Let's discuss fentanyl on campus: what is it? how can we respond?
NAAW 20116
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Dear Community of Practice Members, 
To mark National Addiction Awareness Week, and address what health officials have deemed a "fentanyl crisis", we have compiled FAQs, best practices, and resources to share with your campus community. The theme of this year's Addiction Awareness Week is "Addiction Matters", a reminder that substance use prevention, harm reduction, and treatment all belong in our system of care.

This issue also features a story of an accidental fentanyl overdose. Carrie, a British Columbia mother, who recently lost her daughter, Emily, has shared her story in an effort to bring awareness to the prevalence of fentanyl, and encourage those who are at risk to seek help.  
  • Fentanyl FAQs
  • Best practices
  • Carrie's story
  • Campus resources
  • In the news
Fentanyl FAQs
Q: What is fentanyl?
Fentanyl is a synthetic opiate traditionally prescribed for treating severe or chronic pain, as it is 50 to 100 times more potent than morphine. The drug is becoming more prevalent among recreational users due to a shortage in heroin. On the street fentanyl is also known as: Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, or Tango and Cash.

Q: What makes it so dangerous?
Non-prescription fentanyl is commonly mixed with other substances, such as heroin, cocaine, and oxycodone, and packaged similarly. This is especially dangerous because oftentimes, people are unaware they are consuming fentanyl and there is no quantity control; not only does each batch contain varying amounts of fentanyl, each dose or application does too. An overdose of fentanyl is only two milligrams—the equivalent of two grains of salt. Since fentanyl reacts to opioid receptors in areas of the brain that control breathing rate, a high dose can cause breathing to stop completely.  

Q: Is it always fatal?
No, not if treated immediately. The current best response to a fentanyl overdose is the administration of naloxone, a medication that reverses the effects of overdose from opioids. Naloxone, also referred to by its brand name, Narcan, is a nasal spray that is ready-to-use and delivers a four-milligram concentrated dose. First responders are generally now equipped with and prepared to administer the medication. Though Narcan is also available as a take-home kit, this is not a substitute for emergency medical care. Campus members are urged to call 9-1-1 in the event of a suspected overdose.
Best Practices
While the lack of quantity and quality control in manufacturing fentanyl is problematic, it is important to consider what else has contributed to these circumstances. There is more isolation and (di)stress among students from community breakdown than ever before, making the motivation to use substances a community issue. Therefore, how can we, as a community, address this “crisis” together?

Changing the Culture of Substance Use, a Healthy Minds | Healthy Campuses project, has a few suggestions:
  • Reach out to your campus community with essential information about fentanyl through your campus website, social media, residence services, health services, and other campus services without communicating an alarmist message. The intent should be to promote a culture of harm reduction, dialogue, caring, and connectedness on campus that will help foster the health and safety of campus community members.
  • Let campus members know how and where they can access support services.
  • Educate and train campus members on how to respond to an overdose, without the fear of repercussions, and provide information on how campus members can access naloxone on and off-campus (e.g., residence services and/or security services).
  • Encourage family members to have conversations about fentanyl. Provide guidance on how to start an open dialogue with someone who may be using substances in a risky way, and how to help a friend or loved one in the event of an emergency.
  • Research and invest in further harm reduction approaches to substance use, such as installing sharps containers in washrooms.
  • If there is concern over consequences for students who are caught using or in an overdose situation, campuses may want to consider revising their policies to reflect the need for “Good Samaritan” protections. This will encourage students to respond appropriately and quickly to ensure the health and safety of their peers.
Campuses might also consider developing platforms for open dialogue to better understand why people use substances so they can tailor their health promotion and prevention accordingly. This format offers people the opportunity to explore questions and concerns together, and reflect on their own relationships with substances.
Carrie's Story

Carrie has kindly offered to share her story after losing her daughter, Emily, to an accidental fentanyl overdose in September. Her story describes the tragic circumstances surrounding Emily’s overdose, their inability to find help, and what she wants families and youth who might be in a similar situation to know:

Carrie and Emily had just celebrated Emily’s 23rd birthday at the Pacific National Exhibition (PNE) in Vancouver, BC, when Emily resolved to stop using.

She had tried to quit before, but using made coping with her depression much easier. Emily started to self-medicate in high school with alcohol and marijuana, then later with oxycodone. It was hard to find resources that suited her needs, and even harder to find someone she could confide in and trust. It was daunting for Emily to tell a stranger what she was going through over and over again, and re-live the emotional pain she was in.

Carrie visited Emily for her 23rd birthday shortly after nine people in Delta, BC, overdosed on cocaine cut with fentanyl, one of whom died. Carrie remembers Emily acknowledging how scary and sad that was, and remarking that she didn’t want to take that risk anymore—after she finished celebrating. Carrie said Emily really wanted to change and was ready to. But a couple of days later, she passed away in her sleep. Like many unsuspecting people who have died of a fentanyl overdose, Emily had no idea the cocaine she had taken was mixed with toxic levels of fentanyl.

Carrie and her family were devastated. This was the most hopeful Emily had ever been and she never got the chance to see that hope realized. Carrie was always aware of Emily’s substance use, as they had a very open relationship, but Emily still shielded Carrie from the worst of it. Emily thought she could recover on her own, that she could stop any time.

“I wish she’d been completely honest with me so I would have known the extent,” says Carrie. “I tried to never judge her, and I understood her pain, but she didn’t want to disappoint mom. If I had been aware I could have helped her.” 

By sharing Emily’s story Carrie hopes to prevent this from happening to another family. “If kids are getting into a situation that they know is dangerous, talk to somebody. If that isn’t your parents, tell your cousin, your aunt, ‘I’m scared’. It’s better to disappoint a loved one than not get the help you need.”
Resources for Your Campus
Understanding Substance Use

Understanding Substance Use

From a health promotion perspective, heretohelp's guide illustrates the spectrum of outcomes that can result from substance use and offers practical guidance on how to build the capacity of people to engage in healthy actions that minimize harm. 

Learn more >>>

Helping people who use substances

Helping People Who Use Substances

heretohelp's guide offers suggestions on how you might help someone who is using substances in a harmful way and regulate conditions in a community to promote healthier relationships with substances overall. 

Learn more >>>

Dinner and Dialogue

Dinner and Dialogue: Engaging Community in Conversation about Drinking Culture

HM|HC's guide to hosting conversations about substance use (specifically drinking culture) in the community. The materials can be adapted to address a variety of topics, including opioid use.

Learn more >>>
Hosting a Dinner Basket Conversation

Hosting a Dinner Basket Conversation on Substance Use

This guide from Selkirk College is a tried-and-true recipe to engage in meaningful conversation about substance use on campus that includes guiding questions for facilitators, a reflection sheet for participants, and recipes for preparing a balanced meal.

Learn more >>>

Community Call

Have we answered all of your questions?

We understand if the answer is 'no'. The increasing (and often undetected) prevalence of fentanyl in our campus communities is complex and distressing. In order to provide as much support as possible, Healthy Minds | Healthy Campuses will be scheduling an open teleconference with campus members to respond to the growing need for information and best practices. If interested in participating, please click the link below to provide your contact information and identify the topics you'd like addressed. 
Join the Conversation --->>
Featured Stories in the News View all news stories
TRU Fentanyl Video

Students at TRU's Wellness Centre in Kamloops, BC, have created a video to caution against the dangers of fentanyl. The hope is that students will share the message on social media and those at risk will seek further support from the Wellness Centre. 

Read the full article >>>

Fentanyl Crisis

As the number of overdoses continues to rise in Vancouver, there is more evidence to suggest that a change in culture and a more responsive approach are what is needed. Claire Vulliamy reports on the advent and escalation of the "fentanyl crisis".

Read the full article >>>

UBC Naloxone kits

To combat the problem of accidental overdoses, UBC students will now be able to pick-up free naloxone kits on campus if they think they are at risk for fentanyl exposure. The launch of these kits is in response to eight illicit drug overdose visits to the UBC Urgent Care Centre between January and September of this year.

Read the full article >>>


UofC Naxolene Kits

The University of Calgary has had four naxolene kits ready for use, but students aren't picking them up. Despite an unsuccessful series of educational programs, workshops and awareness campaigns, organized by the Wellness centre, the university remains committed to investigating and removing any barriers to access.

Read the full article >>>

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