‘It feels like murder': The devastating impact of fentanyl in B.C.
Sandra Tully with a photo of her son, Ryan Pinneo, who died after taking pills laced with fentanyl.
Pinneo had enrolled in a detox program and several times tried to quit opioids cold-turkey. With his family by his side, he tried desperately to “get the demons away,” Tully said.
“Part of me is so mad at myself, too, because we were so involved in the addiction part of it, I never thought I’d lose him to an overdose,” she said.
A toxicology report concluded that her son had overdosed on fentanyl – a toxic, synthetic opioid that’s increasingly being cut into illicit street drugs to bolster or mimic their effects.
“He had written down drugs that he had experimented with and fentanyl was not on that list,” Tully said.
“So, to me, he was really sold something he didn’t know was fentanyl. To me, it feels like murder.”
Up to 800 could die of illicit-drug overdoses in B.C. in 2016
A North American drug crisis has planted deep roots in B.C.
The B.C. Coroners Service has ample data on this: Last year, at least 480 people died of an illicit-drug overdose, up from 274 in 2012. But in just the first four months of 2016, such overdoses have already killed at least 256 in the province.
Of the 480 deaths last year, fentanyl was detected in 32 per cent of cases, up from five per cent in 2012. In the first three months of 2016, fentanyl turned up in 49 per cent of overdoses.
If the death toll continues at its current rate, 800 people could die from illicit drug overdose in B.C. this year, up 67 per cent from last year.
Confronted by the surging death count, B.C. health authorities, police and drug policy experts are desperately trying to find ways to curb the opioid’s devastating impact.
“I’ve not seen anything like this,” said Dr. Jane Buxton, harm reduction lead at the B.C. Centre for Disease Control. “The numbers are so worrisome.”
Illicit drug dealers have been shifting away from pure heroin since finding a lucrative business model in importing relatively inexpensive powdered fentanyl, mostly from labs in China .
They use the fentanyl to boost the effects of street drugs such as heroin, crack cocaine and crystal methamphetamine or use pill presses in clandestine labs to mix it into counterfeit prescription pills – typically fake Oxycontin 80s, known as “green meanies” or “beans” on the street.
With a kilogram of powdered fentanyl, which can cost as little as $3,300 US to produce, a dealer can press about $1 million US worth of pills at street value, according to the US Drug Enforcement Administration.
Drug users who ingest a pill containing a salt-grain-sized amount of fentanyl might get a familiar opioid high. But if they take a pill containing about two grains worth – what police call “hot spots” – they overdose. A dose as small as two milligrams can be fatal.
Whether a drug user gets back up again after an overdose depends on many factors, including the dose, the user’s tolerance and the availability of the overdose-reversing drug naloxone.
The fallout from this trend is staggering.
![VANCOUVER, BC - MAY 5, 2016, - VANDU board member Hugh Lampkin holds $10 worth of heroin in Vancouver, BC. May 5, 2016. Story on fentanyl-overdose users and survivors. (Arlen Redekop / PNG photo) (story by Nick Eagland) [PNG Merlin Archive]](http://wpmedia.vancouversun.com/2016/05/vancouver-bc-may-5-2016-vandu-board-member-hugh-lampk.jpeg?w=300&quality=55&strip=all)
VANDU board member Hugh Lampkin holds $10 worth of heroin in Vancouver, B.C. He says the powdered substance contains Fentanyl.
Opioids are addictive substances that act on the body’s opioid receptors to reduce the perception of pain. On the street, opioid users might seek white, black tar or brown heroin. But opioids also include common medications such as morphine, OxyContin and codeine cough syrup.Fentanyl is a potent, synthetic opioid, 50 to 100 times stronger than morphine and typically used to provide comfort to patients with moderate to severe pain, such as pain caused by cancer. Most often, fentanyl is administered as a skin patch, lozenge, pills, oral film, nasal spray or intravenously.Victims of a opioid overdose demonstrate the “opioid triad” of symptoms – pinpoint pupils, unconsciousness and respiratory depression. If not treated with the opioid-overdose reversing drug naloxone, they can die.
Overdose fallout leads to ‘public health emergency’ in B.C.
On April 14, provincial health officer Dr. Perry Kendall took the rare step of declaring a public health emergency in response to the surge in drug-related overdoses and deaths.
“At some point, you have to say, ‘OK, we can’t just watch this, we need to take a step,” Kendall told Postmedia News.
With Kendall’s announcement came an order bolstering medical health officers’ ability to collect detailed data from health authorities and first responders.
Kendall said his office plans to record the ages and identities of those who overdose, where and when the overdoses occur, and whether the person has previously connected with health services, so that health authorities can focus their outreach and prevention efforts.
In B.C., the first police alert regarding fentanyl came in May 2013 when Prince George RCMP warned drug users to be wary of a powerful drug resembling heroin being sold on the streets.
In October 2014, concerns over an emerging crisis grew following a cluster of 31 overdoses at the Insite supervised injection site in Vancouver over the Thanksgiving long weekend. The cluster prompted Vancouver Coastal Health and Vancouver police to put out public warnings.
Last year, public attention was drawn to the overdose deaths of British Columbians who didn’t fit the profile of the entrenched Downtown Eastside drug user.
On July 20, Hardy and Amelia Leighton, both in their early 30s, were found dead after ingesting toxic amounts of fentanyl in their North Vancouver home. They left behind a two-year-old son.
On Aug. 1, 17-year-old Jack Bodie died when he and a 16-year-old friend overdosed in a Vancouver park after consuming fake Oxycontin 80 pills laced with fentanyl.
Of the 98 dead whose blood showed traces of fentanyl this year, 24 were in the Fraser Valley, 23 on Vancouver Island, 20 in the Interior and 27 in Metro Vancouver.
“It’s really across the province,” said B.C.’s chief coroner, Lisa Lapointe.
“For the most part, it’s entrenched drug users, so people who have been using illicit drugs for a long time. We’ve had the occasional death where it’s somebody who’s using it recreationally.”
It appears to be a viable option still to cut heroin with fentanyl to make a profit, and people are taking advantage of that to make money. But they are directly killing people as a result of that. – Sgt. Randy Fincham
Lapointe said victims of overdose tend to be 80 per cent male and 20 per cent female. Most are between 20 and 50 years old.
Sgt. Randy Fincham, spokesman for the Vancouver Police Department, said in the last three to four years police have seen “a huge increase” in fentanyl.
“A lot of it comes down to organized crime,” he said.
Fincham said police were optimistic things would change last year after they launched “Know Your Source,” a campaign alerting drug users to fentanyl’s dangers.
“Unfortunately, we’re still seeing the numbers climb,” he said. “It appears to be a viable option still to cut heroin with fentanyl to make a profit, and people are taking advantage of that to make money. But they are directly killing people as a result of that.”
Overdoses surge on the streets of Surrey
It’s mid-May and “The Strip ” — a two-block stretch of commercial property in Surrey’s Whalley neighbourhood — resembles a battleground.
There, support workers from the Lookout Emergency Aid Society and drug users trained to reverse overdoses constantly rush up and down the street to cries of “Narcan! Narcan!” – the U.S. trade name for naloxone – as they work to save as many as a dozen people from overdoses each day.
Drug users and homeless residents of The Strip’s tent city said overdoses surge when welfare cheques are distributed. Many users have overdosed multiple times this year.
“I’ve had 26 overdoses in the last six months,” said James Pollock, 40, a heroin user who lives on The Strip.
“With fentanyl, you just hit the ground … lights out, you don’t even know. You just wake up every time to the paramedics above you.”
Pollock described fentanyl as “dramatically different” to heroin and far more addictive. He said heroin users are actively seeking fentanyl because of its strength. They ignore its potentially lethal effects.
Indeed, several heroin users on The Strip said they covet fentanyl despite round-the-clock overdoses and the deaths of many of their neighbours and friends.
Tamara Ashley prepares to receive an injection on the Surrey strip.
Tamara Ashley, 29, a Strip resident who has used heroin since she was 16, said once a user tries fentanyl, they have a hard time going back to heroin.
“When you do fentanyl once or twice, you get to where you need the fentanyl,” she said. “It’s stronger, you go on the nod from it – which is what you want from heroin.”
Another heroin user said she’d rather spend $20 on pure fentanyl — enough for her and a friend to get high — than $40 on heroin that’s likely laced with an unknown quantity of fentanyl anyway.
Ron Moloughney, president of the Surrey Area Network of Drug Users and a former alcohol and drug user who has been clean for five years, visits The Strip to provide information and assistance.
He said many longtime users still don’t realize that the drugs they’re buying are likely to contain fentanyl or other adulterants.
“They don’t know there’s fentanyl in there until it’s too late,” Moloughney said. “It’s ridiculous. It’s out of control, absolutely out of control.”
Crime concerns in Kamloops
In Kamloops, where fentanyl has been linked to five deaths this year, the drug’s effects have been felt acutely, said Bob Hughes, executive director of ASK Wellness Society.
Hughes said ASK outreach workers are hearing from drug users that fentanyl is being brought into the community by a crew of dealers from Surrey.
“They come up around income-assistance week and blow their stock out on the town, and then bail when they’ve spread it around,” he said.
In 2009, when two of the notorious Bacon Brothers were arrested and their stronghold on the drug trade in B.C. ended, the region became stable again, Hughes said.
But with fentanyl on the streets, Hughes fears more dark days are ahead.
“I would argue that over the past year, we’ve definitely seen a return to levels of street violence and chaos reminiscent of back in 2005 to 2008,” Hughes said.
Downtown Eastside drug users wake up to dangers
Samantha Boss, a former drug user who lives in Vancouver’s Downtown Eastside, said a fentanyl overdose is what prompted her to quit one year ago.
“My partner had OD’d last summer on heroin,” Boss said.
“Little did he know, it was laced with fentanyl. Myself being a drug addict, I was into the crack cocaine and I did a small little toke and all of a sudden, my head, it felt as if it had hit a brick wall and I thought, ‘OK, what’s going on?’
“And that’s when I knew it was laced with fentanyl, and I tossed it.”
Hugh Lampkin of the Vancouver Area Network of Drug Users (VANDU) said despite the surge in overdose deaths, “a lot of people don’t know” that fentanyl is on the street.
For drug users there, sharing information has become vital.
“News gets passed really quickly down here,” Lampkin said. “Here in the Downtown Eastside, it’s kind of fortunate because we have some pretty knowledgeable drug users as to what’s going on.”
When a family’s “worst nightmare” occurs
Lapointe said that when the B.C. Coroners Service is called to a scene, investigators will speak with the victim’s family.
They regularly see the devastating impact of the overdose crisis firsthand.
“In many families, they want us to know that their loved one was a good person,” Lapointe said.
“They think that we are going to think, ‘Well, because they used drugs, they weren’t a good person.’ We don’t think that. We know how many wonderful people have become addicted to drugs.
“And so families will show us pictures and tell us about their school and their career and their successes, and just how tragic it was that this addiction took over their life, and that now their worst nightmare has happened – their loved one is dead.”
Tully said the addiction that took over her son’s life put the family through six months of “absolute hell.”
But after his death, she was embraced by other families who went through similar experiences, and wanted to share their stories with her. She was shocked to learn they “were all living with this struggle and nobody was talking about it.”
Tully offers advice for families struggling to help a loved one with a drug addiction: “Every resource that you can find, you’ve got to throw at it. Because it doesn’t go away on its own, it’s not just a phase. And when you change your brain chemicals and that need that is always there … there’s very few people who can kick addiction on their own.”
Still, not a day goes by that Tully doesn’t feel some anger toward her son, she said.
“I go into his room and yell at him. Because it just is so stupid for a high, but it’s something he couldn’t control, either.”
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