Fentanyl Contamination as a Risk Priority: the Impact of the Fentanyl Epidemic on Club Drug-Using Behaviours

Abstract

Background

Over the last decade, rates of fentanyl-related overdoses have increased substantially across North America, a phenomenon which has widely been described as the “fentanyl epidemic.” While research has explored the cultural impact of the fentanyl epidemic on opioid and/or injection drug use, less is known about its impact on other types of drug use. Drawing on two years of ethnographic research with people who use club drugs in Toronto’s Electronic Dance Music (EDM) scene, this study looks at how people who use club drugs make sense of and respond to the fentanyl epidemic.

Methods

Data for the study was collected via participant observation and semi-structured interviews (n = 26).

Findings

The key finding was that fentanyl contamination had become a “risk priority” for the participants. They thereby adjusted their drug-using behaviors to account for this risk. However, by prioritizing fentanyl contamination above everything else, they often overlooked and/or disregarded other forms of harm reduction that they had once practiced (like getting testing kits to test for other adulterants).

Conclusion

The findings suggest that the fentanyl epidemic has impacted not only practices of illegal opioid use, but also practices of club drug use. They suggest that the fentanyl epidemic has in some ways facilitated the adoption of risk management, while in other ways undermined it. The findings are interpreted with reference to Rhodes’ “risk environment” framework and with particular attention to the need for harm reduction interventions that take into consideration how risk perceptions and behaviors are situation- and context-dependent.

Keywords:

• Fentanyl
• epidemic
• risk management
• opioids
• club drugs
• ethnography

Acknowledgements

I would like to extend a very special thanks to Dr. James Williams, my dissertation advisor, for all of the help and support he provided me throughout this research project. I would also like to thank my committee members Dr. Sarah Flicker and Dr. Amber Gazso for their invaluable feedback and advice.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Funding

This project was supported by a SSHRC Doctoral Fellowship.