It is the weekend clubgoer dabbling in ecstasy, the stagette participant taking cocaine and the long-weekend camper experimenting with special K. None of them would consider themselves drug addicts, but their use of street drugs puts them at risk of fentanyl overdoses.
In the wake of the public health emergency triggered by hundreds of fentanyl-related deaths in British Columbia, a Vancouver harm-reduction group has been courting such casual drug users, imploring them to check their drugs in an anonymous, non-judgmental environment.
"'Just say no' doesn’t work," says Munroe Craig, co-founder of a volunteer-driven group called Karmik.
The group has held a free clinic once a month for the past three months in the Downtown Eastside of Vancouver, allowing participants to anonymously test their recreational drugs for fentanyl and other adulterants with a state-of-the-art machine able to undertake a detailed analysis of any substance in a matter of a minutes.
"I think we need to provide access so people can make their own informed choices," Craig says, explaining that clients can decide whether to take a substance that’s contaminated with fentanyl or anything else.
Dr. Ian Garber demonstrated the Fourier-Transform Infrared Spectrometer (FTIR) for CTV News with a tiny amount of powder carefully placed on a sensor on the machine, which essentially looks like a microscope attached to an average flat-bed scanner. It’s then plugged into a laptop computer, the entire setup taking up no more room than a typical folding table.
"It's a non-destructive test. It just bounces a beam of light off the sample, so it doesn't destroy it," says Garber.
He runs the spectrometer at Karmik events and the Insite Safe Injection Site in the Downtown Eastside. He’s seen some unusual results, including during the course of three recent tests for what clients believed was heroin. When the computer attached to the FTIR ran the sample through its database of substances, it turned up a shock.
"It actually came up as Plaster of Paris. So this was a piece of plaster or it may have been drywall, which is the same chemical, that was dyed a colour to look like these heroin pebbles," says Garber.
The test he conducted for CTV News was a non-descript white powder composed of ibuprofen and an anti-depressant.
British Columbia’s health officials have struggled to convey the dangers of the fentanyl-tainted illicit drug supply to recreational drug users and those who don’t consider themselves “addicts.” Paramedics and firefighters are the first to point out they attend overdose calls at middle-class condos and upscale homes, not just the poverty-stricken Downtown Eastside.
Craig says she in discussions with summer music festivals to set up the FTIR machine for concertgoers to test their drugs anonymously in a stigma-free environment, even though she knows it’ll come under fire from critics who believe it’ll enable and encourage more people to use drugs, risking addiction and negative health impacts.
"Nobody needs permission to do drugs. It's self-autonomy,” responds Craig. “People can put whatever they want into their bodies and they've probably already made a choice before we're judging them."
She points out that samples are also used to monitor trends in the illicit drug market, which can warn health officials about new fentanyl analogues and other adulterants. For example, a surge in carfentanil, which is resistant to the opioid antidote naloxone, would be a red flag for first responders and doctors trying to revive a patient who could otherwise be assumed to be overdosing on a fentanyl-tainted product.
“There’s lives being lost all the time,” says Craig.
“Over 80 per cent of overdoses occur behind closed doors.”
