- 123 samples were checked: 72% were substances1 and 28% were used paraphernalia2
- 65% of the samples checked were expected3 to be fentanyl or cocaine
- 20% of the expected3 fentanyl samples checked were known to be associated with an overdose: most of these samples contained fentanyl, caffeine, and a benzodiazepine-related drug
- We published an alert about the introduction of highly potent opioid etonitazene in samples checked
- Highly potent opioids isotonitazene and carfentanil continue to present in expected3 fentanyl samples checked
- 59% of expected3 fentanyl samples checked contained at least one benzodiazepine-related drug
Expected fentanyl substances
- 78% (25) of expected3 fentanyl substances checked4 contained fentanyl and other drugs, including:
- 92% (23) contained caffeine
- 80% (20) contained a benzodiazepine-related drug (!):
- 68% (17) contained etizolam (!)
- 56% (14) contained deschloroetizolam (!)
- 16% (4) contained bromazolam (!)
- 16% (4) contained flualprazolam (!)
- 8% (2) contained flubromazolam (!)
- 4% (1) contained alprazolam (Xanax) (!)
- 48% (12) contained despropionyl fentanyl (4-ANPP) (!)
- 20% (5) contained cocaine
- 12% (3) contained phenacetin (!)
- 8% (2) contained furanyl UF-17 (opioid-related) (!)
- 4% (1) contained acetyl fentanyl (!)
- 4% (1) contained xylazine (!)
Unexpected noteworthy drugs found in other expected substances
- 23% (13) of the remaining substances checked,4 meaning substances that weren’t expected3 to be fentanyl, contained an unexpected noteworthy drug, including:
- 26% (5) of expected cocaine substances contained levamisole (!)
- 21% (4) of expected cocaine substances contained a benzodiazepine-related drug (!)
- 11% (2) of expected cocaine substances contained phenacetin (!)
- 100% (2) of expected crack cocaine substances contained phenacetin (!)
- 50% (1) of expected heroin substances contained fentanyl (!)
1 | Substances: Two types of samples are accepted by Toronto’s drug checking service: substances and used paraphernalia. Substances could be a small amount of powder, a crushed bit of a pill, blotter, or a small amount of liquid.
2 | Used paraphernalia: Two types of samples are accepted by Toronto’s drug checking service: substances and used paraphernalia. Used paraphernalia could be a used cooker or filter, or leftover liquid from a syringe.
3 | Expected (drug): When a sample is submitted to be checked, the drug that sample is expected to contain is recorded. We call it the “expected drug”. Knowing the expected drug helps us tailor our harm reduction advice. It also helps us understand contamination to drugs rather than combinations of drugs (e.g., fentanyl was found in a cocaine sample rather than fentanyl and cocaine were found together).
4 | Reason for reporting only substance samples: While Toronto’s drug checking service checks both substances and used paraphernalia, we’re sharing findings from substances only. Paraphernalia, like cookers, are often re-used. The mass spectrometry technologies used for this drug checking service are so sensitive that very trace amounts of drugs may be found. This means that when paraphernalia is re-used, drugs from past use may present in the results for the sample that is being checked. This can interfere with up-to-date drug supply monitoring, so we’ve excluded used paraphernalia from this report.
(!) | Unexpected noteworthy drug: “Noteworthy drugs” are drugs that that (i) are linked to overdose or other adverse effects, (ii) are highly potent or related to highly potent drugs, or (iii) may not be desired by some clients. Noteworthy drugs are flagged when they are unexpectedly found in checked samples.