[2015 Drug Threat Assessment  Continued from Part 81 Heroin]

DEA Releases 2015 Drug Threat Assessment Fentanyl

The US Drug Enforcement Administration 2015 National Drug Threat Assessment (NDTA) is a comprehensive report of the threat posed to the United States by the trafficking and abuse of illicit drugs, the nonmedical use of CPDs, [Controlled Prescription Drugs] , money laundering, TCOs [Transnational Criminal Organization] , gangs , smuggling, seizures, investigations, arrests, drug purity or potency, and drug prices, in order to provide the most accurate data possible to policymakers, law enforcement authorities, and intelligence officials.  

Part 82 United States Drug Enforcement Administration  Releases 2015 National Drug Threat Assessment Summary.  Fentanyl is a Schedule II synthetic opioid 80 to 100 times stronger than morphine, and 25 to 40 times more potent than heroin. Commonly laced in heroin. Mexico. China. Transdermal patches, lozenges, and liquid. 700 overdose deaths. . Fentanyl’s short-lasting high, coupled with its high mortality rate, renders it unappealing to many opioid users who prefer the longer-lasting high that heroin offers.

Overview Fentanyl 

Fentanyl is a Schedule II synthetic opioid that is approximately 80 to 100 times stronger than morphine, and 25 to 40 times more potent than heroin. Fentanyl was developed for the pain management treatment of cancer patients; however, its powerful opioid properties have made it an attractive drug for abusers. Clandestinely-produced fentanyl is sometimes added to heroin to increase its effects, or mixed with adulterants and diluentsxvii and sold as heroin; many users believe they are purchasing heroin and have no knowledge of the presence of fentanyl. Pharmaceutical fentanyl is also diverted for abuse.

In March 2015, DEA issued a nationwide alert about the dangers of fentanyl and fentanyl analogues/ compounds, stating “Fentanyl is commonly laced in heroin, causing significant problems across the country, particularly as heroin use has increased.” Most recently, there have been over 700 deaths in the United States related to fentanyl and its analogs between late 2013 and late 2014. The deaths have continued in 2015. The last fentanyl crisis occurred in 2005 through 2007, resulting in approximately 1,000 deaths, primarily in midwestern and eastern states.

Adulterants are substances added to drugs to augment or increase their effects. Diluents are substances added to drugs in order to increase quantity or volume; they do not alter the drugs’ effects.

Clandestinely-produced fentanyl is primarily manufactured in Mexico, with its analogs and precursors obtained from distributors in China. Mexico-produced fentanyl is smuggled across the Southwest Border and mixed with heroin or diluents in the United States and then distributed in heroin markets, primarily in the eastern United States.

Availability Fentanyl

Fentanyl is available in the United States in two varieties: pharmaceutical fentanyl, which is illegally diverted; and clandestine fentanyl, which is illegally manufactured. Both types of fentanyl are abused, primarily in white powder heroin markets.

Pharmaceutical fentanyl is diverted from healthcare facilities, pharmacies, and manufacturing plants for personal use or sale, albeit on a much smaller scale than clandestinely-produced fentanyl. Pharmaceutical fentanyl is available in transdermal patches, lozenges, and liquid.

Clandestine fentanyl is illegally manufactured in clandestine laboratories, primarily in Mexico. Clandestine fentanyl is available throughout the United States, most commonly in white powder heroin markets. Fentanyl is added to heroin to increase its potency, or is mixed with diluents and sold as fentanyl or disguised as highly potent heroin.

Abuse Fentanyl

Fentanyl is abused for its strong opioid properties. Fentanyl provides users with an intense, albeit short-term high and temporary feelings of euphoria. Adverse effects of fentanyl abuse include a dangerous reduction in respiration and blood pressure, nausea, fainting, seizures, and death.

Clandestine fentanyl is typically abused by injection or inhalation, like heroin. In fact, many times users purchase heroin touted as a stronger heroin, unaware that it contains fentanyl. Occasionally, users seek out fentanyl outright.

• Hartford, Connecticut: In February 2014, DEA and local law enforcement officers seized wax envelopes of heroin. Laboratory testing concluded that some of the heroin samples were mixed with fentanyl. The fentanyl was 5.6 percent pure.

Pharmaceutical fentanyl is diverted in its transdermal patch, lozenge, and liquid forms. Pharmaceutical fentanyl is often diverted in personal use quantities.

• Philadelphia, Pennsylvania: In 2014, state law enforcement officers reported fentanyl was being diverted from nursing homes by unscrupulous staff members. Transdermal patches are cut and squeezed to remove the fentanyl gel and the empty patches are left affixed to patients.

• St. Albans, Vermont: In 2014, Vermont law enforcement officers arrested a pharmaceutical manufacturer employee for diverting transdermal fentanyl patches. The employee stole 27 fentanyl patches and smuggled them out in his clothing.

There have been over 700 deaths related to fentanyl and its analogs across the United States since late 2013. (See Map 6.) While fentanyl is often abused in the same manner as heroin, it is much more potent, resulting in fatalities of even experienced opioid users. However, many coroners and crime laboratories do not test for fentanyl specifically, unless give a reason to do so. Further, some fentanyl deaths have been attributed to heroin.

Production Fentanyl

Clandestine fentanyl is manufactured primarily in Mexico. The fentanyl seized in 2005-2007 was produced in a single clandestine laboratory in Toluca, Mexico. Investigative reporting indicates the currently available fentanyl is also being produced in a laboratory or laboratories in Mexico. The fentanyl responsible for the deaths during the 2005-2007 fentanyl crisis ranged from 20 to 25 percent purity at the wholesale level. Wholesale quantities of fentanyl involved in the most recent deaths (late 2013 to early 2015) ranged from four to seven percent purity.

Analogs of fentanyl, such as acetyl fentanyl, are also available in the United States. Most of the acetyl fentanyl available in US markets is manufactured in China. As noted in the Executive Summary (page viii), on October 1, 2015, the Chinese Ministry of Public Security announced new controls on 116 chemical compounds, including acetyl fentanyl. Acetyl fentanyl is unscheduled in the United States and is not intended for human consumption.

(U) Map 6. States Affected by Fentanyl Overdose Incidents and Deaths, 2013 – 2014 Source: State Medical Examiners’ Death Data and Open Source Reporting

U) Photo 2. Twelve kilograms of suspected fentanyl.

Source: DEA

Transportation and Distribution Fentanyl

Fentanyl is smuggled across the Southwest Border in kilogram quantities and stored at stash houses, often with other drugs.xix The fentanyl seized in kilogram quantities in 2014 and 2015 has ranged in purity from 4 to 7 percent. Because fentanyl is so potent, these purities are wholesale-level, and the drug must still be diluted several times before being distributed in user quantities at the retail level.

 It is transported concealed in spare tires, gas tanks, and hidden compartments. Fentanyl is also transported across the country through mail courier services.

• Los Angeles, California: In November 2014, DEA Los Angeles FD and High Intensity Drug Trafficking Area (HIDTA) officers arrested three individuals and seized 12 kilograms of fentanyl, 28 pounds of methamphetamine, a stolen semi-automatic handgun, and $25,000 from a local stash house. (See Photo 2.)

• Buffalo, New York: In March 2015, the DEA Buffalo RO and the Buffalo PD arrested two individuals and seized 8 kilograms of fentanyl and 24 kilograms of cocaine.

Clandestine fentanyl is distributed in the United States in the same manner as heroin. It is sold in its powder form in glassine bags or wax envelopes, often stamped with brand names. It is often sold as heroin, with many users not aware of the presence of fentanyl in the substance.

Outlook             Fentanyl

Fentanyl will remain a threat while the current clandestine production continues; however, it is unlikely to assume a significant portion of the opioid market. Fentanyl’s short-lasting high, coupled with its high mortality rate, renders it unappealing to many opioid users who prefer the longer-lasting high that heroin offers and who wish to avoid the increased danger from fentanyl. Fentanyl will continue to remain available in limited quantities; however, it will most commonly be consumed unknowingly, mixed with heroin or other drugs. Fentanyl will remain a significant threat to law enforcement personnel and first responders as minute amounts—equivalent to a few grains of salt—of fentanyl can be lethal, and visually, can be mistaken for cocaine or white powder heroin.

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[2015 Drug Threat Assessment continues next at Part 83 Meth]