'Bionic' opioid 100 times stronger than fentanyl may already be on Canadian streets

As a former drug addict, Byron Klingbyle knows all too well the dangers of addiction. In recovery for close to 20 years, the 59-year-old now counsels others dealing with substance abuse.

In his hometown of Windsor, Ont., the drugs of choice are opioids, such as oxycontin, morphine and fentanyl. But a new street drug, one so toxicit's primarily used to sedate elephants, has him worried.

"It's10,000 times more powerful thanmorphine, 100 times stronger than fentanyl," Klingbyle said. "It's not for human consumption. It's for large animals."

He's referring to carfentanil, a synthetic opioid so deadly police sayas little as 20 micrograms would be fatal to the average person, with one microgram being smaller than a grain of salt.

Carfentanil is more commonly used in zoosand by wildlife workersas a tranquilizer for elephants and other large animals. Parts of the U.S. have recently seen an alarming number of carfentanil overdoses. Ohio, for example, had 25 overdoses in just a three-day period in July.

'Superhuman drug'

In many cases of overdose, the carfentanilhas beenmixed into heroin, at timeswithout the drug user's knowledge. Police in East Liverpool, Ohio, said they suspect carfentanillwasinvolved inthe case of a couple who were photographed overdosing in their car and whosephotos were posted onlineby police as a wayof attracting attention to the drug problems officers are dealing with.

"It wouldn't surprise me at all to know that we got more and more bionic opioids responsible for mortality on our streets,"said Dr.HakiqueVirani,medical director at Metro City Medical Clinic, an addiction treatment centre in Edmonton.

'Micrograms of a dosage of theseopioidscan kill and have killed.'- Dr.HakiqueVirani

"When we describe this as a superhuman drug, it's not to attract people to it.It's because it's literally what it is, where micrograms of a dosage of these opioids can kill and have killed."

Virani, who is also an assistant clinical professorin the division of preventative medicine at the University of Alberta Faculty of Medicine,says that while addicts might live in fear thatthe next hit will be their last, that fear is not enough to curb demand.

"There's a demand driving this opioid crisis, and organized crime is meeting that demand with more and more toxic opioids, because they're easier to traffic," he said.

Calgary-bound package intercepted

Police say carfentanil is likely manufactured in China and shipped to drug traffickers in Mexico. From there,itenters the U.S. and, eventually,Canada.

In June, Canadian border officials intercepted a package in Vancouver containing a kilogram of carfentanil. It was bound for Calgary.

"We're extremely concerned about this, and it really takes an international collaboration to stop the importation of this," said Calgary Police Service Staff Sgt. Martin Schiavetta.

Last weekin Winnipeg, policeseized about 1,500blotter tabsthat they believe contain carfentanil.

"Typically, when police seize something, it's not the first shipment that's tried to make its way across the border," Virani said.

He saysopioid addictionis a public health emergency.

"To deal with this problem, we require extraordinary measures, because clearly, our ordinary measures aren't working."

A game of whack-a-mole

He says a co-ordinated, all-hands-on-deck approach is needed from the health community, law enforcement and the justicesystem.

"I have yet to meet a police officer who has said they can arrest their way out of this problem, and I have yet to meet a judge who's said that he can incarcerate his way out of this problem, and I certainly hope that health isn't thinking [they can] ignore-and-wait their way out of this problem, because it is clear it is getting worse and worse and worse."

He says the changes that are needed include:

• Opening more supervised injection sites.
• Ramping up treatment for opioid addicts.
• Equipping first responders with naloxone, the medication used to reverse an opioid overdose.
• Improving measurement of morbidity and mortality rates foropioid-related deaths.

ButVirani fearsthat until a comprehensive approach is developed, the opioid epidemic will continue to grow.

"[I]expect this to be much like a game of whack-a-mole, where you knock down a traffickerbut something else will come up. History has taught us that the next thing that pops up will be more toxic and more frightening," he said.