Across Canada, provincial health experts and authorities have expressed concerns due to the growing incidence of detection of benzodiazepines in the illicit drug supply. According to the findings of a report released by the BC Coroners Service, the detection of benzodiazepines – a class of psychoactive drugs that depresses nervous system function – has been significantly increasing in the province’s drug supply.
While fentanyl is still present in the vast majority of illicit drug deaths and drug samples, the combination of strong benzodiazepines, such as Valium and Xanax, with potent opioids, is especially dangerous since both types of drugs cause sedation and can result in cessation of breathing.
In her interview with CBC News, Karen McDonald, the lead for Toronto’s drug harm reduction services operating out of St. Michael’s Hospital, notes that it is becoming increasingly difficult to provide individuals sufficient information to plan their drug use. So far, at least 13 different types of benzodiazepines have been detected in illicit drug supply in Ontario, some of which are not prescribed in Canada. “It’s consistently changing. We feel like we can’t keep up with how many new drugs are coming in and out,” McDonald said.
Sarah Blyth, the executive director of the Overdose Prevention Society, said that similarly to fentanyl when it was first introduced, benzodiazepines began “popping up” randomly in drug checking and now they are ubiquitous.
“People completely black out, they don’t know who they are sometimes, where they are,” said Blyth. “It’s leaving people with long-term damage, if they don’t die.” According to Blyth, this unprecedented increase in the presence of benzodiazepines in the illicit drug supply can be attributed to unregulated supply, which continues to allow more unpredictability and volatility in the drugs.
The data from BC Coroner Service’s Illicit Drug Toxicity report released earlier in December show that between July 2020 and October 2021, the detection rate of benzodiazepines in B.C. spiked from 15% to 53%.
It’s “the norm” that most opioids tested in Victoria will include a benzodiazepine, said Dr. Bruce Wallace, an associate professor at the University of Victoria’s school of social work who works with the Victoria Drug Checking Program.
“To have an opioid with a benzodiazepine, and having a whole range of benzodiazepines … [it’s] challenging to try to figure out what does that really mean to somebody using that substance,” said Dr. Wallace.
Furthermore, many individuals who use drugs are also unknowingly ingesting benzos, says Dr. Paxton Bach, a medical director at the British Columbia Centre on Substance Use (BCCSU).
“We don’t know what people are using. They don’t know what they’re using,” said Dr. Bach. According to Dr. Bach, withdrawing from benzodiazepines is also a significant concern, since detoxing from these substances is “dramatic” and, unlike fentanyl withdrawal, patients withdrawing from benzodiazepines must be monitored in a hospital setting. The withdrawal from benzodiazepines includes tremors, sweats, nausea, extreme anxiety, and even seizures. Dr. Bach added, “Anyone who uses drugs daily now is going to have [benzodiazepines] in their system. The question is, how much, what kind?”