Police in Toronto say that while the city doesn’t yet have as large a fentanyl problem as that seen in Canada’s West, it’s likely only a matter of time.

Toronto Police Drug Squad Unit Commander Insp. Howie Page issued a warning Monday that fentanyl is being found mixed into heroin, fake oxycodone pills and other drugs in Ontario, and it’s leading to overdoses.

Page could not give specifics on the number of overdoses or deaths caused by fentanyl , noting that police services are still working with the coroners’ offices to get a handle on numbers. But he said fentanyl-laced drugs are being found regularly in drug raids.

“Although we have not seen saturation of fentanyl in Toronto as of yet,†trends can shift quickly in the illicit drug culture, he told reporters.

In recent weeks , there has been a notable spike in the number of fentanyl-related deaths in British Columbia and Alberta. Earlier this month, police in Vancouver responded to 16 fentanyl-related overdoses in a single day.

Page warned that there is no way to know from looking at a pill or powder how much fentanyl it might contain, which means that no pill can be considered safe. Even most street-level dealers don’t know themselves what is in the drugs they are selling.

Page said drug producers working in clandestine labs are cutting fentanyl into other drugs because it’s up to 40 times stronger than heroin, meaning a little can go a long way.

He added that some drug users are also accessing the drug by buying fentanyl patches and scraping off the drug to snort, smoke or chew.

Many of these patches are prescribed to patients in chronic pain, such as cancer patients or accident survivors, because fentanyl is a highly effective painkiller, Page said. But the problem is some patients are selling their patches – or even their used patches, which often still contain significant traces of the drug.

These patches are then finding their way onto the street, where they are sold for $200 or more each, or cut up into smaller pieces and sold off.

Other times, the patches are stolen. Just this month, Page said, 20 prescription patches were stolen from a vehicle in North York. “Those patches are still out there,†he said.

One way that police and pharmacists are combating the problem of fentanyl patch diversion is through an initiative called Patch4Patch. The program aims to have patients return their used patches to the pharmacy before they are able to receive more.

Page says the program, which has the support of many physicians and pharmacists, is currently run only on a volunteer basis. But he and members of the Ontario Association of Chiefs of Police would like to see a private member’s bill on the Patch4Patch Initiative become law in Ontario.

“The misuse of fentanyl is having a devastating impact in many communities throughout Canada, including unnecessary deaths,†Page said.

“…Limiting the supply and accessibility of fentanyl patches in our communities will contribute to further enhancing the overall health and safety of our communities,†Page said.