Community Drug Alerts

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August 18: The Overdose Monitoring Alert and Response System (OMARS) is issuing an Extended Community Drug Alert for Waterloo Region.  
There were 25 suspected overdoses/drug poisonings and 3 suspected drug-related deaths in Waterloo Region from August 14 to August 17. 
This is an extension of the alert issued August 4.
The street drug supply is highly toxic: street drugs may be different than expected and may cause unexpected reactions.
People who use unregulated (street) fentanyl may be at greater risk for overdose/ drug poisoning. Sanguen’s Drug Checking Program found:
  • Fentanyl with high amounts of Medetomidine and other opioids (Para-fluorofentanyl and suspected Nitazenes)
  • Fentanyl with long-acting benzodiazepines (Flubromazepam and Gidazepam)
  • Fentanyl is stronger than expected
There are reports of:
  • Complex overdoses. Deep sleepiness (on the nod, heavily sedated) and a very low heart rate. These are signs to go to the hospital.
  • Complex withdrawal. Signs to go to the hospital:
    • Throwing up a lot
    • Chest pain
    • Going in and out of awareness
    • Very high heart rate and blood pressure

See the full printable version of the alert.

For tips to stay safe if using drugs, click here.   

Drugs found through Sanguen Health Centre’s Drug Checking Program
The drugs below were found unexpectedly in fentanyl samples. People who use unregulated (street) fentanyl may be at greater risk. Opioids, tranquilizers, or benzodiazepine mixed with any of these drugs increases risk for overdose/ drug poisoning because their dangerous effects become stronger when they are together.

Medetomidine

  • What is it? A strong sedative, like xylazine but much stronger. Not an opioid.
  • Effects: Last a long time (90 minutes or several hours). Deep sleepiness (on the nod, heavily sedated).
    • Passing out. People may be hard to wake up.
    • Slow breathing, heart rate, and blood pressure.
    • May cause hallucinations or confusion.
    • Dizziness, nausea, vomiting.
  • Medetomidine Withdrawal: Can start quickly and be very serious. Signs to go to the hospital:
    • can’t stop throwing up.
    • chest pain.
    • going in and out of awareness
Para-fluorofentanyl 
  • Effects:
    • Deep sleepiness (on the nod, heavily sedated). 
    • Passing out. People may be hard to wake up. 
    • Slow breathing, heart rate, and blood pressure
 
Nitazenes
  • What is it? A very strong unregulated opioid.
  • Test your drugs with Nitazene test strips. A positive result could mean Nitazenes are in your drugs.
  • Effects:
    • Deep sleepiness (on the nod, heavily sedated).
    • Passing out. People may be hard to wake up.
    • Slow breathing, heart rate, and blood pressure.
    • Very low or no pulse.
 
Fentanyl
  • What is it? A strong opioid.
  • Test your drugs with fentanyl test strips. A positive result could mean fentanyl is in your drugs. 
  • Fentanyl was found to be stronger than expected. People who use unregulated (street) fentanyl may be at greater risk for overdose/ drug poisoning.  
  • Effects:
    • Slows breathing and heart rate.
    • People may be hard to wake up (heavily sedated). 
    • Memory loss.
    • Feeling of a stiff or tight chest.
Benzodiazepine (“benzo”) – including Gidazepam and Flubromazepam
  • What is it? A strong sedative. Not an opioid.
    • Flubromazepam is a strong long-acting benzodiazepine. Effects are strong and last a long time
    • Gidazepam is a long-acting benzodiazepine. Effects may not be as strong as other benzodiazepines but last a lot longer.
  • Effects:
    • Deep sleepiness (on the nod, heavily sedated).
    • Passing out. People may be hard to wake up.
    • Slow breathing, heart rate, and blood pressure.
    • Blackouts (memory loss).
    • Slurred speech, trouble focusing eyes, poor balance.

What to do:  

  1. Shout their name and shake their shoulders. 
  2. Call 911 if they won’t wake up or if breathing is very slow or not at all.
  3. Give naloxone.
  • Fentanyl, para-fluorofentanyl, and nitazenes and are opioids. Naloxone will work on these drugs.
  • Medetomidine and benzodiazepines are not opioids. Naloxone cannot stop the effects of medetomidine or benzodiazepines. Give naloxone because it will work on opioids that may be mixed in the drugs.
  1. Check that the person is breathing regularly. They may not wake up right away. Perform rescue breathing or give oxygen if you can.
  2. Additional doses of naloxone may be needed. Give another dose every 2-3 minutes until breathing is back to normal.
  • If they are very sedated (sleepy) but still breathing, encourage them to keep breathing.  
  • Stay with them until help arrives. 

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About community drug alerts

The OMARS (Overdose Monitoring, Alert and Response System) Committee monitors data and information about overdoses in Waterloo Region. OMARS issues community drug alerts to warn people who use drugs and service providers when there is a higher risk of overdose in Waterloo Region because of,

  • A sudden spike in 911 calls for overdoses in a short time 
  • A sudden spike in suspected drug-related deaths in a short time 
  • Unexpected drugs found in the local unregulated supply 
  • Unexpected reactions to drugs in the local unregulated supply 

The unregulated drug supply is highly toxic. Anyone who uses these drugs is at risk of harms including overdose and death. For more safety information while using drugs, see our drug page.  

If you have had an unexpected reaction to street drugs, or an overdose, OMARS encourages you to talk with a harm reduction worker. 

Resources

Past alerts

Community Drug Alerts

 

 

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