The Northern American Fentanyl Crisis

Author: Nikita Burke, Ph.D.

Addiction to opioids has reached epidemic proportions in North America. Fentanyl is an opioid, which are a class of painkillers that includes morphine, oxycodone. Fentanyl has proved to be particularly insidious. The beloved musician Prince died of an accidental fentanyl overdose last year at the age of 57. In Alberta, six people died from fentanyl overdose in 2011. In 2016, this soared to 343 deaths. 


Fentanyl is 100 times stronger that morphine and became widely used in the ‘90s for treating pain in cancer patients when other opioids failed. The drug was administered via transdermal patches, providing slow, sustained release that eliminated pain for a couple of days. However, doctors began prescribing fentanyl for non-cancer pain and in parallel, money-hungry drug dealers soon realised the potential of fentanyl. Due to its potency, fentanyl hydrochloride can be manufactured and transported much easier than other illegal drugs. A pound of pure powder has a street value of over $9 million. Pressed into pills resembling the popular OxyContin, it appeals to more people than the injectable heroin. Produced in makeshift labs, fentanyl’s quality is uncontrolled, resulting in a Russian roulette for users. 


Because fentanyl is potent and addictive, it is often mixed with or disguised as other drugs like heroin, oxycodone or even cocaine. Many people have died from unwittingly ingesting fentanyl-laced drugs. Users do not realise that they are dealing with a substance much more powerful than what they are accustomed to. A fentanyl high hits quicker than heroin, wears off earlier, and produces a worsened state of withdrawal. This drives the user to continue taking the drug to avoid withdrawal. Symptoms of withdrawal include sweating, diarrhoea, nausea and insomnia. In contrast, the psychological dependence with opioids is complex and protracted – overwhelming cravings lasting for months or years contribute to an extremely high relapse rate. Crime rates soar in parallel with opioid use, as users will do anything to feed their habit. It only takes a few grains of fentanyl to be fatal. This potency directly contributes to its danger.

Lethal dose of heroin 

versus lethal dose of fentanyl

Getting clean from opioids is gruelling, and rehabilitation programs are rare due the previous government’s conservative policies. Now, there is a push towards harm-reduction to address the epidemic. Naloxone, an opioid blocker that works to quickly reverse an overdose, is available free of charge throughout Alberta. The Minister for Health, Jane Philpott, recently announced $6 million of emergency funding, combined with a comprehensive, collaborative, compassionate and evidence-based approach to tackle the crisis. Dr. Hakique Virani, an addiction specialist in Edmonton, says the fentanyl crisis pervades all levels of societies – from young to old; homeless to young professionals; soccer moms to divorced dads; new immigrants and natives. If we don’t tackle this problem head-on, fentanyl’s cold hand of death may come knocking on the door of one of your loved ones.