Category: Harm Reduction series

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Focusing on fentanyl: If you party, plan ahead

As returning students head back to campus and new students set foot on campus for the very first time, one thing we can all count on is that this is a time we’re looking to make new friends and solidify old bonds. While not all students like to party, and even fewer use drugs when they party, some do. It’s important for students to consider the risks of using substances these days, when fentanyl has become part of our drug supply.

First of all, what is fentanyl?

Fentanyl is one of a class of drugs called “opioids”, drugs that bind to receptors in our brain and alter our perceptions of pain. There are many different opioids, including prescription drugs like Tylenol 3, OxyContin, and Percocet. When prescribed, they are often used after surgery or for moderate-to-severe pain treatment.

Some opioids that are available by prescription or used in hospitals are also manufactured in illicit labs, or “kitchens”. These drugs can be made to look like prescription drugs, and can also be sold as, or show up in, party drugs, like cocaine or MDMA.

Different opioids also have different potencies (strengths). It has been reported that fentanyl is 100 times stronger than hospital-grade morphine. And the even newer carfentanil is said to be 100 times stronger than fentanyl.

What’s important for students to know (when it comes to fentanyl and other opioids)?

The real challenge with the drugs that students are using at parties is that they’re part of an uncontrolled supply chain. When drugs are manufactured and obtained outside of a regulated system, it’s impossible to be sure about the contents of the drug and amount they’re taking.

When people can trust what they’re taking, they can better manage their risk. Like alcohol. This is important to remember because fentanyl is often not the drug the person is intending to take. Many people who have overdosed believed they were taking MDMA, cocaine, another type of opioid or something else altogether—but the substance contained some fentanyl.

Haven’t we already talked about this enough?

Open conversations create trust, reduce fear, and make it possible for us to learn from one another.

Engaging in thoughtful, open-ended conversation helps us to develop the skills to assess risk, think critically, and make better decisions. Once we’ve considered something carefully we’re a lot less likely to act out of impulse, habit, or in response to influences like peer pressure.

And we can apply these takeaways to other aspects of life—like how to help a friend going through a rough patch, recognize the signs of overdose, respond in a crisis, and how to be true to ourselves. But we need to take care not to lecture. 

Is there anything we can really do to prevent overdosing?

Understanding the risks and how to mitigate them can go a long way!

Risk is central to our growth and development, and we often embrace ones with the potential for reward because the pay-off helps us lead fulfilling lives.

Ever tried or considered rock climbing? In order to get the most out of it, you would take time to identify safe practices that mitigate the risk, such as bringing a buddy and testing the quality of your harness.

Many of us think that the opioid overdose crisis only affects people who use drugs regularly, or have an addiction. But even a single occasion that (accidentally) involves fentanyl can lead to overdose.

So it makes sense to use the same care and thoughtfulness when going to a party where you and your friends will likely encounter new opportunities, and risks.

What do you suggest then?

You can still have a good time out, while managing your risk! A few tips to keep in mind:

  • It’s safest to only party with friends or people you trust (i.e., use in a safe environment).
  • If you are using a drug in a group, it can be useful for one person to try the drug first. You can also “test it before you ingest it” using these fentanyl test strips.
  • Know your source (but remember there are no truly safe sources for uncontrolled substances!).
  • Stick to one substance and pace yourself so you don’t get in over your head (you can always do more, but you can never do less).
  • Avoid mixing alcohol with other drugs, as they can interact in unpredictable ways. You can also learn more about how different drugs can interact using this drug combination chart.
  • If you or someone you know does overdose, it helps to know the signs and symptoms of overdose and how to respond. Most campuses now offer overdose training and naloxone kits.
  • If you find yourself using more often, it might be time to ask yourself why—are you using substances to cope with life or maybe feeling pressured by others?

Learn more >>>

Catriona Remocker, Campus Projects Consultant, Systems View Consulting

Tanya Miller, Provincial Coordinator, Healthy Minds | Healthy Campuses

A photo of Kristina Jenei

Kristina Jenei, Research Assistant, Canadian Institute for Substance Use Research, Opioid Dialogues

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Avoiding Harm from Misrepresented Drugs

Drug checking at music festivals

by Warren Michelow

The summer music festival season is full of fun and excitement, but there can be a dark side to the exuberance—people overdosing or suffering negative effects from drugs. Too often, what someone buys as ecstasy turns out to be something else, including chemicals with a history of causing injury or death. Enter drug checking, a quick and simple method for screening drug samples. The technique uses reagents to indicate the presence of target chemicals through changes in colour. While most of these tests don’t determine dose or purity, they do help people know if they are getting what they paid for and can identify contaminants or unwanted substances.

Drug checking using both reagent-based screening and mobile laboratories has been available at European venues since the 1990s. To date, tougher drug control in North America has made it harder to provide drug checking here; nevertheless, several community groups in Canada and USA have offered drug checking at events over the years. For example, ANKORS (AIDS Network Kootenay Outreach and Support Society) in Nelson, BC has provided drug checking at the Shambhala Music Festival for over a decade1.

drug-testing-at-festival

Chloe Sage from ANKORS and Warren Michelow, a graduate student associated with CARBC, have just released “Drug checking at music festivals: A how-to guide”, funded by the BC Ministry of Health, that distills knowledge and practices learned from providing drug checking and other harm reduction services at music festivals and events since the early 2000s. The guide is intended to help people in the community and public health groups interested in providing services at events or in other community settings. It describes in practical detail how to set up and run a drug checking service, how it can fit with other health-related services at a festival, and how to do the testing in a legal way.

Drug checking services are accessed by people interested enough in using drugs to already be in possession of a substance they intend to use. Seeking out drug checking demonstrates an interest in health-oriented information about substance use and potential hazards associated with the substance they think they have. Describing the strengths and limitations of results from reagent-based screening and getting confirmation of understanding is a key part of a drug checking encounter (see “Testing Disclaimer” in the Guide for an example). The natural flow of a testing encounter offers a scaffold to engage in conversation about drug-related knowledge and strategies for responsible use and managing risk. Field experience shows that after receiving an unexpected result—especially one that suggested the presence of something known to be harmful, e.g., suspected PMMA—people choose to dispose of that substance rather than take it2.

Between 2008 and 2015, the United Nations early warning system received reports of 644 new psychoactive substances with 75 being reported in the first part of 2015 alone3. Sometimes these are sold as exotic new “legal highs”, but often they are misrepresented as more popular and better known drugs such as ecstasy or LSD. Being so new, we know little about the potential for adverse health effects from consuming these substances.

Having capacity to screen for misrepresented substances and known hazardous substances is an essential tool for preventing avoidable harm at festivals and other entertainment venues where substance use takes place. In the absence of any better alternative, rapid presence/absence screening serves a vital public health function.

Download the guide and find related resources at http://michelow.ca/drug-checking-guide/ and http://www.ankorsvolunteer.com/.

1 Warren Michelow, Cheryl Dowden. “Start Small, Take it Easy” Results from the ANKORS Harm Reduction Survey at the 2013 Shambhala Music Festival. Available at http://michelow.ca/r/smf2013rep.

2 Chloe Sage. Harm Reduction and Drug Checking: A wrap-around service for festivals. Case Study: Shambhala Music Festival /ANKORS Drug Checking Harm Reduction Service data 2015. Available at http://michelow.ca/r/smf2015dcsum.

3 United Nations Office On Drugs and Crime. World Drug Report 2016. (United Nations publication, Sales No. E.16.XI.7). Available at http://www.unodc.org/wdr2016/.

Michelow_portraitWarren Michelow is a graduate student affiliated with the Centre for Addictions Research of BC. He is currently a Ph.D. candidate in the School of Population and Public Health at UBC and his doctoral research is on simultaneous polysubstance among mainstream substance users.  He has received the Frederick Banting and Charles Best Canada Graduate Scholarships Doctoral Award, the Integrated Mentor Program in Addictions Research Training Fellowship and a MITACS ACCELERATE Internship.