Help fentanyl labs make a safer drug

Illegal fentanyl lab operators don’t intend to kill users. They would prefer to have return customers. The problem, I suspect, is that the fentanyl used is so concentrated that it’s hard to dissolve to a uniform consistency. The resulting doses are uneven –from low to deadly. It’s a good idea to provide testing facilities for fentanyl cooks to let them know the potency of their product. Dr. Tyndall of the BC Centre for Disease Control says:

  fentanyl lab. image: Global news

“I’m still firmly of the belief that nobody’s actually trying to kill people. These manufacturers don’t know what they’re doing and they’re putting out ridiculous concentrations of these drugs.”

The BCCDC recommends an expansion of drug-checking services where anyone, including producers of illegal fentanyl, can have their drugs tested for toxicity. B.C.’s Minister of Health, Judy Darcy, endorses the expansion.

As it stands, drug policy is perverse because we tell users not to use street drugs but provide no other option when legal supplies fail.

“We strongly advise people to stop using street drugs,” says Dr. Tyndall, “and if they can’t do that, then we offer them … Suboxone or methadone, and if that doesn’t work, we basically tell them to go and find their own drugs even though there is a very real possibility of dying.”

The BCCDC suggests ten “areas of action.” If they were adopted, opioids would be essentially legalized much in the way that marijuana will be next year. Grower’s clubs and individuals would be allowed to make medical grade opiates. To clarify, opiates are derived from poppies whereas opioids include all synthetic and natural products.

Legal opioids are not likely to happen any time soon. I started lobbying for legalization of cannabis 40 years ago and look how long that took. Optimistically, with the model of legalized marijuana to be established soon, it won’t take another 40 years for the legalization of opioids.

Even without legalization, off-label uses of opioids are allowed. The BCCDC suggest dispensing take-home opioids such as oral hydromorphone which users could take home, grind up, and inject without supervision.

If the above recommendations only seem radical, it’s only because of a false sense of what criminalization can achieve. Criminal law can’t accomplish societal goals. If we want to stop people from using harmful drugs, criminalization has been a dismal failure. Instead, make drugs legal and educate people of the unhealthy consequences of use. It works with tobacco. If the goal is harm reduction, the recommendations don’t seem so radical.

Imagine that we are talking about baby strollers instead of drugs, and that some early models collapsed resulting in injury or death. An irrational solution would be to make strollers illegal. The sensible solution would be to regulate manufacture of the strollers to make them safe.

Prohibition of opioids isn’t working. It didn’t work for coffee, cigarettes or alcohol.

If the current trend continues, the death rate will continue to climb. More than 1,500 will die in British Columbia this year -ordinary people like friends, family and neighbours. Forget the stereotype of street people overdosing in alleys: 90 per cent of deaths are indoors. Isn’t it time to abandon prohibition and give harm-reduction a chance?

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Legalize heroin and save lives

Legal opiates are being use to adulterate illegal ones with tragic consequences. More than 800 British Columbians were killed in fentanyl-related overdoses last year. Many of them were ordinary Canadians you might find living next door. One of them was my nephew who died a few years ago.

Calgary Herald

They injected what they thought was heroin, or some other illegal drug. If they had injected legal heroin, of known purity and strength, they would still be alive. I’m not naive; they would still be addicted but their quest for bliss would not have ended in death.

It’s a question of harm prevention. Legalization of heroin may seem like a radical idea but not long ago so did giving drug addicts clean needles and a safe place to inject.

Like the prohibition of alcohol, the prohibition of drugs has been a dismal failure. Prohibition simply pushes the drug trade underground. When a trade is unregulated, who knows what junk users will end up taking? Drug manufacturers don’t intend to kill users: it’s bad for business to kill your customers. They just want to maximize profits.

Fentanyl is perfectly legal. It’s prescribed by doctors for controlling pain. Fentanyl is just one the opium family. It turns out that all of them are addictive.

A brief history of legal opiates is a guide to the intersection of illegal ones. Opium from Persian poppies has been used for pain control since the fourth century. Researchers discovered the active components of opium -morphine, codeine and theobain- in the 1800s. In an attempt to find a non-additive painkiller, heroin was derived from morphine. The manufacturer of heroin, Bayer, pulled it from shelves in 1913 once it was found to be addictive.

In the quest for a non-addictive pain killer, Perdue Canada filed a patent in 1992 for OxyContin, a pill that would treat pain “without unacceptable side effects (Globe and Mail, Dec. 30, 2016).” Perdue encouraged doctors to prescribe the pill and soon it was a blockbuster hit with billions of dollars being made.

But OxyContin turned out to have terrible side effects and thousands of were hooked. Canadians consume more prescription opiates on a per-capita basis than any other country in the world according to a United Nations report.

As in all opiates, those hooked on OxyContin become habituated so that they needed more pills to control pain. Purdue attempted to control the problem with the replacement OxyNEO in 2012, a tamper-resistant alternative that is difficult to crush, snort or inject. And that same year, the provinces stopped paying for both opiates.

Both factors drove addicts to the streets to find a fix. Illegal drug manufacturers care not how their clients get hooked, whether it be from the pursuit of bliss or the relief of pain.

Fentanyl is now the universal opiate. Manufactured in China in concentrated form, it can be ordered on the internet and sent through the mail. From there, it is pressed into pills to mimic OxyContin and other opiates.

Making fentanyl illegal is not the solution. Drug abuse is a medical problem, not a criminal one. All opiates should be legalized and safe doses prescribed. Education, as in tobacco and alcohol abuse, is the only solution.