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December 16, 2022International Journal of Drug Policy95 citationsOpen Access

The increase in benzodiazepine-laced drugs and related risks in Canada: The urgent need for effective and sustainable solutions

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CRCayley RussellJLJustine LawMBMatthew Bonn

Key Points

  • To assess the public health impacts of synthetic benzodiazepine-adulterated opioids and identify policy solutions required to address the evolving overdose epidemic in Canada.
  • Narrative public health and policy analysis evaluating illicit drug adulteration trends, overdose risks, and intervention frameworks across Canadian jurisdictions.
  • Identified an unprecedented rise in synthetic benzodiazepines adulterating illicit opioids ('benzodope'), heightening risks of fatal and non-fatal overdoses and severe physical dependence.
  • Determined that co-exposure to benzodiazepines and opioids complicates standard overdose reversal interventions and elevates morbidity and mortality.
  • Identified critical policy priorities, including scaling harm reduction services, targeted education on combined toxicity, and strategies to eliminate contaminated drug supplies.

Abstract

The overdose crisis in Canada has continuously evolved and is increasingly challenging to contain, while efforts from governments and policymakers to address it have often fallen short and resulted in unintended consequences. One of the main repercussions has been an unprecedented rise in adulterants in the illegal drug supply, including a wide array of pharmacological and psychoactive compounds and chemicals, which has resulted in a progressively toxic drug supply. Most recently, there has been a stark increase in synthetic benzodiazepine-laced opioids (i.e., 'benzodope') in some Canadian jurisdictions. This unique combination carries distinct and amplified risks for people who use drugs including fatal and non-fatal overdoses, increased dependence and withdrawal symptoms, and places them in extremely vulnerable positions. The emergence of benzodiazepines within the illicit drug supply has substantially contributed to drug-related morbidity and mortality in Canada, and has further complicated current public health initiatives and overdose prevention efforts. This reality underscores the need for effective and sustainable policy solutions to address the evolving overdose epidemic including increased knowledge and education on the specific harms of opioid and benzodiazepine co-use (especially in regards to the complexity of opioid/benzodiazepine overdoses), scaling-up harm reduction measures, and eliminating the toxic drug supply altogether.

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Cite This Study

Russell et al. (2022) studied this question.

synapsesocial.com/papers/69dd3a6527c48be1bb40c66dhttps://doi.org/10.1016/j.drugpo.2022.103933
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