Health experts are turning to a cheap drug test strip kit from a Toronto suburb as a tool to curb soaring overdose rates linked to fentanyl.
In July, Vancouver's safe injection site Insite became the first to offer free voluntary tests for clients to determine whether their supply of heroin or other drugs contained the deadly opioid. Though the kits were originally designed for doctors to test urine samples, Insite workers discovered they could be used by testing drugs diluted in water. Like a pregnancy test, the results are available within minutes. One line on the test strip means fentanyl is present, two lines means it's not.
Following the success of Insite's program, Markham-based medical diagnostic products company BTNX Inc. has received interest in the tests from pharmacies and harm reduction groups across Canada and parts of the US including New York and Washington. CEO Iqbal Sunderani told VICE News his is the only company in North America that manufactures them.
Starting next week, Brothers Pharmacy in Winnipeg will sell the tests for $5 each. The owner, Michael Watts, hopes the local health authority and other pharmacies will follow suit so the kits will reach recreational drug users, and frontline workers.
"The whole world of opioid addiction is very under-serviced right now," Watts said over the phone. "If overdose deaths are something that can prevent with this, then why not make it easily accessible."
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And the difference can be between life or death. The province of BC is under a state emergency over the opioid crisis and is expecting several hundred fentanyl overdose deaths by the end of this year. No other province or territory is tracking overdoses involving fentanyl in real-time, but it's believed around 2,000 people in Canada will die from it and other opioids this year.
Sunderani added that the kits come in packages of 100, but that no health ministry or big pharmacy chain in Canada has inquired about ordering them.
"I have a feeling that because this is going to drug addicts, [big pharmacy chains] don't really like drug addicts to come into their shops. I personally think this is more suited to people like Insite," he said.
He cautioned, however, that research hasn't looked at the effectiveness of using the kits this way.
"In order to scientifically validate us, we need real drug samples. We aren't a drug company, we can't get ahold of the drugs," explained Sunderani. "We aren't going out there to make a scientific case that it works, although Insite says it's working."
More than 330 tests at Insite on drugs ranging from heroin to cocaine have tested positive for fentanyl—around 85 percent of the total tests conducted so far. It's confirmed fears that much of Vancouver's drug supply has been tainted with the deadly opioid. While the tests can detect the presence of fentanyl, it can't determine the quantity. Even a small amount can be fatal.
Insite staff report that a positive fentanyl test rarely dissuades people from using the drugs, but that many users will lower the dose they consume.
Winnipeg has recently seen a spike in fentanyl overdoses around the city, and police there recently seized a massive supply of blotter papers containing carfentanil, the opioid that's far stronger than fentanyl and is meant to be used as a tranquilizer for elephants and other large wild animals.
The city has two clinics that prescribe methadone—a medication that treats opiate addiction by keeping the withdrawal symptoms at bay. And Watts' pharmacy dispenses the methadone to the patients. He says many clients have admitted to using other drugs, some laced with fentanyl, and he was looking for a way to help keep them safe from overdosing.
"You have to assume they are using fentanyl, some patients will admit it, while others swear up and down they aren't using it," said Watts. "And for our patients, it's piece of mind that the stuff they are using doesn't have anything laced."
He added that a group of local mothers who work on addictions awareness will be learning how to use the strips once they arrive at the shop. "It's interesting for parents who tell their kids that if they are going to use, then make sure your stuff is clean."
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