Experts warn of dangerous new synthetic drugs
By Dennis Thompson
health day reporter
THURSDAY, June 16, 2016 (HealthDay News) — The recent overdose death of rock legend Prince has reignited attention to the dangers posed by synthetic opioids — narcotics created in laboratories and modified by chemists to produce potentially deadly while circumventing US drug laws.
Prince Rogers Nelson, 57, died on April 21 of an overdose of fentanyl, a drug often used to calm pain in cancer patients when traditional opioids prove ineffective.
Despite its legitimate medical uses, fentanyl has earned a growing reputation as a dangerous street drug thanks to at least a dozen synthetic variants now available to users, according to the US Drug Enforcement Administration (DEA).
And fentanyl is just one of many synthetic opioids and designer drugs currently flooding the illicit drug market in the United States, DEA Acting Chief Chuck Rosenberg warned during a hearing at US Senate last week.
“We try to follow a picture that changes almost every day,” Rosenberg said. “We have identified something like 400 new psychoactive substances in the last four or five years.”
Another synthetic opioid, U-47700, has been linked to at least 50 deaths nationwide, but it’s so new to the black market that the DEA has yet to decide to screen it, according to the Associated Press.
Synthetic narcotics are dangerous because their potency can far exceed traditional opioids. For example, fentanyl is 25 to 40 times more potent than heroin and 50 to 100 times more potent than morphine, said Dr. Mitra Ahadpour. She is a physician at the Substance Abuse Treatment Center of the US Substance Abuse and Mental Health Services Administration.
Rosenberg testified that “Fentanyl is so dangerous that we had to tell our officers that if they accidentally touch it or inhale it, they could die.”
Several states reported a sharp increase in overdose deaths caused by fentanyl and its analogues in 2014, a health advisory from the US Centers for Disease Control and Prevention noted. Ohio reported 514 fentanyl-related deaths in 2014 compared to 92 in 2013, while Maryland recorded 185 fentanyl-related deaths in 2014 compared to 58 the previous year.
Ahadpour explained that “if someone is not opioid tolerant and uses pharmaceutical or illicit fentanyl, you have a very high risk of respiratory depression and death. Their breathing slows down, becomes shallow, then stops. to breathe.”
The potency of these synthetic drugs varies greatly, and they are often cut with other illicit drugs, Ahadpour added. A user can buy heroin without knowing that it has been cut with fentanyl to increase its potency.
Eleanor Artigiani, associate director of policy and government affairs at the Center for Substance Abuse Research at the University of Maryland, said: “They may think they’re getting heroin, or they’re just buying a Xanax pill in the street, when it’s actually one of those other substances.”
Artigiani added, “From what I’ve heard recently, sometimes even the people selling these drugs don’t know exactly what’s in them either. It’s like Russian roulette, because you don’t know really what you’re getting or what effect it’s going to have on you.”
Toxicology tests concluded that Prince died of an overdose of fentanyl, although the medical examiner’s report did not specify whether the fentanyl was prescription or an illicit analogue, CNN reported.
Designer drugs are usually based on drugs that have been around for decades, Artigiani said.
Fentanyl was first created in Belgium in the late 1950s, according to the DEA, while U-47700 was developed in the 1970s by pharmaceutical company Upjohn as a potential alternative to morphine.
Black-market drugmakers figure out a drug’s formula and then tweak the molecule slightly so it has the same effect on people but isn’t technically the same substance, Artigiani explained.
“There’s a newspaper article or a patent document or something that’s been produced,” she said. “Clandestine chemists find it and replicate it or modify the molecules to look for other types of things that aren’t illegal, that haven’t been programmed yet.”
Other synthetic opioids on the streets include substances with names such as W-18, AH-7921 and MT-45, according to congressional testimony provided by James Hall, an epidemiologist at the Center for Applied Substance Use Research and health disparities at Nova Southeastern University. In Miami.
Illegal drug manufacturers also produce other categories of designer drugs in addition to synthetic opioids, Hall said, including synthetic versions of cannabinoids, stimulants and hallucinogens.
Almost all synthetic opioids and other designer drugs are made in China, Michael Botticelli, director of US national drug control policy, told the Senate.
Designer drugs enter the United States either through the mail or through the Mexican or Canadian border, he said, and are often sold in major stores and other retail outlets.
State and federal lawmakers are considering legislation to improve the response against new synthetic narcotics, Botticelli said, and the United States is leading discussions with international partners to improve the global response to these drugs.
But right now, law enforcement is often several steps behind traffickers because US laws aren’t flexible enough to quickly interdict emerging drug analogues, Rosenberg told Congress.
“I almost feel like every time I sign an administrative control settlement, I’m just saying to the bad guys, ‘Not that one anymore. Move over here.’ And that’s what they do,” Rosenberg said. “For every substance that we have controlled, legislatively or administratively, there are 11 others that are not controlled.”