What is the purpose of this alert?
Between May 20 and June 5, 2020, a synthetic cannabinoid we haven’t seen before was found in 30% (9) of the opioid samples checked by Toronto’s drug checking service. This synthetic cannabinoid is known as ACHMINACA and was found in trace amounts, alongside fentanyl and heroin. The presence of ACHMINACA was not expected by those who submitted the samples to be checked. These samples were collected in Toronto’s west end and downtown core.
As far as we know, ACHMINACA hasn’t been found mixed with opioids anywhere else in Canada. We are sharing this alert to inform people who use drugs, as well as those who support and provide care for them.
What is ACHMINACA?
ACHMINACA is a synthetic cannabinoid. Synthetic cannabinoids are manufactured to be like THC, which is the main psychoactive component in cannabis, but can produce significant negative effects. Unfortunately, we don’t know a lot about the exact strength or effects of ACHMINACA. What we do know is that ACHMINACA belongs to a family of synthetic cannabinoids that are very strong. In fact, synthetic cannabinoids can be between 2 and 100 times stronger than THC.
The effects of synthetic cannabinoids may be intense – even by consuming very small amounts. Common side effects include distorted perception of time, having difficultly moving, increased heart rate, hallucinations, paranoia, confusion, fear, agitation, anxiety, nausea, and vomiting. More severe side effects include rapid loss of consciousness, chest pain or stroke, seizures and involuntary movement, high blood pressure, acute kidney injury, psychosis, aggressive and violent behaviour, and even death.
When synthetic cannabinoids (ACHMINACA or AMB-FUBINACA) have presented alongside opioids in samples we’ve checked, they’ve generally been in trace amounts (less than 5% of drugs found). At this and other amounts, it is unlikely to be able to identify synthetic cannabinoids by sight or taste.
What are the potential effects of using ACHMINACA in combination with opioids?
Unlike cannabis, synthetic cannabinoids have been known to suppress breathing and other vitals during overdose situations. When synthetic cannabinoids and opioids are used together, the risk of dangerous suppression of vitals is increased. This is also true for synthetic cannabinoids in combination with other central nervous system depressants, like benzodiazepines or benzodiazepine-related drugs, which are presenting in over 30% of all opioid samples we’ve checked. Unfortunately, we don’t know much more about the effects of using opioids and synthetic cannabinoids together.
Advice to reduce potential harms
- Get your drugs checked before using. In Toronto, drug checking services are offered at Parkdale Queen West Community Health Centre (Queen West site), South Riverdale Community Health Centre, and The Works at Toronto Public Health. You can also check your drugs after you’ve used them by submitting paraphernalia, like a cooker or a filter.
- Use at a supervised consumption site or overdose prevention site. Here is a list of sites that offer supervised consumption in Toronto.
- Use with someone else and take turns spotting for each other. Stay 6 feet from your buddy if you are not from the same household to avoid passing COVID-19. A buddy system is safer than using alone. If you must use alone, call someone you know and have them stay on the phone with you while you use. Tell them your address and keep your door unlocked. Alternatively, you could call the Overdose Prevention Line at 1-888-853-8542 if you are about to use drugs and are located in Ontario.
- Do a small test dose first.
- Carry and be trained to use naloxone, which can be picked up for free from your local frontline harm reduction agency or pharmacy.
- Call 911 in an overdose situation. The Good Samaritan Drug Overdose Act provides legal protection from drug-related charges for carrying drugs for personal use and other simple possession offences.
- If your drugs did not contain what you were expecting, consider talking to the person you got your drugs from, or get your drugs from another source if possible.