Key findings
- 91 samples were checked: 47% were substances1 and 53% were used paraphernalia2
- 75% of the samples checked were expected3 to be fentanyl or cocaine
- 80% of expected fentanyl substances checked4 contained etizolam (benzodiazepine-related)
- A synthetic cannabinoid, AMB-FUBINACA, was unexpectedly found alongside fentanyl again. We haven’t seen it consistently since November 2019. Synthetic cannabinoids can suppress breathing and other vitals during opioid overdose situations. We published an alert about it on October 22, 2020.
- Xylazine, a tranquilizer used primarily on horses, deer, dogs, and cats, was unexpectedly found alongside fentanyl. This is the first time we’ve seen xylazine. When xylazine and opioids are used together, the risk of dangerous suppression of vitals is increased. We published an alert about it on October 28, 2020.
Expected fentanyl substances
- 100% (15) of expected fentanyl substances checked4 contained fentanyl and other drugs, including:
- 93% (14) contained caffeine
- 80% (12) contained etizolam (benzodiazepine-related) (!)
- 33% (5) contained despropionyl fentanyl (4-ANPP) (!)
- 7% (1) contained n-methyl norfentanyl (!)
Unexpected noteworthy drugs found in other expected substances
- 32% (9) of the remaining substances checked,4 meaning substances that weren’t expected to be fentanyl, contained one or more unexpected noteworthy drug, including:
- 57% (4) of expected cocaine substances contained phenacetin (!)
- 14% (1) of expected cocaine substances contained levamisole (!)
- 100% (2) of expected crack cocaine substances contained phenacetin (!)
- 50% (1) of expected crack cocaine substances contained levamisole (!)
- 100% (3) of substances that didn’t have a stated expected drug contained fentanyl (!)
- 67% (2) of substances that didn’t have a stated expected drug contained one or more benzodiazepine or benzodiazepine-related drug (!)
- 33% (1) of substances that didn’t have a stated expected drug contained despropionyl fentanyl (4-ANPP) (!)
Notes
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 are highly potent, linked to overdose or other adverse effects, or may not be desired by some clients. Noteworthy drugs are flagged when they are unexpectedly found in checked samples.