Montreal father warns against counterfeit synthetic opioids after death of teen son

A father wants to spread awareness about synthetic opioids sold to teens after he says his son died of an overdose.

Christian Boivin says 15-year-old Mathis was a normal teenager with many friends who loved life, travelling andmusic. His life was cut short on Dec. 21 when he took a drug known as isotonitazene thinking it was oxycodone, said Boivin.

"For us it was a normal day. We had dinner with him. He went to his bedroom after that to play video games with a friend," he said.

"In the morning at eight, I was listening to his alarm and went, 'Mathis, Mathis!' I entered his bedroom, 'Mathis! Mathis!' But it was too late."

Boivin said that's when they found a bottle of blue pills. Mathis had been vaping and tried smoking cannabis, and was open about it with his father who wanted him to consume safely. Boivin said Mathis had told some of his friends he wanted to try oxycodone.

"I said 'OK,Mathis, but don't take the blue pills, please.' And he took the blue pills," said Boivin.

"Kids and even adults, everyone, don't even try it. Mathis tried it and he died at the first experience. Even once is too much."

What is isotonitazene?

Isotonitazene is a synthetic opioid, more potent than fentanyl, that started showing up in Canada's streets in 2019. Montreal Public Health issued a warning that tablets containing isotonitazene were being sold as oxycodone in November 2020.

Since then, the opioid has been detected in the post-mortem toxicological analyses of 14 people in the city. According to Montreal Public Health, an isotonitazene overdose can cause respiratory failure. For people who have never taken opioids before, a single dose can be deadly.

"The risk is very high," said Jean-Franois Mary, the executive director of CACTUS Montreal, a community organization that focuses on harm reduction.

"Without tolerance, and without help from a seasoned fentanyl user, it's sure to lead to a severe overdose and death if the person is alone, without someone with Naloxone trained at CPR."

Nicholas Chadi, a pediatrician with a specialization in addiction, says he has treated teens who overdosed on isotonitazene. Though none of his patients died, he says some are left with long-lasting health consequences like heart or brain damage.

How to prevent overdoses?

Naloxone which is available for free in Quebec's pharmacies can reverse an overdose, but it's becoming more common to need up to three or fourvial to do so effectively, said Mary.

CACTUS offers safe consumption sites, free naloxone kits and harm reduction information. Mary saysthere were 100 fentanyl overdoses in CACTUS's safe consumption room lastOctober,and 80 in November. There were no deaths as those who use the service are frequent users and staff members are on hand to revive them.

Mary says most synthetic opioids on the street are fentanyl analogues, which are relatively simple to make, but isotonitazene is becoming an attractive alternative with increased substance control.

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Test kits exist to detect fentanyl in recreational drugs, but there are no strips that recognize isotonitazene yet.

Mary said the synthetic opioid black market is like a game of whack-a-mole: The more the law cracks down on a substance, the more potent alternatives pop up.

"The concept is called the iron law of prohibition. Like we did with alcohol prohibition, this regulation system needs to be stopped," he said.

Chadi says decriminalization and legalization of drugs could be one approach, but it'seducation that is key. He says there are already programs in schools to teach curious teenagers about the risks of substance use, even seemingly innocuous ones like alcohol and cannabis.

He says it's best that parents not buy their teens any substances, even if it's to stop them from turningto the black market. He also says to keep any painkillers out of sight.

"It does send the message that it's not so harmful and that there are ways to use it safely as a teen," he said."But substances are not safe for young people."