Thursday, June 15, 2006

DEA Holds Chicago Conference On Fentanyl And Heroin

The DEA held their conference on fentanyl and heroin here in Chicago today. The Chicago Tribune has a short blurb. MSNBC reports on the conference as a part of a larger story about the epidemic. MSNBC has a headline that I think is bizarre: "Killer heroin: Users die for the high: 100 times stronger than morphine, super heroin ravages drug community". That speaks of addicts as though they were just another census demographic: the drug community, just another group alongside the Baptist community or the medical community or the immigrant community. The New York Times has a long report about the epidemic but it was written without reference to the conference.

A consensus opinion that seems to be emerging among law enforcement officers is that many of the victims go looking for the high they have heard fentanyl offers. From the Times:

[Chicago Police Superintendent Philip J.] Cline said city officials had been frustrated because warnings appeared to have partly backfired. Drug dealers were even seen waving the fliers the city distributed this year, advertising that they were selling the very thing the police were so worried about.

"The biggest problem is that we have willing victims," he said.

Also from the Times:
One heroin user, Sean H., 20, who was visiting the treatment van and spoke only on the condition that his last name not be used, said a friend died six weeks ago from a fentanyl-related overdose. The man, 24, specifically sought out fentanyl, Sean said, and had just recovered from one overdose. His body was found on a train.

And from MSNBC:
The Chicago Recovery Alliance supplies clean needles and other services to addicts. Cheryl Hall says dealers have tricked users into thinking the drug offers a unique high.

"People will go to any lengths to get it," she says. "Even death. Even death."

One thing that is being mentioned in recent stories that I don't recall seeing before is the value of naloxone (or narcan), a drug which reverses a the respiratory failure that results from a fentanyl overdose. From the times:
The [Chicago Recovery Alliance's] medical director, Dr. Sarz Maxwell, said she knew of at least five people in Chicago who had stopped breathing after using heroin-fentanyl and were saved by friends.

"We even heard of a couple of complete strangers who found somebody, had naloxone and saved a life," Dr. Maxwell said.

What stands out to me the most is that the fentanyl has appeared on such a wide scale that it appears it may be from more than one source or from one very powerful source. From this I infer that fentanyl will have a lasting presence. Again from the Times:
In the labyrinthine and often paranoid world of illicit drugs, tales of killer heroin have come and gone before. But this time is different, law enforcement and health officials say.

The pattern of cases is broader, involving many markets at once, suggesting, they say, a larger and more sophisticated distribution network. The additive [fentanyl] has been traced to laboratories in Mexico, which has traditionally supplied much of the Midwest heroin, raising fears that other hybrid pharmaceutical street drugs might emerge.

Now combine that statement with this, from later in the Times article:
"It is becoming easier to manufacture mind-altering substances, and the Internet has spread that knowledge all over the world," said Martin Y. Iguchi, a professor of public health at the University of California, Los Angeles, who was running a drug treatment clinic in New Jersey when the Tango and Cash cases unfolded in the 90's. "That's got to have an impact longer term."

It appears fentanyl will not be going away. As one federal drug policy official said to MSNBC: "If you are addicted to heroin, there'’s never been a better time to stop."

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