Vol. 79, No. 1Just the facts

Fentanyl patch.


Credit: Julie Laflamme, RCMP


Fentanyl is a fast-acting opiate that's estimated to be 100 times more potent than morphine. It has legitimate clinical uses for treating chronic pain, but is extremely dangerous when consumed illicitly. It's a growing danger — both in Canada, and around the world.

  • According to the B.C. Coroners Service, there were 238 illicit drug overdose deaths from January to June 2016, which is a 250 per cent increase over the same period in 2015. Fentanyl was detected in over half of these deaths.
  • Fentanyl is often stamped into pill form and sold on the street as oxycodone. Less commonly, it's diluted and sold as counterfeit or synthetic heroin. The drug also comes in patch form for long-term pain relief, and these patches are often sold, partially used, on the black market.
  • The Canadian Association of Chiefs of Police has reported that fentanyl addicts can consume up to 15 pills a day, which is a $300-per-day habit. In order to fund their addiction, many turn to property, sex, and drug crimes, which provide only 10 to 20 per cent financial return — requiring thefts of $3,000 or more per day to fund their habit.
  • According to the United States Drug Enforcement Agency, the primary source of illicit fentanyl is China. Organized crime and independent dealers are able to buy the drug online and have it shipped across the border, with many Chinese manufacturers even offering free replacements if the first shipment is seized.
  • A recent United Nations report found that Canada consumes the most prescription opioids (includes natural opium and synthetic or semi-synthetic drugs that emulate opium) per capita of any country in the world. Many users begin with legitimate prescriptions but end up turning to the opiate black market to feed their growing addiction.
  • Pill presses, the machines used to convert fentanyl into tablet form, aren't regulated in Canada or China. The Canadian Association of Chiefs of Police has called for new legislation to prevent pill presses from entering the country without being registered.
  • A single kilogram of fentanyl, worth a few thousand dollars, can be cut down into more than 100,000 pills — worth millions on the street, according to the U.S. Drug Enforcement Agency.
  • Street names for fentanyl or fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash, according to the U.S. National Institute on Drug Abuse.
  • In 2013, North Bay, Ont. launched the "Patch 4 Patch" initiative, requiring patients to return their used fentanyl patches before refilling a prescription. By preventing individuals from reselling their used patches on the black market, the local fentanyl trade dried up. This initiative is expected to become an Ontario-wide law soon.
  • Naloxone is a drug that can be injected to quickly counter the effects of fentanyl overdose. Ambulances in Western Canada already carry naloxone kits to allow for a rapid response to overdosing patients, and Health Canada has deregulated the drug to help speed its uptake by the rest of the country.
  • The Canadian Centre on Substance Abuse reported in 2015 that there were 655 fentanyl-caused deaths across all of Canada from 2009–2014 — a figure that the report notes is likely an underestimate. In Ontario, fentanyl is now the leading cause of opioid-related deaths.
  • According to the European Monitoring Centre for Drugs and Drug Addiction, a lethal dose of pure fentanyl is two milligrams. Fentanyl can be absorbed through the skin, so extreme caution is advised when handling unknown substances.
  • Because of widespread abuse, the popular painkiller oxycodone changed its formula to be less addictive in 2012. As a result, nearly all oxycodones being sold on the street today are actually fentanyl in disguise. In Canada, these counterfeit pills are often coloured green and stamped "CDN 80" to emulate the appearance of pre-2012 oxycodone.
  • In 2015, there were more than 13,000 forensic exhibits of fentanyl tested by the United States Drug Enforcement Agency — a 65 per cent increase from 2014.
  • Even as police crack down on fentanyl, more powerful substitutes are beginning to appear. Shipments of carfentanil and W-18, which are both 100 times stronger than fentanyl, have recently been seized by police in Canada.
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