Sudbury's illegal drug supply laced with substances naloxone can't reverse, public health officials warn

Responding to drug overdoses in Sudbury is becoming more complicated and unpredictable, public health officials warn.

Sam Mortimer, a nurse with Public Health Sudbury and Districts, says non-opioid adulterants being cut into street drugs are making it harder for first responders to reverse overdoses using naloxone, since the medication only works on opioids. 

"We just have had to kind of pivot our response and make sure that the messages that we're giving to the public really emphasize how toxic the supply is," she said. 

What is a complex overdose?

Mortimer explained that the unregulated drug supply is often tainted with benzodiazepines and xylazine, an animal tranquilizer not approved for human use, resulting in increasingly complex overdoses.

"In a classic opioid poisoning, you would see things like blue or purple lips, fingertips. Skin could also ashen depending on skin tone, pinpoint pupils, like gurgling or choking sounds, difficulty breathing, drowsiness or not being able to wake somebody up," she explained.  

"The part that gets added to that with the introduction of the benzodiazepines and tranquilizers, is amplifying those symptoms even more."

Mortimer said the tranquilizer xylazine has no reversal agent and is known to cause severe wounds, including infections like necrosis or dead tissue, whether the user is injecting or inhaling the drugs. 

She said despite the added complication of non-opioid substances, the response to an overdose remains the same. 

"We want people to give naloxone, we want people to wait for help and to give rescue breaths. But it just means that because of the strength of the drugs and what's in them, people may be sedated or not waking up for long periods of time, which can increase risk for safety," she said. 

Kaela Pelland with Sudbury's Réseau Access Network, a harm reduction organization which ran the city's safe consumption site until it closed down last March, said the overdose crisis has only worsened in recent years.

"Especially within the last year or so and right now, we're really seeing an increase in complex overdoses and also wounds that people who don't inject are getting. That's something we've had to pivot and learn more about," Pelland said. 

Pelland said most if not all the overdoses the organization has responded to in recent months have been complex.

"It's been a long time since it's been like a very cut and dry naloxone administration," she said.

'A band aid on a bullet hole'

Pelland, who has been working with Réseau for over 13 years, described watching people struggling with addiction as "heartbreaking."

She said frontline workers responding to overdoses experience significant emotional strain, witnessing people becoming "a shadow of themselves" due to the toxic drug supply. 

Pelland said with the current toxic drug supply becoming increasingly complex and dangerous, frontline workers are struggling to manage an escalating crisis. 

"Right now, it feels like we're just trying to manage the symptoms of a significantly bigger problem. It's a band aid on a bullet hole," she said.