Fentanyl, Inc.: How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic

Fentanyl, Inc.: How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic by Ben Westhoff

In the past, people had to go to a dark corner in the bad part of town to feed their drug habits. Today, they can go on the dark web and have drugs sent directly to their house. This drug economy still poses plenty of risk. You can never be sure exactly what you or ordering, or if what you ordered will be seized. Where do these drugs come from? There are often a number of steps in the process. You may order from a distributor. They may have obtained it from another source that would create the final concoction. This may have required different ingredients that were professionally produced - often in labs in China.

With "designer drugs" and fentanyl, the government is in an uphill battle trying to keep up with new innovations in drug design. Previously, drugs would need to be "scheduled" one at a time. However, labs can easily cook up a slightly different drug and get around it. Thus, there are laws to ban analogs. There are also precursors that can be used to create the drugs. Different countries have different laws. Many Chinese labs operate "above board" in China, but sell chemicals to countries where they are banned.  Scientists also do research to find chemicals with valuable uses, but then see them turn up on the black market. Drug cartels have also pivoted. Mexican cartels help supply fentanyl to US markets. While they may have gun battles in the streets of Mexico, they tend to be peaceful distributors in the US.

Some of the biggest dangers with illegal drugs is the lack of understanding of the contents. Fentanyl is potent and may be concentrated in much higher doses than users are accustomed. Addicts will often be attracted to drugs that have caused others to overdose. Regulation leads to increased black market uses. (The book discusses the challenges of overdoses with ecstasy after it was banned.)

Some harm reduction activities seem to have worked. Testing of drugs so that people know what they are getting can reduce overdoses. Providing opportunities for addicts to safely handle their addiction can allow them to be productive members of society (and not resort to crime.) How can harm reduction be balanced with the desire to reduce preponderance of drugs?