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WebMD Article Reviewed by Neha Pathak, MD on May 17, 2018

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Advocates for people who use drugs say new research showing an overwhelmingly tainted street-drug supply proves the dire need for government to crush the deadly illicit market by distributing safer substances.

Preliminary results from a pilot study by the B.C. Centre on Substance Use released Thursday show that people who brought street drugs into two supervised-consumption sites for testing had often been deceived about their purchases. Using a spectrometer and fentanyl test strips, researchers examined 1,714 samples over six months and found that just 39 per cent contained what they buyer thought they had been sold.

According to the researchers, only 19 per cent of samples sold as an opioid contained the expected substance and 88 per cent had fentanyl, while 89 per cent of samples sold as a stimulant contained the expected substance and five per cent had fentanyl. Only 13 per cent of samples sold as heroin actually contained heroin.

Dr. Ian Garber uses an infrared spectrometer to test heroin that was bought on the street by activist Dean Wilson for testing purposes, for fentanyl during a demonstration at the supervised consumption site at Powell Street Getaway in the Downtown Eastside of Vancouver, B.C., on Friday November 10, 2017. British Columbia is going to test a new drug-checking service in Vancouver to determine if it will help cut the soaring number of overdose deaths in the province. The study began last week in a partnership between the city and the B.C. Centre on Substance Abuse using a portable machine at two supervised consumption sites. DARRYL DYCK / THE CANADIAN PRESS

The results come a week after the B.C. Coroners Service reported that 161 people died of a suspected illicit-drug overdose in March, the second deadliest month since record keeping began. Fentanyl has been detected in about 83 per cent of 391 drug deaths in the first quarter of 2018, the coroners said. It has been two years since B.C. declared a public-health emergency due to increased overdoses, which last year took 1,448 lives.

Jordan Westfall, president of the Canadian Association of People Who Use Drugs, said the pilot study shows the pressing need for safer drugs.

“It’s very clear right now that people are dying because of a contaminated drug supply — ‘fent-in-all’, so to speak,” he said. “It just reaffirms again and again that we need to do something completely different. Otherwise, thousands more people are going to die.”

Westfall said it’s unclear whether the information presented in the study will have an effect on where people buy drugs. Because the supply chain is illicit and unregulated, the street-level dealer may not have been the person who cut the drug with another substance, he said.

He said there is hope for change with evidence-based treatments such as the B.C. Centre for Disease Control’s hydromorphone-pill pilot project. But he said key to stymying the overdose crisis is ensuring people have access to safer substances, which includes expanding opioid-dependency treatment beyond methadone and Suboxone.

Sarah Blyth, of the Overdose Prevention Society, said she is not surprised by what the testing found. At her society’s Hastings Street facility, people will sometimes use a substance and drop to the ground in a seizure, she said. Often, they’ve used a stimulant presented as an opioid or vice versa, or fentanyl mixed with household cleaners, pig dewormer or cement.

“Drugs end up going through many different hands,” she said “Whoever the dealer is that gets a batch of drugs from another dealer, they try to make it twice the amount and just use whatever’s under their kitchen sink.”

Sarah Blyth of Overdose Prevention Society in Vancouver, B.C.ebruary 17, 2017. Sarah Blyth left politics and the Vancouver park board to devote herself to helping drug users stay alive. Arlen Redekop / PNG

The end product may hospitalize a person with an infection or a liver or heart problem, she said.

“We really need to get safe medication to people,” she said. “Having everything dosed and clean, it’s just going to make such a huge difference in the cost of the crisis,” both in terms of tax dollars and human life, she added.

Kenneth Tupper of the BCCSU, the study’s principal investigator, said the testing revealed new information about the high rate of deception in the street-drug supply as well as the high presence of dangerous adulterants including fentanyl.

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