Key findings
- 141 samples were checked: 80% were substances1 and 20% were used equipment2
- 64% of the samples checked were expected3 to be fentanyl, MDMA, or cocaine
- In an average5 fentanyl substance1:
- Fentanyl accounted for 4% of the sample (n=26)
- Caffeine accounted for 15% of the sample (n=27)
- 7% of the expected3 fentanyl samples checked were known to be associated with an overdose: all contained fentanyl and half contained at least one benzodiazepine-related drug
- 26% of the expected3 fentanyl samples checked contained benzodiazepine-related drug(s) and/or xylazine. Of those:
- 20% contained benzodiazepine-related drug(s) and xylazine
- 80% contained benzodiazepine-related drug(s) (but no xylazine)
- 7% of the expected3 fentanyl samples checked contained carfentanil
- 5% of the expected3 fentanyl samples checked contained fluorofentanyl, which is considered to be similarly potent to fentanyl
- 5% of the expected3 fentanyl samples checked contained at least one nitazene opioid
- 2% of the expected3 fentanyl samples checked contained AMB-FUBINACA (a synthetic cannabinoid-related drug)
Expected fentanyl substances
- 78% (25) of expected3 fentanyl substances checked4 contained fentanyl and other drugs, including:
- 96% (24) contained caffeine
- 12% (3) contained etonitazepyne (!)
- 8% (2) contained isotonitazene/protonitazene6 (!)
- 4% (1) contained bromazolam (!)
- 4% (1) contained fluorofentanyl (!)
Unexpected noteworthy drugs found in other expected substances
- 15% (12) of the remaining substances checked,4 meaning substances that weren’t expected3 to be fentanyl, contained an unexpected noteworthy drug, including:
- 27% (4) of expected cocaine substances contained phenacetin (!)
- 7% (1) of expected cocaine substances contained levamisole (!)
- One expected cocaine substance that did not contain cocaine7 contained bromazolam (benzodiazepine-related) (!)
- 33% (2) of expected heroin substances contained fentanyl (!)
- One expected crack cocaine substance that did not contain cocaine7 contained fentanyl (!)
- 100% (1) of expected carfentanil substances contained fentanyl (!)
- 50% (1) of expected hydromorphone substances contained fentanyl (!)
- 50% (1) of expected hydromorphone substances contained metonitazene (!)
Notes
1 | Substances: Two types of samples are accepted by Toronto’s drug checking service: substances and used drug equipment. Substances could be a small amount of powder, crystals, or rocks, a crushed bit of a pill, blotter, or a small amount of liquid.
2 | Used equipment: Two types of samples are accepted by Toronto’s drug checking service: substances and used drug equipment. Used equipment 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 was bought or got as 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 equipment, drug equipment – 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 equipment 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 noted when we exclude used equipment from this report.
5 | Average amount of drugs found: Toronto’s drug checking service can report the amount of fentanyl, cocaine, carfentanil, etizolam, and caffeine found as a proportion of the total sample submitted for expected opioid, cocaine, crack cocaine, and some other powder substance samples. Every other week, we include the average (median) amount of fentanyl, cocaine, carfentanil, etizolam, and caffeine found in expected fentanyl substances in our report. More information is available on our website.
6 | Isotonitazene/protonitazene: Because isotonitazene and protonitazene have a very similar chemical structure, it is not currently possible for Toronto’s drug checking service to differentiate between the two. For this reason, we report the two drugs together.
7 | Substances that unexpectedly contain high-potency opioids or benzodiazepine-related drugs and not the expected drug: Our reports highlight unexpected noteworthy drugs found in all checked substances. When high-potency opioids or benzodiazepine-related drugs are found unexpectedly in a substance sample and the expected drug is not present, we flag it but are hesitant to consider it contamination of the expected drug. Instead, we assume there is an issue with the expected drug: the person who sold or provided the drugs accidentally mixed up their drugs, the service user accidentally mixed up their drugs, or the expected drug was recorded incorrectly during sample collection. These samples require special consideration.
(!) | Unexpected noteworthy drug: “Noteworthy drugs” are drugs 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 service users. Noteworthy drugs are flagged when they are unexpectedly found in checked samples.