Drug Cocktails Becoming Increasingly Toxic

The street drug supply in Canada includes more and more highly potent mixes with opioids like fentanyl, creating an unpredictable and often unidentifiable mixture of substances that leave frontline medical personnel scrambling at how to treat overdoses. Even the usual tools to help prevent overdose deaths do not always perform as intended.

Benzodiazepines (benzos) don’t respond to Naloxone, although this treatment can reverse the effects of opioids, which are often mixed with benzos. Many who purchase opioids on the street have no idea what has been mixed in with the drugs they purchase, and community-based treatment programs can’t always handle the longer-term care necessary.

“It means people who overdose on opioids mixed with benzodiazepines are harder and more complex to treat,” says Dr. Paxton Bach, an addiction medicine specialist at St Paul’s Hospital in Vancouver. Drug users who unknowingly take opioids cut with benzos can lose consciousness for hours or days, leaving them highly vulnerable.

“It makes you very, very susceptible to robbery, sexual assault, or just waking up in a really unsafe situation,” Bach said. Both short- and long-term solutions must be identified to address the growing toxicity of street drugs, in addition to better supports for those experiencing poverty, homelessness, and mental health issues.

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