Health officials in Montreal are warning the public about a dangerous counterfeit opioid circulating in the city, disguised as a common cough syrup. The product, sold illegally, is being presented in bottles labeled “Promethazine with Codeine Oral Solution,” but contains a toxic mix of opioids and benzodiazepines that could lead to overdose.
The Montreal Regional Public Health Department (DRSP) issued the alert after recent analyses revealed the presence of protonitazene, a highly potent opioid, and bromazolam, an unregulated benzodiazepine with sedative effects, in some of the bottles. According to Geneviève Paradis, a spokesperson for the DRSP, the contents are “completely unpredictable.”
“The danger comes from the cumulative toxicity of the two substances,” Paradis explained. “When taken together, the effects of the opioid and the benzodiazepine are intensified, which increases the risk of respiratory arrest.”
This isn’t the first instance of dangerous substances being sold as legitimate medication. In 2023, a person in Laval, a city near Montreal, died after consuming a counterfeit syrup containing a combination of synthetic opioids, benzodiazepines, and antihistamines.
Unpredictable Composition
While the DRSP reports no overdoses or deaths in Montreal have been directly linked to this specific product as of February 11, 2026, authorities are concerned about the potential for a surge in overdoses. The exact quantity of the counterfeit syrup in circulation remains unknown, making it tricky to assess the scale of the risk.
Public health officials emphasize the importance of avoiding drug use alone and utilizing drug checking services when available. The DRSP also stresses the critical need to have naloxone readily accessible, as this medication can temporarily reverse the effects of opioids and restore breathing.
The emergence of this dangerous counterfeit medication highlights the ongoing risks associated with the illicit drug market and underscores the importance of harm reduction strategies to protect public health. Individuals who suspect they or someone they know may have consumed this counterfeit syrup are urged to seek immediate medical attention.
