Fentanyl: From Analgesic to Bioterrorism Agent to Drug of Abuse

As I live in the isolated, educated, and overly-pampered environs of Ann Arbor, sometimes I forget that such a place as Detroit lurks only 30 minutes away.

But then, I have the Detroit News to remind me, with chilling stories such as this. Over 30 people in Detroit have died in the last week of fentanyl overdosing, the most recent death being a Wayne State film student. He was found in the mens' bathroom, a syringe by his side.

This highlights a disturbing new trend in drug abuse, especially bad in the Detroit area: dealers are spiking heroin or cocaine with fentanyl to give the drugs a bigger boost (read: more addictive). Obviously, the combination can be quite fatal.

Legal and Illegal Uses
Fentanyl is a synthetic opioid (Schedule II), 50-80 times more potent than morphine. It was patented in 1963, in France. Like many abused drugs, fentanyl began as a therapeutic molecule aimed at relieving severe pain. Analogs have been manufactured to aid in heart surgery, and "bring down" very large animals. There is fentanyl on a stick (Actiq): a cherry flavored lozenge candy which delivers the drug to combat breakthrough cancer pain. Fentanyl is also given as an epidural during childbirth.

But, given time, most any opioid will be abused. Illicit use began in the 1970s; the biological effect is identical to heroin, but much, much more potent and is metabolized at a much faster pace. Actiq on the street is called a "percopop," fetching a price of $20-60, and fentanyl is also sold in powder form similar to heroin.

Fentanyl as Bioterrorism Agent
Now here's an interesting bit of trivia: fentanyl has also been used as a bioterrorism agent against Chechen rebels. From the Center for Nonproliferation Studies (CNS):

"On October 23, 2002, in the middle of an evening performance at a Moscow music theater, some 50 Chechen terrorists equipped with firearms as well as large quantities of explosives suddenly seized the venue and the 800 people inside. The terrorists threatened to kill everyone inside unless Russia ended the war in Chechnya. Although the Chechen militants agreed to release some of the hostages during the first couple of days, negotiations with the Russian authorities eventually stalled. Just before dawn on October 26, Russian special police units resorted to using an incapacitating gas based on the drug fentanyl to end the crisis. All of the Chechen militants were killed, and most of the civilian captives survived. But while the operation was largely a success, at least 117 of the hostages died from the effects of the gas."

It is, of course, no secret that a lot of money and research was put into the development of chemical warfare during the Cold War, both in the US and Russia. The point was not to kill the person, but rather to incapacitate them (LSD, belladonna, scopolamine, etc. was used to this purpose). Opiates (such as fentanyl) seemed a natural choice, as they had a strong action in the human nervous system, and in the right amounts, could induce unconsciousness. However, US chemists soon discovered that the opiate dose to induce unconsciousness was not far from the lethal dose. Such a narrow margin of error made opiates unattractive as a large-scale chemical warfare agent. However, its development and use in covert operations continued (fentanyl darts were used to target important Viet Cong by the US, and fentanyl spray was used by the Israeli Mossad as late as 1997 against Hamas leaders). Apparently, Russia also continued its development as a counter-terrorism weapon, and either didn't know or didn't care about the "narrow margin" thing.

Star-wipe to present day Detroit. It seems a very bad sign that even pseudo-junkie college students are OD-ing on fentanyl; it suggests that the pervasiveness of fentanyl has passed from the hardcore heroin users and into the more mainstream weekend warriors.

Yeah, a bad sign.