CCENDU Bulletin: An Update on Stimulant Use and Related Harms in Canada and the United States

This bulletin summarizes the most recent updates on stimulant use and related harms in Canada and the United States. Revisiting indicators from the 2019 CCENDU Bulletin Changes in Stimulant Use and Related Harms: Focus on Methamphetamine and Cocaine, this update explores whether previously reported trends have continued or changed. Highlights include changes in methamphetamine manufacturing and that polysubstance use has increased significantly, with a high proportion of substance-related deaths involving some combination of opioids, stimulants and benzodiazepines.

Xylazine (CCENDU Drug Alert)

Summarizes the increased risk of accidental overdose due to xylazine in Canada’s unregulated drug supply. Xylazine is a non-opioid pain reliever developed as a sedative and muscle relaxant for animals. It is being found as an adulterant in other drugs. In combination with other sedatives like fentanyl, benzodiazepines or alcohol, xylazine can increase the risk of overdose and death.

Nitazenes (CCENDU Drug Alert)

This alert summarizes the increased risk of accidental overdose due to nitazene compounds being identified in Canada’s unregulated drug supply. Nitazene compounds are ultra-high potency, synthetic opioids, usually found unexpectedly in substances thought to be other opioids, such as fentanyl.

CCENDU Bulletin: Risks and Harms Associated with Nonmedical Benzodiazepines in the Unregulated Drug Supply in Canada

This bulletin summarizes the risks and harms associated with nonmedical benzodiazepines and benzodiazepine-like substances that are increasingly being identified in drugs on the unregulated market, particularly drugs sold as opioids.

Summarizes preliminary information about the impact of COVID-19 on the illegal drug supply, the provision of harm reduction services and the associated health impacts for people who use drugs. Data were compiled from multiple sources across Canada between March 31 and May 10, 2020.

Drugs bought and sold on the illegal market are unregulated, unpredictable and often contaminated with substances in addition to, or instead of, those intended, which increases the probability of drug-related poisoning and other health threats. This bulletin provides a snapshot of drug contents on the illegal market in Canada using 2018–2019 data from drug seizures, drug checking services and a drug content monitoring study. It is accompanied by a technical report that explains the research methods used and provides more detailed findings.

In response to reports of increasing harms related to methamphetamine use in Canada, this bulletin summarizes recent changes in stimulant-related harms in Canadian communities. It includes reports from municipalities, provinces and territories describing notable trends in stimulant use, levels of concern and local responses.

This bulletin provides a snapshot of drug use trends, drug risks and lessons learned emerging from Canadian music festivals between May 1, 2017, and July 31, 2017. This information can be used to inform efforts to safeguard attendees at subsequent festivals.

This bulletin provides the first Canadian estimates on rates of calling 911 in drug poisoning situations. People trained to administer naloxone and who had used a naloxone kit to treat an overdose did not call 911 in 30% to 65% of cases. The bulletin recommends that anyone distributing naloxone to laypeople emphasize that calling 911 in drug poisoning incidents is critical.

This bulletin aims to outline the implications of newer synthetic opioids for frontline workers and those working in related fields. This bulletin includes information on W-18, although emerging evidence calls into question whether W-18 is an opioid. 

This bulletin describes the availability of take-home naloxone programs in Canada and the steps required to make naloxone available without a prescription. It notes that access to naloxone, a drug used to temporarily reverse the effects of opioid overdose, is only one part of an overdose prevention strategy, which should also include overdose prevention education, training and services.

This bulletin reports on the marked increase in the number of deaths involving fentanyl in Canada between 2009 and 2014, with data collected from 12 participating provinces and territories. During this period, deaths involving fentanyl increased significantly in Canada’s four largest provinces, ranging from almost doubling to an increase of over 20 times.

This alert is to advise that, as of February 6, 2015, there continues to be reports of fatal and non-fatal overdoses that are suspected or confirmed to involve non-pharmaceutical (illicit) fentanyl. Most overdoses appear to be in individuals who thought they were using heroin, oxycodone, cocaine or another substance, but have mistakenly taken fentanyl.

This bulletin addresses drug-related deaths and illnesses that occurred at Canadian music festivals during the summer of 2014. The bulletin issues a call for additional information and announces the assembly of a group of experts to develop recommendations for preventing, preparing for and responding to drug-related overdoses at large festivals.

This bulletin contains an overview of synthetic cannabinoids and their presence in Canada.

This alert is to advise that counterfeit oxycodone (popular brand name OxyContin®) pills containing fentanyl have become increasingly available in several Canadian communities. The presence of fentanyl in these counterfeit pills increases the risk of overdose among people using them. 

This bulletin finds that, as of November 21, 2013, there have been no confirmed reports of desomorphine in Canada or the United States. Unconfirmed reports might have resulted from the observation of severe wounds at injection sites among drug users.

This alert notes that reports from Canada and the United States indicate that illicit fentanyl produced in clandestine laboratories, rather than diverted prescription-grade fentanyl, has been appearing for sale on the streets.

This bulletin provides a series of short snapshots describing opioid misuse and local responses in Vancouver, Saskatoon, Winnipeg, Toronto, Ottawa and St. John’s.

This alert provides information on a new and emerging synthetic amphetamine-type drug referred to as “bath salts.”