Text alerts about Island toxic drugs signals deepening crisis, but not an informative tool: experts

Island Health has launched a new way to warn people of a spike in toxic drug-related deaths in a city through text messages.

It’s a step that acknowledges the far-reaching nature of the drug poisoning crisis, but may not be helpful to people who need it most, according to Dr. Bruce Wallace, a UVic professor, scientist at the Canadian Institute for Substance Use Research. At the same time, a project that seeks to share updates about street drugs in circulation every week is stalled due to a lack of funding.

Dr. Wallace, who co-leads Victoria’s drug checking project, said using text messages to reach people is a good tool, but the alerts themselves don’t necessarily provide useful information.

“There are a number of elevated indicators related to drug poisonings that signal the extension for this advisory,” a recent alert reads, before pointing to the Toward the Heart website for safe drug use tips.

“Just releasing alerts about particular high rates of overdose…is really limited in that it can feed into the general public's drug scare narrative—‘all drugs are bad’—if we're not balancing that with other drug information and also with drug alternatives,” Dr. Wallace said.

Instead, the drug checking project is trying to create an open dashboard that would tell substance users, and people who work with them, the concentration of substances on the streets. This project would be informative, rather than alarmist, he said, in an effort to reduce stigma around substance use as well as tell people about what they’re buying.

The dashboard would share “things like the fentanyl concentration in the region that week, if there’s carfentanil that week, if there’s xylazine…and also what’s not there, so people can know that meth and cocaine (stimulants) don’t have fentanyl, that that’s included in the reporting too so people are knowing the overall markets,” Dr. Wallace said.

They hope to partner with Island Health to build this initiative, but have yet to receive funding. In response to Capital Daily’s questions, Island Health said they were aware of the funding request and have “no updates to share right now.”

The text alert system that is available instead of this dashboard, however, is an expansion of a program that was first up and running in the Interior and Fraser Health regions earlier this year.

These alerts, which people can sign up for by texting “JOIN” to 253787, contain the general location of a spike in overdoses (for example, “Parksville/Oceanside communities”) alongside the warning. It also has a link to the Toward the Heart website, which then shares the usual health authority tips: where to find an Overdose Prevention Site, advice about carrying naloxone and using with a friend.

In the past other health authorities have shared the nature of the substance causing a spike in overdoses and deaths—the type of drug, a photo of what it looks like, and what it contains.

This information has never been shared by Island Health in the past, but a spokesperson for the health authority told Capital Daily that “if specific information about specific substances is known, it will be included.”

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Comparison of an Island Health alert and an Interior Health alert, from the Toward the Heart website.

At the drug checking project, Dr. Wallace and his colleagues have already been collecting data and sharing their findings on what type of substances are out there.

Their weekly reports, posted on Substance UVic’s social media accounts, break down the type of drugs being sold on the street—based on samples tested at their Cook Street location—whether or not they contain other fentanyl and its analogues, descriptions of what the substances look like, and sometimes the part of the city they were purchased in.

In a previous interview with Capital Daily, Dr. Wallace likened a need for awareness about drugs in the market to the same kind of information that is available about alcohol; someone who is not accustomed to a high spirit content in alcohol is more at risk of alcohol poisoning, and the same, he says, holds true for fentanyl. The organization’s monthly drug checking report for October, for example, found that fentanyl concentrations ranged wildly, with a median of 13.9% but a maximum of over 80%.

“If somebody might be expecting 6% fentanyl, but the next sample is 20% fentanyl, it’s quite a bit more concentrated and more potent,” Dr. Wallace said at the time. “People have preferences or needs and it's very hard to be able to…secure that in a safe way.”

These weekly drug checking reports, if disseminated via text message every week, would be an informative way of helping people navigate the toxic drug crisis, he said.

The text alerts, as they currently stand, can be useful for people who have access to an alternative source of the drug they would have purchased on the street, Dr. Wallace said—however at the moment, there is no widely available safe supply program in Victoria.

It could also be useful for those who support or work with drug users, to know when to seek more information. But mostly, he said, the text alert rollout shows that the province and health authorities consider the toxic drug crisis severe enough to add a new way of disseminating information about it.

“That there's now been so many overdoses throughout the Island over the years that we need to build an infrastructure around that, I think just really shows how tragic the crisis is and how enduring it's been, regardless of the responses to date,” Dr. Wallace said.

In Island Health’s statement about the new alerts, they quoted BCCDC public health physician Dr. Alexis Crabtree as saying the alert system is “one way people can quickly receive information to reduce drug poisoning events and deaths” until a regulated supply of drugs is accessible.

However the question of whether or not alerts could reduce drug poisonings is moot, Dr. Wallace said. The number of toxic drug deaths have been rising at a rate that outpaces the introduction of harm reduction services to deal with the crisis.

“The things that have been tried have not reduced overdose or they haven't been implemented in a way that are going to have a significant level,” he said. “This is why people are continually pushing for decriminalization and safe supply in a way that could have a meaningful impact.”