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Animal tranquillizer detected in growing number of human overdose deaths in Ontario

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A powerful drug used to sedate horses and cattle is creeping into Canada’s illicit drug supply and has been detected in a growing number of human drug poisoning deaths in Ontario.

The animal tranquillizer xylazine is already causing concern in the United States and results from a drug-testing site in Canada show it’s becoming more common north of the border.

Nigel Caulkett, a professor of veterinary medicine at the University of Calgary, says xylazine produces a deep state of sedation that affects cardiovascular function and can induce vomiting.

He says he is concerned that people are mixing the powerful drug with opioids, which can lead to more profound reactions.

“There have been a number of case reports of people overdosing on xylazine and, in those cases, they often have to put the person on a ventilator to get them through that crisis,” Caulkett said.

In Ontario, the tranquillizer was not linked to any deaths in 2019 but was detected in five opioid-related fatalities the following year, the Office of the Chief Coroner said in a statement.

There was a significant rise in 2021. Xylazine was detected in 26 opioid-related deaths and played a direct role, along with other substances, in three of those cases.

Data from drug seizure samples submitted to Health Canada by law enforcement and public health agencies show a substantial rise in the presence of xylazine in Ontario from just seven matches in 2019 to 414 last year. Matches decreased slightly in Alberta and fluctuated in B.C.

In a statement, Health Canada cautions that there are limitations with its data, and it may not be representative of drug seizures or what substances are circulating in the illicit market.

In the northeastern U.S., xylazine was involved in two-thirds of fatal drug overdoses in 2019, said a report from the Centers for Disease Control and Prevention.

A media report in Philadelphia said people using xylazine were in some cases needing to have fingers and toes amputated.

Caulkett said there have been no such reports in his animal patients but suggested that if people are reusing or sharing needles, it could lead to infection. High doses of the tranquillizer could also result in “death of the skin.”

Unlike opioids, there is no available antidote to reverse a xylazine overdose.

Results from Get Your Drugs Tested, a free drug-checking website in Vancouver, show xylazine often appears in combination with other drugs like fentanyl or benzodiazepines. It’s been identified in substances described as brown chunks, light pink powder, light orange or white crystals, and brown pebbles.

Since the service was founded in May 2019, 85 samples have come back positive for xylazine in varying proportions, mostly from areas in British Columbia, but also from Alberta, Saskatchewan and Ontario.

Last year, there were 50 positive results, up from just five in 2020. So far this year, the drug has been detected in 28 samples as of Friday, the latest identified over the past week.

Allen Custance, site manager of Get Your Drugs Tested, said there’s limited information on xylazine’s effect on people as it’s relatively new to the drug market.

Some samples have been highlighted on the website in red with warning notes attached. Custance said samples are typically pointed out if someone reported an overdose or death.

“Xylazine is a veterinary drug used as a sedative, analgesic and muscle relaxant in animals. In humans, it could cause central nervous system depression, respiratory depression and even death,” said one warning attached to a February sample from Vancouver.

In that instance, xylazine was sold as ketamine.

In Alberta, there have been seven deaths between January 2019 and this March where xylazine was detected in low concentrations, but the Office of the Chief Medical Examiner did not provide dates.

The Saskatchewan coroner’s office said there have been no reported deaths linked to the tranquillizer since last year, when four people died in a three-week span in February and March, which prompted a public warning.

This report by The Canadian Press was first published April 3, 2022.

 

Alanna Smith, The Canadian Press

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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