A significant fraction of people who use opioids in the metropolis could be unknowingly exposed to a tranquilizer for horses, xylazine, which is already wreaking havoc elsewhere in Canada and the United States.
The product was detected in 30% of 50 urine samples provided in a recent study by drug users who had used fentanyl or one of its derivatives, detailed data provided Thursday showed. The Press by the Regional Public Health Department (DRSP) of Montreal.
The organization had launched a call for vigilance in a document sent at the beginning of the day to stakeholders in the health sector, indicating that it had “confirmed significant exposure” to xylazine in the metropolis.
The text cited the preliminary results of a screening study showing that 5% of 300 urine samples collected in the fall of 2022 in Montreal from illicit drug users with various profiles contained the tranquilizer.
However, it did not specify the contamination rate obtained by considering only the samples also containing fentanyl or one of its derivatives.
PHOTO HILARY SWIFT, THE NEW YORK TIMES
Makeshift encampment in the Kensington neighborhood of Philadelphia where xylazine is wreaking havoc among illicit drug users.
Xylazine is being used more and more often to cut drugs of this nature. In some particularly affected cities in the United States, such as Philadelphia, nearly 90% of fentanyl samples analyzed in the laboratory contain it.
The DD Carole Morissette, medical adviser attached to the DRSP of Montreal, indicated in an interview Thursday morning that the contamination rate noted at 5% was “worrying”, but only gave a partial picture of the seriousness of the situation, particularly in regarding opioids. More detailed information on this subject was subsequently sent to The Press.
Xylazine increases the risk of overdose when used in combination with opioids such as fentanyl and can lead to significant skin damage if taken chronically.
Authorities on the alert
The Montreal DRSP asked in its call for vigilance that clinicians in the health network report “as soon as possible” any case of overdose presenting symptoms “compatible” with the presence of xylazine. Community workers are also called upon to “intensify” preventive actions.
Ontario health authorities have also sounded the alarm recently about the growing presence of the tranquilizer in the province’s illicit drug supply.
Health Canada, for its part, is concerned about the increase in the number of samples analyzed in its laboratories that contain it and plans to more closely regulate the sale of the product in the veterinary sector to prevent abuse.
Vermont, which borders Quebec, also multiplies the warnings by noting that the tranquilizer is detected in a growing number of overdose cases.
Toxic and complex
The situation in Quebec is not well known since establishments do not systematically check for the presence of xylazine. The DD Morissette said on Thursday that efforts were underway, in particular to strengthen the analytical capacities of key laboratories.
The DD Marie-Ève Goyer, who is the medical head of addiction and homelessness programs at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, is not surprised that tranquilizers are present in the illicit drugs of Province.
We often run after the train in Quebec. We do not detect in real time what is happening. When we see it happening to our neighbours, we say to ourselves that it will come to us, but it is often already there.
The DD Marie-Ève Goyer, Medical Head of Addiction and Homelessness Programs at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal
The specialist points out that the illicit drug market is changing at full speed and that increasingly toxic and dangerous contaminants are appearing, complicating the task of responders in the field.
“I’ve never seen what I see now in my patients,” says the doctor, who says he is unable to treat certain cases with traditional molecules such as methadone due to the complexity and toxicity of the products consumed.
“At the medical level, I will never be able to win this battle,” she notes.
More services to analyze the content of illicit drugs before consumption and rapid testing efforts in clinics and hospitals could help curb the problem caused by the arrival of xylazine and other dangerous contaminants, notes the DD Goyer.
“But it will take a decision to expand the tests and it will cost money,” recalls the doctor, who would like to see drug addiction problems receive as much attention from Quebec society as COVID-19.
Learn more
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- 1350
- Number of illicit drug samples tested in 2022 across the country in Health Canada laboratories that contained xylazine
Source: Health Canada