Junior Ganymede
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Fentanyl deaths: Screw-up or conspiracy*?

June 20th, 2017 by Bookslinger

(*Americanized version of a Dr. Charlton post’s title.)

So a lot of addicts have died recently because there’s too much fentanyl or carfentanyl  mixed  in the heroin that they are injecting or otherwise ingesting.

Heroin has always needed to be diluted or “cut” with an inert filler.  Pure heroin kills. At least according to the TV shows and movies I’ve seen. So, when adding the cheaper and more powerful synthetic opiod fentanyl to heroin, it would need  to be diluted even more. 

Some heroin addicts die every year just taking  “standard” concentration heroin. In their stupor or desperation, they carelessly just take too much.  But when dozens or hundreds of people in a geographic area all overdose in the same day or two, something else is in play.

If the illicit drug manufacturers were carelessly putting too much fentanyl, or not enough filler, in their product, wouldn’t they have corrected the problem by now, so as to not kill off thousands of their customers?

I suppose there is a product “pipeline”, downstream of the manufacturer,  that needs to be cleared out. It’s not like they are going to recall everything like a bad batch of Tylenol.  But these sporadic localized fentanyl-laced heroin overdose epidemics have gone on for well over a year now.

Another possible  explanation I’ve read is that some overdose “outbreaks” were not necessarily due to too much fentanyl in the batch, but rather that the fentanyl (or carfentanyl) was not evenly distributed in the batch, and therefore some retail-level bags received too much, while others received too little.   One source said that some manufacturers use kitchen appliance food processors instead of industrial lab-grade mixers.

Either way, whether the illicit drug makers got the ratio of ingredients botched, or if it was a failure of mixing procedure, shouldn’t the people behind the heroin “industry”, worth at least in the 100’s of millions, have made the necessary fixes so as to not kill off their customers?  

Are the thousands of annual fentanyl-laced heroin  overdose deaths such a miniscule fraction of the overall heroin market that the manufacturers don’t care?   Or is there just a really long learning curve, and too many small-fry drug makers don’t know what they’re doing?  Or is there some conspiracy to kill off heroin addicts?

Comments (9)
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June 20th, 2017 15:15:38
9 comments

Vader
June 20, 2017

I think I’d go with the first option. Though I’d not rule out the third; there may be some business advantage to killing your customers once they’re sufficiently wrecked.


[]
June 21, 2017

I’d go with the second. These aren’t Six Sigma MBA ancap captains of industry we’re dealing with.


Bruce Charlton
June 21, 2017

@Books – I don’t think heroin ‘needs’ to be ‘cut’ – instead cutting is a process of dishonest dilution and/ or adulteration with cheaper or inert ‘substitutes’; supplying people with less of the drug than they think they are getting, so as to make more money.

(An alcohol equivalent would be selling people claimed whisky at the price of real whisky, but actually supplying them with watered whisky fortified with cheap and toxic methanol.)

Sometimes, deaths from overdose come when people take un-cut, pure heroin, instead of the usual diluted type they have become used to (a high dose of heroin kills by respiratory suppression – you just stop breathing.

With morphine instead of heroin, this was how Dr Harold Shipman, Britains most prolific serial killer, killed so many elderly people – by giving a much higher dose than he wrote on their prescription, to people unused to the drug.

i don’t really understand the matter as you describe it – and I don’t know where an honest account might be found. On the face of it, fantanyl would be no more likely to kill people than heroin – as such; but some people say that carfentanyl is just a poison (without any therapeutic use) – so anyone knowingly adding it (rather than its being an accidental contaminant) must be doing so in order to kill the user…?

As I say, the story of ‘why’ so many people are dying doesn’t make much sense, as stated in your account. Presumably some vital piece of information is missing.


Bookslinger
June 21, 2017

http://bigstory.ap.org/article/7c85cda5658e46f3a3be95a367f727e6/chemical-weapon-sale-chinas-unregulated-narcotic

covers the Chinese sourcing and “push” for carfentanyl. If there’s a conspiracy, that’s likely part of it. Big business in China does nothing without their government’s tacit, if not explicit, approval.

According to Wiki, Carfentanyl was totally unregulated in China until March 2017.

It’s killing off our middle class, the strength of America. And it’s killing off our lower class, requiring us to import low-skilled laborers.

So, “cock-up or conspiracy?” It’s both and neither. The individual players are working out their own greed, self-interest, and sloppiness; and the confluence of it all is doing the enemy’s work.

I recently spoke to a friend who was recently a state legislator, and before that he was an employee in a state level prison system. So he has ties to both the political system and the criminal justice system, and as a counselor/case-worker got to know many criminals of all types. (Insert joke about politicians and criminals here.)

He says it’s still getting worse, and going to get much worse. He said “A”, the thousands of deaths are a drop in the bucket, and the makers and dealers really don’t care about the lives/customers lost, because new addicts are made every minute of every day.

But that AP story about the China connection really makes one think.


Bookslinger
June 21, 2017

Wiki has basic articles on fentanyl and carfentanyl. Both are Schedule II drugs, available with prescription for human use, in the US. There is a govt quota on the total manufacturer of carfentanyl of 19 grams/year, in the US.

And Chinese manufacturers are selling carfentanyl by the kilogram.

Canadian authorities recently confiscated 50 million lethal doses. I assume much of that was destined for the US market. Assuming that would equate to 100 million non-lethal doses, it indicates one of two things: either the opiod addict market is huuuuuge, much greater than the media lets on, or….., there is some kind of conspiracy.


Bruce Charlton
June 21, 2017

@Books – What isn’t clear from the sources is why anybody would want to buy carfentanyl for any reason other than killing people (or doing operations on elephants)…

I can only assume that because it has such extreme potency (effectiveness per unit dose) that people must be able to dilute it greatly and get multiple ‘highs’ cheaply.

More likely, its extreme potency gives a very powerful high – due to rapid occupation of receptor sites.

Rapid absorption and onset of effect is the reason why heroin is more abused than morphine, and why intravenous or inhaled heroin is *much* more addictive than dilute and slowly absorbed opiates like Laudanum.

(Laudanum was crude opium dissolved in alcohol, which was buyable anywhere and by anybody and widely used medically in Britain for more than a hundred years, with very little problem of addiction. My father was given it as a child, in a proprietory mixture, when ill and in pain – he said it was very effective. Coleridge and De Quincey became addicted to Laudanum; but this really took a lot of doing, almost intentional in the case of De Quincy – because it involved drinking pints and pints of the stuff!)


Bruce Charlton
June 21, 2017

Another aspect is that this may be an early indication of something I have predicted: an epidemic and normalisation of suicide among the atheist, nihilistic and despairing modern population – perhaps especially among the ageing baby boomers:

http://charltonteaching.blogspot.co.uk/2011/04/culture-of-suicide.html


Bookslinger
June 21, 2017

The wiki articles and the AP article state that fentanyl and carfentanyl are added to heroin by the illicit heroin industry due to the mere fact they are much cheaper than heroin, and the concentrated nature makes it easier to smuggle than heroin. (And I’m guessing that the addiction explosion has outstripped natural heroin supply/opium poppy cultivation.)

So the economic decsion-making is happening at least two levels up from the addict. (Street level dealers rarely, if ever, are makers.)

The potency of the illicit (car)fentanyl/heroin product is then adjusted (by the manufacturer of the end-product, not the retail dealer or user) down to the level of heroin by the use of filler, so that it can be sold as heroin. Hence, the likely (and as reported by law enforcement) scewups of improper measuring and improper mixing.

My understanding of the chain goes like this poppy -> opium -> morphine -> heroin. Where heroin is twice the potency of morphine. Fentanyl is completely synthetic, and carfentanyl is just an analogue of fentanyl, no poppies needed.

Legal Fentanyl prescription doses for humans are measured in micro-grams (Wiki), so for even a large 1,000+ dose batch of fentanyl/heroin/filler, the fentanyl would be measured at around the 1 gram level (estimate on my part based on Wiki), with a needed precision of 1 milligram or less, when adding it to a heroin/filler base.

Carfentanyl is multiple times (one source said 50) more potent per weight than fentanyl, so that precision would need to be 1/50th as fine, at the 20 micro-gram level, even for that hypothetical 1,000 batch dose.

Assuming that fentanyl and carfentanyl come as powder, measuring by volume (as opposed by weight) during the manufacture/mixing process would allow lethal doses to slip through just due to the variable packing factor of powder.

People have OD’ed and died from taking loose powder caffeine because they overpacked their measuring spoon/device instead of weighing it. (Loose powder bulk caffeine is silly to use, when 200mg tablets are less than 5 cents/each over-the-counter at all pharmacies and grocery stores.)

The reports of mixing screwups also seems very plausible when adding 1 gram of something to a 500 gram batch. The Cuisinart just ain’t gonna do it right.

My understanding is that retail level drug dealers and their customers are led to believe they are buying heroin, or a heroin equivalent. If the information about fentanyl or carfentanyl is passed along, I would assume they are told it’s “better” and to “use it just like heroin”.

It is not all (car)fentanyl laced heroin that is killing people. Most such adulterated heroin is sold and used without any effects worse than plain heroin. It’s sporadic pockets of higher-than-intended concentrations of the (car)fentanyl.

The people who are most hurt in the “business” sense (aside from the people who die, and their families), are the retail level dealers who unknowing sold individual packets of higher-than-intended concentrations. Word eventually gets around that a bunch of/most/all of so-and-so’s customers OD’ed. The problem is that his replacement is likely to buy wholesale from the same source, even if using a diferent mid-level distributor.

I’ve met a couple reformed dealers of illicit drugs. I’ve talked to regular patrol police and to city level narcotics police about drug trade. I’ve read a lot, and tried to only believe what comes from multiple sources, news outlets as well as wiki.

I don’t have the whole story, so technically what I’m writing here is conjecture and hearsay. But I’m trying to think it through, and ask the right questions.

I liked your explanation of the false dichotomy, cock-up or conspiracy. I think it’s the same source of evil, using conditions on the ground to further its evil agenda. If there are mortals in on the “uktimate” purpose, then they too exploit situations that already exist, and they have their own agendas of greed and warfare. And the people below them are put in place because their goals are already compatible with the agenda, and don’t have to be told.


TWS
June 22, 2017

Heroin is cheaper and stronger than it use to be. Needle use is less of a stigma (perhaps tattoos and piercings have something to do with that). Knuckle heads are chasing a high shooting up one on top of another.

When I was a boy my grandfather was chief of detectives. My uncle’s were law enforcement. I was a cop and my son is now. It’s more common now than ever in our family’s recollection.

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