Hamilton plagued by extremely potent ‘Yellow Down’

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New drug contains a mix of fentanyl and sedatives. Opioid-related deaths in Hamilton are 45 per cent greater than the Ontario average. Photo credit: Realtor.ca 


Hamilton Public Health has now released two warnings in 2023 that an extremely potent fentanyl called “Yellow Down” is circulating in the community.

The “Yellow Down” drug contains fentanyl and sedatives and is likely to cause people to lose consciousness. The drug is also less responsive to naloxone. 

Naloxone is administered to reverse the effects of opioid overdoses.

Similar to someone with allergies who is encouraged to carry an EpiPen with them, those who use opioids are now being encouraged to carry naloxone with them. 

It should be noted that naloxone is also sometimes called Narcan. Just as EpiPen is a common brand of a series of epinephrine products, Narcan is a common brand of naloxone products.

Narcan is also typically a nasal spray.

While some opioid overdoses can typically be reversed with one treatment of naloxone, “Yellow Down” is so potent that multiple treatments of naloxone may be required to reverse effects.

Hamilton Public Health adds that they consider “Yellow Down” responsible for a number of suspected overdose deaths this summer.

They note that at the end of July the city had four suspected overdose deaths in only four days.

The city also reports that paramedic calls for suspected opioid overdoses have been rather high in 2023 so far.

From January 1, 2023 to August 27, 2023, Hamilton Paramedic Services has responded to 686 incidents related to suspected opioid overdoses. That is an average of about 86 per month.

The city averaged 68 per month in 2022 and previously peaked at 76 per month in 2021 according to city data. It should be noted that the data only dates back to January 2017.

July 2023 alone had 106 incidents, which is the second highest number recorded by the city’s dashboard. The number of monthly paramedic incidents peaked at 109 in August 2021.

In the city’s warning about “Yellow Down”, Hamilton Public Health encourages opioid users to always test the effect of drugs with small amounts before using in larger amounts. Public Health also says that opioid users should never use alone.

The city’s official warning also suggests that opioid users go to the city’s Consumption and Treatment Services (CTS) site at 70 James Street South when they are using, to carry naloxone, and to call 911 for every suspected drug poisoning.

Earlier this year Hamilton City Council declared opioid overdoses a state of emergency and called on the federal and provincial governments to provide more funding to help improve the issue.

Opioid-related deaths in Hamilton are 45 per cent greater than the Ontario average. 

There were 166 estimated opioid-related deaths in 2021 which is up from 26 in 2005.

Various public health professionals have called for more drug testing sites where people can test their supply before using. There have also been calls for governments to provide “safe supply” to users.

Hamilton City Council appears to agree.

Council unanimously approved a new Opioid Action Plan which authorized $667,000 for Housing Services to initiate a call for applicants to operate a men’s shelter-based supervised consumption site for 19 months.

Once established, that location would be the city’s second supervised consumption and treatment site.

Currently, the city’s only site is 70 James St S near Jackson St W. However, that site is reportedly being relocated to a new building at 430 Cannon St E near Wentworth St N soon.

The Council-approved Action Plan also calls for the scaling up of Supervised Consumption Sites across the city going forward as well as more rapid detox and residential treatment programs.

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