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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

Information for clinicians

Pre-hospital Scene Safety and Force Protection

Read Article

​Acrylfentanyl And Naloxone Effectiveness

Office of National Drug Control Policy one-pager

Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders 

​ACMT and AACT Position Statement

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

Manitoba Memo
District 42 Board Request
Service Entity Personnel: Ohio Board of Pharmacy
British Columbia Memo
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
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Novel Synthetic Opioids in Counterfeit Pharmaceuticals 
Canadian Centre on Substance Use and Addiction Bulletin

Little if any heroin left in Vancouver, all fentanyl: drug advocates
Click here to read the article by Geordon Omand of The Canadian Press

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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