06/7/16

Buyer Beware Drugs

At the end of March in 2016, detectives with the Onondaga County Sheriff’s Office executed a search warrant at a split level home in quiet suburban neighborhood about 8 miles north of Syracuse, New York. They discovered a fentanyl processing operation where six people were mixing and packaging fentanyl for street-level sales. Detectives found an estimated 5,866 doses of fentanyl, 2 ounces of A-PVP (flakka), a loaded 12-gauge shotgun, a replica sub machine gun, drug paraphernalia and $3,571. The total street value of the drugs was $60,000.

The individuals arrested were considerate enough to warn the arresting officers not to touch the fentanyl without gloves. The drug is potent enough to be absorbed through the skin if you touch it without gloves. I guess they were concerned about a possible felony murder charge on top of the drug charges. Although the source of the drug was not known at the time of the drug bust, it typically comes from international sources in Mexico and increasingly from China.

A similar arrest took place near Los Angeles, where four men were operating a pill lab in Baldwin Park. Police found several pill presses and large quantities of variously colored powders, among them acetyl-fentanyl and methamphetamine. DEA Agent David Dowling said: “Fentanyl and its analogues pose a serious public health risk. Even small doses absorbed through the skin or accidentally inhaled can be fatal.” They were getting their drug supply from China. The Southern California lab was just one of four by law enforcement in the U.S. and Canada in March of 2016.

David Armstrong reported for STAT News on both of the above incidents as well as a lab in a custom car business in British Columbia that was shipping 100,000 fentanyl pills monthly to nearby Calgary, Alberta. Police reported that the equipment used to press the pills had come from China. Recently a quarter-ton pill press was intercepted before it was transported to a suburban Los Angeles drug lab. It had been labeled as a “Hole Puncher.”

In an affidavit, DEA agent Lindsey Bellomy said that based on wire transfers and other evidence, she “strongly believes” the Southern California group acquired its fentanyl from China. The affidavit lists a dozen deliveries from China to members of the group in January and February.

The China connection is allowing local drug dealers in North America to mass produce fentanyl in pill form, in some cases producing tablets that look identical to an oft-abused version of the prescription painkiller OxyContin. It also has been added to Xanax pills.

The emergence of decentralized drug labs, using materials obtained from China, makes it difficult to police fentanyl sold as a street drug. A report from the Department of State’s Bureau for International Narcotics and Law Enforcement Affairs indicated China is still a major producer and exporter of fentanyl and other drugs for illicit international markets. Lax regulation, low production costs, and government corruption, mixed in with the country’s large chemical and pharmaceutical industries, makes China a perfect supply source for the materials needed for the illicit drug labs.

Fentanyl pills masquerading as hydrocodone were recently blamed for a wave of overdoses and 11 deaths in the Sacramento California area. The Sacramento Bee reported on April 13, 2016 there had been 51 fentanyl-linked overdoses since late Mach of 2016. By April 27th, the death toll was up to 14. The pills were exact replicas of a medium-strength opioid painkiller, Norco. The CDC discussed this outbreak in detail in one of their Morbidity and Mortality Weekly Reports (MMWR).

Analysis of the fake Norco pulls showed they contained fentanyl, promethazine, acetaminophen and trace amounts of cocaine. Normally used to treat nausea vomiting and motion sickness, promethazine is used here to boost the high of the opioid. Reporting for the Digital Journal, Karn Graham said the pills were exact replicas for the real ones. It was only pure luck that health officials were able to get one of the fake pills from an overdose patient in order to analyze its ingredients. Keri Blakinger, writing for The Fix, said in Canada, British Columbia has declared a public health emergency from the increase of fentanyl overdose deaths in the province.

Lookalike oxycodone pills containing fentanyl have also appeared in Tennessee and Ohio. In testimony before the Committee on Homeland Security and Government Affairs in the U.S. Senate, Carole Rendon, the Acting U.S. Attorney for Northeastern Ohio said the overdose deaths from heroin and fentanyl had risen until they began to see an average of two overdose deaths per day in March of 2016. She said: “Opioid addiction knows no boundaries. It is an equal opportunity killer of old and young, men and women, urban, suburban, and rural, rich and poor, black, white, and Hispanic. We are all at risk.”

In February, Tennessee officials warned about the availability of counterfeit drugs, specifically pills being sold as Percocet that actually contained fentanyl. David Reagan, the Chief Medical Officer of the Tennessee Department of Health said: “When people sell fake pills appearing to be oxycodone but actually containing the more powerful pain medicine fentanyl, lives are at risk.” During a traffic stop in May of 2015 a police officer discovered several 30 mg pills of what appeared to be oxycodone, with its signature A/215 stamp characteristic. Lab analysis showed they were fentanyl. In January of 2016, 300 pills stamped with the characteristic markings for Percocet were found to be fentanyl.

Even worse, counterfeit Xanax pills that contain fentanyl are appearing. In October of 2015 at least three people died from ingesting the combination drug in San Franciso. Saint Petersburg Florida reported that nine people died in Pinellas County from what was being sold as Xanax on the street. The pills were actually a combination of fentanyl and Xanax. The Daily Mail said the combination is sold as “Super Pill” on the street for as little as $5 a pill.

Last, and probably worst, there is another synthetic opioid coming onto the illicit drug market, W-18. It is 100 times more powerful than fentanyl; 10,000 times more powerful than morphine. And again, the likely source for the drug is China. Alan Hudson, an associate professor with the department of pharmacology at the University of Alberta, said W-18 is one of the most dangerous drugs in the whole spectrum of analogs. A tiny speck can cause respiratory failure and kill you.

Global News reported that the drug comes from a “W-series” of opioid compounds first discovered at the University of Alberta in Canada in 1982. Of the 32 compounds, W-1 to W-32, W-18 was the most toxic. As little as four kilograms of the drug is enough to produce millions of tablets. An Edmonton-area drug bust in December 2015 netted four kilograms of W-18.

Because of its potency, W-18 exponentially raises the stakes for potential overdoses. “It’s just too potent to even consider using.” It was never listed as a controlled substance; never tested on humans. So it is technically legal and for sale online—typically from China. “Obviously somebody in China has picked up on the fact that W-18 is quite easy to make in large quantities and they’re trying to sell it to the North American market.”

If you are having trouble understanding why the practices above persist, think about basic branding, marketing and salesmanship. Established brands in the drug market include “heroin” and various pills like: “OxyContin”, “Percocet”, “Xanax”, and even “MDMA.” A significant segment of the drug market has a negative view of heroin, so they prefer to use pharmaceutical versions of opiates/opioids. So they seek out “OxyContin”, “Percocet”, and others. There is also a higher production cost for pills due to their stricter regulation. Pharmaceuticals are legally produced; heroin is not.

Over the past 100 years or so, the government has developed a regulatory process to give consumers some assurance that when they buy pharmaceuticals, they are getting what they paid for. Even with all the problems in the existing regulatory procedures, the modern pharmaceutical consumer is better protected today than they were during the time of patent medicines. THERE IS NO REGULATORY PROCESS FOR ILLICITLY PRODUCED DRUGS.

So if drug dealers and manufacturers want to increase their profits, they produce knockoffs of the more popular drug brands (like Percocet or heroin) by substituting cheaper products for the known brands. Since there is no regulatory process, they can and do sell knockoffs to their customers as the real thing with relative impunity. Illicit drugs today are truly a “buyer beware” market. The consumer/user is risking their health and their life as they seek out the newest, best high.

11/23/15

Cocaine’s Secret Ingredient

Writing for Time back in 2010, Maia Szalavitz described how the connection between levamisole and cocaine first came to light. In the summer of 2008, a man and a woman in their twenties were both admitted to a Canadian hospital with fevers, flu-like symptoms and dangerously low white blood cell counts. Although the symptoms were consistent with agranulocytosis, at the time it was only known as rare disease found in chemotherapy patients and others taking certain antipsychotic medications. Neither of the Canadian patients fit that profile. But they had one thing in common: they used cocaine. A search of the medical literature at the time didn’t find any studies linking agranulocytosis with cocaine.

But in April of 2008, a New Mexico lab had notified the New Mexico Department of Health (NMDOH) of a cluster of unexplained agranulocytosis cases in the preceding two months. The NMDOH launched their own investigation and “identified cocaine use as a common exposure in 11 cases of otherwise unexplained agranulocytosis.” In November of 2008, the NMDOH investigation and the Canadian public health officials connected with one another. In January of 2009 the NMDOH posted a notification of its findings on the CDC’s Epidemic Information Exchange. In a still separate investigation, public health officials in Seattle Washington identified 10 cases of agranulocytosis among persons with a history of cocaine use between April and November of 2009.

In the midst of this growing public health mystery, two high profile overdose deaths occurred. Celebrity disk jockey Adam Goldstein, better known as DJ AM, died of an overdose of cocaine and prescription drugs in September of 2009. Among the drugs found in his system was levamisole. Goldstein had been a fixture on the A-list party circuit and was a well-known cocaine user. Ted Koppel’s son Andrew accidentally overdosed in June of 2010. The medical examiner found a combination of drugs in his system at the time of death, including cocaine and levamisole. It was likely that neither men knew they had been snoorting any levamisole.

SAMHSA, the Substance Abuse and Mental Health Administration, posted a public health alert the same month of Adam’s death warning of the dangers of levamisole. Citing information from the DEA, the report said the percentage of cocaine specimens containing levamisole tested in its labs has steadily risen since 2002. In July of 2009, 70% of the illicit cocaine tested contained levamisole. They said there had been around 20 cases agranulocytosis, including two deaths associated with cocaine adulterated with levamisole.

Levamisole is used in veterinary medicine as a deworming agent for cattle, sheep and pigs. In the past, it was approved for use with humans to treat autoimmune diseases and cancer. It’s been increasingly found as an additive to cocaine in samples tested worldwide. It has some serious side effects like a weakened immune system, painful sores and wounds that don’t heal—the above noted condition called agranulocytosis. Left untreated, it could lead to death. Here is a short video on Adam’s death and some pictures of individuals with agranulocytosis from cocaine use. Don’t watch it if you have a weak stomach.

A recent case report in the British Medical Journal described a 42 year-old woman who came to an outpatient clinic in Britain suffering from vasculitis, an inflammation of the blood vessels. She had severe joint pain, muscle pain, intermittent abdominal pain and lesions. Initially, she repeatedly denied any cocaine use, but eventually admitted using it in the past. Hair testing done was positive for her recent use of levamisole-contaminated cocaine.

Erowid, a pro-drug website cautioned its readers to be honest with healthcare providers about their illicit substance use when they seek treatment for conditions like high fever that could be from levamisole to improve their chances of proper diagnosis and quick recovery. In other words, don’t do what the woman in the BMJ case report did. There was an informative article there on levamisole that noted how widespread levamisole-tainted cocaine is: Australia, Canada, Colombia, France, Guyana, Italy, Jamaica, the Netherlands, Spain, Switzerland, the United Kingdom, and the United States. Speculating why cocaine is adulterated with levamisole, Erowid said:

According to the DEA, levamisole–as well as other adulterants–is apparently present in some shipments of cocaine intercepted before they are broken up for further distribution to consumers. Considering that, in one batch, only 6% by weight of the total product sold as cocaine was levamisole, it seems possible it is more than simply a bulking agent. One theory is that levamisole or other adulterants boost the effects of cocaine, permitting material to pass for higher-quality product despite additional cuts made down the line. Another theory is that levamisole or other adulterants are added as chemical signatures used to track distribution of material.It may be that levamisole has been used because it has similar solubility properties to cocaine and therefore is difficult to remove and has not previously been considered a serious health hazard. As of October 1, 2009, there is no definitive answer as to why it is used as a cocaine adulterant.

Kim Gosmer, a chemist specializing in narcotic samples at the Department of Forensic Medicine as Aarhus University in Denmark speculated that levamisole-tainted cocaine originated from South America. Cited in a Vice article, he said that forensic chemists are finding levamisole-tainted cocaine all over world, increasingly from every level of distribution. Gosmer believed this suggested the adulterant is added to the cocaine in South America before it is exported. “So the question is: Why bother diluting high-grade cocaine that costs almost nothing to produce (compared to street prices) with a compound that’s more expensive than other adulterants and diluents?”

He went on to say that the amount of levamisole found in cocaine is typically not very large. So it’s not added strictly to cut the cocaine. But one of its metabolites called aminorex has amphetamine-like properties. Another possibility is that levasimole increases the amount of dopamine released by glutamate levels in the brain. “Levasimole could potentially increase the effect of cocaine through its release of dopamine.”

Casual cocaine users purportedly don’t have to worry; but habitual users should worry. With upwards of 70% of the cocaine from around the world testing positive for levamisole, the typical cocaine user will snort some levamisole sooner or later. SAMHSA warned levamisole was a dangerous substance and that agranulocytosis was a very serious illness that needed to be treated at a hospital. Remember the similar warning given by Erowid. So if you use cocaine, watch out for:

high fever, chills, or weakness
swollen glands
painful sores (mouth, anal)
any infection that won’t go away or gets worse very fast, including sore throat or mouth sores -skin infections, abscesses -thrush (white coating of the mouth, tongue, or throat) -pneumonia (fever, cough, shortness of breath).”

It used to be that you could trust drug dealers to only cut their cocaine and heroin with inert ingredients. It seems that the cost of snorting cocaine is going up in more ways than one.

10/12/15

“Shake and Bake” Meth Labs

The DEA posted maps of the total number of meth lab incidents from 2004 through 2014. There were 23,829 total incidents in 2004; 6,858 in 2007; 13,432 in 2012; and 9,306 in 2014. Missouri, Tennessee and Iowa were the state with the highest amounts of reported meth lab accidents in 2004; Indiana, Missouri, and Tennessee for 2014. Many states throughout the US had dramatic decreases in reported accidents. That’s the good news. The bad news is that a CDC study indicates injuries from methamphetamine-related incidents are on the rise in some parts of the country.

The CDC report noted there was an increase of reported incidents from 2001 through 2004; followed by decreases through 2007; with increases again through 2012. In 7% of the meth-related incidents, 162 people were injured, including 26 children (16%). Among the injured, 136 (84%) were treated at a hospital, including 19 of the injured children. There were also two reported deaths: one probable meth cook and one law enforcement official.

The percentage of incidents with injured persons increased from less than 5% during 2001-2004 and 2005-2007 to 10% during 2008-2012. Most of the injuries were to members of the general public (97) and law enforcement officials (42). The most frequently reported injuries overall were: respiratory irritation, burns and eye irritation. Burn injuries were almost exclusively experienced by the general public, with 42 of the 44 reported injuries.

The researchers speculated that the initial declines in injuries were related to state and federal restrictions on the retail sales of common meth precursor drugs, ephedrine and pseudoephedrine. This was reversed in 2008 when meth cooks adapted by buying permitted quantities from multiple locations, often with false identification. Additionally, a new method for making meth became popular, one called “shake-and-bake.” This involves shaking smaller amounts of the precursor chemicals in a 2 liter plastic bottle. Unfortunately, the bottles frequently burst, causing burns and environmental contamination. “Burn injuries increased during this time, particularly to members of the public, who might have been meth cooks or household residents.”

Children who are present during the production of meth face many hazards. The Horton et al. study cited below reported that half the events with injured children occurred between midnight and 6 am, when most children are asleep. The authors speculated that sleeping children have an even higher risk of acute injury during an emergency event. “This is particularly true if the parents/care givers are in another part of the house and/or are under the influence of meth.” Several states have enacted laws to protect children from meth-related injuries.

A 2003 study by Horton et al. examined data from Hazardous Substances Emergency Events Surveillance (HSEES Events) identified eight children injured in meth events. “Five of the meth events with children occurred in private residences: three of which occurred in houses, one in an apartment building, and one in a duplex.” One of the children injured was 8 years-old. They concluded:

The HSEES data appear to indicate that the numbers of meth labs and associated emergency events will continue to increase, putting more children and other unsuspecting individuals at risk for hazardous substance(s) exposure. More action is needed to remove children from these dangerous environments and to educate innocent bystanders, as well as the substance abusers themselves, about the risks involved with meth and its illicit production.

A 2009 study by Thrasher et al., using case reports from the Washington State Poison Control Center found that a large proportion of meth lab exposures occurred in private households. Of the 198 exposed persons, 10.6% were meth cooks, 15.7% were law enforcement personnel, 35.4% were residents and 38.3% were classified as other. Twenty-eight of the reported exposures (19.2%) were children. “A subject’s own residence was the predominant site of exposure for cooks (71%), other adults (41%), and children (66%).”

Although the CDC study indicated recent increases in an increase in meth-related injuries, there is distinct likelihood the true incidence is significantly under reported. One limitation of the CDC study was that only five states were included. Now this was because those five states (Louisiana, Oregon, Utah, New York, and Wisconsin) were the only ones with complete information available for the time period 2001-2012. Another limitation was that meth incidents in homes were not included in the original data from the National Toxic Substance Incidents Program (NTSIP) unless there was a public health action, such as an evacuation.

	Total Meth Incidents 2004	Total Meth Incidents 2014
Oregon	632	1
Utah	107	1
Wisconsin	109	14
Louisiana	176	11
New York	136	197
Missouri	2,913	1,034
Tennessee	2,341	958
Iowa; Ohio (2014)	1,666	919
Illinois; Michigan (2014)	1,576	750
Indiana	1,377	1,471

One illustration of this under reporting can be seen by examining the incidents reported in the DEA maps for those five states included in the CDC study to the incidents in the five states with the highest reported incidents in 2004 and 2014. The five states included in the CDC study were: Oregon, Utah, Wisconsin, Louisiana, and New York. The five states with the highest reported incidents in 2004 were: Missouri, Tennessee, Iowa, Illinois, and Indiana. The five states with the highest reported incidents in 2014 were: Missouri, Tennessee, Indiana, Michigan, and Ohio. The total meth incidents for the five states in the CDC study, for 2004 AND 2014 were less than the incidents for just one of the top five states—for both 2004 and 2012. Another readily noticeable fact is that the highest incident states for both 2004 and 2014 cluster in the Midwest, with the border states of Tennessee and Kentucky thrown in for good measure.

We can say there was an increase for the five states included in the CDC study, but can’t assume that increase holds throughout the US. It is likely the real total is much higher, especially in the selected states from the DEA map noted here.

The Department of Justice has produced a handy pamphlet of “Fast Facts” about meth labs. It described signs to look for if you suspect the presence of a meth lab. These signs include: unusual odors; excessive trash, especially chemical containers, coffee filters, red stained pieces of cloth, and duct tape rolls. Other indications are secretive, unfriendly occupants; frequent visitors, esp. at unusual hours; curtained or blackened windows; extensive security measures or attempts to ensure privacy, such as “no trespassing” or “beware of dog” signs.

Meth labs come in all sizes. Super labs produce 10 pounds or more of meth at a time; smaller “box” labs produce as little as an ounce and can fit in a box or backpack. They can be located almost anywhere: private homes, hotels and motels, automobiles, boats and luggage. They can also be found in commercial and industrial districts; or nestled away in a secluded rural area.

The chemical used to produce methamphetamine are extremely dangerous. Some are very volatile and could ignite if not handled properly, as apparently was the case in the motel video mentioned below. Even if there is not fire or explosion, meth production is dangerous. Exposure to the chemical can pose a series of health risks, including respiratory problems, severe chemical burns, pulmonary edema, and more. Look at a table in the pamphlet listing various chemicals used in meth labs and the hazards associated with them.

Health Research Funding posting some facts about meth lab explosions and also had two embedded videos of meth lab explosions. One video shows a mobile home in a rural setting going up in smoke. The other captured an explosion in a motel room on a security camera. Seven burn units have shut down over the last six years because of the unreimbursed costs of treating burn victims in meth lab explosions. One pound of meth results in six pounds of toxic waste. Eighty percent of the meth labs found and dismantled by authorities used the “shake and bake” method.

The simplified “shake and bake” method and smaller size of these labs means that rolling meth labs in cars, trailers or mobile homes can be easily moved to a secluded location where the manufacturing fumes can’t be detected and the toxic waste discarded. In 2002, Interstate 24 in southwest Kentucky was temporarily shut down when a car containing anhydrous ammonia exploded. It was a rolling meth lab. “Trucking down the highway allows them to disperse the rotten egg smell the labs produce and keep the waste out of their own homes.” Of the 2,000 chemicals that could be used to make meth, at least half are explosive.

Illustrating how meth labs can be found anywhere, here is an article about an explosion that occurred at a federal facility in Gaithersburg, MD. The explosion happened on the main campus of the National Institute of Standards and Technology (NIST) on June 19th, 2015. Federal law enforcement officials found pseudoephedrine, drain opener and a recipe for making methamphetamine in the lab. Representative Lamar Smith wrote in a letter to the Commerce Secretary said: “I am troubled by the allegations that such dangerous and illicit activity went undetected at a federal research facility.”

04/13/15

The Economics of Heroin

I live in the suburbs of Pittsburgh. At least nine times each week I drive past a retail store where someone I know once told me they shot up heroin in the store’s parking lot. The store sits on a busy street. This incident was a few years ago, but I’m pretty sure that wasn’t the only time someone used heroin in my neighborhood, because it’s happening all around me.

A teacher from the Montour School District was recently charged with two counts of possession with intent to deliver. Police said he was selling heroin out of his home. The school district suspended him immediately. The school district’s solicitor said there was no evidence that the man possessed or sold drugs on school property. The accused has been a math teacher for at least a decade. The ironic twist is that he rented his home from the Robinson Township police chief, who said he’s never had any problems with the accused … until now.

The Pittsburgh Post-Gazette reported at the end of February 2015 that three people from Armstrong County were charged in connection with an overdose death linked to fentanyl-laced heroin known as “theraflu.” I work part time at an outpatient treatment center in Pittsburgh and remember when the theraflu scare was going on in January last year. Seventeen people from around Pittsburgh died of overdoses in a week. A local medical examiner at the time said it was “major public health crisis.”

An ongoing investigation of drug trafficking in Homewood and other communities in the Pittsburgh metro area recently added 14 new defendants to the 40 who were originally indicted in October of 2014. US Attorney David Hickton said they were “important cogs” in a multi-state drug distribution ring. “They would be the Pittsburgh connection to this organization that has reach far beyond out state.” The trafficking involved heroin, cocaine and crack cocaine coming from Los Angles to Homewood via Cleveland. Harold Hayes of KDKA said: “The FBI says the long-term investigation has led to the indictment of more than 100 people and the seizure of more than $1 million.”

The 2014 National Drug Threat Assessment Summary (NDTS) published by the DEA stated that the threat posed by heroin in the US has been increasing across the country, particularly in the Northeast and North Central regions. The two major geographic areas for heroin supply in the US are Mexico and South America. Together they account for 96% of the heroin analyzed by the DEA in 2012. The NDTS reported that heroin seizures increased 87 percent in five years, from 2009 to 2013.

The observed increase in demand for and abuse of heroin is said to be the result of individuals who used to abuse prescription opioids switching to heroin. Reasons given for the switch include: the relatively lower cost of heroin than prescription opioids; the decreasing availability of prescription opioids versus the increasing availability of heroin; the reformulation of OxyContin, making it more difficult to abuse. My own experience with people abusing heroin is that the switch is mostly market driven, by the cost differential and the availability of heroin.

In 2013 and 2014, the Northeast and Midwest reported a spike in overdose deaths from fentanyl being sold as heroin. Fentanyl is 30 to 50 times stronger than heroin. The overdoses include both new and experienced users. Thinking they are buying heroin, the users typically don’t realize they are buying fentanyl or a fentanyl-heroin mixture. Between 2005 and 2007 over 1,000 overdose deaths were traced back to a single laboratory in Mexico. The lab was seized and destroyed. The recent outbreak, noted above, covered a wider geographic area than in 2005-2007 and involved both fentanyl and fentanyl analogs.

In Mexican states like Sinaloa and Guerrero, poor farmers living in wood-plank, tin-roofed shacks with no indoor plumbing are growing the poppies that eventually become the heroin sold in American cities like Pittsburgh. Jake Bergman, reporting for the PBS show Frontline, noted how Sinaloa has been the breadbasket for Mexico for decades. Now it a drug-rich area, “the cradle of the biggest traffickers Mexico has ever known.” They even have their own “patron saint”—Jesus Malverde. Malverde’s legend says he robbed from the rich and gave to the poor. Nevertheless, he was hung by the governor of Sinaloa in 1909. His “sainthood” is not recognized by the Roman Catholic church. Father Antonio Ramirez said: “Nobody has become a saint robbing and killing, he was a bandito.”

Nick Miroff reported last year for the Washington Post that the drug trade in Sinaloa has been going through a transition lately. Farmers who used to grow cannabis are now planting opium poppies. Rodrigo Silla, a lifelong cannabis farmer, said it’s not worth it anymore. The wholesale price for a kilogram of cannabis dropped from $100 to less than $25. “I wish the Americans would stop with this legalization. . . . There’s no other way to make a living here.” The Silla family consists of three generations of drug farmers.

A kilo of the raw, sticky opium sap that is used to make heroin sells wholesale for $1,500 in the northern Sierra Madre, nearly double its 2012 price, according to growers. With fertilizer and favorable weather, a well-tended poppy field can yield eight kilos of sap per acre, nearly enough to make a kilo of raw heroin.

David Shirk, a researcher at the University of California at San Diego said that the farmers are simply diversifying because they have a product losing its value. “The wave of opium poppies we’re seeing is at least partly driven by changes we’re making in marijuana drug policy.”

Sinaloa has grown opium poppies since the time of the arrival of Chinese settlers in the last half of the 19th century. But large-scale production did not begin until World War II. Japan controlled the Asian opium market and the US military needed morphine for its soldiers. During this time, many Sinaloans made a fortune. Everyone was growing it. Even some government officials got into the opium export trade. After Japan was defeated, the US no longer wanted the inferior Sinaloan opium. “But many farmers continued to produce opium and heroin; operations became more clandestine, and a smuggling network was set up.”

Writing for the Associated Press, Mark Stevenson reported that farmers in Guerrero don’t like growing opium poppies, but it’s the only thing that will guarantee them a cash income. Humberto Nava Reyna, the head of a group promoting development projects in the region said: “They can’t stop planting poppies as long as there is demand, and the government doesn’t provide any help.” Residents say there are no local users. “It all goes for export, a lucrative business mostly run by the Sinaloa Cartel.”

So it’s sounding like the war on drugs needs to begin changing tactics. Instead of spending so much time and energy on chocking off the supply routes, there should spend more time and energy on drug treatment and prevention to dry up the demand. And there should be some funds given to Humberto Reyna and others like him to help the multi generational drug farmers transition to non-drug crops. And I think I’ll start praying for the Silla family and other drug farmers when I pass by that retail store in my neighborhood.

11/3/14

Strange Bedfellows: Terrorists and Drugs

© Hurricanehank | Dreamstime.com - Terrorist In Mask With A Gun Photo

This past May, the DEA raided a Birmingham Alabama warehouse as a part of Project Synergy. Inside, agents found hundreds of thousands of “Scooby Snax” baggies containing spice (synthetic marijuana). Sales of the product were also linked to $40 million in wire transfers to Yemen. Yemen is the home base for Al-Qa‘ida in the Arabian Peninsula (AQAP). While not able to directly link the money to a particular group or organization, DEA spokesperson Rusty Payne said: “It doesn’t take a rocket scientist to figure out that people aren’t sending $40 million to their struggling relatives overseas.”

Derek Maltz, the director of the Special Operations Division of the DEA said: “There’s a significant, long history between drug trafficking and terror organizations.” More than 50 percent of the State Department’s designated foreign terrorist organizations (FTOs) are involved with the drug trade. While the Obama administration has been successful in cutting off state-sponsored funding for terrorist organizations, they have looked for other sources of revenue. The $400 billion annual international drug trade is the most lucrative illicit business in the world and a tempting “investment opportunity” for terrorists.

Maltz went on to say that the synthetic drug market is a “two-for-one deal” for terrorists—they undermine Western countries with the drugs and make millions in the process. We’ve put a bull’s-eye on our back, he said. “When you see a designer synthetic drug industry as lucrative as this in the U.S., it would only be natural that it would be a huge target for those trying to finance their terrorists.”

The world of narcoterrorism has some diversity in its investers. The Taliban in Afghanistan distribute heroin; FARC in Columbia deals in cocaine; and al Shabab in West Africa is alleged to sell khat. While the association of al Shabab and khat may be questionable (here and here), the links between the Taliban and heroin as well as FARC and cocaine are well documented.

While Afghanistan and growing opium have been linked for thousands of years, it has only been in the last three decades that it has become the center for worldwide opium cultivation. Since 2001, opium production in Afghanistan has increased from 70 percent of the overall global opium production to 92 percent. To give you a sense of the size of this, the 2013 World Drug Report indicated that in 2011, Afghanistan produced 5,800 tons of opium, down from 7,400 tons in 2007. The next largest opium producer in 2011 was Myanmar with 610 tons of opium.

The World Bank estimated that the opium GDP of Afghanistan is between $2.6 and $2.7 billion. This amounts to 27 percent of the country’s total GDP, both licit and illicit. And yet, only 3 percent of the natural agricultural land in Afghanistan is used for its production. Poverty is widespread in Afghanistan and many of farmers are compelled by economics and force to grow opium. “Opium is valued at over $4,500 per hectare, as opposed to only $266 for wheat.” Because of this potential profit, many farmers are pressured to cultivate opium by various organizations, warlords and landowners.

The provinces of Helmand and Kandahar, which were regularly in the news during the war in Afghanistan, are also the primary opium producing provinces in the country. As former Afghan president Hamid Karzia said: “The question of drugs . . . is one that will determine Afghanistan’s future. . . . [I]f we fail, we will fail as a state eventually, and we will fall back in the hands of terrorism.”

According to sources in Spanish intelligence, the Islamic State and other jihadist groups are using their connections in the illegal drug market to finance their operations in Iraq and Syria. Jihadists use their knowledge of drug smuggling routes to export arms, contraband and new recruits from Europe to Iraq and Syria. Ironically, the pressure to dry up legal fundraising for terrorist organizations has contributed to their increased trade with illegal arms and drugs.

According to reports from Spain’s recently established government intelligence and counter-terrorism unit CITCO, 20% percent of those detained in Spain under suspicion of working with Islamic State and other jihadist groups have previously served prison sentences for offences such as drug trafficking or document counterfeiting.

FARC rebels control over 60 percent of Columbia’s drug trade, including overseas trafficking. The Revolutionary Armed Forces of Columbia (FARC) earns about $1 billion annually from the production and sale of cocaine in Columbia. According to General Jose Roberto Leon, the head of the Columbian national police force, “We have information found on computers after operations that have captured or killed FARC leaders, and it’s involvement in drug trafficking is evident.” The Columbian anti-narcotics police chief, General Ricardo Restrepo, said that officials fear that if a peace deal with FARC is successfully negotiated, thus cutting into cocaine production, that new gangs producing synthetic drugs will emerge. “It will be our next battle.”

The connection between terrorism and drug trafficking does not currently get much attention in the news media, in part, because the connections are difficult to make. But it does exist and seems to be a growing trend. Spanish intelligence sources have reported that European jihadist groups are using drug smuggling routes to export drug contraband and new recruits from Europe to Iraq and Syria. And most of the cocaine entering Europe is reportedly going through territories controlled by the Islamic State.

The Birmingham bust discussed above is particularly disturbing to me as it connects the making and distribution of the newest addictive danger, new psychoactive substances (NPS), with terrorism. This combination truly is a two-for-one threat. But we can have a two-for-one response to that threat. Both the war on drugs and the war on terrorism can be fought by social policies as well as drug treatment and education that aim for the reduction of drug use. Who would have thought that the slogan in the war on drugs would someday be: Fight Terrorism by Becoming Drug Free.

09/29/14

Psychoactive Science or Sideshow

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There is a growing call to permit research into the therapeutic benefits of a variety of psychoactive drugs currently classified by the DEA as Schedule 1 controlled substances. The editors of Scientific American called for the U.S. government to move LSD, ecstasy, marijuana and others into Schedule 2, with cocaine, methamphetamine, fentanyl and Ritalin. They point out that such a move would not lead to decriminalization, “but it would make it much easier for clinical researchers to study their effects.”

Schedule 1 controlled substances are “drugs with no currently accepted medical use and a high potential for abuse.” They are seen as the most dangerous drugs, “with potentially severe psychological or physical dependence.” Schedule 2 controlled substances are “drugs with a high potential for abuse, less abuse potential than Schedule 1 drugs, with use potentially leading to severe psychological or physical dependence.”

British researchers have also called for greater access to “classical hallucinogens” such as psilocybin (magic mushrooms, another Schedule 1 drug) and LSD for research into treating depression.

Classical hallucinogens alter the functioning of this system [serotonergic], but not in the same way current medications do: whilst there are identified receptors and neurotransmitter pathways through which hallucinogens could therein produce therapeutic effects, the neurobiology of this remains speculative at this time.

These drugs are all caught in a catch-22, de facto ban on their use in medical research because of their Schedule 1 placement. “These drugs are banned because they have no accepted medical use, but researchers cannot explore their therapeutic potential because they are banned.” Three United Nations treaties extend similar prohibitions to rest of the globe, further complicating their reclassification as Schedule 2 drugs.

British psychiatrist David Nutt has argued that the U.N. charters are outdated and restrict doctors and scientists from studying hundreds of drugs. He likened this “research censorship” to the Catholic Church banning Galileo from teaching or defending heliocentric ideas in the 1600s. Nutt suggested the Catholic Church banned the telescope, but the ban was actually on books that taught Copernican beliefs.

Nevertheless, he called the laws, which do not discriminate between research and recreational drug use relics of another age. “These laws serve no safety value. . . . The licenses and bureaucracy surrounding them can increase the costs of research tenfold, further limiting what is done.” Dr. Nutt commented on how LSD and other hallucinogens like psilocybin had potential to explore and treat the brain. “Other therapeutic targets for psychedelics are cluster headaches, OCD and addiction.”

The argument for reclassifying psychoactive substances like marijuana, LSD, ecstasy and psilocybin from Schedule 1 to Schedule 2 has its pros and cons for me. The above discussion presents the case for reclassification, permitting future research into these substances. IF the ideal of rigorous, methodical research into the therapeutic potential of these drugs is followed, all is well.

But we are now in the midst of an epidemic of prescription drug abuse that came through the very same gauntlet of review and approval that these known recreational drugs would pass through to become medicinal agents once they were reclassified. And while there are potential therapeutic applications for marijuana, the current state of medical marijuana looks more like the older sideshow of patent medicines, where you could get cocaine toothache drops, heroin for cough relief, and Mrs. Winslow’s Soothing Syrup (which contained morphine) for teething discomfort.

If special interest groups can be held off from bringing about a new age of snake oil salesmanship, then reclassifying these substances and permitting legitimate scientific research makes sense. Done correctly, it might even demonstrate that some of the existing curative claims for medical marijuana and other substances were false. But if these psychoactive substancess achieve FDA approval for any reason, they could be prescribed “off label” as is currently the case with other FDA approved drugs.

Faith Seeking Understanding

Charles Sigler, D.Phil.

Tag Archives: DEA

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Psychoactive Science or Sideshow