Our opioid crisis is fueled by fentanyl, largely a direct product or precursor manufactured in China – a rocket-fuel inversion of the Opium Wars when Britain smuggled illegal opium into China.
Fentanyl
First it was heroin. Next, it was fentanyl-laced heroin. Then it was fentanyl. Now it’s xylazine-laced fentanyl. Will nitazenes be next? Will policymakers ever learn that the Iron Law of Prohibition cannot be repealed?
The insanity of trying to control overdose deaths by banning certain drugs became evident years ago with fentanyl. Yet we now have a new monster on the street called Tranq and some people think that making it illegal will get rid of it. Simple chemistry guarantees that this plan will fail. Here's why.
As fentanyl-related overdose deaths soar to new heights, and with fentanyl found in stimulants, tranquilizers, and other recreational drugs obtained in the black market, it makes sense to let drug users use a simple test that detects fentanyl in products they are about to consume. But cruel and irrational drug paraphernalia laws in 42 states make it illegal for them to do so.
4-ANPP is not a term that most of you know but it's hugely important. It is the chemical that is the precursor to fentanyl. Although 4-ANPP is not an opioid, there is not a single thing anyone would do with it except convert it to fentanyl. And there is plenty of 4-ANPP to be had now the bad guys use synthetic organic chemistry to make it.
People who take oxycodone need to be careful when also taking antifungal drugs or drinking grapefruit juice. Why? Because both the juice and the drug can result in abnormally high, perhaps dangerously so, oxycodone blood levels. The same goes for fentanyl. But people taking morphine or Dilaudid don't have to worry; neither the juice nor the antifungal drug will have a significant effect on the opioid levels. Believe it or not, this all makes sense.
Illicit fentanyl continues to kill tens of thousands of people annually in the U.S. In fact, this number may very well be increasing as the "fentanyl epidemic" continues unabated. But now a fentanyl vaccine – which could be of some use in mitigating damage – appears to protect mice from the drug. Will it succeed in humans and, if so, how might it be used?
Recent news reports have spurred concern that just touching fentanyl can be dangerous. Let's take a look at the chemistry behind this claim. Comedian Bill Maher recently attacked the fat-acceptance movement as a danger to public health, sparking ferocious criticism on social media. Sadly, few people recognized the most important point about Maher's commentary: he was right.
Cato Institute Senior Fellow Dr. Jeffrey Singer (also a member of the ACSH Scientific Advisory Board) has written a powerful piece about the inability of policymakers to realize that their plan to reduce drug overdose deaths is wrong on every level.
Since 2020 Dr. Roneet Lev has been doing podcasts called High Truths, most often about addiction and drugs. So, I was happy to participate in an episode about fentanyl. It turned into quite a bit more.
You can be blindfolded, throw a stone, and probably hit a writer who gets the opioid crisis all wrong. Today, let's throw one at German Lopez of The New York Times.
The term "opioid epidemic" is outdated to the point where the message conveyed is inaccurate. Also, every time the phrase is used most people will automatically think "pills." But pills are now a minor contributor to overdose deaths; it is illegal street drugs – especially illicit fentanyl – that’s (by far) driving the surge in overdoses. Substituting the term "fentanyl epidemic" would instead shift the blame to where it belongs, while going a long way toward halting the demonization of vitally important medicines. Words matter.