A highly dangerous synthetic street drug which increases the chance of fatal overdose is on the rise in Canada.
Doctors have warned that the recently-emerged “benzo dope”, which most often contains a mixture of fentanyl and black-market benzodiazepines, leaves drug users even more prone to fatal overdoses than fentanyl alone – a drug which has already fuelled a drug death epidemic across the U.S. and Canada.
Fatal overdoses are more likely to occur after using benzo dope because the life-saving opioid overdose reversal drug, naloxone, is not effective against benzos.
Benzo dope, also known as ‘purple heroin’, is most commonly dark purple, blue and orange, but it has been found to be other colours.
Drug forensic experts in British Columbia found that in October last year one in six (16 percent) of fentanyl deals were cut with benzodiazepines – a type of drug not usually found cut into opioids – compared to five per cent last January and zero before 2019.
The most common benzo identified in benzo dope was etizolam, a super potent benzo that is fuelling record drug death rates in Scotland.
Authorities in Canada were first alerted to benzo dope when health workers noticed a cluster of 30 “atypical” overdoses over two weeks in Vancouver in April 2019, where drug users were not responding to naloxone. A warning about the new drug combo was issued by Vancouver Coastal Health.
The combination of benzos and fentanyl causes prolonged loss of consciousness, profound respiratory depression and amnesia. In January, half of the 165 suspected illicit drug toxicity deaths in British Columbia – most of which involved fentanyl – also involved benzos, compared to only 15 percent in July last year. Last year was the deadliest year on record for overdoses in British Columbia, the epicentre of Canada’s drug death crisis.
The product has also jumped the border into America, with several overdoses linked to ‘purple heroin’ in Michigan.
“To our knowledge this is the first report of a sizeable outbreak of benzodiazepines in the context of a continuing opioid overdose epidemic. The advent of the adulteration of high-potency synthetic opioids [with benzos] is of particular concern,” said a report into the new drug published last week in the International Journal of Drug Policy.
The report’s lead author, Matthew Laing, from the University of British Columbia’s Department of Medicine, said that while opioids and benzos have been used as separate drugs by the same people for decades – because benzos can prolong an opioid high and reduce withdrawal symptoms – benzo dope “represents a new phenomenon” which “should remain at the fore of consideration for public health, harm reduction, and care providers”.
Benzo dope, which like regular fentanyl purchases is most commonly smoked or inhaled, although sometimes injected, has spread outside of British Columbia. It is also being sold, according to the report’s authors, in Alberta and Ontario.
As with the introduction of fentanyl into the heroin supply, the report, by the British Columbia Centre on Substance Use and University of British Columbia, suggests the addition of etizolam into the fentanyl supply has been done so for economic reasons. Since China clamped down on the production and export of fentanyl in 2019, the drug’s price on the black market has gone up. So suppliers in Canada have opted to replace some of the fentanyl with cheaper etizolam.
Most drug users have told drug workers they do not like benzo dope, describing it as an unpleasant, and sometimes dangerous, surprise. But as with fentanyl, some drug users are already getting used to the benzo dope high and are actively seeking it out in downtown Vancouver.
In Scotland, etizolam, known as “fake valium’, is most often sold in the form of blue pills for 50p each. The drug, most often imported from chemical labs in China, has supplanted less powerful benzos such as diazepam on the street drug market. But since its introduction into the country’s drug supply, deaths have rocketed.
British Columbia has some of the most progressive harm reduction policies in the world, including drug checking and drug consumption rooms. Last month the province asked the federal government to decriminalise all drugs which it says would be a “significant step” in saving lives, reducing stigma, and treating problematic drug use as a health issue and not a moral or criminal issue.
“We are particularly concerned about the toxicity of the drugs detected in many of the deaths recorded in January,” said Lisa Lapointe, British Columbia's chief coroner on Tuesday.
“The findings suggest that the already unstable drug supply in B.C. is becoming even deadlier, underscoring the urgent need for supervised consumption options, prescribing for safe supply, and accessible treatment and recovery services.”