Tag Archives: DEA

Oct 9 2017

There Are No More Heroin Overdoses

Report by Terry Gotham

Enough people sent me the NY Times article about Fentanyl overtaking Heroin that I had to say something about it. If you’ve not seen it and the plurality of think pieces surrounding it, the only piece you need to read on it is by the person who runs The Dose Makes The Poison, Kevin Shanks. He’s been one of my go to sources on novel psychoactive substances for years now, and he, along with a handful of others have been yelling as loud as they possibly can. The point he raised almost a month ago is one I’ve not seen a single mainstream medical journal begin to grapple with in any kind of meaningful way.

As I’ve said for a while now, this ain’t your father’s heroin. At what point do we stop calling it heroin and refer to the standard “heroin” product on the street as fentanyl?
~Kevin Shanks (9/2/17)

While drug overdose deaths are up 22% from 2015 alone, fentanyl deaths doubled. That’s not including the fact that cases are severely under counted, given the volume of fentanyl analogs in circulation right now. I previously reported on the report coming out of Ohio with 24 analogs & active metabolites being identified. That, combined with the increased cost in testing for analog substances, we’ve arrived at a place where medical staff have no idea how many chemicals they’re not testing for. How many rural communities are testing for acrylfentanyl or butyrylfentanyl? How many rural communities are seeing analogs that we don’t even know about yet? Communities along the migratory arc that fentanyl takes from China into Western Canada or Mexico into border communities, that see these substances first, are they still getting the same analogs, or is there already something new? At this point, it’s likely the unknown unknowns are already on the ground and slowly being consumed for the first time.

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Aug 30 2017

Why It’s So Important MDMA Has Been Designated a “Breakthrough Therapy” By the FDA

Report by Terry Gotham

At Burning Man 2006, at the Entheogen Camp on the Esplanade, I watched someone ask Shulgin how many times a year he thought it was safe to take MDMA. He said “do you really want to know?” The guy who asked the question wasn’t so sure, being confronted with the possibility of a real answer. On August 26th, 2017, the Multidisciplinary Association for Psychedelic Studies announced that the FDA had granted MDMA the Breakthrough Therapy Designation for its treatment of post-traumatic stress disorder. After decades of demonization, lies, bad science and straight up villainy by the powers that be, MDMA is being given its time to shine. This victory in a long road that MAPS & MDMA have traveled is a long time coming and absolutely pivotal. “Breakthrough Therapies” are seen as crucial, high-value drugs that the FDA wants to assist through development and review. To receive this designation, a drug must qualify in two ways:

  1. The drug treats a serious or life threatening disease or condition.
  2. Preliminary clinical evidence indicates the drug may demonstrate “substantial improvement over existing therapies” on “one of more clinically significant endpoints.”

This designation is a victory, but if you only know MDMA as something to take at parties, you might not know why. From its use as a legal alternative to alcohol in the club/house music scene in 80’s Chicago/Dallas/NYC to its current iteration as the much maligned “Molly,” MDMA has gotten a pretty bad rap over the years. To understand why this news is being celebrated in harm reduction, drug policy and legalization advocacy circles, we need to look back at how MDMA took hold of America & how it became illegal, because a lot of what you think you may know about its history is wrong. For example, most believe Alexander Shulgin invented the compound for the first time in 1965 for Dow Chemical, while it was actually first synthesized in 1912 by Anton Köllisch, a German chemist working for Merck. The chemist was studying substances to stop bleeding but without bumping into the patent held by Bayer for hydrastinine, so in a bit of 20th century novel psychopharmacology, they developed an analogue, methylhydrastinine. MDMA was actually only synthesized as an intermediate step in the methylhydrastinine synthesis process. One of the most important drugs of the 20th Century was created accidentally, just like Hofmann producing LSD accidentally 36 years later.

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Apr 21 2017

Here Are the Drugs Americans Did in 2016.

By Terry Gotham

Every 3 months, the DEA releases the “Emerging Threat Report.” This document catalogs the various substances that have been seized and analyzed by the DEA over a 3 month period. Every year, the DEA compiles that data into an annual report, which in my opinion, is the best window into the drug taking habits of Americans available anywhere. The 2016 results are in, and I have to tell you, it isn’t pretty.

2016 was a fentanyl jamboree folks. While in years past, we’ve dealt with “bath salts” and N-Bomb and Flakka, these substances didn’t seem to be growing in popularity this year.  The chart above is pulled directly from the DEA report and breaks down the most popular emerging opioids & pain meds. 70% of the identifications were fentanyl, which means that 7 out of every 10 opioid drugs seized was fentanyl. What’s even more terrifying is the sheer number of fentanyl analogues that were discovered in drug seizures. As my regular readers know, the adulterant problem in the recreational drug taking community becomes fatal once opioids are stepped on with fentanyl. 42% of fentanyl seizures test for fentanyl and heroin, which indicates that more and more users are getting fentanyl in addition to heroin. It’s becoming more likely to encounter multiple types of fentanyl over the course of your use. That is a whirlwind of risk for dependent or recreational users. 9 of the 15 opioid substances identified (60%) were identified for the first time. To reiterate, there are 9 totally new fentanyl analogues in the wild that our EMTs, emergency medical staff & even toxicologists have little to no experience with.

I can’t make it any more clear than that folks. Fentanyl is being found routinely with cocaine & meth. That whole “why would dealers mix uppers & downers” question can be put to rest. It’s happening, and it’s happening so often, it’s classed as a “routine” occurrence by law enforcement.

Next up, the synthetic cannabinoids. The two most popular fake pot offerings, FUB-AMB & 5F-UR-144 accounted for 34% of the identifications. Yes, those are the names of the two most popular new drugs people are smoking when they want to get high and don’t want to smoke cannabis. The long tail of synthetic cannabinoids has grown over the last couple of years, but only 3 of the 37 different substances identified in 2016 were totally novel. This could be an indication that novel synthetic cannabinoids are not being developed because of market saturation or due to recent emergency scheduling, but we don’t have good data on preferences between synthetic cannabinoid brands or why some die out while others flourish.

Cathinones are following predictable if not slightly heartening paths. While we are still seeing a significant number of them in seizures & identifications, only 5 of the 24 substances were novel. Dibutylone, Ethylone, Methylone, a-PVP, and 4-MEC make expected chart appearances, but the novel drugs on the chart are interesting. 4-CEC, 3-CMC, 3-MEC are chemical analogues of 4-MEC, which is known as “second-generation” mephedrone. 4-methoxy-a-PV8 and 4-fluro-a-PHP are the next iterative cycle after a-PVP. These novel cathinones are entirely analogues of drugs that have been scheduled in the last 6 years. You can almost set your watch to it. And now, for something completely different.

Three. That’s it. 1 identification of 2C-B & two iterations of the problematic NBOMe substance that scared the hell out of us a few years ago. To me, this is an encouraging sign that the kids are alright. If fewer people are doing NBOMe because the community recognized the risk it posed  and rejected it, that could be startlingly strong evidence that harm reduction works. If lethal chemicals are not supported within a community to the point where they don’t have a market, as no hippie wants to go to jail for selling a drug you can die from taking, then that means something is getting through.

It’s important to stress, all of these numbers could be grossly under-counting the true depth of fentanyl analogue and novel psychoactive substance proliferation. This data is generated from the substances that have been both seized and analyzed in a timely manner. Even the DEA doesn’t have enough funding to test everything being seized, and of course, there could be analogues or novel substances that simply haven’t been seized by law enforcement or documented by clinicians or recreational users. To put what we know in perspective, I’ll go to the DEA’s words themselves:

There were 21 substances reported for the first time in CY 2016, meaning they have not been encountered for at least the last two years. This equates to one new substance approximately every two and a half weeks.
~DEA Emerging Threat Report 2016

Ultimately, the data presented here by the DEA itself, supports the hypothesis that the War on Drugs creates more dangerous drugs, especially opioids. Pain medication users can’t afford prescription meds and heroin is has become problematic to import. So, dealers just make their own opiates or import a novel analogue of fentanyl to pass off as heroin for your clients. Fast forward a couple of years and we’ve got the overdose crisis plaguing most states. The iteration on a-PVP & 4-MEC/mephedrone is in direct response to laws passed in this decade. Those drugs would likely not be in circulation to the volume required to end up in a seizure without their precursors being scheduled. That’s the main thing I’d really like anyone still reading to take away from this: None of these drugs being consumed in the vast quantities that they are, would be ,if drugs that are already illegal, weren’t. If you are willing to stop you addiction from any drug buy kratom online and get what you desire.

Of course heroin would still cause overdoses, and people abusing psychomotor stimulants would have problems if drugs were legal. To say otherwise would be impudent & myopic. But, as I illustrated previously, hospital & ER staff had a pretty good handle on how to take care of heroin/morphine/prescription painkiller overdoses. How many emergency workers do you know that have ever heard of 4-CEC or a-PHP? Exactly. One crucial benefit from decriminalizing or legalizing hard drugs is that we’ll have a much cleaner substance pool for recreational users to draw from. This will return us to a careflow that is familiar and scaleable. No hospital has the resources to keep up with 9 new fentanyl analogues a year, and if TrumpCare passes, it will be even more difficult.