Since the early 2010's, the potency of Canada's illegal opioid supply has been increasing and the composition has become more unpredictable. The introduction and expansion of illegal fentanyl was a primary driver of this trend. Recently, the addition of benzodiazepines to many illegal drugs has contributed to an increase in Ontario's overdose deaths.
Fentanyl is around 50 to 100 times stronger than morphine. This makes the risk of accidental overdose much higher. Other, even more potent opioids such as carfentanil, may also be present. High potency opioids have been found in non-opioid drugs such as cocaine, methamphetamine and MDMA.
Remember that even if you are buying drugs from someone you know and trust, you cannot be sure what is in the drug. It is impossible to see, smell or taste whether the drugs you are buying contain what you think they do.
Benzodiazepines are drugs that are used to treat anxiety, seizures and insomnia, but are also found in the illegal drug market. They are not opioids but have increasingly been found in the illegal opioid supply. Because benzodiazepines and opioids both cause sedation, using them together can increase the risk of overdose.
Although naloxone does not reverse the effects of benzodiazepines, it does reverse the effect of an opioid overdose and can be safely given to people who have taken both opioid and non-opioid drugs. If a person has overdosed on a mixture of benzodiazepines and opioids, naloxone may re-start their breathing even if they remain sedated.
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