A Winnipeg woman who survived after using a fentanyl-based street drug but couldn’t save her friend is speaking out to warn others about substances known as pink and purple down.
Trudy Monias, 40, originally from Pimicikamak, said her own drug and alcohol use is linked to the trauma and abuse she’s faced in life. Recently, her partner of eight years, who she called her soul-mate, died by suicide, causing her to rely even more on substances to cope with her pain.
Monias had two friends over one night in March after buying drugs off a dealer for $20.
“I thought it was coke. It wasn’t coke. But I bought it anyways,” she said. “And so I snorted it. She took the first big one. It was pink powder.”
She said her friend immediately fell backwards into her bathtub. She fell to the floor beside her.
“And she just said, my heart is pounding. I thought she was having a panic attack, or the stuff was good, or something like that. She lied there, not even three minutes. ‘Wake up,’ I said. ‘Wake up.'”
Monias shook the woman and rubbed her breast bone but her eyes would not open.
Pink or purple down is heroin laced with fentanyl — an incredibly potent opioid that has contributed significantly to the number of people who died by overdose in the province this past year. The blend can also be laced with benzodiazepines, which can slow someone’s breathing further, and don’t respond to Naloxone, or Narcan, which reverses the effects of opioids.
‘We would’ve died, all three of us’
Monias said moments after they passed out, another woman discovered the three of them unconscious in the apartment and called an ambulance.
Paramedics gave many doses of Narcan, she said. She survived, but her friend, who was originally from Norway House Cree Nation, never woke up.
“I still have a vision of her death,” said Monias. “I can’t believe she’s gone. And I just think to myself, ‘I wish I didn’t buy that shit.”
Between January and December 2020, 372 people overdosed and died in the province, exceeding all of 2019 by 87 per cent, according to data from Manitoba’s Office of the Chief Medical Examiner.
The majority of drug-related deaths, 254, were linked to opioids — including fentanyl — putting Manitoba at about 18 opioid-related overdose deaths per 100,000 per year, one of the highest rates in the country.
‘Massive respiratory depression’
The administrative director for the Paramedics Association of Manitoba says paramedics are being increasingly called to more severe overdoses related to pink and purple down.
Rebecca Clifton said in the past year, the toxic opioid blend has replaced meth as the most common overdose-related call, and now patients aren’t able to tell first responders what they’ve taken, which makes them difficult to treat.
“They’re unconscious and they’re barely breathing and sometimes they’re not breathing at all,” said Clifton, who also works as a paramedic, adding people who had overdosed on straight fentanyl would typically be “barely breathing.”
“Now more commonly, it is the full respiratory arrest and progressing into cardiac arrest.”
She added it’s also harder to revive these patients. The starting standard dose of Naloxone, or Narcan, for a fentanyl overdose is 0.4 mg, she said, but it’s not enough with people who have used the heroin-fentanyl blend.
“Now we almost always are going to 2mg of Narcan [five times the amount] as the starting point because these patients are just so severely unconscious and gasping — gasping if breathing at all,” she said.
She said more education is needed so people know that street down (a heroin-fentanyl blend) causes severe respiratory depression and sometimes death. She would like to see more mental health supports for people, as well as a safe consumption site in the province, where people can be supervised as they use drugs while having access to health care and other social supports.
“These people are screaming for help, they need help and we just need more resources out there. If one of the resources was a safe injection site, I think that would provide some benefit as well.”
“It’s pretty infuriating”
The head of Manitoba’s Harm Reduction Network says urgent action is needed to ensure people have access to a safe supply of their drugs, which means being able to purchase and know what’s in them, as is possible with alcohol and cannabis, as well as a safe site.
“Our overdose numbers were 181 in 2018, in 2019 they were 191, and here we are in 2020 and our numbers are 372; that’s atrocious,” said Shohan Illsley, executive director of Manitoba’s Harm Reduction Network.
“It’s pretty infuriating because it’s so tragic, the fact that it is 100 per cent preventable and yet it’s still happening.”
In the past year, one person died on average per day, according to the data released by Manitoba’s Office of the Chief Medical Examiner. But that data wasn’t immediately forthcoming and doesn’t appear to have been reported to Health Canada at all last year.
“We need to be able to see the data in a really timely manner so we can respond immediately to what’s happening and so that we can inform the community of what’s happening with the supply,” Illsley said.
She said COVID-19 has had a ‘massive’ impact on rates of overdose deaths; more people have been using drugs alone due to health measures, they’re accessing an increasingly contaminated drug supply due to border closures, and have fewer harm reduction services available.
Illsley said as long as drug use is seen as a criminal problem rather than a health issue, people will continue to be stigmatized and less likely to seek help. Despite recommendations in the 2019 VIRGO report and calls from the medical community, harm reduction groups and a push from city council, the province has shown no support toward the measure.
Monias wants to pay her respects to her friend’s family. She understands their grief as she faces the loneliness and hopelessness each day without her own partner. Monias says she has a sense of community with her friends, many of whom are homeless, who gather in front of Portage Place Mall, but there’s also the everyday danger.
A woman who died in the bus shelter in front of the mall overdosed on pink down just weeks before her friend, she said, purchased from the same person. She doesn’t want anyone else in the community to die this way.
“If I had something to give them, more better than that, they wouldn’t have to live like this. They wouldn’t have to struggle,” she said.