivation.

“I don’t see how or why anyone would want to prosecute heroin distribution under a terrorism statute,” he said. “The penalties (for trafficking) are already extremely high, so I don’t understand what point would be made.”

Miskell granted the odds of success weren’t good, but said the president could still bulldoze the proposal into the public consciousness. Treating drug dealers like terrorists would be a wedge issue no Democrat would support, he said, and would hit favorite Trump hot buttons like crime and border security.

“If we had normal apparatuses in politics right now, what would be the point?” he told the Tribune. “But you write a good article and I’m gonna get a tweet.”

“Not a good idea”

Closer to home, it’s hard to find support for Miskell’s plan. The Illinois Association of Criminal Defense Lawyers called it “unconscionable” for a defense attorney to push for tougher penalties. Cappellini, the public defender, said it was “certainly not a good idea.”

Roalson said the Ottawa Police Department, like many others, is moving away from a punitive approach. He has helped drug users get into treatment, he said, and doesn’t believe low-level sellers struggling with addiction deserve prison.

“It’s hard to generalize that anyone who provides an illegal substance like that should be held accountable for a terrorist act,” he said.

Activists combating LaSalle County’s opioid crisis were more pointed.

“In my eyes, the only thing that resembles domestic terrorism are unethical pharmaceutical practices and the continuance of decades (of the) old failed war on drugs,” said Luke Tomsha, a former heroin user who runs a harm-reduction organization called Perfectly Flawed.

“Ninety-nine percent of active users also sell or facilitate drug use,” said Debbie Hallam, who lost a son to an overdose. “If you want to put people in jail for selling opioids, our jails are going to be so overpopulated we’re not going to know what to do.”

“His action is the opposite of what I think needs to be done,” said Lori Brown, whose son also fatally overdosed.

But two people with no qualms about Miskell’s proposal are Don and Diann Martin.

They are raising Nickie’s children, and watching the two boys play outside their Ottawa home, they remembered their 16 years of pain — the lying, the stealing, the deception, the arrests, the relapses, the overdoses, the hopes endlessly raised and dashed.

For Don Martin, it didn’t even peak with Nickie’s death. Three weeks later, a daughter from an earlier relationship also died of a drug overdose. The half-sisters are buried next to each other in a nearby cemetery.

Diann Martin said Nickie was occasionally involved in heroin sales, a hustle that under Miskell’s plan would have netted her a lengthy prison sentence. Martin said she would have been OK with that.

“She’d be safe,” she said through tears. “I’d rather see her in prison than dead.”

jkeilman@chicagotribune.com

Twitter @JohnKeilman

Boyd County Coroner Mark Hammond on Tuesday provided The Daily Independent with the latest statistics regarding drug overdoses in Boyd County.

They are, in our view, ominous numbers in many regards. They show how little progress has been made in deterring the use of illicit drugs in the county and in our region.

Hammond said in Boyd County alone there have been 22 overdose related-death scenes in just the past six months. Two were ruled as suicide and the other 20 were ruled as accidental. That certainly seems like a lot to us for a small county. Hammond said that five of the deaths were female and the other 17 deaths were male. The age of the deceased ranged from 34 years old to 70 years old.

In November the Boyd County Coroner’s Office released numbers stating that the office had responded to 33 overdose related death scenes at that point in 2018, and on average an overdose related death was being investigated in Boyd County every 10.89 days. In other words it certainly appears Boyd is on track to surpass last year’s numbers by a large margin.

Of course we suspect the main culprits here are heroin, fentanyl and other hardcore illicit drugs. One note of interest — Hammond said the coroner’s office has also seen instances of fatal overdoses involving methamphetamine containing fentanyl.

“We are still seeing heroin, but in the past year we are seeing a big shift to methamphetamine with it all containing fentanyl,” said Hammond. “Even marijuana, we are seeing it in that. Almost every overdose has more than one drug that caused their death also.”

Hammond said that fentanyl is prominent in this area.

“Along with almost all toxicology having Gabapentin in the toxicology,” Hammond added.

We are saddened by this news. We report on it because it shows how much work there is to do in fighting drug use here in Eastern Kentucky. We continue to be baffled as to why anyone would even think about using any of these drugs knowing the lethality and misery that comes with them. They are a true scourge on society. We don’t have the answers to this other than to say education continues to be the key. Teaching people about the horrific consequences of using drugs like heroin, meth, fentanyl and other illicit substances is the ultimate weapon against the tragedy that is the opioids epidemic.

This letter is in response to Richard Turner’s letter to the editor “The many problems this country faces come from within the administration” that was published on July 3.

I find it very disheartening that Mr. Turner would write an article that disparaged my view on lawless people.

Many people are diametrically opposed to each other when it comes to the steady flow of migrants coming in through Mexico. I think that it is a discussion worth having, however, I will not stand by when someone distorts what I wrote in my article.

Turner said, “Referring to others as the filth of the world does not promote unity and peace.” That is taken out of context as I was talking about all of the filth that would kill harmless people.

I wrote that “the truth is that all of us who are willing to live with others peacefully are in the crosshairs of the filth of the world.”

Turner said: “He states that only good people be allowed to enter our country, but does not explain how that is to be determined.”

I wrote that “Republicans and Democrats in Congress should pass comprehensive laws that would insure that good people have a chance to experience the American dream. At the moment political posturing in both parties has hamstrung immigration.”

Mr. Turner, in a constitutional republic that is how it is to be determined.

Turner said that “it is also well documented that the vast majority of drugs enter the country through legal ports of entry.”

Folks, the truth is there are 50 legal ports of entry that span our border with Mexico. Our 2,000-mile border with Mexico includes Texas, New Mexico, Arizona and California where border authorities at these legal ports of entry confiscate many illegal drugs that he correctly pointed out in his article. His assumption is that these drug smugglers will only transport their drugs through legal ports that only span less than 100 miles of the border.

I do agree with Mr. Turner that drug companies are responsible for a considerable amount of the crisis. They are also culpable for their irresponsible cover up of some of these addictive drugs, and our legislators should pass laws that will hold them accountable.

The National Vital Statistics Report, Vol. 67, No. 9 dated Dec. 12, 2018, listed the five drugs that caused the most overdose deaths in 2016. They were Fentanyl (16,981 deaths), heroin (15,075), cocaine (10,618), methamphetamines (6,448) and Alprazolam (5,225). Most fentanyl overdoses were drugs that were illegally made.

Finally, Mr. Turner said, “The problems that this country face are from within. We have an administration that strives to divide us with rhetoric that promotes hate that does nothing to bring people together with a message of our commonality.”

In the same vein he continued to say that respect for diversity is paramount and only then can we heal as a nation?

I have lived for almost 80 years, and I believe that I am a God loving person who does believe in different points of view, however, accurately stating my point of view would go a long way towards a respectful and a diverse conversation.

May God bless Mr. Turner with the hope that he will understand that many of us do believe in different points of view where honest discussions can lead us all to a better world. After all, we are the people.

Tiffany Potter is the Waynesboro Democratic Committee Chair. A graduate of the University of Maryland, she has worked in many areas of healthcare in NYC, Tucson, and now in Virginia in diagnostic imaging.

Grande Prairie started the year with the highest per capita rate of accidental fentanyl-related poisoning deaths in Alberta, says a provincial opioid surveillance report.

From Jan. 1 to March 31, Grande Prairie had 11 fentanyl-related poisoning deaths with the rate calculated at 59 per 100,000 population. Last year, Grande Prairie had 34 deaths of this type in total.

“The numbers for use are really shocking because it’s not our street-engaged population people who are dying,” said Melissa Byers, executive director of the Northreach Society. “This report—from our organization’s perspective— just kind of gives us things to question and things to really look at.”

Formerly named HIV North, Northreach is a not-for-profit group that provides a variety of services to Grande Prairie and northern Alberta, such as outreach, distributing Naloxone, needle disposal and community education and training about drug use.

Byers explained that Northreach did not know the profiles of the 11 individuals who died from fentanyl-related poisoning early 2019. She hoped that Alberta Health, which authored the report, could provide more details about the background of these victims.

“This is kind of a different number for us because it’s not the people that we’re supporting,” Byers said.

While Alberta Health was unable to provide specific details about Grande Prairie not already in the opioid report, Chief Medical Officer of Health Deena Hinshaw stated that opioid deaths occur across numerous sectors of the province.

“It’s not just one group that’s affected,” Hinshaw said. “There are multiple different segments of society that are impacted and anyone who uses drugs that they sourced from the street for any reason would be at risk of fentanyl overdose.”

The report also had a map of the city that showed the general areas that lethal fentanyl overdoses were most concentrated. While the hottest spots tended to be around hotels, Byers explained that many of the spots were within suburban areas.

“That just also points to the stigmatization of drug use and hidden drug use and how dangerous that is,” she said. “More community education is needed.”

EMS responses

Grande Prairie came in second for the highest rate per capita of EMS responses to opioid related events at 65 responses. Lethbridge came in first.

“It’s good that people are calling EMS, I think that’s great, but it also says to me that the (drug) supply in Grande Prairie is maybe unsafe,” Byers said. “And people are maybe using alone or they’re not using harm-reduction principals when they are engaging.”

Byers stated that overdose victims in Grande Prairie are most often young males in their late 20s or early 30s.

“Potentially, we need to be doing some more drug education,” she added. “I imagine the EMS calls points to the state of drug use in our community and it’s alarming.”

The city’s rate was higher than the provincial average. Hinshaw noted that EMS response rates fluctuate in rough correlation with the overdose rate.

“If there’s a batch of illicit drugs with a particularly high concentration of fentanyl, we would expect to see that the EMS calls would go up at the same time the risk of death—and in this case Grande Prairie’s numbers and rates—have also gone up,” she said.

Supervised drug consumption

The mobile supervised drug consumption site in Grande Prairie had 2,326 visits and reversed 47 overdoses between its March 11 opening and the end of June.

Operated by Northreach, the mobile site caters towards street-level users and is located near Rotary House. Byers stated that the site has also gotten supported 133 unique individuals and offered referrals for 287 visits.

“The population that we’re supporting, we’ve had no deaths,” Byers said. “And the population that generally accesses supervised consumption services isn’t going to be your typical middle-class individual who’s housed or your person who’s just got off shift and is staying in a hotel.”

“It’s that hidden population, that hidden drug culture,” she added. “Generally, they’re not going to leave their houses to use drugs in a stable location.”

Hinshaw said it was too early to tell how much of an impact Grande Prairie’s supervised drug consumption site had on the rate of lethal fentanyl overdoses.

Naloxone

Another method of addressing the opioid crisis is the distribution of Naloxone, a fast-acting drug that temporarily reverses the effects of opioid overdoses.

Multiple groups are currently distributing Naloxone in Grande Prairie with Northreach alone handing out 1,702 kits so far this year between January and May.

“There’s a massive uptake of the community-based Naloxone program but then people also have to go and access them,” Byers said.

As of the first quarter, 146,892 naloxone kits have been distributed across the province through Alberta Health Services’ program since Jan. 1, 2016.

Across the province

Meanwhile, the big cities continue to have the highest actual number of fentanyl-related poisoning deaths with Calgary at 51 and Edmonton at 31.

Overall, 137 Albertans died from accidental fentanyl-related poisonings in the first quarter of 2019, which is a decrease from the 160 deaths in the previous quarter.

Alberta also had 66 accidental opioid-related poisoning deaths that were non-fentanyl during its first quarter. One death of this type occurred in Grande Prairie.

In 2018, 789 Albertans died from accidental opioid-related poisoning in 2018. Most deaths occurred in major municipalities such as Grande Prairie.

“The key message for me is that the more we understand that addition issues cut across all segments of society, the more we can be compassionate, the better off we’ll all be,” Hinshaw said.

Police arrested a Delaware woman accused of hiding drugs in iced tea cans while her 4-year-old stepdaughter was inside her car.

On Monday, police spotted Arianna Mojica, 20, of Wilmington, driving a silver Acura TL at a high speed at Bungalow and Cypress avenues in Elsmere, Delaware, according to investigators.

The officers pulled Mojica over and determined she did not have a valid driver’s license, was wanted for two outstanding capiases and was also on probation, police said.

The officers searched through the vehicle and found two iced tea cans along with her 4-year-old stepdaughter. While the iced tea cans were normal in appearance and size, police discovered they were concealing drugs, according to investigators.

In all, police found 23.9 grams of marijuana in several packages, one bag of crack cocaine weighing half a gram and 54 bags of fentanyl, a synthetic opioid that’s 80 to 100 times stronger than morphine and also responsible for numerous overdose deaths across the region, investigators said.

The girl was taken to safety and released to a guardian. The Division of Family Services was contacted and will conduct an investigation.

Mojica was arrested and charged with possession with intent to distribute a controlled substance, possession of a controlled substance, tampering with physical evidence, endangering the welfare of a child, unlawfully dealing with a child/allowing child to remain in a place drugs are stored and other related offenses.

Mojica was ordered to have no contact with the town of Elsmere and released on an $11,702 unsecured bond.

The number of Ontarians taking carfentanil, and dying from it,  has spiked since the year began, according to he province’s chief medical officer of health.

Dr. David Williams sent a warning to the province’s public health units in late June about a “sharp increase” in the presence of the powerful fentanyl analogue. 

Using information from Ontario chief coroner Dirk Huyer, Williams wrote that in the first four months of 2019, carfentanil “directly contributed” to 142 deaths in Ontario. 

That number, wrote Williams, is “already 50 per cent more than the total number of deaths in which carfentanil directly contributed in all of 2018, which was 95 deaths.” 

Also spelled carfentanyl, the drug started making headlines in Canada in 2016 and 2017 as it was detected in street drugs and linked to overdose deaths. 

It has been traditionally used as a tranquilizer for very large animals, and some studies have described it as 100 times stronger than fentanyl.

Not known if drug is being taken intentionally

In his June release, Williams also lays out evidence that more Ontarians are taking carfentanil, whether knowingly or not, than before.

In 2017 and 2018, between zero and 100 people who did urine tests with LifeLabs — a private operator of community lab services — had carfentanil in their systems.

In April and May of this year, that number surged to more than 700, though Williams acknowledges the sample of people using LifeLabs services is small and that the data might not reflect what all Ontario drug users are doing. 

Wiliams also writes that it’s not clear to health providers whether “people were using carfentanil intentionally or unintentionally.’ 

The drug, which can sometimes look like fine white grains, can also be packaged in other forms.

In the past few years, it’s turned up in counterfeit oxycontin pills in Ontario, been sold as heroin in Calgary, and been discovered on the back of LSD-laced stamps in Quebec. 

Waterloo police have also connected carfentanil to a wave of what appeared to be purple-tinted heroin that made a deadly sweep through Ontario last year. 

Williams ends his release with a series of tips for health care providers on the ground, including people who work in overdose prevention.

Among his suggestions are to remind drug users about never using alone or at the same time as a friend, and to always carry overdose antidotes like naloxone.