Amazon, but for deadly drugs: Why fentanyl and W-18 are here to stay

published on May 24, 2016 by Nick Eagland in The Vancouver Sun

On a sunny May morning in Vancouver’s Downtown Eastside, it takes justeight minutes to find a fentanyl dealer.

“Alan,” who speakson the condition his real name not be reported, says he has customers who seek it exclusively.

For $30 to $80, he’ll sell patches of Teva or Ratio brand fentanyl, which doctors typically prescribe for relief ofchronic, acute pain in cancer patients.

Dr. Seonaid Nolan, aclinician scientist attheBC Centre for Excellence in HIV/AIDS and addiction medicine physician at St. Paul’s Hospital, said the hospital’s doctors haven’t been specificallytesting patients for presence of W-18.

But there have been some concerning cases.

“I have seen two patients in particular who have come through the emergency department whose urine drug screens have been negative for all opiates and opiate metabolites, but whose clinical presentation seemed consistent with an opiate overdose,” Seonaid Nolanaid.

“One patient in particular did require a long-term Narcan (naloxone) infusion for treatment of that.”

BC’s chief coroner, Lisa Lapointe, said there have been cases”highly suggestive” ofanoverdose, but the toxicology report has come back negative.

“We suspect that what’s happened in those situations is that there’s another fentanyl analogue, so it’s a synthetic opioid, a synthetic fentanyl, but it’s slightly different in its makeup, and our lab hasn’t been able to test for it yet,” Lapointe said.

But with W-18, Lapointe said one of the challenges is because it’s so strong, “the amount that would kill a person would be so small that the sensitivity to detect it is going to be very, very challenging. It’s terrifying.”

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