LETTER: No correct dose for illicit drugs

The Feb. 7 editorial stated that overdose deaths increased from 914 in 2016 to 1,422 in 2017.

The Canadian Medical Association Journal published a letter in January, by Xie, Green, Puri & Sheikh about “Updating our language around substance use disorders,” which included the following:

“The term ‘overdose’ suggests that the patient knows the nature of the substance taken and has taken more than what she or he was tolerant to or intended to use. ‘Overdose’ also implies that there is a correct dose. No correct dose exists for use of illicit formulations. Opioid formulations sold in unregulated markets have variable and unknown potency, so dosing is impossible. In addition, people lose tolerance because of inconsistent use and concurrent illness. Consequently, we suggest that the more precise term ‘poisoning’ be used. This use of words is compatible with public understanding regarding other substances: we say ‘alcohol poisoning,’ not ‘alcohol overdose.’”

The opioid crisis affects people throughout Canada and the U.S. The crisis has been caused by the sudden availability of the synthetic opioid fentanyl, most of which is probably synthesized in laboratories in China. Fentanyl is cheap and extremely powerful. It is mixed with other products sold on the black market. Users don’t know what they are getting. A big dose of any opioid can cause respiratory arrest: the person stops breathing.

The use of recreational chemicals is a medical problem. If a person feels she or he needs an opioid, it is safer to get a known amount of a medication under professional supervision than to use an unknown product from a friend or dealer. Island Health funds Mental Health and Addictions – Addictions Services.

Robert Shepherd

Saanich

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