Evolving drugs pose challenges
Stemming the tide of illicit opioids has the U.S. Drug Enforcement Administration playing whack-a-mole with constantly evolving synthetic drugs.
Those who illegally make fentanyl, a powerful painkiller 50 times more potent than heroin and 100 times more potent than morphine, and increasingly seen in overdose deaths, kept one step ahead of law enforcement by making minute changes to the formula.
All that changed last year when Governor Tom Wolf announced that fentanyl-related substances will now be classified as Schedule I drugs, making them illegal substances. The action closes a loophole that had required each substance to be classified individually in order to be considered unlawful. The burdensome process forced police, prosecutors and policymakers to constantly react when new, or even slightly modified, substances were introduced.
DEA supervisory special agent Patrick J. Trainor, based in Philadelphia, describes what agents were seeing.
“The challenge for us is the constantly evolving synthetic substances, there are so many combinations to identify and schedule.
“It’s a challenge for us because we don’t know the strength or chemical composition. People who take them for sure don’t know know the strength. This is why were seeing the fatal numbers that we do,” Trainor said.
“There are now a significant number of fentanyl-related substances. It is increasing,” he said.
Fentanyl, a synthetic opioid that has legitimate medical uses, including as a surgical anesthetic, had to be defined to be classified as a controlled substance. That means that a specific formula had to be registered with authorities.
However, Trainor said, illicit drug makers kept “a step ahead” by changing the chemical structure.
“Then it’s a new substance, which makes it not illegal,” he said.
“The fentanyl-related substances continue to evolve, and that’s a real challenge for us,” he said.
“Illicit fentanyl is hands-down responsible for most of the overdose deaths in our region,” he said.
Trainor and his colleagues are particularly concerned about the prevalence of carfentanil, which is 10,000 times stronger than heroin.
“It poses a much greater risk to the people in our region,” he said.
Carfentanil is used legitimately as a veterinary anesthetic for large animals such as elephants.
The opioid analogs are typically manufactured in China and Mexico, Trainor said.
“They are not being produced here. The precursors used to make the drugs are closely monitored here. That’s not the case in other sections of the world,” he said.
“Drug trafficking organizations, such as cartels, often get here through well established trafficking routes. The same routes are used for cocaine, meth, and heroin,” Trainor said.
“Also, the really novel fentanyl related substances are being sold on the dark web, and shipped to the user directly, no middleman,” he said.
In his 20 years on the job, the biggest change Trainor has seen is the number of people dying as a result of opioids.
“The numbers are deeply, deeply troubling,” he said.
“The single biggest issue is that people are starting to abuse (opioids) as a result of prescriptions,” he said.
Drugs like oxycodone and percocet are very effective painkillers. When prescribed and taken properly, they are extremely effective. But for people who are predisposed, there is the ability to develop tolerance or dependency; often exceeding the prescription amount. Then they try to purchase them on street,” Trainor said.
“As your tolerance increases, the need for the drug increases.
“If someone is purchasing oxycodone, it’s $30 a tablet. People run out of the money and turn to heroin, which is significantly more unpredictable and dangerous,” Trainor said. “That’s what we’re seeing more and more as leading to overdose deaths, significantly more.