Key findings
- 10% of the expected1 fentanyl samples5 were known to be associated with an overdose – all samples contained at least one high-potency opioid (an opioid as strong as or stronger than fentanyl), many in combination with a benzodiazepine-related drug and/or a veterinary tranquilizer
- 66% of the expected1 fentanyl samples5 contained multiple high-potency opioids, including fentanyl, fluorofentanyl and/or a methylfentanyl-related drug
- 61% of the expected1 fentanyl samples5 contained a methylfentanyl-related drug (up to 10 times stronger than fentanyl)
- 55% of the expected1 fentanyl samples5 contained a veterinary tranquilizer – 44% contained medetomidine and 13% contained xylazine
- 51% of the expected1 fentanyl samples5 contained fluorofentanyl (up to 2 times stronger than fentanyl)
- 36% of the expected1 fentanyl samples5 contained a benzodiazepine-related drug – 14% contained multiple benzodiazepine-related drugs
- 17% of the expected1 fentanyl samples5 did not contain fentanyl – most of these samples instead contained a methylfentanyl-related drug and/or fluorofentanyl, some in combination with a veterinary tranquilizer and/or benzodiazepine-related drug
- Amount of drugs found in expected1 fentanyl drug samples2. To stay on top of the composition of the rapidly changing unregulated fentanyl supply, we have updated our method to determine the precise amount (aka quantity or concentration) of some noteworthy substances found in the drug samples we check. In addition to fentanyl, fluorofentanyl, bromazolam, xylazine, and caffeine, we now also quantify methylfentanyl-related drugs, medetomidine, alprazolam (Xanax), and primidone. Previously quantified drugs, including carfentanil, cocaine, etizolam, flubromazepam, heroin, and phenacetin, remain available on our website.
- In 83 expected1 fentanyl drug samples2:
- 0.8% was the average3 amount of fentanyl found
- 0.2 – 2.3% was the range4 of fentanyl found in half of the drug samples2
- In 48 expected1 fentanyl drug samples2:
- 0.3% was the average3 amount of fluorofentanyl found
- 0.2 – 1.7% was the range4 of fluorofentanyl found in half of the drug samples2
- In 61 expected1 fentanyl drug samples2:
- 1.5% was the average3 amount of methylfentanyl-related drugs found
- 1.0 – 2.9% was the range4 of methylfentanyl-related drugs found in half of the drug samples2
- In 42 expected1 fentanyl drug samples2:
- 0.8% was the average3 amount of medetomidine found
- 0.4 – 1.2% was the range4 of medetomidine found in half of the drug samples2
- In 13 expected1 fentanyl drug samples2:
- 0.3% was the average3 amount of xylazine found
- 0.1 – 0.4% was the range4 of xylazine found in half of the drug samples2
- In 29 expected1 fentanyl drug samples2:
- 1.8% was the average3 amount of bromazolam found
- 1.1 – 2.5% was the range4 of bromazolam found in half of the drug samples2
- In 83 expected1 fentanyl drug samples2:
Expected fentanyl drug samples
- 76% (84) of the expected1 fentanyl drug samples6 contained fentanyl and other drugs, including:
- 99% (83) contained caffeine
- 69% (58) contained at least one additional high-potency opioid (!):
- 60% (50) contained a methylfentanyl-related drug (!)
- 45% (38) contained fluorofentanyl (!)
- 56% (47) contained a veterinary tranquilizer (!):
- 51% (43) contained medetomidine (!)
- 6% (5) contained xylazine (!)
- 33% (28) contained at least one benzodiazepine-related drug (!):
- 32% (27) contained bromazolam (!)
- 11% (9) contained desalkylgidazepam (!)
- 1% (1) contained nordiazepam (!)
- 2% (2) contained furanyl UF-17 (opioid-related) (!)
Unexpected noteworthy drugs found in other expected drug samples
- 8% (6) of the remaining drug samples,6 meaning drug samples2 that weren’t expected1 to be fentanyl, contained an unexpected noteworthy drug, including:
- One expected1 bromazolam (benzodiazepine-related) drug sample2 contained AB-CHMINACA/AEP-CHMINACA7 (synthetic cannabinoid-related) (!)
- One expected1 2C-B drug sample2 contained caffeine, ketamine, MDMA, cocaine, and xylazine (!). Based on what was found in this sample, we believe it’s “tusi” – sometimes called “pink cocaine.” Tusi is a polysubstance that usually contains ketamine, MDMA, and/or cocaine – sometimes with other drugs. It is believed the name tusi comes from attempts to mimic the effects of 2C class drugs by combining substances.
- One expected1 heroin drug sample2 that did not contain8 heroin contained fentanyl (!), fluorofentanyl (!) and bromazolam (benzodiazepine-related) (!)
- One expected1 Percocet drug sample2 that did not contain8 oxycodone or acetaminophen contained nitazine opioids isotonitazepyne/protonitazepyne7 (!) and metonitazene (!) – learn more about the increase we are observing in the presence of nitazene opioids in samples expected to be oxycodone (OxyContin), Percocet, hydromorphone (Dilaudid), hydrocodone, and oxymorphone
- One expected1 Percocet drug sample2 that did not contain8 oxycodone or acetaminophen contained diazepam (Valium) (!)
- One expected1 MDMA drug sample2 that did not contain8 MDMA contained a benzodiazepine-related drug (!)
Notes
1 | Expected (drug): When a sample is submitted to be checked, the drug that sample was bought or got as is recorded. We call it the “expected drug”. Knowing the expected drug helps us tailor our harm reduction advice. It also helps us understand contamination to drugs rather than combinations of drugs (e.g., fentanyl was found in a heroin sample rather than fentanyl and heroin were found together).
2 | Drug samples: Could be a small amount of powder, crystals, rocks, blotter, or liquid, or a crushed bit of a pill.
3 | Average amount: We arrange the amounts of a substance found as a proportion of the total fentanyl drug sample from smallest to largest, determine the median (i.e., the middle number), and use that number as the “average”. For more information, view our amount of drugs found graph.
4 | Range: Known as the interquartile range, represents the middle 50% of the amounts of a substance found as a proportion of the total fentanyl drug sample. For more information, view our amount of drugs found graph.
5 | Samples: Includes both drugs and used drug equipment. Drugs could be a small amount of powder, crystals, rocks, blotter, or liquid, or a crushed bit of a pill. Used equipment could be a used cooker or filter, or leftover liquid from a syringe. For more information, view our terms of service.
6 | Reason for reporting only drug samples: While Toronto’s Drug Checking Service checks both drugs and used equipment, drug equipment – like cookers – are often re-used. The mass spectrometry technologies used for this drug checking service are so sensitive that very trace amounts of substances may be found. This means that when equipment is re-used, substances from past use may present in the results for the sample that is being checked. This can interfere with up-to-date drug market monitoring, so we’ve noted when we exclude used equipment from this report. For more information, view our service and technology limitations.
7 | Reporting similar substances together: These substances have a very similar chemical structure, and it is not currently possible for Toronto’s Drug Checking Service to differentiate between them. For this reason, we report these substances together. For more information, view our drug dictionary.
8 | Drug samples that unexpectedly contain noteworthy drugs and not the expected drug: Our reports highlight unexpected noteworthy drugs found in all checked drug samples. When noteworthy drugs are found unexpectedly in a drug sample and the expected drug is not present, we flag it but are hesitant to consider it contamination of the expected drug. Instead, we assume there is an issue with the expected drug: the person who sold or provided the drugs accidentally mixed up their drugs, the service user accidentally mixed up their drugs, or the expected drug was recorded incorrectly during sample collection. These samples require special consideration.
9 | High-potency opioid contamination: Based on the information we have about this sample, we are reporting it as contaminated with a high-potency opioid. However, it is very unusual that our program finds high-potency opioids unexpectedly in samples expected to be stimulants, psychedelics, and depressants, and these samples always require special consideration. There is increasing consensus in the drug checking community that the unexpected presence of high-potency opioids in other drug types is the product of accidental cross contamination rather than intentional adulteration. Cross contamination may result from poorly cleaned scales, storing drugs together (e.g., storing LSD in a baggie that was originally used for storing cocaine), or using drug equipment with different batches of drugs.
(!) | Unexpected noteworthy drug: “Noteworthy drugs” are drugs that (i) are linked to overdose or other adverse effects, (ii) are highly potent or related to highly potent drugs, or (iii) may not be desired by some service users. Noteworthy drugs are flagged when they are unexpectedly found in checked samples.