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A synthetic opioid first detected in Montreal in 2019 has been recently linked to the December 2023 death of a 15-year-old boy.
Mathis Boivin of Montreal died after taking a single dose of isotonitazene in tablet form last month. His father, Christian, said his son believed "he was taking oxycontin.”
According to the country's public health agency (PHAC), isotonitazene is the most frequently detected synthetic opioid in Canada and has been associated with numerous deaths.
“We're getting these synthetic versions of opioids that are incredibly strong. And because of that, the risk has gone up substantially because now we're dealing with potency levels that we've never seen before,” says Jennifer Jackson, a registered nurse and an assistant professor in the faculty of nursing at the University of Calgary.
What is isotonitazene?
Isotonitazene is similar to other synthetic opioids, like fentanyl and methadone. Unlike natural opioids like morphine and heroin which are extracted from the seed pot of certain varieties of poppy plants, synthetic opioids are created in a lab.
According to California Southern Rehab, isotonitazene, which belongs to the nitazene/brorphine chemical group, is considered “more potent” than fentanyl, and is causing more overdoses.
PHAC notes that the number of opioid-related poisoning hospitalizations in Canada that were reported between January 2023 and June 2023 was 11 per cent higher compared to the same period in 2022.
In total, 3,036 opioid-related poisoning hospitalizations were reported in 2023 between January and June, for an average of 17 hospitalizations per day. PHAC says 43.5 per cent of Nitazene/Brorphine were from Ontario, followed closely by Quebec with 38.5 per cent.
“The toxicity of the illegal drug supply continues to be a major driver of the overdose crisis with over 80 per cent of opioid-related deaths involving fentanyl and fentanyl analogues,” Health Canada says on its website.
Why is isotonitazene use on the rise?
Jackson tells Yahoo Canada isotonitazene has taken over the market because it’s easier to produce and obtain; the increase is also driven by other factors related to mental health.
“We've seen since the COVID-19 pandemic that the rates of people using drugs have gone up because we know that getting these kinds of drugs is driven by complex trauma,” says Jackson.
“We’re seeing the effects of a lack of mental health support, toxic masculinity and childhood trauma that we haven’t had resources to address,” she adds.
There are also many barriers and risks that people who use drugs face, which continues to fuel the overdose crisis.
According to Health Canada, some of the barriers include an “overburdened health and social services, including life-saving harm reduction and treatment services and supports.”
There’s also an “ongoing stigma surrounding substance that discourages people from seeking health and social services, and can reduce the quality and availability of services received.”
“There is this faulty mindset that using drugs is a personal choice and people who do so are weak and they deserve what they get, and they can stop any time, which is completely wrong,” explains Jackson.
Should parents be worried about isotonitazene?
Jackson recommends parents engage with their kids and discuss substance use while recognizing the fact that "generally teenagers engage in risk-taking behaviour," which could involve drug use.
“The idea of just telling them to never use drugs, that doesn't work. People will end up using drugs anyway. And so what we need to do is provide comprehensive information so that young people can make informed choices,” she says.
Jackson recommends informing teenagers about drug use the same way they approach sexual health: educating them so that they know the risks and what kinds of supports are available to keep teens safe. .
“We need to have parents that can talk to kids about the need to test drugs first before using them,” says Jackson.
In Canada, people can test their substances in multiple ways, either through on-site, take-home fentanyl test strips, by visiting a technician using an FTIR Spectrometer or through Get Your Drugs Tested.
How old do kids have to be before you talk to them about drugs?
Jackson says there’s no specific age of when parents should discuss drug use with kids, but it might be sooner than people think. Teens and kids in general need to be aware of the significant consequences that come from using drugs.
“We need to approach these discussions with the aim of keeping people safe rather than solely trying to regulate behaviour,” says Jackson. “It’s important to operate within the reality that people will use drugs. The question is, 'How can we make sure they’re as safe as possible?'"
How to talk to your kids about drugs
Nemours KidsHealth recommends begin by asking children as they grow older what they've heard or know about drugs.
“Ask in a nonjudgmental, open-ended way, so you're more likely to get an honest response,” the organization advises.
The website also encourages parents to show their kids that they're listening and paying attention to their concerns and questions which may involve doing some research to provide them with answers.
Jackson also points out that parents should talk to their kids, especially teenagers, about the need to “start slow, go slow” when using drugs.
“If you're using drugs, there needs to be a sober friend there who can keep an eye on people, so they can intervene if there is someone who experiences drug poisoning,” says Jackson. “Use just a small amount. See how your body reacts to it rather than using a large amount.”
Jackson explains that a lot of the synthetic opioids being bought and used are laced with other substances that make them more potent and more dangerous.
“We see things like Valium getting mixed in, and so we're getting combinations of synthetic drugs that we've never seen before, and it's increasing the risk of harm,” she says.
In addition to testing drugs, another preventive tool parents can use is to have naloxone kits nearby. These portable kits contain an opioid antidote and are available for free at pharmacies across the country. Teaching kids how to administer the antidote, either by injection or through the nose, can help revive an unresponsive person who may be overdosing.
Jackson notes that many people who use drugs long term have experienced complex trauma, and encourages parents to "prevent a complex trauma or mitigate its effects."