The regional public health department at CIUSSS du Centre-Sud-de-l’Île-de-Montréal (Montréal DRSP) was informed that acetylfentanyl has been found in powder sold as cocaine that may have been the cause of an overdose death in the city at the end of April 2018.
Acetylfentanyl is a fentanyl analogue that is less potent, but still 5 to 15 times more potent than heroin. This synthetic opioid is associated with risks of overdose and death.
The Montréal DRSP urges caution
The Montréal DRSP urges drug users to be cautious, and encourages clinicians and other care providers to enhance overdose prevention interventions with this population:
1. Disseminate information about the possible presence of acetylfentanyl in powder sold as cocaine.
2. Provide counselling on safer drug use practices:
- For people who inject, use supervised injection services regularly
- Avoid using alone
- When using with other people, don’t all use at the same time
- Reduce the amount used to test the effects
- Have naloxone close at hand, and know how to use it when someone shows signs of overdose
- If possible, use test strips that detect fentanyl and its analogues
- Call 911 if someone overdoses (the Good Samaritan Drug Overdose Act provides immunity from simple possession charges for those who call 911 in the case of an overdose)
3. Inform people about naloxone and, if needed, go with them to get naloxone in any pharmacy listed on the Ministère de la santé et des services sociaux web site.
4. As needed, refer individuals with problems associated with opioid use to addiction treatment services.