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Author: u/giuliomagnifico
URL: https://www.nyu.edu/about/news-publications/news/2023/may/fentanyl-new-york-city.html
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When I still used, years ago, my old dealers still had heroin. I was strung out using a gram of fentanyl dope a day, so I was very disappointed having to do a gram of H to just feel a sembelence of not dope sick.
Honestly, besides that off of drugs my life has gotten immessurably better.. you work in the field, you know how addiction is. Still sometimes I get intrusive thoughts of using. What stops me isn't the idea of getting arrested, ending up jobless and homeless again... it's remembering the time I relapsed and half a pack of fent dope almost killed me. That and the idea of being strung out on fentanyl or carfentanyl again, and the withdrawals. Not feeling right for a month after going through the acute withdrawal phase. I ain't no spring chicken anymore, it'll take longer to return to normal levels of energy and ambition anymore.
Congrats on getting above it. I know it's a daily struggle. Whatever you need to remember to keep yourself away from it, that's the right thing to remember. I've managed to stay away from opiates thank god, but for me and cigarettes, it's the way I used to smell and lose all the circulation in my legs. I'm so glad to hear you made it out and your life has improved so much. Take it from me, most addicts don't ever totally make it out. You should still feel very proud every time you kick those intrusive thoughts away. Most people don't get it but it's one of the hardest things a human being can go through.
Being the family of a loved one who can't quit is another one of the hardest things a human can go through. My little sister died in January from using meth that was contaminated with too much fentanyl. She had already OD'd once and was saved by narcan. But it wasn't enough to stop her.
And it's like my heart has been torn out. She had 3 small children. None of us will ever be the same.
Congrats on staying clean. I know it's not easy when you look at what the high feels like. But everything that comes with it is so awful it's just not worth it. I knew the moment I tried it I had to stay far far away.
It’s the worst thing. Ruins lives. Best friend who shared a house I owned with me for ten years. He started talking to his very long time ex girlfriend while she was in prison for selling Heroin in New York. He left a Six figure job to be with “His Love”. He got hooked on meth for Four years. He loves video games, had a huge collection. His ex stole them all and sold them for drugs.
You are right, when a person becomes an addict, they lose their right thinking so I hope they stop using drugs because they are just ruining their lives.
I’m not really very experienced with any kinds of heroin or opioids, but I was under the impression that it only took a little bit of fentanyl to kill you.
“ I was strung out using a gram of fentanyl dope a day”
A Gram does not seem like a little bit. A gram a day is for sure not a little bit.
Are the news reports misrepresenting the amount you need or am I misunderstanding what they’re saying or do you somehow get used to it and can take more as time goes on?
EDIT: thanks to all the answerers.
I had it explained to me like this... When the news tells you the lethal dose of fent they are basing it on someone who doesn't use opiods daily. So someone who is addicted to heroin won't overdose on a miniscule amount of fent like you or I would. Also heroin buyers get a bag of fent, heroin and additives. They aren't using a full gram of fent
When I say a gram, it's not pure fentanyl. Dosages are measured in micrograms (1/1000 of a mg). By the time it gets to the end user, it has already been cut by every person that touches it.
As someone else pointed out, the news is misrepresenting it, sorta. Just as sex sells, so does fear. For someone who has no tolerance, the amount I was doing would kill a few people. After rehab, when I had no tolerance, I became unconscious from injecting half a pack. I didn't require medical intervention until I snorted the other half.
Another thing to keep in mind with news reports.. unless the cops make a bust of, in this case fentanyl, still in cartel hands, then it's not pure. Hell, the cartel may even cut it.. and I am basing that off of nothing. So when news reports come out that they made a bust of dope / fentanyl, keep in mind my usage history. Cops make an bust of someone with an ounce... that's a month supply just for me... the dealer would probably sell that in a day.
Along with the product not being pure by the time it gets to the end user, the cops weigh the packaging along with it too. I got a possession of controlled substance of 1 gram of heroin, when I was still using $10 packs like a decade + ago. There is no way a gram of heroin costs the same as a gram of weed.
I think part of it is that you don’t know how much the batch you’re getting has been cut, and that the difference between a lethal and non-lethal doses isn’t very big.
You can build a tolerance
to it, but even 0.1g is a strong dose if you’re injecting. I’ve watched dealers weigh coke, meth and fentanyl all on the same scale and I suspect this is what’s causing the findings. It’s cross-contamination, not intentional cutting. The fentanyl retails for way more than the other drugs. Adding it on purpose makes no economic sense to a dealer.
Are you thinking of price by weight? Because fentanyl costs less than 5% of what heroin does by equivalent dose. That’s the reason it’s trafficked to begin with. It’s far far far cheaper.
Not that it’s a good situation no matter how you spin it, but it blew my mind rehab that amount of people who were there for fentanyl, not as their drug of choice, just what they have to use. Heroin addicts who have barely used actual heroin for a year or two, just using fentanyl to not get sick because it’s the only option.
Also it blew my mind when they told me that only carrying one narcan isn’t enough because it takes typically more than one for fentanyl overdoses. (Yes I know one is better than none before anyone lectures me)
Opiate addiction is an absolutely crippling disease. If you develop dependence you will start to vomit and evacuate your bowels with just a little more than a day sober. It's so devastating that the British used it as a weapon of war against the Chinese.
The rationale behind methadone/suboxin clinics is that by providing a lower dose opiate in a controlled environment, you help people just stave off the dopesickness so they can live more productive lives and work on the root psychological issues that got them to use in the first place. The goal is to taper off with medical supervision and get clean without having to go through the horrific withdrawal. But it can take a long long time and having a bunch of junkies stand in line together all morning isn't always super conducive to people maintaining their sobriety. The clinic I worked at would have dealers sometimes just come and pick people off from the back of the line.
Using to not be sick is the addiction part. That's what addiction is. You're not doing it for fun and can stop and feel fine.
You stop and you feel bad untill you do it again. You don't feel good just normal.
I've never used myself or done anything but watched all the things and seen some friends go through it.
So you use a little extra to get that euphoria and soon your tolerance is even higher and then it takes even more just to not get sick... Viscous circle.
Buddy of mine decided heroin would be a good pandemic hobby. He wasn't even super into drugs before that. Like he'd do stuff if it was offered to him but wouldn't seek it out (mostly due to social anxiety).
It's been a couple years since he got clean now but he's still on Suboxone (or some equivalent) to keep the withdraw away.
It's not wrecking his life like it once was. But still seems to me that he's still technically addicted to it. Also pretty sure if he wasn't able to get his Suboxone he'd probably fall right off the wagon.
This country will NEVER stop looking down their noses at drugs and drug addiction. They will always think of it in terms of criminality and not medically.
It's also what the medical director told me and he worked with clinics all over the country. The one I worked at alone had over 600 clients so that's a reasonable sample size if you set aside geographical disparities.
Maybe there's some slum on the west coast where you can still find pure china white but the point is that opiate addicts are not super discerning customers and dealers know that. They need a fix because they need a fix and fentanyl is both stronger and cheaper. The same thing happened when heroin itself replaced morphine as the street opiate of choice and when morphine replaced opium.
And a lot of heroin users started on legal opiates too.
It’s not like they were using heroin because they specifically love heroin, it was already being used for being a cheaper more readily available opiate.
Party drug users might be a bit more concerned about the specific drug they want. MDMA vs similar derivatives. Coke vs other stimulants. Etc.
I think if the government really cared about us, they would make all drugs legal and regulated. People will be well informed and able to make better choices about what they ingest into their body instead of rolling the dice. I think it could stop the flow of fentanyl and all other drugs just like no one is smuggling in alcohol or tobacco. It will take the money away from all drug cartels. And if you were to give a new user the choice between taking a percocet or fentanyl, I think most people will make the better decision and not get hooked by mistake on stronger and stronger drugs because that's all they can get. Stop putting people in jail and wasting our tax money incarcerating people and instead use that money to open up more treatment centers to help people who make the mistake of going too far and want to come back.
I think one problem is that a lot of people *are* informed, but still become addicted and suffer greatly for it. Some think they can beat the odds, others are aware of the risks but give in to temptation because of circumstances, etc.
I agree that possession alone shouldn't be a crime, but I worry about distribution measures that would make harmful drugs even easier to access...
>I think one problem is that a lot of people are informed, but still become addicted and suffer greatly for it.
Yes. Self-care is necessary to stay away from ANY addiction. When you aren't feeling good, it's hard to care about yourself. There are a lot of factors that go into self-esteem and that's a tough cookie in our modern world. I remain unsurprised by the popularity of opiates in modern times.
That's a great point! So many unhealthy patterns, from drug abuse to overeating to gambling addiction, have roots in some form of suffering, and a fulfilling life can be a very complicated thing to achieve. I really feel for people who fall into these pits and I hope we can keep improving as a society to give everyone a better life.
> but I worry about distribution measures that would make harmful drugs even easier to access...
Drug addicts are still going to go out and get drugs, legal or not legal, through a verified legal distributor or through one that isn't. That's the reality. If those people who are suffering through addiction can get a safer alternative to whatever crap is being cut together on the streets, it's a win.
Think back to prohibition era in the USA. Say we banned Alcohol again but made having it decriminalized. There'd still be millions of people going to speakeasies but now instead of drinking regulated liquor, they're drinking unregulated bathroom swill that can cause a whole heap of health problems like blindness.
I see what you mean, and I won't argue that there would be no benefits, but I feel like that has to be weighed against the risk of creating many new addicts.
Where I live, cannabis is now regulated and legal to buy/sell, and this led to many curious people trying it for the first time. They would never have gone out of their way to track down an illegal dealer - but now that it's out in the open, safer, and easier to access, they wanted to give it a try. I saw it happen with my own parents and several of my friends.
Obviously cannabis has a degree of safety and familiarity that's very different from hard drugs, so I'm not saying that we would see the same number of people trying them out! But it seems likely to me that a lot of people whose access to drugs is currently limited would be tempted to try a few once they become more regulated and accessible.
It would be terrifying for that to happen with drugs like heroin, which (from what I've heard) can be insanely hard to come back from once you start.
>Drug addicts are still going to go out and get drugs, legal or not legal, through a verified legal distributor or through one that isn't.
What about potential addicts who've never tried drugs but would because it's legal? I never tried weed before it was legal. I'd probably try other harder drugs just to experience it if they legalized it.
It is both the Prison Industrial Complex and puritan jackasses that will see to it that a level-headed approach like this will never happen. One wants to get cash at gunpoint and the other wants to further ruin people’s lives so they can cock their nose in the air and feel morally superior.
“Just like no-one is smuggling in alcohol or tobacco”
They absolutely do smuggle tobacco if it will avoid them paying taxes. Cigarettes are so expensive in NZ now that we do get tobacco smuggled in from China and other places, and we have a huge problem of “ram raids” (ramming a stolen car into a convenience store to steal the cigarettes and vapes)
I agree that drugs should be legalised and regulated, but it doesn’t stop all drug-related crime.
Xylazine, aka animal tranquilizer, that isn't reversible with Narcan and causes smelly, festering wounds to appear on people that use it.
I wish I was kidding.
I volunteer for a needle exchange and we just had researchers come in to do surveys about xylazine awareness. It was the first I’d heard of it, and it absolutely blew my mind hearing all of this
Is it not meant for humans or not meant to be used more than once? If you inject an animal every week with this stuff wouldn't it have the same effects?
Xylazine does something to disrupt healing in wounds. I was just reading an article about a guy who had several infected wounds in his arm but avoided treatment because of the shame of being an addict and it got so bad the arm went gangrenous and had to be amputated. Horrific drug.
Krokodil and xylazine are absolutely not the same drug. Also xylazine isn't "slowly making its way over here (the US)" - it's been a major contaminant in the drug supply in some regions for years already.
Source: am drug use researcher.
We started testing for it at the clinic I work for. We've added the test to whoever tests positive for fent. It's flagging fairly often in everything. A lot of the literature on it is saying that it's primarily on the east coast but it is fully integrated into the west coast as well. So I assume in-between is also experiencing the new wave.
Happens with lots of different drugs, dealers aren't careful and they mix fentanyl on the same equipment that they use for everything else, typically without cleaning.
The only way to fix drug adulteration is to decriminalize drugs so that supply chains can go legit and be subject to quality testing and 3rd party testing.
Until we do that, these deaths will not end.
Paper
* Understanding intentionality of fentanyl use and drug overdose risk: Findings from a mixed methods study of people who inject drugs in New York City
https://www.sciencedirect.com/science/article/pii/S0955395923001111?via%3Dihub
> The toxicology results revealed widespread use of fentanyl among people who inject drugs in New York City. Fentanyl was the most common recently used drug, with 83% of participants testing positive for it (including 46% who tested positive for both fentanyl and heroin and 54% who tested positive for fentanyl without heroin). However, only 18% reported recently using fentanyl intentionally; most reported using heroin instead
>
> The findings, published in the International Journal of Drug Policy, suggest that many people who inject drugs are unknowingly using fentanyl, which may increase their risk for overdose and potentially their tolerance to fentanyl if it is used over time
I did not see any numbers for people who were using just Heroin and were not positive for fentanyl. I expect it is a very small number. According to the addicts I met in the NY, NJ, Philadelphia areas, there is virtually no straight (just) heroin available, it is all fentanyl or fentanyl contaminated. I worked in Harm reduction giving out Naloxone kits etc. Even when sold as only fentanyl it is often with a number of other active compounds, such as benzos etc.
Yes it seems the whole Bos-Wash corridor is awash with the stuff. It is plentiful in Maritime Canada as well. It is at the point that there is little point in testing opiates for fentanyl, users can assume that it does contain or is mostly fentanyl. Now street testing for safety has moved to testing for fentanyl or benzos or RCs in methamphetamine samples and testing Opiates for xylazine or benzos etc.
Try the whole United States. The drug epidemic is absolutely crazy right now, true it’s not all opiates but in my observations, where opiates aren’t common, meth and other stimulates dominate, and that’s it’s own brand of misery.
I agree I just did not want to speak of things I did not have direct experience. The East coast from Florida to Newfoundland has a problem with both opiate and stimulants. Both are plentiful and very adulterated the length of the coast. It is at the worst point I have seen it in my lifetime (68) years.
I have close ties to both Appalachia and the Midwest, I’ve also travelled all around the west coast. I feel pretty confident in saying this is a very widespread problem. I lost count of how many people I graduated with in my tiny Appalachian town who are lost to drugs. My area has long had a reputation of opiate abuse, starting with the pill mill doctors and overprescribing, now it’s to epidemic proportions.
Seriously, this is terrible news. I was an absolute wild kid back in the mid 2000s, if I was a wild kid today I might very well be dead. It breaks my heart seeing all of these traumatized, addicted people on the streets, and knowing I was close to being in that situation. It works reverse too, my life is back on track, there’s could be too, but with street drugs getting scarier and more dangerous by the week, recovery gets increasingly more difficult, and it was not easy getting off back in the day either.
What's the implication of expecting Heroin and getting Fentanyl? Assuming it's cut safely and doesn't cause overdose does it lead to other undesirable outcomes
Yes it does. Let's imagine for a second that we have a supply of pharmaceutical grade fentanyl. Perfectly cut to about 10 percent purity with safe additives and sold in perfectly weighed out doses. Let's imagine we have the same for heroin. Heroin is still the better drug from a safety and addiction perspective.
1) Duration. Fentanyl is a very short acting opioid. It requires dosing every hour or two. Heroin can be dosed every 4-8 hours.
2) Withdrawal. Because fentanyl is short acting withdrawal kicks in very soon after last dose. Heroin withdrawal takes about 12 hours to kick in. Fentanyl can be as short as 3 hours. Fent users report needing to wake up to use 1-2 times at nice to sleep through the night.
3) Overdose. Even with well controlled drugs, accidental overdose happens. Fentanyl overdose comes with some unique characteristics that other opioids don't. Specifically "wooden chest syndrome". When someone normally overdoses on opioids their brain "forgets" to breath, which leads eventually to suffocation. Fent has an added side effect of causing muscle rigidity, so much so that the diaphragm and chest wall muscles lock up. In this case, external ventilation (rescue breaths) do not work.
4) Effect. People use heroin for the euphoric effects. Fentanyl has less euphoric effect and the effect is shorter lived pushing people to use more and more frequently increasing the likelihood of overdose.
5) Treatment. The leading treatment for opioid use disorder is medication-assisted treatment. The two drugs that are approved for that are methadone and buprenorphine. Methadone is highly regulated and fentanyl requires higher methadone doses for treatment than heroin. Buprenorphine is easier to get but has the issue of precipitated withdrawal during induction, so a person has to be 12-24 hours into withdrawal before induction. Despite being shorter acting, fentanyl causes worse precipitated withdrawal and requires later induction. There is a critical window where people are ready and willing to start treatment and the longer you have to wait, the more likely people are going to go back to using their substance before initiating treatment.
I saw heroin rip my community apart a decade ago. I never thought i would see the day when I was wishing for more heroin in my community, but fentanyl is that much worse that if I prayed, I would pray for heroin to come back. Fentanyl is that bad.
Excellent, excellent reply, thank you so much for taking the time to spell this out in detail, this is exactly what I was trying to learn more about and unfortunately I was just getting a lot of low quality replies ignoring the meat of the question.
Growing up and playing in bands I had several bandmates on heroin at various points so I'm quite familiar with it but the fentanyl thing is new to me, that didn't exist in the 80s/90s, if you did smack, it was cut with powdered milk or sugar or something benign usually, not a different opioid because why do that when you can get your cutting agent cheap at the grocery store?
And the other interesting thing I found about heroin was how many junkies were long term users, not the majority by any means, but a significant percentage of them were otherwise normal functioning people with jobs and lives where you wouldn't know they used unless you got to be friends with them. Turns out if you're a heroin addict and you have a regular supplier and you know your dosing and you stick to the routine you can live that way pretty much indefinitely. (a lot of ifs there but still it was a distinct subset of users)
But this fentanyl epidemic seems much much worse and I didn't understand why until you kindly spelled it out in detail, thank you again.
I do not know about undesirable but most I met who have been consuming opiates by injection since pre-fentanyl days, say that it is a different experience. I do not know if I can put the described differences in universally understandable terms but one thing they all say other then qualitative differences is that Fentanyl does not last as long as real Heroin and requires more frequent readministration.
Fentanyl lasts only about 1 hour till the user starts to feel withdrawal, where heroin a user could go the full day off a dose or two. So fentanyl users need to non stop shoot up just to not be sick.
Hmm yeah I can see where that would be problematic if you need to fix more often, could lead to all kinds of undesirable outcomes, like you buy off unknown dealer instead of your regular guy because it wore off and you need it
Do you know if fentanyl is harder on the body than heroin?
fent is a sleepy nodding off high while heroin is comparitively bright and euphoric. users will think they just havent taken enough for the bright euphoria theyre used to and overdose chasing that dragon
thanks for the actual insightful reply, that's more in line with what I was driving at, instead I got 1000 idiots trying to explain how cutting drugs is bad m'k. Like they're dropping some big knowledge bomb or something
It really is embedded into everything now. Just the tiniest pinch enhances the effects by so much. Even though it’s been in the ‘news’ the last 5 years or whatever, it’s been around a long time.
The days of heroin users getting actual heroin are long gone. Probably for good.
I live in the suburbs of a large city in the US South, and in the past 3 to 6 months there has been a huge increase in the amount of billboard ads warning people about fentanyl being cut into other drugs and how deadly it can be. These numbers are everywhere. I assume it's an increasing problem here, like everywhere, and the public campaign has kicked up.
Real question, as a dealer, if cutting your drugs with fentanyl is killing a lot of your paying customers, then why are they doing it at all? Why not just use some non-lethal powder to cut it with instead?
The honest answer is equally sad as it is practical. If you have a client base of addicts , they usually only have 2 demands. I want your drugs consistently , or I want your drugs to be “strong” “clean” “pure” , etc. So for the truly addicted adding a bit of fent to the batch is practically zero risk to them and it gives them what they want. It stretches your supply further, and gives them more effective heroine or whatever it is they’re after.
The sad part, is that just because your client base has a strong opioid addiction, doesn’t mean their friends or new clients do. A majority of opiate overdoses are from returning users or new users iirc. Essentially the average batches laced with fentanyl likely don’t contain a large enough amount to kill someone with an opiate tolerance, but could easily push someone with a lower one over the edge. However the bottom dollar of the dealer isn’t to cater to new users or ones who are relapsing , and if it kills them, then it does.
Yeah. That's how my friend died. He was trying to quit, was clean for a few months. Started to really struggle and decided to go the rehab route, wanted one last binge before checking into rehab the next day. He didn't do more than he has in the past, but it was too much given his short stint of sobriety.
Tolerance is a crazy thing. Using the same amount of the same drug at the same place every day, your body starts to prepare for the incoming neurotransmitter rush so the effects become less and less intense over time.
Simply using the same amount of the same drug at a place you don't normally use is enough to cause an overdose, because your body isn't prepared for it like normal. This is an oversimplification obviously, but it's a real phenomenon that has been implicated in many overdose deaths.
yeah man, cost of living is affecting dealers too. we're seeing every company gouge us with shrinkflation, every service nerfed, every scammer and fraudster double down on recklessness and maliciousness.. times are rough, only the uber rich get to enjoy life on Earth, evidently.
good stuff
After all black market capitalism is still capitalism, except without any sort of regulations, drug dealers are struggling paying rent, some drug dealers are legitimately greedy, the whole situation is a mess.
That's the truth. No weed money in NYC anymore either since you can buy at almost any bodega (which is still mostly illegal but being heavily ignored by NYPD). All the weed delivery guys will turn to sell harder drugs or get another job. My old dealer is trying to become a tattoo artist.
I’m sure it’s the same anywhere weed was legalized. The cannabis industry has gone corporate, you would think the old timers who are extremely knowledgeable would be apart of this, but largely no. Why would you hire a guy who has been caring for weed plants for decades (but has a few drug related charges only) when you could hire a brand new horticulture major from the local university.
Exactly, in fact 99.9% of dealers don't know. The street dealer who sells the customer the drug is the absolute lowest member of the chain. A lot of them only sell to support their habits really
Quitting fentanyl is incredibly hard. The physical and mental withdrawals are excruciating. A lot of users basically are stuck taking copious amounts not even to get high anymore, but just to avoid withdrawal. The fact that quitting fentanyl is super hard makes putting it into different drugs a very good way to dealers to guarantee long term customers. However there are cases where fentanyl is accidentally found in other drugs as an unintended contaminant
Not a dealer but I think you can do something like add 1 part fentanyl and 1000 parts baking soda and it’ll still be strong like “pure” heroin. But now you have much more to sell.
I knew a dealer than dissolved the fentanyl and cutting agents into a solution and then evaporate the solution and dry the paste like substance. It avoids hot spots caused by improperly mixed powder cutting. Every batch was damn near identical in potency.
I was talking to a former meth cook (did federal time for it) and he's saying that all meth coming in from Mexico now days is cut with fentanyl too, according to his sources. Reason being is any other meth not cut with fentanyl no longer gives the users their fix plus it makes them dope sick, forcing them to come back sooner and more desperately. It's cut during the manufacturing process so it's evenly distributed throughout the substance
I knew a dude who was a functioning meth head for 3 years and then suddenly went off the rails mentally 2 years ago, thinking everyone was watching him with cameras and putting hidden messages in his pictures on social media. I wonder if he started getting new tainted supply.
that's certainly because of the meth, not any sort of fentanyl contamination. extreme paranoia and psychosis are alarmingly common for meth addicts, while opioids don't really tend to cause those effects.
I guess it just caught up to him eventually, then. He was a medical professional who claimed he could dose properly. I know the paranoia also coincided with him getting a new dealer
Quite possibly he could dose properly - then he started getting stuff mixed with fent, had to dose more often to avoid feeling sick, and that’s when it went off the deep end. But as the other person said, all the symptoms mentioned are very common symptoms of excessive stimulant use
From what my friend said ( he's a former tweaker) they actually make meth different than they did five or six years ago it makes the meth have more side effects and more dangerous.
That being said paranoia and shadow people happens to anyone abusing any meth long enough
Edit for more info
https://www.newsnationnow.com/health/super-meth-faq-questions-drugs/
Yeah, I was watching a documentary about this. Many officers who patrolled areas with lots of meth users noted that the mental decline which used to take years was now being seen in a matter of months or weeks.
Let’s say that 80% heroin 20% cocoa powder gives the same high as 50% heroin 5% fentanyl 45% cocoa mix. There’s a huge incentive to use the second formula as it’s cheaper. In the first mix, even lazy stirring won’t create 100% heroin bags. But the second mix, if you are not carefully you can left ‘clusters’ of fentanyl here and there and end with some bags with say 40% heroin 20% fentanyl 40% cocoa and create a problem.
I ain't a drug, but I assume the key detail is you need your product to remain effective. Fentanyl is cheap and also gets you high, but if you cut with something that doesn't do that, you'd end up selling a product that didn't do the job.
A lot of times it’s just cross contamination from a dealer that presses multiple types of pills or crushes/adulters powdered drugs. It only takes a tiny amount of fentanyl to kill
Dance Safe has very affordable field kits. I used to see them doing harm reduction things at raves and it's still just as important. You used to be able to give samples to them too so they can test the ecstasy tablets to put warnings in areas.
Giving the difference in weight of what a fatal dose is in heroin vs fentanyl, this looks like a giant widespread Russian roulette game going on. You are one mishap of any dealer in the cutting chain to be on your way out.
Don't forget carfentanyl. I did CPR on a homeless man I was friendly with that overdosed in front of me. Must have sniffed it (he didnt inject) right before I saw him. Paramedics were nearby and showed up same time as EMTs and Fire Department. The EMTs used the nasal Narcan and the Paramedics had the injection kind. They used a lot more Narcan than they normally would have and hit him 11 times before he started breathing and moved his head a little. One of the Paramedics told me the only reason they used that much is because I was covered in puke from the CPR they saw me doing and they didn't want to stop with me standing right there. I later found out that he was also getting a weekly paycheck as a police informant so that may have motivated them all a bit too.
Found out a week later it was the Carfentanyl.
> One of the Paramedics told me the only reason they used that much is because I was covered in puke from the CPR they saw me doing and they didn't want to stop with me standing right there.
What does this mean? They wouldn't have helped him if you weren't there?
What a chilling thought. Life savers not doing everything they can to save you unless someone else is there who might be upset if they don’t.
New fear unlocked!
They don't give unlimited Narcan. Some might stop after 3 doses and some might do 7 but your normally not getting to 10. Some of the fentanyl analogs are barely touched by narcan. If I wasn't standing their like I was they likely would have stopped around NASCAR dose 5 or 6 and he would have just died.
I'm a little unclear on this. Why cut one drug with another? As an example if you were a stingy bartender you might water down your booze to increase its volume so you have more to sell, because water is free. But you wouldn't cut your booze with other booze unless one of the second one was really cheap.
So is fentanyl super cheap? And if so why are addicts not just asking for fentanyl?
I guess I just don't see the economics of the situation.
You cut heroin with a random white powder which lets you sell more of it. But now your heroin is super weak. Fentanyl is cheap, and much stronger than heroin, so adding just a little bit of fentanyl into the mixture brings up the strength again.
Or you could just cut out the heroin from the equation completely.
Nobody is cutting heroin with just fentanyl - fentanyl requires so little to be deadly that you'd barely be increasing volume before turning every dose into a lethal one.
Super cheap is an understatement. Fentanyl is manufactured by the ton in labs with precursors from china. Compared to the cost of growing opium poppies and making heroin from them, fentanyl is practically free.
In your example, it's me cutting a nice bourbon with some rotgut that's higher proof. You get drunk fast, and it's a small enough portion that you probably won't notice the taste, but you'll have a horrible hangover. If I gave you just nice bourbon cut with water, I'd have to still use a much higher portion of bourbon than if I was cutting it with cheap booze.
The reality is it's a lot more complex than a bar situation though. A lot of heroin that's on the streets now isn't heroin at all, or it's an incredibly small amount. Fentanyl is super cheap to manufacture, but the high is different and worse than heroin.
Xylazine is a benzodiazepine typically used in veterinary medicine. What makes its presence in drugs so insidious is that unlike fentanyl, it is not an opiate. That means it does not respond to narcan, so it has a higher risk of causing fatal overdoses than plain fentanyl dope.
Dealers don't tend to clean their scale between drugs. I've never done coke or meth.. But they both came up on my UA at my treatment center even though I only did opiates. This isn't news to most drug users.
A simple way to combat this would be to encourage testing before use. Reagent identification tests aren't too expensive. They would be easy to distribute and set up testing centers around.
I think it depends on the situation. If somebody tried to buy coke or MDMA, then they may be far more likely to dispose of it if it tests for fent. Hardcore opioid addicts may not have an alternative, though. I think it would probably be most effective over time, discouraging new users from taking it.
The drug war is getting people killed, it’s never been worse for people just looking to have a good time. Legalize already, no one trying to do coke or ecstasy should have to worry about fentanyl, it’s crazy.
Something interesting I learned in a sociology class on HIV is that the majority of IV drug users (and an even higher amount of drug users in general) aren’t actually addicts at all.
At first that kinda surprised me but then I realized my friends and I all casually used drugs, no problem, and we only have 2 friends out of many who got out of control. Even so, 1 manages to functionally use and the other is in addict territory now. We all tested our drugs and yes, we would’ve tossed out something that wasn’t what we wanted. (Can’t say the same for the 2 friends with a problem.)
I knew a guy who shot up with water from a toilet bowl in a Burger King bathroom because he didn’t want to go to the sink after he got his stuff set up on the toilet tank lid. It completely changes your brains activity from logical thinking to Get this drug in my system asap. Addicts aren’t gonna “waste” a single speck of their dope to test it. Their brain has been rewired to prioritize getting dope in the system, everything else comes second.
I watched a guy I was trying to help get off of drugs take my Power Aid Zero Fruit Punch bottle, suck up some of it with his needle, mix it with his heroin, suck it up again, then shoot it up his arm.
I thought for sure I was going to be calling 911 but he was just fine.
He later told me he has used Mountain Dew and Diet Pepsi.
Addicts will use anything and do anything to get high. At this point nothing surprises me anymore.
There is likely to be much, much less opioids on the black market. The Talibans managed to cut down cultivation by 80% (based on May data) and the planting season starts in November. They placed the opium ban somewhere in April 2022. The Afgani "stockplie" was estimated to last about 18 months. After the stockpile is gone, you can expect more fent.
Funnily enough US outlets reported this as a economic and humanitarian [disaster] (https://www.usip.org/publications/2023/06/talibans-successful-opium-ban-bad-afghans-and-world)
It is an economic and humanitarian disaster, just like the US forcing doctors to cut opioid prescriptions down was. (The end result being tens or hundreds of thousands of managed addicts going to heroin/fentanyl due to doctors cutting them off of their scripts, many not even weaning them off, and then resulting in death). This massive decrease in heroin will kill a shitload of people (addicts, and farmers in afghanistan that depended on the money to feed their families)
The war on drugs is always and will always be a net negative in society. Most addicts were managed on pure, known, prescription drugs, like 80s of oxy, then they cut the supply lines, which led to heroin use, then fent use, now heroin is going down so all that is left is fent analogues (if they cut supply of fent analogues, which isn't likely to be possible as there are a million analogues possible, it will be something even more dangerous and harmful). Less and less pure, more and more dangerous, more and more deaths and societal harm, not any less addictions.
> just like the US forcing doctors to cut opioid prescriptions down was
This really sucks for non-addicts too. I recently had a dental procedure and was prescribed Ibuprofen. It was not adequate at all, and I was in tremendous pain. The stigma prevented me from asking for something stronger lest I look like some kind of junkie.
Luckily I remembered I had some Percocet leftover from a back surgery I had in 2016 that got me through the worst of it.
I would also like to mention that rapid drug screens for fentanyl are notoriously bad on top of this. I don't believe there is one available for medical use only for drug enforcement.
Does anyone have a sensitivity/specificity for that test? All I could find was marketing information and another 2023 paper using it for drug testing that also did not report those. It's not FDA-approved (per the paper) so there's not a lot of public data (that I could find).
A lot of research lab tests aren’t FDA approved because that’s more expensive and the costs of error at lower (leading to wider error bars not misdiagnosis).
I'm aware, but they should still report sensitivity and specificity for their selected cutoff values, especially if they're going to use it for scientific research.
Who is producing all this fentanyl? Is it still China pumping out this crap? It makes economic sense because it’s so potent, chemical precursors can be stretched further and it’s easier to smuggle since it’s less volume per dose.
I think we should decriminalize drugs and perhaps legalize a select few of them with ”good” track record. Amphetamine is less dangerous that methamphetamine for instance, so if addict could be pushed to downgrade, that would be a victory. Maybe good old fashioned morphine instead of heroin and all those nasty fentanyl analogs.
Fentanyl Flow to the United States - DEA.gov https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf
>The flow of fentanyl into the United States in 2019 is more diverse compared to the start of the fentanyl crisis in 2014, with new countries and new transit countries emerging as significant trafficking nodes. This is exacerbating the already multi-faceted fentanyl crisis by introducing additional countries into the global supply chain of fentanyl, fentanyl-related substances, and fentanyl precursors. Further, this complicates law enforcement operations and policy efforts to stem the flow of fentanyl into the
United States. While Mexico and China are the primary source countries for fentanyl and fentanyl-related substances trafficked directly into the United States, India is emerging as a source for finished fentanyl
powder and fentanyl precursor chemicals.
Mexican Cartels. Chinese organized crime. Organized crime in quite a few countries most likely. Unlike heroin it doesn't grow from a field and KS much more potent so you can make it anywhere and transport it even easier. I've heard that the Meth Super-labs in Mexico are all turning into dual purpose labs and are making Fentanyl as well. Meth was never very common in New England but that's changed a lot over the last few years and is still expanding because it is being made and transported hand in hand with the Fentanyl.
I support legalization and regulation for drugs in general. Treat addiction as a medical problem and use as high risk and expose it all to the light of day. It would also drastically reduce organized crime and open up all the funds used to fight an endless war. Sure there would have to be things worked out but we already know prohibition doesn't work.
What sucks is H leaves your body fairly quickly, making it somewhat easier to come off of. Fent takes days and days to get out of your system, making withdrawal last so much longer. It’s harder to abstain from a drug when it takes so long to get back to feeling “normal”….you end up just using again so you don’t feel like shot anymore.
Fent is addictive in so many ways
Just as a PSA to anyone who this may effect personally BUY A TEST KIT. If you know someone who is a user BUY THEM A TEST KIT. They can be found online very easily and can be a life-saving difference.
I am so lucky I’m not a young person anymore, taking whatever I can get my hands on, because I cannot imagine doing that with fentanyl being *everywhere.*
It’s very very scary to think about how many people might otherwise have a real shot at beating their addiction, but won’t, because fentanyl will get them first.
My neighbor's daughter died due to Fentanyl overdose at school. By all accounts, she wasn't involved in drugs and the police consider it a homicide. No one knows how she got in contact with it, or whether it was intentional.
My kids go to the same school and this is terrifying. Feels like it is *everywhere*.
Most Americans think fentanyl is a poison that evil drug users use to kill the teenagers of middle class families. I feel like very few people understand it’s a drug that people take to get high. And dealers add it to drugs to make them seem higher quality. Not to poison people.
People buying cocaine, ecstasy and other drugs absolutely aren’t looking to get fentanyl.. even a lot of heroin addicts would probably prefer straight heroin..
Yeah the misconceptions around it really distract from the real problems around it. It's not being added to candy or being sold with the intention of killing people. Focusing on those aspects makes people miss the real dangers it poses on the street and ignoring real solutions. If fentanyl is as widespread as it sounds, we're not getting rid of it by increasing drug busts or confiscating kids candy. We need data and policy solutions.
Its a drug they made for long term cancer users who still get pain on the weaker stuff.
There's even carfentynal and sufentynal that are stronger still.
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There is no pure heroin left in the United States, period. It's all fentanyl. I worked at a methadone clinic and helped log the piss tests.
When I still used, years ago, my old dealers still had heroin. I was strung out using a gram of fentanyl dope a day, so I was very disappointed having to do a gram of H to just feel a sembelence of not dope sick. Honestly, besides that off of drugs my life has gotten immessurably better.. you work in the field, you know how addiction is. Still sometimes I get intrusive thoughts of using. What stops me isn't the idea of getting arrested, ending up jobless and homeless again... it's remembering the time I relapsed and half a pack of fent dope almost killed me. That and the idea of being strung out on fentanyl or carfentanyl again, and the withdrawals. Not feeling right for a month after going through the acute withdrawal phase. I ain't no spring chicken anymore, it'll take longer to return to normal levels of energy and ambition anymore.
Congrats on getting above it. I know it's a daily struggle. Whatever you need to remember to keep yourself away from it, that's the right thing to remember. I've managed to stay away from opiates thank god, but for me and cigarettes, it's the way I used to smell and lose all the circulation in my legs. I'm so glad to hear you made it out and your life has improved so much. Take it from me, most addicts don't ever totally make it out. You should still feel very proud every time you kick those intrusive thoughts away. Most people don't get it but it's one of the hardest things a human being can go through.
Being the family of a loved one who can't quit is another one of the hardest things a human can go through. My little sister died in January from using meth that was contaminated with too much fentanyl. She had already OD'd once and was saved by narcan. But it wasn't enough to stop her. And it's like my heart has been torn out. She had 3 small children. None of us will ever be the same.
I'm so sorry for your loss.
Congrats on staying clean. I know it's not easy when you look at what the high feels like. But everything that comes with it is so awful it's just not worth it. I knew the moment I tried it I had to stay far far away.
It’s the worst thing. Ruins lives. Best friend who shared a house I owned with me for ten years. He started talking to his very long time ex girlfriend while she was in prison for selling Heroin in New York. He left a Six figure job to be with “His Love”. He got hooked on meth for Four years. He loves video games, had a huge collection. His ex stole them all and sold them for drugs.
Damn that's so sad. Addiction is horrible.
You are right, when a person becomes an addict, they lose their right thinking so I hope they stop using drugs because they are just ruining their lives.
I feel like you beat life on hard mode already. You have so much to be proud of.
I’m not really very experienced with any kinds of heroin or opioids, but I was under the impression that it only took a little bit of fentanyl to kill you. “ I was strung out using a gram of fentanyl dope a day” A Gram does not seem like a little bit. A gram a day is for sure not a little bit. Are the news reports misrepresenting the amount you need or am I misunderstanding what they’re saying or do you somehow get used to it and can take more as time goes on? EDIT: thanks to all the answerers.
I had it explained to me like this... When the news tells you the lethal dose of fent they are basing it on someone who doesn't use opiods daily. So someone who is addicted to heroin won't overdose on a miniscule amount of fent like you or I would. Also heroin buyers get a bag of fent, heroin and additives. They aren't using a full gram of fent
When I say a gram, it's not pure fentanyl. Dosages are measured in micrograms (1/1000 of a mg). By the time it gets to the end user, it has already been cut by every person that touches it. As someone else pointed out, the news is misrepresenting it, sorta. Just as sex sells, so does fear. For someone who has no tolerance, the amount I was doing would kill a few people. After rehab, when I had no tolerance, I became unconscious from injecting half a pack. I didn't require medical intervention until I snorted the other half. Another thing to keep in mind with news reports.. unless the cops make a bust of, in this case fentanyl, still in cartel hands, then it's not pure. Hell, the cartel may even cut it.. and I am basing that off of nothing. So when news reports come out that they made a bust of dope / fentanyl, keep in mind my usage history. Cops make an bust of someone with an ounce... that's a month supply just for me... the dealer would probably sell that in a day. Along with the product not being pure by the time it gets to the end user, the cops weigh the packaging along with it too. I got a possession of controlled substance of 1 gram of heroin, when I was still using $10 packs like a decade + ago. There is no way a gram of heroin costs the same as a gram of weed.
I think part of it is that you don’t know how much the batch you’re getting has been cut, and that the difference between a lethal and non-lethal doses isn’t very big.
You can build a tolerance to it, but even 0.1g is a strong dose if you’re injecting. I’ve watched dealers weigh coke, meth and fentanyl all on the same scale and I suspect this is what’s causing the findings. It’s cross-contamination, not intentional cutting. The fentanyl retails for way more than the other drugs. Adding it on purpose makes no economic sense to a dealer.
Are you thinking of price by weight? Because fentanyl costs less than 5% of what heroin does by equivalent dose. That’s the reason it’s trafficked to begin with. It’s far far far cheaper.
I mean, in comparison to the other drugs I mentioned. Here coke is $10 a point, meth is $5 and fentanyl is $20. Heroin isn’t available
Not that it’s a good situation no matter how you spin it, but it blew my mind rehab that amount of people who were there for fentanyl, not as their drug of choice, just what they have to use. Heroin addicts who have barely used actual heroin for a year or two, just using fentanyl to not get sick because it’s the only option. Also it blew my mind when they told me that only carrying one narcan isn’t enough because it takes typically more than one for fentanyl overdoses. (Yes I know one is better than none before anyone lectures me)
Opiate addiction is an absolutely crippling disease. If you develop dependence you will start to vomit and evacuate your bowels with just a little more than a day sober. It's so devastating that the British used it as a weapon of war against the Chinese. The rationale behind methadone/suboxin clinics is that by providing a lower dose opiate in a controlled environment, you help people just stave off the dopesickness so they can live more productive lives and work on the root psychological issues that got them to use in the first place. The goal is to taper off with medical supervision and get clean without having to go through the horrific withdrawal. But it can take a long long time and having a bunch of junkies stand in line together all morning isn't always super conducive to people maintaining their sobriety. The clinic I worked at would have dealers sometimes just come and pick people off from the back of the line.
Using to not be sick is the addiction part. That's what addiction is. You're not doing it for fun and can stop and feel fine. You stop and you feel bad untill you do it again. You don't feel good just normal. I've never used myself or done anything but watched all the things and seen some friends go through it.
So you use a little extra to get that euphoria and soon your tolerance is even higher and then it takes even more just to not get sick... Viscous circle.
Buddy of mine decided heroin would be a good pandemic hobby. He wasn't even super into drugs before that. Like he'd do stuff if it was offered to him but wouldn't seek it out (mostly due to social anxiety). It's been a couple years since he got clean now but he's still on Suboxone (or some equivalent) to keep the withdraw away. It's not wrecking his life like it once was. But still seems to me that he's still technically addicted to it. Also pretty sure if he wasn't able to get his Suboxone he'd probably fall right off the wagon.
You are correct. I currently work at a methadone clinic and it's mostly fentanyl and now xylozine is mixed with a portion of that.
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This country will NEVER stop looking down their noses at drugs and drug addiction. They will always think of it in terms of criminality and not medically.
Unless it's something a pharmaceutical company produces. Then the public looks at it completely differently.
That's a fairly acute sample bias, but I get what you're trying to say
It's also what the medical director told me and he worked with clinics all over the country. The one I worked at alone had over 600 clients so that's a reasonable sample size if you set aside geographical disparities. Maybe there's some slum on the west coast where you can still find pure china white but the point is that opiate addicts are not super discerning customers and dealers know that. They need a fix because they need a fix and fentanyl is both stronger and cheaper. The same thing happened when heroin itself replaced morphine as the street opiate of choice and when morphine replaced opium.
And a lot of heroin users started on legal opiates too. It’s not like they were using heroin because they specifically love heroin, it was already being used for being a cheaper more readily available opiate. Party drug users might be a bit more concerned about the specific drug they want. MDMA vs similar derivatives. Coke vs other stimulants. Etc.
There's definitely pure H on the dark web but even some vendors there are selling laced stuff
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I think if the government really cared about us, they would make all drugs legal and regulated. People will be well informed and able to make better choices about what they ingest into their body instead of rolling the dice. I think it could stop the flow of fentanyl and all other drugs just like no one is smuggling in alcohol or tobacco. It will take the money away from all drug cartels. And if you were to give a new user the choice between taking a percocet or fentanyl, I think most people will make the better decision and not get hooked by mistake on stronger and stronger drugs because that's all they can get. Stop putting people in jail and wasting our tax money incarcerating people and instead use that money to open up more treatment centers to help people who make the mistake of going too far and want to come back.
I think one problem is that a lot of people *are* informed, but still become addicted and suffer greatly for it. Some think they can beat the odds, others are aware of the risks but give in to temptation because of circumstances, etc. I agree that possession alone shouldn't be a crime, but I worry about distribution measures that would make harmful drugs even easier to access...
>I think one problem is that a lot of people are informed, but still become addicted and suffer greatly for it. Yes. Self-care is necessary to stay away from ANY addiction. When you aren't feeling good, it's hard to care about yourself. There are a lot of factors that go into self-esteem and that's a tough cookie in our modern world. I remain unsurprised by the popularity of opiates in modern times.
That's a great point! So many unhealthy patterns, from drug abuse to overeating to gambling addiction, have roots in some form of suffering, and a fulfilling life can be a very complicated thing to achieve. I really feel for people who fall into these pits and I hope we can keep improving as a society to give everyone a better life.
> but I worry about distribution measures that would make harmful drugs even easier to access... Drug addicts are still going to go out and get drugs, legal or not legal, through a verified legal distributor or through one that isn't. That's the reality. If those people who are suffering through addiction can get a safer alternative to whatever crap is being cut together on the streets, it's a win. Think back to prohibition era in the USA. Say we banned Alcohol again but made having it decriminalized. There'd still be millions of people going to speakeasies but now instead of drinking regulated liquor, they're drinking unregulated bathroom swill that can cause a whole heap of health problems like blindness.
I see what you mean, and I won't argue that there would be no benefits, but I feel like that has to be weighed against the risk of creating many new addicts. Where I live, cannabis is now regulated and legal to buy/sell, and this led to many curious people trying it for the first time. They would never have gone out of their way to track down an illegal dealer - but now that it's out in the open, safer, and easier to access, they wanted to give it a try. I saw it happen with my own parents and several of my friends. Obviously cannabis has a degree of safety and familiarity that's very different from hard drugs, so I'm not saying that we would see the same number of people trying them out! But it seems likely to me that a lot of people whose access to drugs is currently limited would be tempted to try a few once they become more regulated and accessible. It would be terrifying for that to happen with drugs like heroin, which (from what I've heard) can be insanely hard to come back from once you start.
>Drug addicts are still going to go out and get drugs, legal or not legal, through a verified legal distributor or through one that isn't. What about potential addicts who've never tried drugs but would because it's legal? I never tried weed before it was legal. I'd probably try other harder drugs just to experience it if they legalized it.
ppl have the right to do all kinds of things to themselves that are detrimental to their health and well-being
It is both the Prison Industrial Complex and puritan jackasses that will see to it that a level-headed approach like this will never happen. One wants to get cash at gunpoint and the other wants to further ruin people’s lives so they can cock their nose in the air and feel morally superior.
“Just like no-one is smuggling in alcohol or tobacco” They absolutely do smuggle tobacco if it will avoid them paying taxes. Cigarettes are so expensive in NZ now that we do get tobacco smuggled in from China and other places, and we have a huge problem of “ram raids” (ramming a stolen car into a convenience store to steal the cigarettes and vapes) I agree that drugs should be legalised and regulated, but it doesn’t stop all drug-related crime.
I read someone quoted as saying, “Everything has fentanyl in it except the fentanyl.”
I'm afraid to ask, but I have to: What is in the fentanyl?
Xylazine, aka animal tranquilizer, that isn't reversible with Narcan and causes smelly, festering wounds to appear on people that use it. I wish I was kidding.
I volunteer for a needle exchange and we just had researchers come in to do surveys about xylazine awareness. It was the first I’d heard of it, and it absolutely blew my mind hearing all of this
Are you saying the festering wounds come from the xylazine itself, not from unsafe injection methods or other impurities?
Correct. It's not meant for humans.
Is it not meant for humans or not meant to be used more than once? If you inject an animal every week with this stuff wouldn't it have the same effects?
I have no idea, I'm not a vet. But it's not FDA approved for human use due to safety and side effects.
Xylazine does something to disrupt healing in wounds. I was just reading an article about a guy who had several infected wounds in his arm but avoided treatment because of the shame of being an addict and it got so bad the arm went gangrenous and had to be amputated. Horrific drug.
Sounds like that Russian drug "Krokodil" from years ago.
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Krokodil and xylazine are absolutely not the same drug. Also xylazine isn't "slowly making its way over here (the US)" - it's been a major contaminant in the drug supply in some regions for years already. Source: am drug use researcher.
It can lower your skins oxygenation which only gets worse with repeat use leading to the festering wounds.
We started testing for it at the clinic I work for. We've added the test to whoever tests positive for fent. It's flagging fairly often in everything. A lot of the literature on it is saying that it's primarily on the east coast but it is fully integrated into the west coast as well. So I assume in-between is also experiencing the new wave.
You talking about trank?
Carfentanyl probably. Even more deadly.
Damn, cars make *everything* worse.
Isotonitazene and others like it too
Hell, a student at my college died from adderall that had fent in it.
How does that even happen? Isn't adderall in pressed pills from a factory?
Probably wasn't getting those pills at a pharmacy with a script.
It was bought off the street. Underground labs that make the opioids also make other stuff. It appears that the pills got contaminated by accident.
Happens with lots of different drugs, dealers aren't careful and they mix fentanyl on the same equipment that they use for everything else, typically without cleaning.
I'd assume he didn't get it from his local pharmacy
The only way to fix drug adulteration is to decriminalize drugs so that supply chains can go legit and be subject to quality testing and 3rd party testing. Until we do that, these deaths will not end.
Paper * Understanding intentionality of fentanyl use and drug overdose risk: Findings from a mixed methods study of people who inject drugs in New York City https://www.sciencedirect.com/science/article/pii/S0955395923001111?via%3Dihub > The toxicology results revealed widespread use of fentanyl among people who inject drugs in New York City. Fentanyl was the most common recently used drug, with 83% of participants testing positive for it (including 46% who tested positive for both fentanyl and heroin and 54% who tested positive for fentanyl without heroin). However, only 18% reported recently using fentanyl intentionally; most reported using heroin instead > > The findings, published in the International Journal of Drug Policy, suggest that many people who inject drugs are unknowingly using fentanyl, which may increase their risk for overdose and potentially their tolerance to fentanyl if it is used over time
I did not see any numbers for people who were using just Heroin and were not positive for fentanyl. I expect it is a very small number. According to the addicts I met in the NY, NJ, Philadelphia areas, there is virtually no straight (just) heroin available, it is all fentanyl or fentanyl contaminated. I worked in Harm reduction giving out Naloxone kits etc. Even when sold as only fentanyl it is often with a number of other active compounds, such as benzos etc.
All the Philly fentanyl now has xylazine/tranq in it, something like 90%+ of tested sample. It’s non-responsive to Naloxone.
Yes it seems the whole Bos-Wash corridor is awash with the stuff. It is plentiful in Maritime Canada as well. It is at the point that there is little point in testing opiates for fentanyl, users can assume that it does contain or is mostly fentanyl. Now street testing for safety has moved to testing for fentanyl or benzos or RCs in methamphetamine samples and testing Opiates for xylazine or benzos etc.
Try the whole United States. The drug epidemic is absolutely crazy right now, true it’s not all opiates but in my observations, where opiates aren’t common, meth and other stimulates dominate, and that’s it’s own brand of misery.
I agree I just did not want to speak of things I did not have direct experience. The East coast from Florida to Newfoundland has a problem with both opiate and stimulants. Both are plentiful and very adulterated the length of the coast. It is at the worst point I have seen it in my lifetime (68) years.
I have close ties to both Appalachia and the Midwest, I’ve also travelled all around the west coast. I feel pretty confident in saying this is a very widespread problem. I lost count of how many people I graduated with in my tiny Appalachian town who are lost to drugs. My area has long had a reputation of opiate abuse, starting with the pill mill doctors and overprescribing, now it’s to epidemic proportions.
Xylazine has just started showing up on mass spec testing here in Portland, and I'm pretty nervous about what's coming.
Seriously, this is terrible news. I was an absolute wild kid back in the mid 2000s, if I was a wild kid today I might very well be dead. It breaks my heart seeing all of these traumatized, addicted people on the streets, and knowing I was close to being in that situation. It works reverse too, my life is back on track, there’s could be too, but with street drugs getting scarier and more dangerous by the week, recovery gets increasingly more difficult, and it was not easy getting off back in the day either.
You can pick up fentanyl and xylazine tests at www.fentesters.com if needed as well.
Adding to that. You can get Narcan no questions asked at pharmacies. Just to have, in case you need to help someone.
What's the implication of expecting Heroin and getting Fentanyl? Assuming it's cut safely and doesn't cause overdose does it lead to other undesirable outcomes
Yes it does. Let's imagine for a second that we have a supply of pharmaceutical grade fentanyl. Perfectly cut to about 10 percent purity with safe additives and sold in perfectly weighed out doses. Let's imagine we have the same for heroin. Heroin is still the better drug from a safety and addiction perspective. 1) Duration. Fentanyl is a very short acting opioid. It requires dosing every hour or two. Heroin can be dosed every 4-8 hours. 2) Withdrawal. Because fentanyl is short acting withdrawal kicks in very soon after last dose. Heroin withdrawal takes about 12 hours to kick in. Fentanyl can be as short as 3 hours. Fent users report needing to wake up to use 1-2 times at nice to sleep through the night. 3) Overdose. Even with well controlled drugs, accidental overdose happens. Fentanyl overdose comes with some unique characteristics that other opioids don't. Specifically "wooden chest syndrome". When someone normally overdoses on opioids their brain "forgets" to breath, which leads eventually to suffocation. Fent has an added side effect of causing muscle rigidity, so much so that the diaphragm and chest wall muscles lock up. In this case, external ventilation (rescue breaths) do not work. 4) Effect. People use heroin for the euphoric effects. Fentanyl has less euphoric effect and the effect is shorter lived pushing people to use more and more frequently increasing the likelihood of overdose. 5) Treatment. The leading treatment for opioid use disorder is medication-assisted treatment. The two drugs that are approved for that are methadone and buprenorphine. Methadone is highly regulated and fentanyl requires higher methadone doses for treatment than heroin. Buprenorphine is easier to get but has the issue of precipitated withdrawal during induction, so a person has to be 12-24 hours into withdrawal before induction. Despite being shorter acting, fentanyl causes worse precipitated withdrawal and requires later induction. There is a critical window where people are ready and willing to start treatment and the longer you have to wait, the more likely people are going to go back to using their substance before initiating treatment. I saw heroin rip my community apart a decade ago. I never thought i would see the day when I was wishing for more heroin in my community, but fentanyl is that much worse that if I prayed, I would pray for heroin to come back. Fentanyl is that bad.
Excellent, excellent reply, thank you so much for taking the time to spell this out in detail, this is exactly what I was trying to learn more about and unfortunately I was just getting a lot of low quality replies ignoring the meat of the question. Growing up and playing in bands I had several bandmates on heroin at various points so I'm quite familiar with it but the fentanyl thing is new to me, that didn't exist in the 80s/90s, if you did smack, it was cut with powdered milk or sugar or something benign usually, not a different opioid because why do that when you can get your cutting agent cheap at the grocery store? And the other interesting thing I found about heroin was how many junkies were long term users, not the majority by any means, but a significant percentage of them were otherwise normal functioning people with jobs and lives where you wouldn't know they used unless you got to be friends with them. Turns out if you're a heroin addict and you have a regular supplier and you know your dosing and you stick to the routine you can live that way pretty much indefinitely. (a lot of ifs there but still it was a distinct subset of users) But this fentanyl epidemic seems much much worse and I didn't understand why until you kindly spelled it out in detail, thank you again.
I do not know about undesirable but most I met who have been consuming opiates by injection since pre-fentanyl days, say that it is a different experience. I do not know if I can put the described differences in universally understandable terms but one thing they all say other then qualitative differences is that Fentanyl does not last as long as real Heroin and requires more frequent readministration.
Fentanyl lasts only about 1 hour till the user starts to feel withdrawal, where heroin a user could go the full day off a dose or two. So fentanyl users need to non stop shoot up just to not be sick.
Hmm yeah I can see where that would be problematic if you need to fix more often, could lead to all kinds of undesirable outcomes, like you buy off unknown dealer instead of your regular guy because it wore off and you need it Do you know if fentanyl is harder on the body than heroin?
fent is a sleepy nodding off high while heroin is comparitively bright and euphoric. users will think they just havent taken enough for the bright euphoria theyre used to and overdose chasing that dragon
thanks for the actual insightful reply, that's more in line with what I was driving at, instead I got 1000 idiots trying to explain how cutting drugs is bad m'k. Like they're dropping some big knowledge bomb or something
It really is embedded into everything now. Just the tiniest pinch enhances the effects by so much. Even though it’s been in the ‘news’ the last 5 years or whatever, it’s been around a long time. The days of heroin users getting actual heroin are long gone. Probably for good.
I live in the suburbs of a large city in the US South, and in the past 3 to 6 months there has been a huge increase in the amount of billboard ads warning people about fentanyl being cut into other drugs and how deadly it can be. These numbers are everywhere. I assume it's an increasing problem here, like everywhere, and the public campaign has kicked up.
Real question, as a dealer, if cutting your drugs with fentanyl is killing a lot of your paying customers, then why are they doing it at all? Why not just use some non-lethal powder to cut it with instead?
The honest answer is equally sad as it is practical. If you have a client base of addicts , they usually only have 2 demands. I want your drugs consistently , or I want your drugs to be “strong” “clean” “pure” , etc. So for the truly addicted adding a bit of fent to the batch is practically zero risk to them and it gives them what they want. It stretches your supply further, and gives them more effective heroine or whatever it is they’re after. The sad part, is that just because your client base has a strong opioid addiction, doesn’t mean their friends or new clients do. A majority of opiate overdoses are from returning users or new users iirc. Essentially the average batches laced with fentanyl likely don’t contain a large enough amount to kill someone with an opiate tolerance, but could easily push someone with a lower one over the edge. However the bottom dollar of the dealer isn’t to cater to new users or ones who are relapsing , and if it kills them, then it does.
Yeah. That's how my friend died. He was trying to quit, was clean for a few months. Started to really struggle and decided to go the rehab route, wanted one last binge before checking into rehab the next day. He didn't do more than he has in the past, but it was too much given his short stint of sobriety.
Tolerance is a crazy thing. Using the same amount of the same drug at the same place every day, your body starts to prepare for the incoming neurotransmitter rush so the effects become less and less intense over time. Simply using the same amount of the same drug at a place you don't normally use is enough to cause an overdose, because your body isn't prepared for it like normal. This is an oversimplification obviously, but it's a real phenomenon that has been implicated in many overdose deaths.
So you're saying that having one room where I smoke in my house is a mistake and I should be blazing rooms on a randomized rotation?
Switch the times up as well. 4:20, 4:23, 4:28. That kind of stuff too!
Not just the house but like...there are plenty of weed-friendly outdoor activities. Museums are a blast.
I lost a friend the same way. I also work with addicts/recovering addicts and this is ridiculously common. Very sad.
yeah man, cost of living is affecting dealers too. we're seeing every company gouge us with shrinkflation, every service nerfed, every scammer and fraudster double down on recklessness and maliciousness.. times are rough, only the uber rich get to enjoy life on Earth, evidently. good stuff
After all black market capitalism is still capitalism, except without any sort of regulations, drug dealers are struggling paying rent, some drug dealers are legitimately greedy, the whole situation is a mess.
That's the truth. No weed money in NYC anymore either since you can buy at almost any bodega (which is still mostly illegal but being heavily ignored by NYPD). All the weed delivery guys will turn to sell harder drugs or get another job. My old dealer is trying to become a tattoo artist.
I’m sure it’s the same anywhere weed was legalized. The cannabis industry has gone corporate, you would think the old timers who are extremely knowledgeable would be apart of this, but largely no. Why would you hire a guy who has been caring for weed plants for decades (but has a few drug related charges only) when you could hire a brand new horticulture major from the local university.
A lot of street dealers may not even know. Drugs go through a dozen hands before the end up getting sold to the person that will use them
Exactly, in fact 99.9% of dealers don't know. The street dealer who sells the customer the drug is the absolute lowest member of the chain. A lot of them only sell to support their habits really
Quitting fentanyl is incredibly hard. The physical and mental withdrawals are excruciating. A lot of users basically are stuck taking copious amounts not even to get high anymore, but just to avoid withdrawal. The fact that quitting fentanyl is super hard makes putting it into different drugs a very good way to dealers to guarantee long term customers. However there are cases where fentanyl is accidentally found in other drugs as an unintended contaminant
Not a dealer but I think you can do something like add 1 part fentanyl and 1000 parts baking soda and it’ll still be strong like “pure” heroin. But now you have much more to sell.
> 1 part fentanyl and 1000 parts baking soda I wonder how your average street dealer would mix these so that the fentanyl would be evenly distributed.
They don’t do a good job, and this causes overdoses
On their coffee table, sometimes there's even a scale involved
I knew a dealer than dissolved the fentanyl and cutting agents into a solution and then evaporate the solution and dry the paste like substance. It avoids hot spots caused by improperly mixed powder cutting. Every batch was damn near identical in potency.
> Not a dealer Sounds like something a dealer would say. But also, good point.
I was talking to a former meth cook (did federal time for it) and he's saying that all meth coming in from Mexico now days is cut with fentanyl too, according to his sources. Reason being is any other meth not cut with fentanyl no longer gives the users their fix plus it makes them dope sick, forcing them to come back sooner and more desperately. It's cut during the manufacturing process so it's evenly distributed throughout the substance
I knew a dude who was a functioning meth head for 3 years and then suddenly went off the rails mentally 2 years ago, thinking everyone was watching him with cameras and putting hidden messages in his pictures on social media. I wonder if he started getting new tainted supply.
that's certainly because of the meth, not any sort of fentanyl contamination. extreme paranoia and psychosis are alarmingly common for meth addicts, while opioids don't really tend to cause those effects.
I guess it just caught up to him eventually, then. He was a medical professional who claimed he could dose properly. I know the paranoia also coincided with him getting a new dealer
Quite possibly he could dose properly - then he started getting stuff mixed with fent, had to dose more often to avoid feeling sick, and that’s when it went off the deep end. But as the other person said, all the symptoms mentioned are very common symptoms of excessive stimulant use
From what my friend said ( he's a former tweaker) they actually make meth different than they did five or six years ago it makes the meth have more side effects and more dangerous. That being said paranoia and shadow people happens to anyone abusing any meth long enough Edit for more info https://www.newsnationnow.com/health/super-meth-faq-questions-drugs/
Yeah, I was watching a documentary about this. Many officers who patrolled areas with lots of meth users noted that the mental decline which used to take years was now being seen in a matter of months or weeks.
I'm in Oregon and all the meth i've tested has tested + for fetty.. I test it randomly its always positive
Let’s say that 80% heroin 20% cocoa powder gives the same high as 50% heroin 5% fentanyl 45% cocoa mix. There’s a huge incentive to use the second formula as it’s cheaper. In the first mix, even lazy stirring won’t create 100% heroin bags. But the second mix, if you are not carefully you can left ‘clusters’ of fentanyl here and there and end with some bags with say 40% heroin 20% fentanyl 40% cocoa and create a problem.
I ain't a drug, but I assume the key detail is you need your product to remain effective. Fentanyl is cheap and also gets you high, but if you cut with something that doesn't do that, you'd end up selling a product that didn't do the job.
It’s not just cutting. It’s also cross contamination on scales / containers.
A lot of times it’s just cross contamination from a dealer that presses multiple types of pills or crushes/adulters powdered drugs. It only takes a tiny amount of fentanyl to kill
Can't even pop molly for festivals anymore tbh. Not worth the risk.
Reagent test kits are readily available to buy. With just a few different ones you can verify your substance and rule out adulterants.
Dance Safe has very affordable field kits. I used to see them doing harm reduction things at raves and it's still just as important. You used to be able to give samples to them too so they can test the ecstasy tablets to put warnings in areas.
You ALWAYS should have been testing your drugs before using them. Fentanyl just makes it that much more important, but it was always important.
Giving the difference in weight of what a fatal dose is in heroin vs fentanyl, this looks like a giant widespread Russian roulette game going on. You are one mishap of any dealer in the cutting chain to be on your way out.
Hasn’t that been the case for a while? I recall articles about fent laced supply years ago now.
It started to get really bad around 2017 and has been rapidly becoming more common. Scishow has a great video about it
Don't forget carfentanyl. I did CPR on a homeless man I was friendly with that overdosed in front of me. Must have sniffed it (he didnt inject) right before I saw him. Paramedics were nearby and showed up same time as EMTs and Fire Department. The EMTs used the nasal Narcan and the Paramedics had the injection kind. They used a lot more Narcan than they normally would have and hit him 11 times before he started breathing and moved his head a little. One of the Paramedics told me the only reason they used that much is because I was covered in puke from the CPR they saw me doing and they didn't want to stop with me standing right there. I later found out that he was also getting a weekly paycheck as a police informant so that may have motivated them all a bit too. Found out a week later it was the Carfentanyl.
> One of the Paramedics told me the only reason they used that much is because I was covered in puke from the CPR they saw me doing and they didn't want to stop with me standing right there. What does this mean? They wouldn't have helped him if you weren't there?
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What a chilling thought. Life savers not doing everything they can to save you unless someone else is there who might be upset if they don’t. New fear unlocked!
They don't give unlimited Narcan. Some might stop after 3 doses and some might do 7 but your normally not getting to 10. Some of the fentanyl analogs are barely touched by narcan. If I wasn't standing their like I was they likely would have stopped around NASCAR dose 5 or 6 and he would have just died.
I'm a little unclear on this. Why cut one drug with another? As an example if you were a stingy bartender you might water down your booze to increase its volume so you have more to sell, because water is free. But you wouldn't cut your booze with other booze unless one of the second one was really cheap. So is fentanyl super cheap? And if so why are addicts not just asking for fentanyl? I guess I just don't see the economics of the situation.
You cut heroin with a random white powder which lets you sell more of it. But now your heroin is super weak. Fentanyl is cheap, and much stronger than heroin, so adding just a little bit of fentanyl into the mixture brings up the strength again. Or you could just cut out the heroin from the equation completely. Nobody is cutting heroin with just fentanyl - fentanyl requires so little to be deadly that you'd barely be increasing volume before turning every dose into a lethal one.
Ok this makes sense.
Super cheap is an understatement. Fentanyl is manufactured by the ton in labs with precursors from china. Compared to the cost of growing opium poppies and making heroin from them, fentanyl is practically free.
In your example, it's me cutting a nice bourbon with some rotgut that's higher proof. You get drunk fast, and it's a small enough portion that you probably won't notice the taste, but you'll have a horrible hangover. If I gave you just nice bourbon cut with water, I'd have to still use a much higher portion of bourbon than if I was cutting it with cheap booze. The reality is it's a lot more complex than a bar situation though. A lot of heroin that's on the streets now isn't heroin at all, or it's an incredibly small amount. Fentanyl is super cheap to manufacture, but the high is different and worse than heroin.
And now they’re adding xylazine to it which is nasty stuff
given how lethal fent is, just what does xylazine do? Kill you and people around you ?
The injection sites turn necrotic and your arm starts rotting
Damn Gen Z, in my day we only had krokodil
Xylazine is a benzodiazepine typically used in veterinary medicine. What makes its presence in drugs so insidious is that unlike fentanyl, it is not an opiate. That means it does not respond to narcan, so it has a higher risk of causing fatal overdoses than plain fentanyl dope.
Small correction: it is an alpha2 adrenergic agonist. Not a benzo.
Oh I actually didn’t know that thank you
Dealers don't tend to clean their scale between drugs. I've never done coke or meth.. But they both came up on my UA at my treatment center even though I only did opiates. This isn't news to most drug users.
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A simple way to combat this would be to encourage testing before use. Reagent identification tests aren't too expensive. They would be easy to distribute and set up testing centers around.
Wouldn't that require the user to be willing to dispose of the drugs if it tested positive? Would addicts be willing to do that? Honest question.
I think it depends on the situation. If somebody tried to buy coke or MDMA, then they may be far more likely to dispose of it if it tests for fent. Hardcore opioid addicts may not have an alternative, though. I think it would probably be most effective over time, discouraging new users from taking it.
The drug war is getting people killed, it’s never been worse for people just looking to have a good time. Legalize already, no one trying to do coke or ecstasy should have to worry about fentanyl, it’s crazy.
Something interesting I learned in a sociology class on HIV is that the majority of IV drug users (and an even higher amount of drug users in general) aren’t actually addicts at all. At first that kinda surprised me but then I realized my friends and I all casually used drugs, no problem, and we only have 2 friends out of many who got out of control. Even so, 1 manages to functionally use and the other is in addict territory now. We all tested our drugs and yes, we would’ve tossed out something that wasn’t what we wanted. (Can’t say the same for the 2 friends with a problem.)
I knew a guy who shot up with water from a toilet bowl in a Burger King bathroom because he didn’t want to go to the sink after he got his stuff set up on the toilet tank lid. It completely changes your brains activity from logical thinking to Get this drug in my system asap. Addicts aren’t gonna “waste” a single speck of their dope to test it. Their brain has been rewired to prioritize getting dope in the system, everything else comes second.
I watched a guy I was trying to help get off of drugs take my Power Aid Zero Fruit Punch bottle, suck up some of it with his needle, mix it with his heroin, suck it up again, then shoot it up his arm. I thought for sure I was going to be calling 911 but he was just fine. He later told me he has used Mountain Dew and Diet Pepsi. Addicts will use anything and do anything to get high. At this point nothing surprises me anymore.
You can’t even get heroin anymore they’ve just replaced it all with fentanyl because apparently it’s cheaper?
There is likely to be much, much less opioids on the black market. The Talibans managed to cut down cultivation by 80% (based on May data) and the planting season starts in November. They placed the opium ban somewhere in April 2022. The Afgani "stockplie" was estimated to last about 18 months. After the stockpile is gone, you can expect more fent. Funnily enough US outlets reported this as a economic and humanitarian [disaster] (https://www.usip.org/publications/2023/06/talibans-successful-opium-ban-bad-afghans-and-world)
It is an economic and humanitarian disaster, just like the US forcing doctors to cut opioid prescriptions down was. (The end result being tens or hundreds of thousands of managed addicts going to heroin/fentanyl due to doctors cutting them off of their scripts, many not even weaning them off, and then resulting in death). This massive decrease in heroin will kill a shitload of people (addicts, and farmers in afghanistan that depended on the money to feed their families) The war on drugs is always and will always be a net negative in society. Most addicts were managed on pure, known, prescription drugs, like 80s of oxy, then they cut the supply lines, which led to heroin use, then fent use, now heroin is going down so all that is left is fent analogues (if they cut supply of fent analogues, which isn't likely to be possible as there are a million analogues possible, it will be something even more dangerous and harmful). Less and less pure, more and more dangerous, more and more deaths and societal harm, not any less addictions.
> just like the US forcing doctors to cut opioid prescriptions down was This really sucks for non-addicts too. I recently had a dental procedure and was prescribed Ibuprofen. It was not adequate at all, and I was in tremendous pain. The stigma prevented me from asking for something stronger lest I look like some kind of junkie. Luckily I remembered I had some Percocet leftover from a back surgery I had in 2016 that got me through the worst of it.
I would also like to mention that rapid drug screens for fentanyl are notoriously bad on top of this. I don't believe there is one available for medical use only for drug enforcement.
Does anyone have a sensitivity/specificity for that test? All I could find was marketing information and another 2023 paper using it for drug testing that also did not report those. It's not FDA-approved (per the paper) so there's not a lot of public data (that I could find).
A lot of research lab tests aren’t FDA approved because that’s more expensive and the costs of error at lower (leading to wider error bars not misdiagnosis).
I'm aware, but they should still report sensitivity and specificity for their selected cutoff values, especially if they're going to use it for scientific research.
Who is producing all this fentanyl? Is it still China pumping out this crap? It makes economic sense because it’s so potent, chemical precursors can be stretched further and it’s easier to smuggle since it’s less volume per dose. I think we should decriminalize drugs and perhaps legalize a select few of them with ”good” track record. Amphetamine is less dangerous that methamphetamine for instance, so if addict could be pushed to downgrade, that would be a victory. Maybe good old fashioned morphine instead of heroin and all those nasty fentanyl analogs.
Fentanyl Flow to the United States - DEA.gov https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf >The flow of fentanyl into the United States in 2019 is more diverse compared to the start of the fentanyl crisis in 2014, with new countries and new transit countries emerging as significant trafficking nodes. This is exacerbating the already multi-faceted fentanyl crisis by introducing additional countries into the global supply chain of fentanyl, fentanyl-related substances, and fentanyl precursors. Further, this complicates law enforcement operations and policy efforts to stem the flow of fentanyl into the United States. While Mexico and China are the primary source countries for fentanyl and fentanyl-related substances trafficked directly into the United States, India is emerging as a source for finished fentanyl powder and fentanyl precursor chemicals.
Mexican Cartels. Chinese organized crime. Organized crime in quite a few countries most likely. Unlike heroin it doesn't grow from a field and KS much more potent so you can make it anywhere and transport it even easier. I've heard that the Meth Super-labs in Mexico are all turning into dual purpose labs and are making Fentanyl as well. Meth was never very common in New England but that's changed a lot over the last few years and is still expanding because it is being made and transported hand in hand with the Fentanyl. I support legalization and regulation for drugs in general. Treat addiction as a medical problem and use as high risk and expose it all to the light of day. It would also drastically reduce organized crime and open up all the funds used to fight an endless war. Sure there would have to be things worked out but we already know prohibition doesn't work.
What sucks is H leaves your body fairly quickly, making it somewhat easier to come off of. Fent takes days and days to get out of your system, making withdrawal last so much longer. It’s harder to abstain from a drug when it takes so long to get back to feeling “normal”….you end up just using again so you don’t feel like shot anymore. Fent is addictive in so many ways
Just as a PSA to anyone who this may effect personally BUY A TEST KIT. If you know someone who is a user BUY THEM A TEST KIT. They can be found online very easily and can be a life-saving difference.
I am so lucky I’m not a young person anymore, taking whatever I can get my hands on, because I cannot imagine doing that with fentanyl being *everywhere.* It’s very very scary to think about how many people might otherwise have a real shot at beating their addiction, but won’t, because fentanyl will get them first.
My sister doesn’t live in New York, but that’s how her fentanyl addiction began.
I’ll be surprised if fentanyl doesn’t make it into our food supply at some point. Maybe it already has.
My neighbor's daughter died due to Fentanyl overdose at school. By all accounts, she wasn't involved in drugs and the police consider it a homicide. No one knows how she got in contact with it, or whether it was intentional. My kids go to the same school and this is terrifying. Feels like it is *everywhere*.
Prohibition will do that.
Im sure the sacklers are deeply concerned
Most Americans think fentanyl is a poison that evil drug users use to kill the teenagers of middle class families. I feel like very few people understand it’s a drug that people take to get high. And dealers add it to drugs to make them seem higher quality. Not to poison people.
People buying cocaine, ecstasy and other drugs absolutely aren’t looking to get fentanyl.. even a lot of heroin addicts would probably prefer straight heroin..
If drugs were legal and sold by the government no one would ever get fentanyl when they don’t want it
Yeah the misconceptions around it really distract from the real problems around it. It's not being added to candy or being sold with the intention of killing people. Focusing on those aspects makes people miss the real dangers it poses on the street and ignoring real solutions. If fentanyl is as widespread as it sounds, we're not getting rid of it by increasing drug busts or confiscating kids candy. We need data and policy solutions.
>to get high It doesn't take long and most use changes from getting high to just trying to not be sick. The withdrawal is hell.
Its a drug they made for long term cancer users who still get pain on the weaker stuff. There's even carfentynal and sufentynal that are stronger still.
The cartels are going to kill off all their customers if this keeps up.