Rising Fentanyl-Related Overdose Deaths In British Columbia

There has been a surge in the number of fentanyl-detected overdoses in 2014 among people who use drugs in British Columbia. Provisional data indicates a constant increase in the number of fentanyl-detected overdoses over the past 3 years. A green pill, 'fake oxy' tablets, which resemble Oxycontin 80mg (oxycodone) have been found to contain variable amounts of fentanyl and not oxycodone. The physiological effects, symptoms and signs of fentanyl overdose are largely indistinguishable from that of heroin. This can complicate the management of overdoses in emergency settings. Emergency room physicians may find that the standard protocol dose of 0.4 - 0.8 mg of naloxone for heroin overdoses insufficient to reverse fentanyl overdoses. In such cases, in addition to investigations to rule out other potential use of other substances, larger doses of naloxone are often necessary to reverse the overdose. Take home naloxone programs are one harm reduction approach which is available in many jurisdictions in US1 and was initiated in British Columbia in 2012 and it is currently available at 62 sites throughout the province of British Columbia.