Overdose alert: cannabis contaminated with opioids

Montreal’s Public Health Department calls on street cannabis users to be vigilant after a severe overdose has been reported.

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According to information from the National Public Health Department of the CIUSSS du Centre-Sud-de-l’Île-de-Montréal (DRSP de Montréal), the case presented signs and symptoms of an opioid overdose with respiratory arrest. The victim required multiple doses of naloxone and was hospitalized.

The event occurred after the victim smoked street cannabis sold in the form of a greenish-brownish colored pot. An investigation is underway to understand the incident.

“In light of this situation, it is possible that street cannabis in circulation is contaminated with opioids. Opioids are associated with a high risk of death, especially among consumers who may be unknowingly exposed,” said the Montreal DRSP in a press release.

It should be noted that a person with an opioid overdose could experience significant drowsiness, snoring, miosis (contracted pupils), breathing difficulties and cyanosis (bluish lips and fingernails). Ultimately, these symptoms could lead to cardio-respiratory arrest.

A drug exists to reverse the effects of an overdose: naloxone.

“In the event of an overdose, call 911 immediately for prompt and optimal response. Hospital care for administration of naloxone under medical supervision or airway management may be required.

The public is invited to report any situation suggesting contamination of street cannabis by opioids via the Public Health website.

The Montreal DRSP urges users of street cannabis to be cautious, regardless of the mode of consumption (by ingestion, inhalation or other), and encourages clinicians and workers to enhance death prevention interventions with these latter:

1. Circulate information about the risk of severe overdose and death from street cannabis use.
2. Provide counseling on safer drinking practices.
3. Recommend the purchase of cannabis from a legal source (known and quality content) at the SQDC.
4. Avoid eating alone.
5. When several individuals consume, avoid consuming all at the same time.
6. Have enough naloxone available and know how to use it when someone shows signs of an overdose. If in doubt, do not hesitate to use it (no danger, even if it is absorbed unnecessarily).
7. Call 911 in the event of an overdose (the Good Samaritan Overdose Victims Act provides immunity from prosecution for simple possession to overdose witnesses who call 911).
8. Inform and support people, if necessary, in order to obtain free naloxone from community organizations and pharmacies listed in the INSPQ directory.