This Drug Is Cheaper And More Powerful Than Heroin — And May Be Killing Way More People


A kilo of heroin nets a dealer $60,000. A kilo of fentanyl?
$1.2 million.

Posted on June 05, 2017, 14:26 GMT

Drew Angerer / Getty Images

The counterfeit pain pills that
killed Prince in April of 2016 held a drug far deadlier
than heroin: fentanyl.

Fentanyl, a synthetic opioid, arrived on the US illegal drug
market at just the right time, in 2012, to set off a wave of
fatal overdoses like a match dropped into a gasoline tank.
After a decade of free-wheeling painkiller prescribing and
cut-rate prices for illegal drugs, more people than ever were
addicted to heroin. And thanks to a hollowed-out economy in
Appalachia and New England, where disability and lack of jobs
has played into an epidemic of drug addiction, people were
looking for the cheapest possible fix.

“It’s our deadliest concern,” Russ Baer of the Drug
Enforcement Agency (DEA) told BuzzFeed News.

The agency is now
routinely seeing
deadly cocktails of heroin, fentanyl, and
fentanyl-related compounds turning up with US seizures of
cocaine and methamphetamines. Of about 33,000 overdose deaths
nationwide tied to opioids in 2015, 9,000 — or about 27% —
were blamed on fentanyl.

For 2016, inquiries by BuzzFeed News to the public health
agencies of all 50 states found that only 30 have so far
tallied a total number of opioid deaths. But even this
preliminary data shows that in 13 states — Delaware, Florida,
Iowa, Kentucky, Maine, Massachusetts, Montana, New Hampshire,
New York, North Carolina, Pennsylvania, Rhode Island,
Virginia, West Virginia, and the District of Columbia — there
were more overdose deaths from fentanyl and other synthetic
opioids than heroin.

That’s all up from hardly any fentanyl deaths in 2012. The
spike is caused by many related factors, but basically boils
down to one thing: money.

“Everything with fentanyl comes back to economics,” Baer
said, echoing experts who spoke at the April Rx Drug Abuse
& Heroin Summit in Atlanta.

Here are the shocking stats you need to know.

Peter Aldhous for BuzzFeed News / Via drugabuse.gov

US Heroin addiction rates have doubled since 2002.

Starting around 2007, heroin addiction rates began to climb
nationwide. The timing coincides with an increase in the
price of cocaine from Colombia and a crackdown in Mexico on
marijuana, which
might have led dealers to turn to heroin as a money
maker.

Whatever the cause, a recent JAMA Psychiatry
report found a roughly 90% increase in heroin use from
2001 to 2013. That’s about 1,127,000 more people trying the
drug.

That’s a lot of extra customers for heroin dealers. There are
now about 467,000 heroin addicts nationwide, according to
NIDA. And another 2.1 million people are addicted to
prescription painkillers like oxycodone, chemical cousins to
heroin.

Many people take painkillers responsibly, whether dealing
with debilitating chronic pain or with cancer. But others
develop a physical dependency, taking them long after their
pain is gone. Some painkiller users switch to cheaper heroin:
About 31% of new heroin users reported being dependent on
painkillers, according to
a 2013 survey.

DEA

Origin of heroin sold in US cities.

The Mississippi River used
to divide the heroin market, with Mexican heroin
predominating in the West and Colombian heroin to the east.
But that’s changed in the last decade or so, with about 80%
of US heroin now coming from Mexico, trafficked largely by

six cartels. The best known is the Sinaloa Cartel, which
was headed by Joaquín “El Chapo” Guzmán Loera, extradited
to the US in January.

Although the Sinaloa Cartel
reportedly controls where much of the opium is grown,
refining it into heroin is more decentralized. Many cartels
have started selling “Mexican White” powdered heroin,
replacing the older black tar and
brown powder versions they used to sell.

Once a trademark of East Coast Colombian criminal networks,
this white powder heroin is more potent (it has a higher drug
“purity”) and cheaper than older varieties, according to DEA
lab results, which means it can be snorted just like a
crushed pain pill. Counterfeit pain pills made with white
heroin have also started to turn up in drug seizures since
2015, aimed at addicts who don’t like needles.

Mexican heroin is now routinely sold in many parts of rural
America where it used to be absent, powered by networks
that essentially deliver drugs like
pizza. Dealers drove into rural states where disability
payments and pain prescriptions had massively spiked — West
Virginia alone received
780 million oxycodone and hydrocodone pills from 2007 to
2012 — just as legal officials were clamping down on pill
mill pharmacies.

“Dealers head east of the Mississippi River — primarily in
Appalachia and Ohio and Indiana and Kentucky and those areas
— where this massive marketing of pills has taken hold,”
crime reporter Sam Quinones, author of Dreamland: The True
Tale of America’s Opiate Epidemic
, said in
a 2015 interview. “Their system takes off hugely because
they stumble upon an enormous new population of addicts.”

Peter Aldhous for BuzzFeed News / Via IDSA

The US street price of a single gram of heroin since
1980.

The bottom really began to fall out of the street price of US
heroin starting in 1997, according to
a 2016 study led by Travis Wendel of St. Ann’s Corner of
Harm Reduction in the Bronx, when Colombian drug cartels cut
the price by more than than a half, from $175,000 to $75,000
a kilo. Soon supply outstripped demand.

“Used to be the custies [customers] fiending for the product,
now it’s the dealers fiending for a custy,” a drug dealer was
quoted as saying in a related study from
2003.

The drop in price may have contributed to reduced crime rates
in major cities, according to Wendel and his colleagues,
because people had to steal less to pay for their habit.

Cheaper heroin also leads to more overdoses. A 2014 study
of 3,400 hospitals nationwide, for
example, found that for every $100 decrease in the price of a
gram of heroin, the number of overdose hospitalizations
goes up by 2.9%, around 10,000 more nationwide.

In studies over the last decade, Daniel Ciccarone of the
University of California, San Francisco, and his colleagues
have shown that marketing, branding, and economics create
unique heroin
markets in different cities. Philadelphia users, for
example, tend to buy powdered heroin in open-air markets
filled with competing brands, whereas people in San Francisco
mostly buy black tar heroin from dealer acquaintances. Every
market, Ciccarone wrote, is driven by a “connoisseurship of
potency,” where users seek out the strongest possible
dose.

Peter Aldhous for BuzzFeed News / Via drugabuse.gov

US opioid overdose deaths 1999-2015, by drug.

Around 2011, into that market for stronger heroin came the
new users from pain pills, who added to those larger number
of heroin users. Within a couple of years, this combined
market began to see heroin tainted with fentanyl, a surgical
painkiller that can be 50 times more potent than heroin, on
the black market.

DEA

A fatal dose of fentanyl next to a penny.

Fentanyl’s chemistry makes it far riskier than heroin.

A typical dose of heroin might require 15 to 30
milligrams for a fix, and an overdose might take 3 to 10
times more than that. In contrast, just 1 milligram of
fentanyl could get someone high and 2 or 3 milligrams could
kill. This leaves little room for error, Baer noted. “These
are not professional chemists.”

Fentanyl-laced heroin sold with names like
“King of Death,” which killed three people this year in
Atlantic City, or “Grey
Death,” which killed four people in two states this
month, plays right into the demand among heroin users for the
most potent drug possible.

CDC/DEA / Via cdc.gov

Number of law enforcement reports of samples that tested
positive for fentanyl (“fentanyl encounters”) from 2014
to 2015.

Fentanyl is not only more deadly than heroin, but can be far
more lucrative.

“A kilo of fentanyl can be split up many more times than a
kilo of heroin, to make more money.”

In the US, Baer said, a kilogram of heroin that costs about
$4,000 dollars might be made into enough does (typically cut
with milk sugar) to garner the dealer around $60,000. A
kilogram of fentanyl might also cost a dealer $4,000
wholesale, according to the DEA, but it can be split into 20
times more doses, garnering $1.2 million or more.

Carfentanil, a related tranquilizer 100 times more powerful
than heroin (even skin contact can trigger an overdose),
pushes the economics even farther, turning up in overdoses
across the Midwest, and
up and
down the East Coast. The first human poisoning with
carfentanil was only reported in 2010 — a veterinarian was
splashed with a dose from a dart intended to
sedate an elk
— so not a lot is known about human use of the drug. So
far, it appears to be a “boutique” occurrence in illegal
drugs, Baer said, albeit one turning up with
increasing frequency.

Unlike such synthetic opioids, heroin requires a lot of
hassle for the cartels: planting poppies in fields in Mexico
(or Afghanistan or elsewhere), harvesting, and processing
them to collect raw opium, which in turn needs chemical
processing to make into morphine and then heroin, all the
while dodging law enforcement and eradication efforts.

Fentanyl only takes a small lab, with raw materials typically
imported from China. In 2015, China started cracking down on
exports of the drug and its chemical cousins to Mexico, the
US, and Canada. As each synthetic opioid is banned, another
still-legal variation on fentanyl pops up for sale. That has
led to a game of outlawing new variants as soon as they
appear on the market.

“It’s whack-a-mole but we have to do it,” Ambassador William
Brownfield of the US State Department’s International
Narcotics and Law Enforcement Affairs office told BuzzFeed
News.

DEA

Counterfeit pain pills with fentanyl.

Prince’s death illustrates the latest chapter in the fentanyl
saga, with the drug turning up in
counterfeit pain pills. Money again explains its
appearance: a $20 fake pain pill might contain much less
fentanyl than a $10 baggie of fentanyl-laced heroin, letting
the dealer split the dose even more and rake in more
money.

One kilo of heroin can make about 20,000 dime bags. One kilo
of fentanyl might make 666,666 counterfeit pills,
according to the DEA. The profits for these tainted pills
can range from $10 to $20 million. Each pill contains 1.5
milligrams. That means two pills could be deadly.

“Cartels are predatory, they don’t care about killing
people,” Baer said. “If for every person who dies another one
to three are addicted, they are fine with that.”

The
“Watson 385” pills reportedly found at Prince’s estate
after his death have led to suspicions the singer
may not have known he was taking fentanyl when he died.
Real Watson 385 pills contain acetaminophen and hydrocodone,
a less potent opioid painkiller, frequently given for back
pain.

Some news reports suggest the counterfeit pills that killed
Prince also contained
UL-47700, a different opioid increasingly turning up in
drug cocktails, as well as in cocaine and methamphetamines.

The surge in fentanyl deaths and opioid addiction defies any
simple solution. The problem is rooted more in economics, a
failed revolution in pain treatment, and the neurobiology of
addiction than the tired stereotypes of the “War on
Drugs.”

“We cannot arrest our way out of this,” Baer said. “The
solution has to come from the demand side, the people taking
this, and from community awareness where they live.”

Dan Vergano is a science reporter for BuzzFeed News and is
based in Washington, DC.

Contact Dan Vergano at dan.vergano@buzzfeed.com.


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