fentanyl – Matters of Substance

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

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

Fentanyl-related overdoses have dominated the headlines in BC—and across the country—over the past year. Deaths involving the synthetic opiate narcotic, which is roughly 50 to 100 times more toxic than morphine, have increased five-fold in British Columbia over the past three years. But despite repeated warnings from provincial public-health bodies and alerts through community-based harm reduction supply distribution sites, fentanyl overdoses continue to rise—particularly among people who do not inject drugs. Clearly, despite efforts on the contrary, the message was not getting through to this population of users.

If you live in BC, you may have seen these posters pop up in your Facebook feed or at a local bar over the past few months. They’re the result of a campaign put together by BC’s Drug Overdose and Alert Partnership (DOAP), a multi-sectoral committee which works closely to monitor harms and deaths from substance use. After an emergency meeting in January 2015, the DOAP set to work crafting a campaign that would get the word out to a population of substance users that traditional methods weren’t reaching.

Coroner’s data revealed that most of the people who were dying of fentanyl-related overdoses (deaths where fentanyl was detected, either alone or in combination with other drugs) were between 19 and 40 and were not injecting drugs, which meant they were likely not accessing harm-reduction-supply distribution sites and likely had missed the posters and alerts that had been put out through those avenues. DOAP members decided to develop a targeted public safety campaign aimed at people aged 19-40 using public posters, Facebook advertising and a website. Thus, the “Know Your Source? Be Drug Smart” campaign was born.

It’s one thing to decide how you are going to get the message out; deciding what the message will be is a totally different beast. We looked to campaigns like Toronto Crime Stoppers’ Cookin’ with Molly, as well as social marketing and behavior changed theories. The aim of this campaign was at the first stage of behavior change theory: to simply raise awareness about what fentanyl was, where it could show up, and how to deal with and prevent an overdose. Evidence from published literature also suggested that the best PSA campaign required input from the target audience, so we held two focus groups with youth.

As for the visual content, it was felt that the images needed to have a bit of shock value to grab the viewer’s attention, but have sufficient detail to convey the message. The idea was not to tell people to not use drugs (because we know that doesn’t work), but for people to learn about what might be in their drugs so that they could be aware of what to look out for. In some sense, the entire campaign took on a harm-reduction approach – we knew people were using and wanted to provide them adequate info to reduce harms from fentanyl use.

After the working group developed draft messages and posters, they were reviewed by staff working in the areas of public health, mental health and substance use, young professionals who personally use drugs or have friends who use drugs in social settings, and at-risk youth who use substances in social settings, including at music festivals or concerts. Feedback helped us to tweak the campaign images and campaign taglines into ones that drug users were more likely to respond to. Public health staff worked with the BC Coroners Service and the BC Drug & Poison Information Centre to compile accurate information about fentanyl for the public and for health care professionals. All the information was integrated into a central website, Know Your Source, a one-stop shop for tips on prevention, harm reduction and treatment.

pacman — These PacMan posters have been popping up around Vancouver.

As fentanyl-associated deaths continue, the Know Your Source campaign provides accurate information and resources across the country. The messages have also inspired some people to create their own posters; these Pacman themed posters have been spotted around Vancouver. The Know Your Source awareness posters and messages have been adapted for use in Alberta and Saskatchewan, and discussions are underway for their use in Manitoba and Ontario.

Author: Ashraf Amlani, Harm Reduction Epidemiologist, BC Centre for Disease Control

Tag: fentanyl

Focusing on fentanyl: If you party, plan ahead

Of powders and pills: designing a fentanyl awareness campaign