People aren't overdosing, they're being poisoned by tainted drug supply, says former Calgary user

Matthew Beal says it's always been risky for drug users in Calgary, but the makeup of the illicit supply seems to be constantly changing as dealers and manufacturers alter their products, creating more dangerous and potentially deadly batches of illegal drugs.

Beal, 34, who describes himself as a recovering addict, now helps users and other at-risk people through community outreach volunteer work. He warns the risks have changed significantly as not everyone knows what they're ingesting or injecting because of the contaminated drug supply. 

"It's gotten extremely more dangerous, the risks are tripled, quadrupled," he said on a recent chilly Saturday morning before heading out to pick up used and discarded needles in East Village and to hand out harm reduction supplies such as naloxone kits to drug users.

The danger becomes very clear when an opioid overdose can't be as easily reversed by first responders and others who've come to rely on naloxone as a lifesaver. 

The drug overdose crisis claimed 1,453 lives in Alberta in 2020.

To the end of August of this year, 1,026 people had died of unintentional drug poisoning, most of them from non-pharmaceutical or illicit opioids.

No fewer than 110 people have died every month in Alberta since May 2020. Most are men and most are between the ages of 25 and 54.

The number of emergency department visits and hospitalizations related to substance use reached their highest levels in five years this past spring, according to the most recent data.

The recent needle pickup was organized by Alberta Addicts Who Educate and Advocate Responsibly (AAWEAR). Lauren Cameron, a former drug user who now works for the agency, describes the street drug supply as toxic.

"People aren't overdosing, they're being poisoned by the tainted drug supply of fentanyl and fentanyl analogs," she said. 

Cameron says more benzodiazepines are being found in street drugs, which is a concern since naloxone can't be used to reverse the effects of an overdose, and it's often the only tool they have.

"Naloxone won't work on benzos, so we have to keep administering naloxone and hope that they come back," she said.

"But with the benzos, they are being poisoned by that. It's a really sad outcome."

Drug alerts, danger warnings

Alberta Health Services (AHS) has been sending out a series of Calgary drug alerts that highlight the findings from Health Canada's drug analysis service (DAS), which analyzes suspected illegal drugs seized by law enforcement agencies across the country.

In November, AHS  warned of the discovery of N-Pyrrolidino Etonitazene, a novel opioid that can cause psychoactive effects similar to heroin, fentanyl and other opioids.

"This substance is newly encountered in your community and is known to be associated with overdoses or deaths," the alert warned.

The substance, in the form of a greenish powder, was seized in June in Calgary, analyzed by the lab and the alert sent out last month.

The sample also contained flubromazolam, which is a benzodiazepine, along with phenacetin, a substance that Health Canada warns has the potential to cause cancer.

Benzodiazepines are some of the most commonly prescribed medications to treat sleep, seizure and anxiety disorders, but if they are mixed in with opioids and other drugs, they can increase the risk of overdose and death because of their sedative properties, Health Canada warns.

They are only legally available by prescription. The sale, production and possession are illegal, unless it's for scientific, medical or industrial purposes.

AHS declined a request for information about its drug alert program.

Over the summer, the DAS analyzed more than 3,200 samples seized in Alberta. Benzodiazepines were found in 408 of them, representing a 179 per cent increase over the same period last year.

'It's brutal'

The head of the Calgary Police Service's undercover operations unit says it's difficult for his front-line officers who respond to fatal overdoses and sometimes have to notify family and loved ones about the deaths. 

"It's brutal. It's hard to see so many people die," said Staff Sgt. Kyle Grant.

He says the most noticeable change has been the addition of different benzodiazepines in the city's illicit drug supply.

Grant says most of the drugs are coming from B.C., Ontario and Mexico and are modified or reprocessed with the addition of other substances that can enhance or extend the "high" for users.

"These products are arriving here from wherever and then individuals are making up their own batches or maybe adding their own special mix of things. And then packaging and distributing it for sale."

Drug checking

The uncertainly and toxicity of the street drug supply has prompted calls for drug checking services in Alberta, similar to what is being done elsewhere, including in B.C. and Saskatchewan. They provide a chemical analysis of illegal and legal drugs sold through criminal channels.

The B.C. Centre on Substance Use describes drug checking as "an evidence-informed harm reduction tool that allows people to check what's in their drugs." It says tests on opioids, stimulants and other psychoactive drugs, including MDMA, can produce results in less than 10 minutes.

The Saskatchewan government says it is expanding access to fentanyl and benzodiazepine drug checking strips "to help curb the number of overdose deaths."

But there are skeptics, including the Alberta government.

Drug checking services and programs are not perfect. Health Canada cautions about their reliability and accuracy, including the potential for false negatives, particularly with fentanyl test strips.

Alberta's associate minister of mental health and addictions says his department is examining drug checking services.

"We're exploring all options," said Mike Ellis at a recent news conference announcing funding for Sublocade, a medication for people with an opioid dependency.

"But at this time, no decision has been made. We're just exploring what the evidence is on this particular issue," he said on Dec. 8.

Bryan Labby is an enterprise reporter with CBC Calgary. If you have a good story idea or tip, you can reach him at bryan.labby@cbc.ca or on Twitter at @CBCBryan.