Opioid overdose spike “worst it’s ever been,” health official warns

This week’s spike in opioid overdoses across Southwestern Ontario is what the region’s top medical officer is calling “the worst it’s ever been” since fentanyl arrived on the drug scene a year ago.

Chris Mackie, the chief medical officer of health at the Middlesex-London health unit said his public health officer hadn’t issued an alert since last August when the highly addictive opioid — 100 times more powerful than heroin — arrived in the area.

Officials have been monitoring its effects on the community through hospital emergency visits and Mackie said the numbers have trended at a stable level since last summer.

But this week, after 16 reported overdoses in the London area, and more than a dozen in the region with at least four deaths since Friday, the health unit issued a second alert about the drug.

“It’s the worst it’s ever been in terms of the number of overdoses,” Mackie said.

Other parts of the region reported similar spikes, including Woodstock, where a 17-year-old died, prompting speculation of a bad batch of potent drugs being sold across the area, including what’s known as purple heroin or blue heroin, a potent opioid often laced with fentanyl.

Mackie said he wasn’t aware of any deaths in the London-Middlesex area, and said the health unit would have been told if any deaths resulted from the recent overdoses.

But, he couldn’t say conclusively there hadn’t been any deaths including casualties that “might not be found yet. They could be in their apartment by themselves still.”

While hospitals report increasing pressure on their emergency rooms, people are dying less often, he said, because of naxolone, the medication that blocks the effects of opioid overdoses, and good medical care.

The street opioid market is “a wild west,” Mackie said, of drugs containing multiple opioids. “Anytime you are using drugs purchased on the street, they could be contaminated with fentanyl, and that’s what’s really behind a lot of these overdoses.”

Fentanyl can be bought on its own or it’s used by the makers of the street drugs as a cheap way to increase potency. “These days, more often than not, no matter what opioids you’re purchasing, unless it’s from a pharmacy, there’s probably fentanyl,” he said.

“It’s buyer-beware in the worst possible way,” he said, adding what drugs are circulating in the community are batch-dependent, and leave users unaware if and how much of the more potent opioids are in their purchases.

London’s supervised drug use site has test strips for users to test their drug supply for fentanyl.

Mackie said users should make sure someone is with them and that they have multiple doses of naloxone on hand.

That advice was echoed by Rhonda Galler, supervisor of family health at Lambton Public Health.

“Anyone using these drugs should be aware of the potential potency of them and they should not use alone and Narcan (a brand of naloxone) should be present and a lot of Narcan because it’s taking larger than the usual dosage to revive people in some cases,” she said.

While no concrete numbers were available, Galler said there is unconfirmed reports of more recent overdoses in the area and situations where naloxone, available for free at health units and pharmacies, has “reversed some very serious situations.”

Galler is convinced a concentrated form of fentanyl is being circulated in the area. “It’s very, very potent stuff,” she said, adding “at least a life is saved every day in Lambton because of the Narcan.”

It’s the worst it’s ever been in terms of the number of overdoses

Chris Mackie

She called the situation “terrifying” for people who are addicted to opioids. “People have a physical addiction to these drugs and they can’t even count on the fact that they are using a safe amount, because the suppliers are putting such potent stuff in them.”

The first hint of a crisis may have been sounded on March 22, when the Grey Bruce Health Unit issued an alert about five overdoses in four events within 48 hours, up from only three in the previous three weeks. The health unit pointed to purple fentanyl as the possible cause.

Since Friday, there have been reports of increased numbers of overdoses in Brant, Oxford, Perth, Middlesex and Lambton, while Chatham-Kent and Essex reported no noticeable increase in opioid-related illnesses.

There have been no reports from Elgin County, but Lisa Gunn, a criminal defence lawyer in St. Thomas said she knows of one death of a client by an apparent overdose.

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“This has been ongoing since the arrival of fentanyl,” she said. “It’s mind-boggling.”

Meanwhile, in Woodstock, 17-year-old Connor Mackay’s family has made funeral arrangements for the teen who overdosed on Saturday and died on Monday. Woodstock police are investigating.

“Our main focus is finding out what the youth had taken and determining how he came into contact with it,” Woodstock police Sgt. Marcia Shelton said.

The police are waiting for autopsy results.

Statistics from Public Health Ontario show there were 1,265 deaths from opioids in 2017, including 117 among the 15 to 24 age group and six among kids younger than 14.

The Public Health Agency of Canada estimated 3,996 Canadians died from an apparent opioid related overdose in 2017.