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If you use drugs, consider using the National Overdose Response Service Line (NORS).  NORS is an overdose prevention hotline for Canadians, providing compassionate, confidential, and nonjudgmental support for people, whenever and wherever they use drugs.  If using drugs alone, call or text (Canada only) 1-888-688-6677 (NORS).

Learn how you can help friends and family who use substances stay safe when using drugs by watching this video created by the Canadian Association of People Who Use Drugs (CAPUD):  How to Spot Someone so They Never Use Alone

Opioids are a family of drugs used to treat and relieve acute and chronic pain. They are commonly known as prescription painkillers. While opioids are effective at treating pain, they are also highly addictive. This may lead individuals to become more dependent on them and require stronger doses. Anyone can become dependent on opioids.

Common opioids include: morphine, codeine, Oxycontin, Percocet, Hydrocodone (Vicodin), Hydromorphone (Dilaudid), Meperidine (Demerol), Methadone, fentanyl, Heroin.

Some people use opioids to get high. Of particular concern is the unpredictable strength of the unregulated (illegal) drug supply available in our communities.  This supply can contain fentanyl, carfentanil and other substances making the street supply much more dangerous.

What are fentanyl and fentanyl analogues?

  • They are powerful synthetic opioids
  • Fentanyl is 100 times stronger than morphine and 40 times stronger than heroin
  • Fentanyl analogues (e.g., carfentanil) are like fentanyl but have a slightly different chemical make-up.  Fentanyl analogues can be much more dangerous than fentanyl and potentially fatal.

Other unregulated substances may contain fentanyl or fentanyl analogues and because it can’t be seen, smelled, or tasted, people may not know that they are taking such a dangerous combination. A very small amount of fentanyl or fentanyl analogues can lead to an overdose/poisoning and possible death.

Opioids affect the part of the brain which regulates breathing. When a person uses more of a drug, or a combination of drugs than the body can handle, the brain is not able to control basic life functions, like breathing. If there is no intervention, then the individual can stop breathing and die if help is not available.

Signs/Symptoms of an Overdose

  • Blue/purple/grey lips, fingernails, or toenails
  • Very slow or no breathing
  • Faint pulse or no pulse
  • Pale and clammy skin
  • Falling asleep or loss of consciousness
  • Choking, snoring or gurgling sounds
  • Limp body
  • Small, constricted 'pinpoint' pupils

Risk Factors

  • Using a greater amount than usual
  • Mixing with alcohol or other drugs 
  • Inconsistent drug quality (illegal drugs are unregulated and therefore unpredictable)
  • Using drugs after a period of time of not using them. Tolerance is less.
  • Using alone – there is no one to help

What to do in the event of an overdose

Step 1: Shout and shake shoulders

Step 2: Call 911

Step 3: Give Naloxone

Step 4: Perform rescue breathing and/or chest compressions

Step 5: Is it working? If no improvement after 2-3 minutes, repeat steps 3&4.  Stay with them until Emergency services arrives.

Take-home Naloxone kits and training are available free of charge and without a prescription for people at risk of overdose and their family and friends. Naloxone kits are available at the Simcoe Muskoka District Health Unit, Community Health Centres, and many pharmacies across the region. Health Cards are not required. Call your pharmacy ahead of time to make sure a Naloxone kit is available.

You can find where to access a kit in your community by accessing:  Where to get a free naloxone kit.
The Good Samaritan Drug Overdose Act provides some legal protection for people who call 911 or need emergency help during an overdose. The Act can protect you from charges for possession of a controlled substance (drugs) and breaches of certain legal conditions. The Act does not provide legal protection against more serious offences like outstanding warrants or production and trafficking of drugs.  

What are Counterfeit Pills? 

Counterfeit pills are fake medications that have different ingredients and composition than the actual medicinal ingredients. Fake pills may contain no active ingredient, the wrong active ingredient or have the right ingredient but the wrong amount. Counterfeit pills may contain deadly amounts of fentanyl and or fentanyl analogues, this is especially dangerous as people are often unaware that fentanyl has been added. This creates the potential for a fatal poisoning

Counterfeit pills are made to look like real prescription pills such as oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin), and alprazolam (Xanax); or stimulants like amphetamines (Adderall). 

The only safe medications are ones that are prescribed by and come from a licenced medical professional. 

Pills purchased through social media or bought online are not real. These pills are unregulated, dangerous, and potentially deadly. 

One single pill, or even half of a pill, could be deadly. Just 2 salt-sized grains of fentanyl can cause fatal overdose


Prescription Fentanyl vs Unregulated Fentanyl

Prescription fentanyl is prescribed and can only be obtained from a licensed physician or pharmacy

Unregulated fentanyl is made and distributed through unregulated drug markets withno quality control and is much more potent than prescription fentanyl.

Counterfeit Pills: What you need to know
Start a conversation about substance use. These opportunities to share and listen are important steps in understanding the effects of drugs and specifically opioids in our communities.

Compassion starts with us - YouTube

For more videos in this series, please see here.

Get informed
Understanding the risks and signs of an overdose can save a life. It can also help you talk honestly and openly with family and friends. Find out how our community plans to address the drug toxicity crisis in Simcoe Muskoka.


Get Involved

Stigma are the negative attitudes, beliefs or behaviours about or toward a group of people because of social aspects of their life.  The words we use when we talk about people who use drugs can make a difference and can either create barriers for access to services or bridge this care. We have the choice to use language that provides dignity and respect for the people involved.

Why words matter

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