A legal drug 50 times as strong as heroin is contaminating street drugs more than ever

Bags of heroin, some laced with fentanyl, displayed before a press conference regarding a major drug bust, at the office of the New York attorney general on September 23 in New York City. (Drew Angerer/Getty Images)

Approximately 80% of heroin used at Insite in Vancouver from July 2016 to March 2017 had been contaminated with fentanyl. Fentanyl, a synthetic opioid painkiller sometimes prescribed to treat severe pain in cancer patients, is showing up more and more on the street.

A study conducted by Canadian researchers at the Insite Supervised Injection Centre in Vancouver found that approximately 80% of heroin used at the site from July 2016 to March 2017 had been contaminated with fentanyl.

Vancouver's Insite is a center that allows drug users to inject intravenous drugs legally and under supervision from medical personnel with sterile equipment. Opened in 2003, the center is part of a "harm reduction" strategy that aims to reduce overdose deaths and transmission of diseases from dirty equipment. It is the only center of its kind in North America, though Seattle is working to open the first in the US.

The researchers found that 80% of the crystal meth and 40% of the cocaine used at Insite were also contaminated with fentanyl. Researchers tested more than 1,000 drug samples, asking Insite clients whether they wanted to test their drugs voluntarily. About five of the center's 600 daily visitors tested their substances, according to Dr. Mark Lysyshyn, the medical health officer for Vancouver Coastal Health and the lead researcher on the study.

Though fentanyl is legal and sometimes prescribed by doctors, it can be extremely dangerous. The drug, which is available in a patch or liquid, is 80 to 100 times as powerful as morphine and about 40 to 50 times as potent as pure heroin.

Because of its potency, fentanyl has become more common in street drugs. Many producers and traffickers now mix fentanyl illegally produced in underground labs with heroin or ostensibly prescription pain medications like hydrocodone or oxycodone to make their drugs more potent.

The overdose death rate for illicitly obtained opioids like fentanyl has skyrocketed by 73% from 2014 to 2015, according to a Centers for Disease Control and Prevention report released in 2016, and 79% from 2013 to 2014.

(Centers for Disease Control and Prevention)

"It's a very scary thing," Van Ingram, the executive director of Kentucky's Office of Drug Control Policy, told the Lexington Herald Leader last year. "What we see across the country is the drug cartels moving away from heroin and moving toward these opioids they're going to produce themselves. People think they're buying one thing and they're actually buying another. The stuff they're selling is so powerful. Some of the stuff we're seeing produced is 50 times more potent than heroin, as if heroin wasn't bad enough."

In the Insite study, approximately 80% of the drugs checked were heroin, while crystal meth represented 7.2% and cocaine represented 5.3%.

Lysyshyn told the Vancouver Sun that the results of the study should not be interpreted to mean that 80% of street heroin in Vancouver is contaminated with fentanyl. While the percentage could be that high, he said, it is most likely lower because people are more likely to test drugs they already suspect to be contaminated.

Still, the study is more troubling evidence that fentanyl is becoming more and more common on the street.

"This study proves that the alarm bells that have been sounding over this public-health emergency are fully warranted," Rick Lines, the executive director of Harm Reduction International, said in a statement.