Why Nanaimo's Fentanyl Overdoses are Stupid

So, here's a piece of irony. At the time of writing this article, I'd just fled the city I lived in to get away from a huge fentanyl problem. I came back home, to Nanaimo - where there had always been a problem with heroin - to find it jam-packed with fentanyl. It's a port city, densely populated with low-income welfare bums, drug dealers, hippies lathered in patchouli, and business-class folk dreaming of relocation - and people hoping to make a cheap buck at the cost of someones' life.

Paula Bronstein/Getty Image

So what's the deal with Fentanyl in Nanaimo?

It's absolute horseshit. Garbage. It's sold as an alternative to heroin , by the point (.01) - supposedly a tenth of a gram. Some people have the decency to let others know the difference between fentanyl and heroin, but a lot of people - users and suppliers - don't have the slightest clue. I've called someone out for selling a mislabeled product at lethal doses and his response was, "uh... I didn't know they could be different."

The fucking RCMP doesn't even know a damn thing about fentanyl, which is a shame. The article says 87 grams of fentanyl was seized, worth around thirty grand and equated to be about 1,400 doses. That's so stupidly inaccurate that I can't even begin to wrap my head around why these people in charge of decommissioning drugs around here. Just because the 87 gram rock you seized had fentanyl in it, does NOT mean it was an 87 gram rock of pure fentanyl. Does a 750ml bottle of whiskey contain 750ml of alcohol? No. Here's some quick math.

• Fentanyl is medically dosed at 20mcg (yes, micrograms) per kilogram for general anesthesia. That means knocking someone the fuck out to the point that you can cut them open and they won't notice. Let's say I weigh 60 kg; a dose to put me into a borderline overdose (aka anesthesia) would be 1200mcg or 1.2 milligrams. MILLIGRAMS.
  THAT MEANS THAT A 1.2 MILLIGRAM DOSE OF FENTANYL WOULD KILL A STREET USER WITHOUT MEDICAL SUPERVISION.  IF THE COPS FOUND 87 GRAMS OF FENTANYL, THAT WOULD BE 87,000 MILLIGRAMS, WHICH WOULD BE ENOUGH TO KILL THE ENTIRE FUCKING POPULATION OF THIS CITY.

If 87 grams of pure fentanyl was sitting around someone's house, people would die just from being there because the goddamn stuff's potent enough that inhaling airborne particles can send you into an overdose. The cops would have absolutely and completely died during their oh-so-accurate 'identification process,' just from rustling the packaging this alleged 87 grams came in.

(Let me also say that I'm well aware that fentanyl comes in a liquid form, pre-dosed for hospitals and pharmacies. This is not the fentanyl that street dealers are dealing with en masse. What they're getting is powder, sourced illegally from some backend lab out in China.)t

The point (ha) I've tried and failed to make to users, is that the shit being sold as fentanyl is dangerously labeled. Here's why -  even if heroin, for some absurd reason, was of a hundred percent purity, it would provide a massive hundred milligrams of DAM (diacetylmorphine, aka heroin) per point.

Conversely, if a "point" of fentanyl was 100% purity you'd have a hundred milligrams of fentanyl - ten thousand fatal doses of the stuff. This is bloody important, and nobody seems to pay attention to it.

"Oh, I'll grab a point of fentanyl Johnny McDealer."
"Sure, I got the best shit in town."

No you don't. If you had the best shit in town, all your customers would be dead (which, in contrast to when I first wrote this article, is a really fucking common occurrence in Nanaimo these days.) More recent and readily available analogues of fentanyl and opiate derivatives - like W18, roughly 10,000 times stronger than morphine, and carfentanyl, of similar potency - have been made available online for even cheaper than fentanyl, which was cheap as fuck to begin with.

Why not deal with something safer?

The idea of a thoughtful, selfless drug dealer is a nice sentiment (and sympathetic dealers do exist, to a degree) but it's never going to be the standard. Drug dealers want money from people, knowing to the fullest extent that they're profiting off their misery.

You could buy enough fentanyl to kill a small city's population for a few hundred bucks (and no, I won't tell you how.) Now, you can get shit that's dozens of times stronger for even cheaper. Seriously, if you handled W18 in a respirator suit through a glass wall wearing gloves, you could kill someone just by having them breathe in the dust off your suit. Maybe even through their own respirator. 

So, yeah. More likely your point is 99% of some unknown crap (caffeine anhydrous is a popular cut, allegedly to provide stimulation  strong enough to power through the overdose that the dealer's selling  to their customer) and a few micrograms of what you actually want to pay for.  That leaves you roughly 1% for the actual active product.

This could kill fifteen people

1% of 100mg leaves a huge fucking margin for error when it comes to drugs this strong. If one junkie's loading his shots of 'fentanyl' with a half point each time he picks up, he's going to keep doing that. One day his dealer doesn't mix his shit well enough and there's a hotspot in the dope where there's five milligrams of fentanyl instead of the couple hundred micrograms El Junko is used to. He/her loads up their half point shot, gets ten times his expected dose, and hits the floor.

This is exactly why so many people are dying. That's why the university and the methadone clinic have started handing out free overdose kits. Shitty dealers, dumb misunderstandings, and overconfidence. Ignorant suppliers don't care if their customers understand their product as long as it sells, and cocky junkies like myself would mutter on our way off, "dealers always say their stuff is really strong." The difference comes into play when their stuff IS really strong, and you're not expecting it to be.

So on one hand we have our resident idiots who are oblivious to what fentanyl is. They have no idea that their point of "fentanyl" contains less than 0.1% of what they're actually paying for. On the other hand, we have Mr and Mrs. Gung-ho, selling a fentanyl product DOZENS of times stronger for the same price, himself just as unwittingly misinformed as the people buying his product.

If these two groups of people meet, things are going to get extremely messy, extremely fast.

(Update: these groups of people are completely fucking interspersed now and there's a tragic overdose every single day.)

How does a thoughtful junkie inform a careless one? They can't. I've had friends die and be resuscitated twice within the same day. Some people don't care or just won't listen.

I've always been loathe to people telling me that death from overdose is caused by stupidity. Sometimes - such as I just described - it can be, and it's not always the stupidity of the user. Most drug users that I know are cautious, caring and concerned for their well-being and that of others. But when unwitting dealers are selling unwitting customers insanely strong dope, mistakes are going to get made and people are going to drop like flies - as they have been.

To tie it all off...

(yes, terrible joke, I know.)

The city's just vastly uninformed about the availability and strength of fentanyl. They're unaware of how EASY it is to just buy a thousand doses of one of fentanyl's cousins for a hundred bucks, buff them down, and have a thousand flaps of 'heroin' that sell for twenty bucks a pop.

A lot of these analogues aren't even illegal yet. I'm not one to support drug prohibition, but this is idiocy.

Aside from warning friends and users - ADAMANTLY - about preparation and safety, there's not a lot  one can do. It's hard to tell an entire populace of addicts about the "insane strength of this new dope," because I'll just sound like every other pusher and they'll seek the stuff out. There's signs everywhere warning about fentanyl. People know its name but not its structure. Telling people "if you inject this stuff, you will quite literally die," is often taken as a challenge. That's what we like to hear our dealers say.

Know your limits, though. Play within them - or else.

RealOverdose