Two suspected 'bad heroin' deaths not caused by heroin at all

At least two of the five so-called “bad heroin” deaths being probed by the coroner from last summer weren’t caused by heroin at all, toxicity reports show.

Results have come back on two people who died from overdoses in late July, just before police and the city issued impassioned warnings about extremely toxic heroin circulating on the street.

But those two people – a man and a woman – overdosed on a combination of cocaine and the powerful prescription painkiller fentanyl, reports show. “Fentanyl and cocaine are a common theme here,” said regional coroner Dr. Jack Stanborough. “In my line of work we most often see oxycodone, fentanyl, cocaine and heroin.”

“Those are the ones that tend to create deaths in people who abuse drugs.”

Stanborough is still awaiting final results on three more people, who overdosed and died in late July/early August. While those results could change things, so far results have “not supported the concern” about overly toxic heroin that the city and police were warning people about, he says.

Stanborough has cautioned throughout the entire process that the only way to know for sure how someone died is to wait for the toxicity screens to come back. Still, the response from the city and police at the time was the right one, he says.

Similar overdose symptoms to heroin

Hamilton police denied requests to speak with vice and drug representatives for this story, but spokesperson Const. Debbie McGreal-Dinning said in an email that officers are still investigating the deaths.

“We have always maintained that we were unable to determine the origin, contents and even type of drug although we did recognize that heroin was a possibility,” she said.

It’s understandable that police and the city assumed heroin was the culprit here because someone who has overdosed on fentanyl could look similar to heroin, says Debbie Bang, the manager of St. Joseph’s Healthcare Womankind addictions service. “It’s still an opiate – it’s just a man-made one,” Bang told CBC Hamilton.

Fentanyl is a prescription painkiller that is many times more powerful than morphine or heroin. It suppresses breathing, especially when taken in large doses. Cocaine, on the other hand, is a stimulant that increases your heart rate.

Taken together, they could create a massive strain on the body, Bang says. “Typically, you would not see that combination,” she said.

Why mix these drugs?

So why were these people taking drugs – either separately during the same night or together in a combination – that are such polar opposites? One reason could be that they simply didn’t know what they were taking, Bang says. Another is that a dealer could be combining them for a more intense high.

“There is an advantage to have your product talked about – because it makes it more sought after,” she said. There are also cases of people “being their own pharmacist,” and taking a stimulant like cocaine in an attempt to counter the effects of fentanyl.

Bang also cautions that people who have addictions often have underlying issues in their lives like trauma and mental illness that influences their choices.

“You’re not making decisions in the same way,” she said. “Who knows what their optimism in terms of the future is?”

She also says the push to get the word out about toxic drugs from the city and police was the right move – if for nothing else because it gets people talking. Oftentimes her organization is fielding calls from family and friends of people who are using drugs, asking for help and harm reduction techniques.

“There is a product here that is dangerous, and that needs to get out,” Bang said. “And anyone who is using, you need to be careful. Please think about what you’re doing.”