Municipal Drug Strategy
Co-ordinators Network of Ontario
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About the Bootleg Fentanyls
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Bootleg fentanyls (NOT pharma-produced) were first detected in Ontario in 2013. Bootleg fentanyls and opioids are of high potency and now present in a variety of substances: pressed into fake pills (Oxy 80, CDN 80, A215, Xanax etc.), and as powder exclusively or mixed into heroin, cocaine, and crystal meth.  People using substances occasionally and daily are at risk. Many if not most people will be unaware they are consuming bootleg opioids.

An opioid overdose victim can not save themselves.  The onset of overdose from a small amount of bootleg fentanyl(s) is rapid.  Naloxone administrations exceeding 2 x 0.4mg/ml doses may be required to resuscitate. Most people engaged in illicit substance use will not call 9-1-1 during a medical emergency due to fear of criminal justice sanctions.
  • Deaths from bootleg fentanyls in Alberta have risen 5,700% for the period 2011-2016.
  • British Columbia has declared an overdose public health emergency.
  • Many U.S. states are experiencing a rise in (bootleg) fentanyl-detected deaths.
  • Ontario remains alarmingly unprepared.​

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2015
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Harms and clinical management of fentanyl
analogues and other novel synthetic opioids

Pre-hospital Scene Safety and Force Protection

​ACRYLFENTANYL AND
​NALOXONE EFFECTIVENESS

Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders 

Personal Protective Equipment for First Responders

7p Pdf
1page ONDCP Pdf
​ACMT and AACT Position Statement:

PPE: Interagency Board

Is naloxone in your school's First Aid Kit? (unlikely)

Manitoba Memo
Service Entity Personnel: Ohio Board of Pharmacy
British Columbia Memo
District 42 Board Request
New York State Protocols for schools
Health Alert : U.S. Centers for Disease Control and Prevention
Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds
Novel Synthetic Opioids in Counterfeit Pharmaceuticals 
Little if any heroin left in Vancouver, all fentanyl: drug advocates
Geordon Omand, The Canadian Press
Clinical mgmt pdf
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Read Pdf
Read

What is W-18?
W-18 @forensictoxguy
W-18 ++ @DavidKroll

Maryland Poison Center: Update
Synthetic Opioids
Provincial health officer declares public health emergency
BC Overdose Public Health Emergency
How Canada got addicted to fentanyl: Globe and Mail Investigative Series
Globe and Mail Investigations
Fentanyl Analogues: U.S. National Drug Early Warning System
Fentanyl Analogues
Fentanyl Drug Profile:
​European Monitoring Centre for Drugs and Drug Addiction
EMCDDA: Fentanyls

Serious Risks from Emerging Opioid: Fentanyl Analogues.  Ontario 2013.

Community Advisory
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