'We don't know what's in it:' Ottawa's toxic street drug problem is getting much worse

For five years health experts say Ottawa’s toxic drug supply has been leading to worse overdoses, and more deaths.

“They’re playing with their lives,” said Anne Marie Hopkins, a manager at Ottawa Inner City Health working primarily in their consumption and treatment service centre said. 

“How can you have a fighting chance at surviving, at having any type of recovery, of anything, if you’re dead?”

In the first quarter of 2018 there were 14 opioid overdose related deaths in the city; three years later, that number has doubled.

“Particularly since COVID started, we started to see some of the worst overdoses we’ve ever seen,” Hopkins added. 

“Truthfully, we don’t know what’s in it,” said Patrick Sweeney, a longtime fentanyl user.

Sweeney says he has seen more overdoses than he can count, and blames it on the toxic drug supply. 

“I’ve saved many lives, you know, benzos being cut into fentanyl, it just deteriorates your mind, body, soul. I want to see more cleaner drugs,” he said.

Health experts say overdoses are on the rise. At the Sandy Hill Community Centre, Nursing Team Lead for the Oasis Project, Tali Magboo Cahill, says they’re experiencing double - even triple - their usual monthly visits. 

“At the beginning of the pandemic we knew that things were not going to go well for people who used drugs,” she said. “We knew that the supply would be interrupted and that would cause issues but now we’re constantly in reaction mode and we really don’t know what’s going to happen next.”

Near-debilitating sedatives being cut into fentanyl

Making matters worse is that benzodiazepines, a class of near-debilitating sedatives, are being cut into fentanyl - a dangerous opioid responsible for 87 per cent of all opioid overdose related pandemic deaths - with more frequency. 

“They’re trying to wake up and come out of their high, we’re trying to wake them up and get them out of their overdose and they just can’t wake up because benzos are just such a strong sedative for a lot people,” Hopkins said. 

A study from Public Health Ontario found that benzodiazepines werepresent in one in 20 opioid related overdose deaths prior to the pandemic. In 2020, that number skyrocketed to one in four.

Adding to the complication, overdose-reversing medicines like naloxone won’t reverse the extreme sedation caused by benzodiazepines.

“Overdosing is such a huge shock to the body. It’s traumatizing, it’s awful, when we give them naloxone to reverse their overdose it immediately puts them into withdrawal and they’re extremely sick,” Hopking said. “But naloxone does nothing for benzos so they’re just super out of it and they’re in withdrawal and it’s just a horrible position to be in.”

“It’s very challenging, when I start to get sick I have stuff coming out of both ends, I feel like my skin’s crawling in my skin; the benzos make you feel like that” Tony, a drug user who uses fentanyl multiple times a week, said. 

As a result, some drug users are pre-emptively turning down naloxone at safe injection sites. 

“What they’re saying to us is ‘Please don’t Narcan me if you don’t have to,” Cahill said. 

It means patients end up staying at community health centres and hospitals longer while recovering from the effects of sedation. 

“We need to keep people for a longer time for sure. They’re definitely sedated for longer and we weren’t built to house people for that long, so they’re staying for much longer and then we have a wait list and then people might use outside,” Cahill said.  

Users left more vulnerable

Cahill says use of fentanyl outside of safe injection sites isn’t just a concern due to overdosing, but that the effects of the benzodiazepines often leave users in a vulnerable state for hours. 

“Most people are using right on the street and when they pass out I mean people just come and pick through their pockets and take whatever they want, that’s the hard part about it,” Tony said. 

According to Tony, he’s lost everything he owns multiple times in the last year while sedated after getting high on fentanyl. 

“You know when you think you lost your wallet or your cellphone? You know that deep pitted feeling in your gut? It’s like 10 times worse than that. Same kind of feeling, just despair,” he said. 

Health care experts say the solutions in place aren’t equipped to handle the effects of the increasingly toxic drug supply. 

“The staff are kind of exhausted and they’re work is a lot more challenging and they feel they’re kind of forgotten,” Cahill said. “When we talk about health care providers and the crisis we’re going through, my staff are definitely part of the people who are really burnt out.”

They say a safe drug supply, more injection sites, and increased housing supports are all essential aspects of a viable long-term solution. 

“People who use drugs in this city deserve way more than what they’re getting right now and they just continue to be further marginalized,” Hopkins said.