A new substance making its way into the Ontario drug supply has caused the city of Belleville to declare a state of emergency, and the City of Greater Sudbury’s Community Drug Strategy to issue an alert.
Though the ingredient has not yet been found in Sudbury, a release issued by Public Health Sudbury and Districts aims to spread the word of its risk before it arrives.
Medetomidine and dexmedetomidine are tranquilizers used for animals and humans for sedation and pain relief. More potent than Xylazine, which is already causing harm in the Nickel City, these substances have sedative, analgesic, anxiolytic and muscle-relaxant properties.
Much like Xylazine, the substance is used to add “legs” to the high from the substance. The release suggests that medetomidine/dexmedetomidine is being added to unregulated fentanyl to mimic or enhance the sedative and euphoric effects of the opioid a person is using.
Belleville was rocked by a rash of drug poisonings last week thanks to the substance, with the mayor declaring a state of emergency, saying the city's growing addiction, mental health and homelessness crisis and its immense strain on local emergency services.
The municipality of about 55,000 residents stated its emergency crews responded to 17 overdoses in 24 hours. No related deaths were reported, but local police urged residents to stay away from the downtown core during the surge in ambulance traffic.
Hastings-Quinte Paramedic Services told the Canadian Press that within a 2.5 hour timeframe, ambulances responded to 13 opioid related calls and nine patients were transported to hospital on a high priority. The region's paramedics cover a 200-kilometre area and at peak capacity they have 14 ambulances on the road, with six stationed in Belleville.
While they can’t confirm the substance is here in town, the Community Drug Strategy states they receive ongoing reports from frontline workers regarding “unexpected reactions from the use of toxic substances such as:
- Increased and prolonged sedation
- Need for additional naloxone administration in the event of an overdose
- Increased number of suspected overdoses
- Changes in mood (fear and delusions noted
Adverse effects of the medetomidine include:
- Acute harms associated with medetomidine/dexmedetomidine include:
- deep state of unconsciousness
- cardiac and circulatory system depression
- respiratory depression
- dry mouth
- dilated pupils
- hypothermia
- spontaneous muscle contractions (twitching)
- low heart rate
- initial hypertension, followed by prolonged hypotension
The risk of extreme drowsiness and sedation is increased when medetomidine and dexmedetomidine are used in combination with high-potency opioids, benzodiazepine-related drugs and xylazine. This is noteworthy because 100 per cent of the samples checked by Toronto’s Drug Checking Service that contained medetomidine/dexmedetomidine also contained at least one high-potency opioid.
The Community Drug Strategy issued the alert to warn those who use substances of the possible presence of medetomidine, that anyone using any unregulated substance should have immediate access to naloxone.
They also encourage people to not use drugs alone, and encourage people who use drugs to access a supervised setting such as a supervised consumption site, where available.
Here in Sudbury, the supervised consumption site might only be available until the end of February, unless continued or permanent funding becomes available.