Monthly Reports

April 2025 Monthly Report

Derek Robinson

• 11 min read
April 2025 Monthly Report

In this blog post, we discuss our April 2025 report and provide more information on how to interpret the results. The PDF report can be found at the end.

Key findings:

  • The median fentanyl concentration found across all drug categories was 4.3%
  • The median fluorofentanyl concentration found across all drug categories was 5.2%
  • The median ortho-methyl fentanyl concentration found across all drug categories was 1.2%
  • Benzodiazepines were found in 45.4% (93/205) of expected Opioid - Down samples
  • Bromazolam was found in 54 Opioid - Down samples with a median concentration of 3.2% and maximum concentration of 38.9%
  • Xylazine was found in 14 expected Opioid - Down samples with a median concentration of 0.3% and a maximum concentration of 28.5%
  • Medetomidine was found in 9 expected Opioid - Down samples with a median concentration of 0.6% and a maximum concentration of 5.1%

Insight for the April 2025 Monthly Report

This blog, and the associated pdf report, breakdown our sample counts into six categories:

  • Samples received through direct service provision in Victoria, where service users are bringing samples into the Substance storefront. These samples are labelled as "Substance" samples in the figures/tables of this blog post
  • Samples received through direct service provision in Campbell River, where service users bring samples either to the Vancouver Island Mental Health Society (VIHMS) or Campbell River AVI Health & Community Services. These samples are labelled as "Campbell River"
  • Samples received through direct service provision in the Comox Valley, where service users are bringing samples to AVI Health & Community Services in Courtenay, BC. These samples are labelled as "Comox Valley"
  • Samples received through direct service provision in the Cowichan Valley, where service users bring samples to the Duncan Lookout Society OPS in Duncan, BC. These samples are labelled as "Duncan"
  • Samples received through direct service provision in Port Alberni, where service users bring samples into Port Alberni Shelter Society’s OPS. These samples are labelled as "Port Alberni"
  • Samples received through direct service provision in Port Hardy, where service users bring samples into Island Health Mental Health and Substance Use. These samples are labelled as "Port Hardy"
  • Samples received through indirect service provision, where samples are collected through no-contact drop-off envelopes, are collected by harm reduction workers and other community members at supported housing sites, overdose prevention sites, supervised consumption locations, and the Hospital sample submission kiosks located in Victoria, Nanaimo, and Campbell River. These samples are labelled as "Outreach" samples in the figures/tables herein.

Drug types

Day to day at Substance, we receive and check a wide variety of different samples. Figure 1 shows the prevalence of each expected drug category checked, split by sample collection location/method. Table 1 shows the number of samples received at each sample collection location per expected drug category.

Figure 1. Prevalence of drug classes checked during April split by sample collection/method. Bars are stacked by the percentage of samples in each drug class, with the individual percentages overlaid. Drug classes which represent less than 1% of a given location’s total do not have their percent overlaid onto the bar.
Figure 1. Prevalence of drug classes checked during April split by sample collection/method. Bars are stacked by the percentage of samples in each drug class, with the individual percentages overlaid. Drug classes which represent less than 1% of a given location’s total do not have their percent overlaid onto the bar.
Table 1: Sample counts per location
Table 1: Sample counts per location

The Sample Breakdown

For the majority of samples checked, we confirm the presence of the expected drug with no additional active compounds detected above the limitations of the drug check. The bar charts below highlight a few classes of drugs, differentiating samples where only the expected active component was detected - from situations when other unexpected active components were detected.

Figure 2. Compositional breakdown by drug class and sample collection location/method. Bars are stacked by the percentage of samples in each category, with the relative proportions overlaid. Proportions less than 1% are not overlaid for clarity. “Dark Blue” groups samples that were *as expected* with no other notable compounds detected, “Purple” groups samples that contained the expected drug and contained other unexpected active(s), “Magenta” groups samples that did not contain the expected active but did contain unexpected active(s), “Salmon” groups samples where we were unable to determine the composition (e.g. scenarios where we do not have appropriate reference spectra), and “Lime” displays samples where no active compounds were detected.
Figure 2. Compositional breakdown by drug class and sample collection location/method. Bars are stacked by the percentage of samples in each category, with the relative proportions overlaid. Proportions less than 1% are not overlaid for clarity. “Dark Blue” groups samples that were *as expected* with no other notable compounds detected, “Purple” groups samples that contained the expected drug and contained other unexpected active(s), “Magenta” groups samples that did not contain the expected active but did contain unexpected active(s), “Salmon” groups samples where we were unable to determine the composition (e.g. scenarios where we do not have appropriate reference spectra), and “Lime” displays samples where no active compounds were detected.

Dissociatives

85.4% (35/41) of expected dissociatives samples were as expected

3 expected ketamine samples (from Susbstance), were MDMA instead

2 expected ketamine samples contained an active component in addition to ketamine:

  • 1 expected ketamine sample also contained MDMA
  • 1 expected ketamine sample also contained methamphetamine

1 expected 3-MeO-PCP sample contained an unknown component instead

Cocaine

89.6% (69/77) of expected cocaine and crack samples were as expected

8 samples (3 from Substance, 3 from Outreach, 1 from Campbell River, and 1 from the Comox Valley) contained an active component in addition to the expected cocaine or crack:

  • 2 expected crack samples also contained phenacetin
  • 2 expected crack samples also contained fentanyl or an analogue
  • 2 expected cocaine samples also contained fentanyl or an analogue
  • 1 expected cocaine sample also contained levamisole
  • 1 expected cocaine sample also contained acetaminophen

Methamphetamine

87.5% (14/16) of expected methamphetamine samples were as expected

1 expected methamphetamine sample contained crack and an unknown instead

1 expected methamphetamine sample did not have any actives detected

MDMA/MDA

93.5% (43/46) of expected MDMA/MDA samples were as expected

1 expected MDMA sample contained ketamine instead

1 expected MDMA sample also contained MDA

1 expected MDMA sample did not have any actives detected

Benzodiazepines (n=32)

56.25% (18/32) of the expected benzodiazepine samples checked in April came to our service sites in the form of pressed pills with the following expected and detected compositions:

Table 2. The composition of benzodiazepine pressed pills checked in April. “Expected Composition” describes the benzo expected/reported by the service user, while “Detected Composition” describes the contents we found through the drug check. “Benzodiazepine (unknown type)” refers to samples where the benzo strip test was positive but no benzos were identified with our other instruments. These unknown benzo samples either contain a benzo at very low concentrations and/or novel benzos that are not in our targeted method for the mass spectrometer.
Table 2. The composition of benzodiazepine pressed pills checked in April. “Expected Composition” describes the benzo expected/reported by the service user, while “Detected Composition” describes the contents we found through the drug check. “Benzodiazepine (unknown type)” refers to samples where the benzo strip test was positive but no benzos were identified with our other instruments. These unknown benzo samples either contain a benzo at very low concentrations and/or novel benzos that are not in our targeted method for the mass spectrometer.

Within the remaining 12 samples (6 from Outreach, 6 from Substance):

  • 2 expected alprazolam (Xanax) samples were alprazolam (Xanax)
  • 1 expected alprazolam (Xanax) sample was flubromazepam
  • 1 expected bromazolam sample was fentanyl and desalkylgidazepam instead
  • 1 expected bromazolam sample also contained fluorofentanyl, desalkylgidazepam, and flualprazolam
  • 1 expected diazepam (Valium) sample was diazepam (Valium)
  • 1 expected etizolam sample was bromazolam instead
  • 1 expected flubromazepam sample was meperidine and methylmethylphenidate instead
  • 1 expected flurazepam sample was fentanyl, fluorofentanyl, medetomidine, and ethylbromazolam instead
  • 1 * expected* lorazepam (Ativan) sample was lorazepam (Ativan)
  • 1 unspecified benzodiazepine was desalkylgidazepam and fentanyl or an analogue
  • 1 unspecified benzodiazepine was bromazolam and fentanyl

The remaining 2 benzodiazepine samples did not have any actives detected

Opioid-positivity in non-opioid-down samples

In April, we checked 294 samples that were not expected to contain fentanyl or other “unexpected” opioids[1]. Since the opioid-down supply is no longer “just heroin” or “just fentanyl” and is instead a complex, potent, and ever-changing polysubstance market containing other synthetic opioids like fluorofentanyl or nitazenes, here we will examine the prevalence of any unexpected opioid, not just fentanyl, detected in non-opioid-down samples.

  1. Specifically, we are excluding samples that were expected to be “opioid-down” or samples that had an “unknown/missing” expected composition. In the case of “opioid-other” samples, e.g. hydromorphone tablets and oxycodone pills, “unexpected opioids” are defined as any opioid that is not the expected opioid. ↩︎

Table 3. Overview of unexpected opioid detections in non-opioid-down samples in April.

Examining Table 3, we find that 16 samples tested positive for unexpected opioids in April, representing 5.4% of all non-opioid-down samples checked. These samples were as follows:

Expected Opioid - Other samples:

  • 3 expected oxycodone (Oxycontin) samples were N-desethyl isotonitazene instead
  • 1 expected oxycodone (Oxycontin) sample was an unknown nitazene instead
  • 1 expected oxycodone (Oxycontin) sample was MDMA and an unknown nitazene instead
  • 1 expected hydromorphone (Dilaudid) sample was bromazolam, N-Propionyl norfentanyl, and oxycodone (Oxycontin) instead
  • 1 expected hydromorphone (Dilaudid) sample also contained fentanyl or an analogue

For expected cocaine samples, please see the "The Sample Breakdown" section above.

For expected benzodiazepine samples, please see the "Benzodiazepines" section above..

In April, no unexpected opioids were detected in samples expected to be MDMA, dissociatives, psychedelics, methampethamine, or other.

In people’s personal quests for bodily autonomy and informed consumption, there is often evaluation of risk and consequence, but when the consequences can be severe and the risks are unknown or are intentionally exaggerated, these become difficult, if not impossible, conversations to weigh. We believe that drug checking can help provide people with the information needed to evaluate the risks, and provides harm reduction advice to minimize undesired consequences of substance use. These data are not meant to downplay concerns or invalidate past experiences. We recognize the tragic consequences of when fentanyl is found in non-opioid samples and honour the heartbreak that such experiences produce. Instead, we present these data with the intent to combat misinformation and provide an evidence-based context for people to consider when making decisions about substance use. While these numbers reflect what we have seen over the course of the project, these (roughly) 1-in-100 events still occur, so we always encourage folks to get their stuff checked.

Opioid-Down (n=205)

In this section we present results specific to the opioid-down supply, therefore they may differ from the highlighted findings above that are inclusive of all expected drug categories.

  • 43.4% (93/205) of expected opioid-down samples contained fentanyl as the only active opioid
  • 11.2% (23/205) of expected opioid-down sample contained fluorofentanyl as the only active opioid
  • 8 samples contained heroin, of these samples, 6 contained the related alkaloid acetylcodeine and/or acetylmorphine (MAM). In total, this represents 3.9% of all opioid - down samples.
    • 3/8 samples which contained heroin also contained fentanyl or a fentanyl analogue
  • 1 sample contained carfentanil
  • 9.8% (20/205) of expected opioid - down samples contained ortho-methyl fentanyl
  • 45.4% (93/205) of expected opioid-down samples contained a benzodiazepine
    • The most common benzodiazepine in opioid-down samples was bromazolam (62), followed by desalkylgidazepam (29), benzodiazepine (unknown type) (14), flualprazolam (4), etizolam (2), and flubromazepam (2)
  • Xylazine was detected in 6.8% (14/205) of opioid-down samples, most commonly being found in samples from Substance (9).
  • Medetomidine was detected in 4.4% (9/205) of opioid-down samples, most commonly being found in samples from Substance (7).
  • Nitazene were detected in 1 opioid-down sample, specifically, isotonitazene.

In April, 59.0% (121/205) of all opioid-down samples checked contained an additional active to the expected fentanyl/heroin. These data are shown in Fig. 3 highlighting the prevalence of benzos, fluorofentanyl, ortho-methyl fentanyl, and xylazine in the down supply.

Figure 3. The percentage of expected opioid-down samples checked between April 2024 and April 2025 that only contained fentanyl/heroin actives (solid dark purple), opioid-down samples with an additional active detected (dot-dashed light purple), opioid-down samples that contained a benzodiazepine-related drug (dotted magenta), opioid-down samples that contained fluorofentanyl (dashed salmon), opioid-down samples that contained ortho-methyl fentanyl (dashed orange), and opioid-down samples that contained xylazine (dashed yellow).

Ortho-Methyl fentanyl was found in 9.8% (20/205) of opioid-down samples.

Fluorofentanyl (specifically the HCl salt) was found in 42.9% (88/205) of opioid-down samples.

Benzo-related drugs contribute to a majority of the other additional actives found in expected opioid-down samples, with 45.4% (93/205) of expected opioid-down samples checked containing a benzo-related drug. Bromazolam continues to be the most common benzo seen in the down supply, being detected in 66.7% (62/93) of the benzo-positive opioid-down samples.

Scattered detections of other drugs are still found and can be reviewed in the pdf report at the end of this blog.

Quantification for Expected Opioid-Down[1]

In April, we quantified fentanyl for 156 of the expected opioid-down samples containing fentanyl and found the median concentration to be 4.1%[2]. Though the median is a useful indicator, it doesn’t capture the volatility of fentanyl concentrations present in the opioid supply, as half of fentanyl-positive down samples contained between 1.6% and 16.6% fentanyl, and any one sample might be the lowest strength (0.2%) or the strongest (greater than 50%[^3]). Fluorofentanyl was seen at concentrations ranging from 0.2% to greater than 50% as well, with a median concentration of 5.3%. In April, we quantified ortho-Methyl fentanyl in 20 opioid - down samples at a median concentration of 1.2%, with half of ortho-Methyl fentanyl positive down samples containing between 0.9% and 2.4% ortho-Methyl fentanyl. Bromazolam, the most common benzodiazepine adulterant in down samples, had concentrations ranging from less than 0.1% to 38.9% bromazolam, with a median of 3.2%.

[3]: For samples that contain greater than 50% fentanyl, heroin, fluorofentanyl, or bromazolam by weight, our mass spectrometer is presently unable to reproducibly assign a concentration due to the upper limits of the calibration methods currently adopted.

  1. Not all opioid down samples brought to our service can be quantified. This is primarily due to too limited sample collected for our instruments to report a reliable mass percentage. Nevertheless, qualitative detection is still possible. ↩︎

  2. This number is specific to fentanyl quantified in opioid-down samples. The median concentration listed in the Key Findings at the beginning of this blog (4.3%) is inclusive of all samples checked, across all drug classes and unknown samples, that contained fentanyl. ↩︎

Table 4. Quantification of low-concentration active components in expected opioid-down samples in April 2025.
Table 4. Quantification of low-concentration active components in expected opioid-down samples in April 2025.
Figure 4. Violin plots of fentanyl (top panel) and bromazolam (bottom) positive samples quantified during April across all collection locations/methods. 

We can also examine the regional variability in the unregulated market. The table below expands on the quantitative data presented above. It focuses only on fentanyl, fluorofentanyl, carfentanil, bromazolam, and xylazine quantified within expected opioid-down samples, separated by collection location/model. Weight percentage is reported; “IQR” is the interquartile range: the range that contains half of the quantified samples.

Table 5. Quantification of low-concentration active components in expected opioid-down samples, split by service models/location, in April 2025. See Table 4 for the overview from all locations. Weight percentage is reported; “IQR” is the interquartile range: the range that contains half of the quantified samples.
Table 5. Quantification of low-concentration active components in expected opioid-down samples, split by service models/location, in April 2025. See Table 4 for the overview from all locations. Weight percentage is reported; “IQR” is the interquartile range: the range that contains half of the quantified samples.
Substance Drug Checking - April 2025 Monthly Report
Substance Drug Checking - April 2025 Monthly Report.pdf
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Check back next month for the April report!

As always, send us feedback at substance@uvic.ca on how we can continue to offer our drug checking results in a useful way.

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