Drug Alert Re: Increase in Fentanyl Potency or Toxicity and Drug-Related Deaths

Public Health Services (PHS) is notifying healthcare providers of recent information on the local circulating drug supply and an increase in suspect drug-related deaths observed this week.

PHS has been made aware that there may be fentanyl with either an increased potency or toxicity that is circulating in the local drug supply. Locally, since July 3, 2023 the Office of the Chief Coroner has advised there has been 4 suspect drug related deaths in the community. There has also been incidents of increased EMS calls and suspected overdose-related ED visits from June 25-present.

This is a reminder that dangerous and unpredictable drugs continue to circulate locally. It is recommended that people who use drugs carry naloxone and visit the local Consumption and Treatment Services (CTS) site or call the National Overdose Response Service 1-888-688-NORS (6677) to avoid using alone.

Please see below for a list of recommendations to reinforce harm reduction messaging with clients.

For more information related to this medical advisory, please call the Harm Reduction Intake Line Monday to Friday 8:30 am to 4:30 pm at 905-546-4276

Recommendations for Healthcare Providers

Reinforce harm reduction messaging with patients who use illicit drugs.

Careful Use. Test the effect by using a small amount first and avoid using drugs alone.

• Use with a friend, avoid using drugs at the same time so that one person may respond in the case of a drug poisoning event.
• Call a friend, family member or the National Overdose Response Service at 1-888-688-NORS (6677) for anonymous 24-hour support before and while using substances.
• Use drugs in a supervised consumption site, like the Consumption and Treatment Services site located at 70 James St. S in Hamilton.

Carry Naloxone. It is ineffective in response to certain additions such as xylazine/ benzodiazepine toxicity but will help with any opioids.

Call 911. In cases of a suspected drug poisoning call 911 and administer Naloxone.

• Perform CPR while awaiting support.
• Multiple rounds of Naloxone may be required to respond.
• The Good Samaritan Drug Overdose Act provides some legal protection for persons seeking emergency help.

Wound Care. Seek medical support for any unusual wounds or lesions.

Connect patients with additional support services or resources when possible.

Naloxone. Obtain free Naloxone kits at various service locations in Hamilton.

Community Supports. The following agencies provide a variety of harm reduction supports:

• Pharmacy Naloxone Program / Drug & Alcohol Helpline: 1-800-565-8603
• The Aids Network (harm reduction supplies and HIV support): 1-866-563-0563
• The Hub (drop-in support and service navigation): 365-833-7854
• The Van (harm reduction supplies): 1-866-563-0563
• Grenfell Ministries (low-barrier supports for people who use drugs): 1-855-923-9363
• Support and Safer Supply, SASS Clinic (clinic providing prescribed alternatives to the illicit drug supply): 1-833-426-7678 ext.2

Treatment Services

• Alcohol, Drug & Gambling Services: 905-546-3606
• St. Joseph's Healthcare Hamilton Womankind Addiction Service: 905-545-9100
• St. Joseph's Healthcare Hamilton Men's Addiction Service: 905-527-9264
• Alternatives for Youth (youth ages 12-25): 905-527-4469 ext. 3 for intake (referral form available at www.ay.on.ca)

Opioid Agonist Therapies (OAT). For people with opioid use disorder, access to opioid agonist treatments like buprenorphine (Suboxone), methadone, and slow-release oral morphine (Kadian) is available at rapid access addiction medicine clinics.

• RAAM Clinic Hamilton (referral form available at www.stjoes.ca)