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Fentanyl analogs are illicit—and often deadly—alterations of the medically prescribed drug fentanyl. The analogs have similar—but not the same—chemical structure, and they mimic the pharmacological effects of the original drug. Fentanyl is a very strong synthetic narcotic primarily used to ease the suffering of patients with chronic pain or terminal illnesses. Since the s, the drug has been available in a patch or lozenge for easy and effective delivery of the time-released medicines. Fentanyl is so potent that residual chemicals in used patches have been suspected of contaminating water supplies when flushed down the toilet. Used patches have also been known to stick to children or animals, causing unintentional overdoses. But accidental overdoses from legal prescriptions pale in comparison to deaths attributed to illegally imported versions of the drug and its analogs starting in the late s. The effectiveness of the drug, combined with user-friendly delivery methods, drew the attention of bad actors seeking to profit from its potency. Take heroin, for example. Some black-market drug makers create new fentanyl analogs to avoid classification as illegal, get around policy restrictions on manufacturing, and evade detection in standard drug tests. It can be difficult to determine if pills were legally produced for pharmaceutical distribution or illegally produced for illegal drug sales. The availability of black-market fentanyl and fentanyl analogs led to a U. Harm from fentanyl analogs also extends to first responders. A lethal dose of carfentanyl, a fentanyl analog, is about the size of the head of a pin, requiring the full protection of hazmat suits. Fentanyl was created in by Dr. Paul Janssen as an intravenous surgical analgesic. The drug is 50— times more potent than morphine. Because of its strength, the drug was rarely used except in hospital operating rooms or on large animals. In the s, a new transdermal skin patch for fentanyl was developed to treat chronic pain. The non-surgical delivery mechanism offered some unique advantages over other drugs, including quick onset of action, relatively few cardiovascular risks, and low histamine release. These attributes made it a good prescription choice for some patients, because it reduced some of the risks of medical complications that other pain relievers have. The ease and effectiveness of these user-friendly delivery methods led to abuse, and the fentanyl analog market was born. Criminal manufacturers began creating designer drugs—analogs with modified chemical structures—to avoid identification as a controlled substance. From to , the death rate in the United States due to opioid analgesics nearly quadrupled, then began to skyrocket around — This timing coincided with the first detection of illicit pills containing fentanyl, fentanyl analogs, and other novel synthetic opioids such as U Warning signs of the fentanyl-fueled opioid crisis first emerged in the Northeast. Many of the 45, drug-related deaths that year were determined to have resulted from abuse, addiction, and overdoses due to fentanyl. A major contributor to the opioid drug crisis was availability. Modern internet e-commerce enabled individual players, small-scale drug trafficking organizations DTOs , and large-scale DTOs with their own production facilities to flood the illicit drug market with fentanyl. The drugs could be purchased and delivered through standard mail to the United States from places as far away as China. In many cases, drug users and mid-level dealers have no idea where or how their drugs are manufactured or what they might be cut with. Carfentanyl, a fentanyl analog, is an odorless white powder. It is one of the most potent opioids known and used commercially. According to the National Institute on Drug Abuse, carfentanyl is approximately 10, times more potent than morphine, times more than fentanyl, and 50 times more than heroin. In July , carfentanyl was found cut into heroin and fentanyl sold on the streets of Ohio. In a span of three days, 35 overdoses and 6 deaths occurred there. In the same year, in Anoka County, Minnesota, six overdoses and two deaths occurred in a hour period in October These instances and similar cases throughout the nation pointed to single batches of fentanyl-laced heroin as the culprit for dramatic spikes in overdose cases. Most opioid users do not intentionally seek out fentanyl analogs. To unsuspecting customers, the drugs can look like legal opioids or benzodiazepines for pain relief. And once a person is exposed to a higher-toxicity drug, the brain chemistry alters further, and the user will seek out the most potent form of the drug. At the height of addiction, some users are unable to discern risk and are willing to go to any length to obtain the drug, including boiling fentanyl patches to extract the drug for injection or ingestion. And if a user is new to taking opioids, the risk of overdose is even higher because their bodies have no tolerance to the drug. The sheer variety of the drug, including emerging combinations, make toxicology testing and accurate death reporting extremely challenging. Investigations into drug overdoses have shown the difficulty in identifying whether drugs were commercially or illegally produced. For example, carfentanyl and other analogs do not show up on traditional opioid toxicology testing. And specific testing for these substances is not routinely performed. An investigation may show all the scene indications and autopsy findings of an opioid overdose death, but simple toxicology tests can still be negative for opioids. The toll of drug abuse and overdoses extends far wider than deaths, which in reached nearly 50, The costs to families, communities, and emergency response in terms of dollars, psychological, and health effects are incalculable. Nipping the problem in the bud—keeping illicit drugs from reaching the market—is critical for stemming the tide of illegal drug activity and protecting the nation from the scourge of fentanyl analogs. Their goal is twofold: 1 to identify and develop improved fentanyl detection capabilities, including standards and advanced rapid detection technologies and analytics, and 2 to increase capacity to disrupt the supply of drugs being smuggled into the United States. Synthetic opioids present immense challenges to detection, particularly in the vast infrastructure that enables speedy and high-volume legitimate trade. From shipping docks and airports to border crossings and mailrooms, smugglers go to great lengths to hide their drugs in the flow of legal commerce. Dogs with their keen sense of smell have been trained for a variety of U. The first drug-sniffing dogs were put into service in the mids and are now regularly seen in cargo terminals, airports, mail delivery and sorting centers, and even schools. But training and maintenance associated with sniffer dog teams is expensive. And dogs and their handlers can only take so much. They can get burned out, or worse, suffer health effects from the chemicals and fumes associated with illicit drugs such as fentanyl analogs. Even a minute amount of drug-to-skin contact can be deadly. In a dog, the part of the brain used to detect and analyze smells is also about 40 times more efficient than humans. As emerging new compounds appear on the market, nontargeted testing can be aided with LC-HRMS liquid chromatography high-resolution mass spectrometry. But it is one thing to test samples in a laboratory, using known spectra libraries and large instruments. The testing process also takes time—too much time for a field setting. Two early models of handheld chemical analyzers , or spectrometers, came out in quick succession. TruNarc debuted in , followed by TacticID in The compact, lightweight, and robust devices have simple push button controls and work by scanning. For illicit or dangerous substances such as fentanyl, heroin, cocaine, or methamphetamine, the screen turns red. Green means all clear. In , SwabTekTM introduced new field kits with dry test strips capable of detecting fentanyl and other dangerous narcotics. The single-use recyclable spot test uses a paper strip with dry reagent test zones applied to the strip surface. A cotton swab is used to transfer the suspect residue to the paper strip test zone. Field technologies such as the ones described above require close contact to the sample source. Rather than searching for particle residue using surface swipes or pulses of air to dislodge particles for analysis, the system 'sniffs' for vapors, much the way canines do. VaporID joins an atmospheric flow tube with a mass spectrometer. The system can accurately detect organophosphorus compounds and narcotics at ultra-low levels previously impossible to detect in the presence of other chemical vapors. The technology could complement or replace contact and canine-assist detection methods for drug screening used in mailrooms, airports, and shipping centers. Unscrupulous scientists persist in exercising their craft, working in underground labs to manipulate fentanyl, isolate analogs, and create deadly combinations. The collection of hard-to-trace substances entering the market continues to kill users and sicken law enforcement as they battle the epidemic. The Department of Homeland Security DHS has a significant role in countering the trafficking of opioids and other narcotics into the United States, including detection and interdiction of illicit narcotics, as well as investigative efforts to disrupt and dismantle smuggling operations. In January , DHS announced a new multiphase study to improve the detection of synthetic opioids. In collaboration with PNNL, the study will assess the performance of field-portable drug detection equipment from industry against fentanyl and fentanyl-related compounds, other drugs, and cutting agents. For the study, the industry partners will obtain the latest reference spectra for approximately 50 DEA-controlled substances, including novel synthetic opioids, as well as independent test results, which will enhance their capability and marketability. End users of the equipment—the first responder and interdiction communities, as well as interested federal, state, and local agencies—will also benefit by receiving system updates with the expanded libraries at no cost. They will gain a broader understanding of the capabilities and limitations of current field detection equipment to feel more secure with detection performance. The effort specifically targets instruments used by federal, state, local, tribal, and territorial law enforcement and first responders that use spectral libraries to identify unknown samples suspected of containing illicit drugs. At PNNL, teams of biologists, chemists, and engineers work every day to solve challenges related to chemical and biological detection and forensics. This multidisciplinary approach supports important national security missions, including the development, integration, and evaluation of methods to detect biomolecules such as illicit drugs. The work informs standards and tools for quickly detecting fentanyl and its analogs. Advances in both these areas aim to reduce the exposure of dangerous drugs to emergency responders. Unlike any other product of its type available, the tool captures relevant biodefense policy directives and sections of the U. Code in a format conducive to visualization. Launched in , it was designed to help the government understand the current state of the U. Before a public version hits the streets—or the airport, or the mailroom, or any number of places where public safety is imperative—portability and integration into existing screening methods are key hurdles that need to be overcome. These are just a few examples of collaborations between PNNL experts and DHS, industry, and communities to improve detection equipment and methods used by emergency responders to sniff out fentanyl analogs and other dangerous opioids. Skip to main content. What are fentanyl analogs?

Heroin Mismatch in the Motor City: Addiction, Segregation and the Geography of Opportunity

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Illegal drugs are commodities that are bought and sold in markets. Many farmers are engaged in small amounts of drug growing in the producing countries, but there are comparatively small numbers of refiners, smugglers, and top-level importers. Compared to most legal markets, there are many sellers relative to the number of buyers in drug markets. One consequence of the network character of drug distribution is its resilience. Eliminating individual players or even entire organizations within a mature drug distribution network has little impact on the ability of the network as a whole to transport drugs from their source to the customers. This adaptability of mature drug distribution networks limits the ability of enforcement authorities to eradicate mass-market drugs. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. 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Expand Section I Introduction. Collapse Section II Drug epidemiology and drug markets. Collapse 5 Illegal markets: the economics and social costs of drug distribution. Expand 5. Note Note. Expand Section IV The policy arena. Expand Section V Synthesis and conclusions. Expand End Matter. Glossary of terms. Thomas F. Babor , Thomas F. Oxford Academic. Google Scholar. Jonathan Caulkins , Jonathan Caulkins. Benedikt Fischer , Benedikt Fischer. David Foxcroft , David Foxcroft. Keith Humphreys , Keith Humphreys. Isidore Obot , Isidore Obot. Peter Reuter , Peter Reuter. Robin Room , Robin Room. Ingeborg Rossow , Ingeborg Rossow. John Strang John Strang. Annotate Cite Icon Cite. Permissions Icon Permissions. Cite Babor, Thomas F. Select Format Select format. Abstract Illegal drugs are commodities that are bought and sold in markets. Keywords: illegal markets , economics , social costs , drug distribution , price , trafficking. Collection: Oxford Scholarship Online. 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