Following a sudden spike in fentanyl-related deaths, the heads of Health Canada and the Public Health Agency of Canada have released a statement to say they are “deeply concerned†about the illicit use of the painkiller and the rise in overdoses.

Health Canada Chief Medical Advisor, Dr. Supriya Sharma, and Dr. Gregory Taylor, Canada’s Chief Public Health Officer say they are aware that fentanyl is being created in powder form in illicit labs. There, the drug is often mixed with street drugs in powder form or pressed into pills before being sold on the street.

They also point to statistics from the Canadian Centre on Substance Abuse that say as many as 655 Canadians have died in the last five years from fentanyl overdoses. Health Canada’s Drug Analysis Service labs have also been detecting fentanyl more often in street drugs sent to them by police for testing.

Health Canada says it is working to respond to this issue, including reviewing the prescription-only status of naloxone, which is a medication that can reverse an opioid overdose.

A number of provinces and cities have started programs in which they hand out naloxone kits to opioid users or their families, and have pressed Health Canada to ease restrictions on the drug.

The health agencies say they are also concerned that legitimately-prescribed fentanyl is being misused.

Fentanyl is meant only for those with severe pain and should not be the first choice for pain management, Sharma and Taylor write. Because of the drug’s strength, the drug can pose significant risks, including the potential for addiction, overdose and side effects, they note.

The health agencies advise those with fentanyl prescriptions to follow the medication's instructions closely, keep their supply in a secure place, and dispose of the used patches properly.

“Health Canada and the Public Health Agency of Canada will continue to monitor this issue and will continue to work closely with provinces, territories, law enforcement, and other stakeholders to help protect the health and safety of Canadians,†the agency heads said in their statement.