A community drug alert is in effect after the Overdose Monitoring Alert and Response System (OMARS) noticed a distressing trend in Waterloo Region.
The organization is extending the warning initially issued on Nov. 6 after three suspected overdoses or drug poisoning deaths were reported between Nov. 11 and Nov. 14.
It also came after 35 suspected overdoses and drug poisonings were noted between Oct. 31 and Nov. 11.
OMARS said deep yellow, pale yellow, orange and green fentanyl are considered substances of concern.
Meanwhile, the Kitchener Consumption Treatment Site Drug Checking Program detected medetomidine/dexmedetomidine, fentanyl analogues, Xylazine and Oxazepam in recent samples.
Experts said opioids taken in combination with medetomidine/dexmedetomidine can increase the risk of an overdose.
OMARS also said community members raised concerns with the local supply of meth, saying unexpected reactions had been reported.