Roger-Luc Chayer (Image : AI / Gay Globe)
Yesterday, Montreal Public Health issued a statement of exceptional gravity:
Montreal Public Health has issued an alert following the confirmation of several fatal overdoses involving carfentanil, an extremely powerful synthetic opioid.
The composition of street drugs is unpredictable, and an overdose is a medical emergency. Our teams regularly respond to overdose incidents, and rapid intervention can save a life.
Avoid using drugs alone and call 911 immediately if the person:
➡️ is unconscious;
➡️ does not respond when spoken to or when someone attempts to wake them;
➡️ is having difficulty breathing, is breathing very slowly, or has stopped breathing.
Even if a person regains consciousness after receiving naloxone, a medical evaluation remains essential because the effects of some opioids can last longer than the effects of naloxone.
What Is Carfentanil, the Opioid Alarming Public Health Authorities?
Montreal Public Health recently issued an alert after confirming several fatal overdoses involving carfentanil, a synthetic opioid recognized as one of the most powerful substances ever to appear on the illicit drug market.
Originally developed for veterinary use, carfentanil is used to immobilize very large animals, including elephants. Because of its extraordinary potency, it has never been approved for medical use in humans.
An Opioid of Extraordinary Potency
Carfentanil belongs to the same family as fentanyl, but its effects are far more powerful. Experts estimate that it is approximately 100 times more potent than fentanyl and up to 10,000 times more potent than morphine. At such concentrations, an amount measured in micrograms can be enough to cause a fatal overdose.
This extreme potency explains why public health authorities consider its presence in street drugs especially alarming.
An Often Invisible Danger
The greatest danger is that carfentanil is frequently mixed with other illicit substances, including fentanyl, heroin, cocaine, or counterfeit pills. Users are often unaware of its presence, dramatically increasing the risk of overdose.
Because it cannot be detected by sight, smell, or taste, a person may consume what they believe to be a normal dose while unknowingly ingesting a potentially lethal amount of carfentanil.
An Overdose Can Occur Within Minutes
Carfentanil acts directly on the central nervous system, progressively slowing breathing until it can cause respiratory arrest.
The main signs of an opioid overdose include:
- Loss of consciousness;
- Inability to wake the person;
- Very slow, irregular, or absent breathing;
- Bluish lips or fingernails;
- Extremely constricted pupils.
Without immediate intervention, oxygen deprivation can result in irreversible brain damage or death.
Naloxone Remains Effective, but Medical Monitoring Is Essential
In the event of an overdose, naloxone remains the recommended emergency treatment because it can temporarily reverse the effects of opioids. However, in cases involving carfentanil, multiple doses may be required due to the drug’s extreme potency.
Even when a person regains consciousness after receiving naloxone, immediate medical care remains essential. The effects of carfentanil may outlast those of the antidote, exposing the victim to a second episode of respiratory depression once the naloxone wears off.
Authorities Urge the Public to Remain Vigilant
As carfentanil-related deaths continue to rise, public health authorities remind the public that anyone showing signs of an overdose should be treated as a medical emergency. They recommend calling 911 immediately, administering naloxone if available, and remaining with the individual until emergency medical services arrive.
The Montreal alert reflects a troubling reality seen across North America: the growing presence of highly potent synthetic opioids on the illicit drug market continues to fuel a public health crisis with devastating consequences.
A Personal Reflection
As the publisher of a media group serving the LGBTQ+ communities, I spend every day in Montreal’s Gay Village and have become a trusted confidant for many people. I can no longer remain silent about the alarming number of young people I meet who feel the need to talk to me about their addiction to street drugs. Sadly, I can say that every single day I encounter between 5 and 15 people struggling with drug addiction. It is a reality that can no longer be ignored.
Even more troubling, I now know more people living with drug addiction than people who do not use drugs. It is a heartbreaking reality that often leaves me feeling powerless, except for writing about it in the articles I publish here.
We rarely talk about the impact this crisis has on the mental health of those who witness it every day. Watching human beings deteriorate a little more with each passing day is profoundly heartbreaking.
I often think of Guillaume. One week, he was doing well. He was a handsome young man, smiling and full of life. The following week, I saw him again in the Gay Village, wearing torn, visibly dirty clothes that appeared not to have been washed in a very long time. He seemed to be going through involuntary withdrawal and was simply begging for enough money to buy a sandwich.
I witness stories like Guillaume’s far too often. Behind every person living with addiction is a human being, a personal story, deep suffering, and, all too often, an overwhelming sense of abandonment.
Sadly, the chances of these individuals reclaiming their lives are very slim. These powerful drugs gradually destroy the brain, the body, and, all too often, a person’s human dignity.
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