My Overdose on “Benzo Dope” Was Part of a Current Wave

    It’s hard to write a story about events of which you have almost no recollection. But as the days pass, bits and pieces have started to come back to me, together with the accounts of people who interacted with me before and after I overdosed on “benzo dope.”

    If you have no idea what benzo dope is, I guess we should start there. North America’s unregulated drug supply was toxic as fuck long before benzodiazepines started to creep into the “down” that was once supposed to be heroin. Fentanyl and its analogues have long been the best-known adulterants, involved in countless deaths even as some of us seek it out. But many other substances are involved too. Filter reported on the presence of the veterinary tranquilizer xylazine in the supply back in 2019, for example—“tranq dope”— and it has only spread since, with many associated harms.

    Like xylazine, benzos mixed in can increase the “legs” of fentanyl, which is potent but much shorter-acting than many drug users want.

    Benzo dope, as the name suggests, combines benzodiazepines—a class of depressants commonly prescribed for anxiety and other conditions—with opioids like fentanyl. It often involves illicitly manufactured etizolam. Benzos have benefits for many people and can be used quite safely on their own, but when they interact with opioids they heighten overdose risk and have been involved in rapidly increasing numbers of opioid-related deaths. Benzo dope has been common in Canada since at least 2021.

    As someone who loves using down, the evolving supply means that increasingly, benzo dope is what’s available to me. Some of us seek it out, too. That’s in part because, like xylazine, benzos mixed in can increase the “legs” of fentanyl, which is potent but much shorter-acting than many drug users want.

    Dr. Joseph Friedman, a researcher at UCLA Center for Social Medicine, was co-author of a recent study on the growing prevalence and harms of xylazine in the drug supply. “Many people we spoke with detest xylazine but others like it,” he told Filter. “Mostly that’s because it solves one of their biggest issues with fentanyls, which is the short duration. Tranq seems to give fentanyl legs, so some people like it despite the negative aspects.”

    I outgrew prescription opioids close to 10 years ago and have been chasing fentanyl ever since. I also love benzos. So benzo dope is like eating a bite of warm apple pie to me—when I can remember what and how much I am taking.

    The week it happened felt much like every other week. But I had been battling urges for quite some time. I just happened to let my guard down and bought a bag of blue benzo dope.

    I overdosed in a grocery store bathroom, which is a typical place for me to use due to the restricted safe consumption services we have here.

    On June 13, I overdosed in a grocery store bathroom, which is a typical place for me to use due to the restricted safe consumption services we have here in Halifax, Nova Scotia. Honestly, all I remember is doing one shot—the rest of it is just fragments. Someone found me in the grocery bathroom and called paramedics.

    An ambulance arrived. To the best of my knowledge they gave me naloxone but the benzo dope was so strong, I don’t remember even if they did—I certainly wasn’t in precipitated withdrawal. I was admitted to hospital. Surprisingly, they treated me like gold at that hospital—with compassion, kindness and lots of food. My favorite was the chocolate pudding.

    But I don’t remember leaving at all. Next thing I know, I woke up at home and a friend—I’d been using the dope with him—was pounding on the door. He doesn’t remember anything either.

    The next few days were a blur. My family took away my drugs, as they hate when I use, and called the police. But I wasn’t arrested. After arguing and trying to get my drugs back, I got light-headed and fainted all of a sudden. The police called paramedics and they brought me to the hospital once again.

    This time, knowing it was my second admission in a few days, they didn’t treat me so nicely. They just stigmatized me like so many others in health care and society. Typical junkie, was the attitude I felt, and they just wanted to get rid of me. One doctor was okay, but I got the feeling he was getting pressure to get me out of there. They ran multiple tests and tried taking blood from everywhere you can think of, but I left not knowing any results.

    I had also overdosed earlier in the COVID-19 pandemic, and benzos were involved then, too. So I can understand the exasperation that some people might feel. Some people around me, including family members, look at me as a failure for exposing myself to these risks again and again. I hate hurting other people and have a lot of regrets after that week. I may end up missing seeing a very close friend due to this. When I get in this state, I always lose things. It’s true that I might have protected myself by being more careful.

    But look: People who use drugs do not want to overdose or die. I certainly don’t. But like many of us, my relationship with drugs is a central part of my life. Often, drugs are the only thing that can give me any kind of joy or relief. They make me feel like the person I am supposed to be, regardless of how fucked up that might sound to others. To criminalize drug use, then, is to criminalize me as a person and many others like me.

    If you accept my current relationship with drugs as a fact, you need to acknowledge how unnecessarily dangerous it is made for me.

    Because, as I said, I don’t want to die, I have tried to change how I live. I have been to plenty of detoxes and treatment centers. I won’t stop trying until it works.

    But so far, it hasn’t worked. So if you accept my current relationship with drugs as a fact, you need to acknowledge how unnecessarily dangerous it is made for me and so many others.

    Prohibition itself creates the conditions that cause death by incentivizing ever more potent, riskier supply. “Unfortunately we’ve only seen this crisis escalate over the past decades as the drug supply becomes more toxic,” Friedman said. “There are powerful market pressures driving the availability of these products.”

    Meanwhile, services and interventions that are proven to save lives—from provision of a safe, regulated supply to safe consumption sites—remain unforgivably limited and restricted.

    That’s very true even in Canada, which has been renowned for its harm reduction innovations. There are various safe supply programs that offer a variety of drugs, and there was an increase of 258 percent in safe supply programs between March and May 2020, at the outset of the pandemic. Medical safe supply programs offer a variety of medications (mainly opioids), and a few on the West Coast even offer various types of fentanyl, as Filter has reported.

    But in an unprecedented crisis of deaths, it’s not enough. Here on the East Coast, there’s far less provision. And in general, the programs are too few in number, remain too restricted in what they can offer, and still pose too many barriers to access through their medicalized models.

    We desperately need more forms of community-based safe supply programs or “compassion clubs,” like the model advocated by Vancouver’s Drug User Liberation Front. DULF’s unsanctioned program has handed out hundreds upon hundreds of doses of tested heroin, cocaine and methamphetamine—and not a single known overdose has followed. If a safe supply of the drugs I wanted were available to me, I would not have overdosed this month. Yet DULF’s bid to scale up its work through a sanctioned model has been blocked by Health Canada. That will inevitably cause more deaths.

    As the US Centers for Disease Control and Prevention (CDC) noted, “From April–June 2019 to April–June 2020 … illicit benzodiazepine-involved overdose deaths increased … 519.6%. During January–June 2020, 92.7% of benzodiazepine-involved deaths also involved opioids, and 66.7% involved illicitly manufactured fentanyls.” With the increasing prevalence of pre-mixed benzo dope, I believe death rates will only get worse. From where I’m standing, tranq dope and benzo dope are the current “wave” of the crisis, and they’re not going anywhere.

    Both tranq dope and benzo dope have serious implications for the overdose crisis and for the ability of people who use drugs to keep themselves safe” Friedman said. “These formulations often have greatly increased overdose risk, increased risk of abscesses and other health problems, have wildly fluctuating potency, and are generally bad products to be consuming.”

    Safe supply and drug checking are the way forward,” he continued. “The past 50 years are a testament to the failure of trying to interdict, police, and arrest our way out of this crisis. Instead we need to equip consumers to modify their demand. Drug checking can help folks understand the market and demand better products. Safe supply gives them something safer in a regulated way. Overall there’s good evidence on this issue supporting safe supply. What we need is political will from decision makers.”

    If we don’t raise shit over it, no one will.

    Too right. And it’s up to us to exert pressure on the policymakers who are letting us down. One life needlessly lost is far too many, and we’re suffering thousands all the time. If we don’t raise shit over it, no one will.

    While we keep pushing them, I can only repeat advice that I myself haven’t always followed, because doing so is made so hard by the conditions they create. If you’re doing benzo dope or tranq dope—or something that could be—look for ways to test it. Start low and go slow. Try not to use drugs alone, but to use with someone you trust. Someone who can be there with you for a day or more, who has multiple naloxone doses and knows rescue breathing.

    Regardless of what people say, people who use drugs care for one another. Despite how much society hates us, people who use drugs can and do have each other’s backs. More than once, I have owed my life to that. If I die, please understand that drug prohibition, the resulting toxic market and opposition to harm reduction caused it.


    Photograph by Matthew Bonn

    • Matthew is an International Board member with International Network of Health and Hepatitis in Substance Users, and a knowledge translator for the Dr. Peters Centre. He was previously the program manager with the Canadian Association of People Who Use Drugs. His freelance writing has appeared in publications including The Conversation, CATIE, Doctors Nova Scotia, Policy Options and The Coast. Matthew was also on the 64th Canadian delegation to the Commission on Narcotic Drugs. He is a current drug user and a formerly incarcerated person.

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