DEA Struggles to Keep Pace as "Bathtub Chemists" Create One New Synthetic Drug After Another

DEA Struggles to Keep Pace as "Bathtub Chemists" Create One New Synthetic Drug After Another

By Dorri Olds 12/09/16

These chemicals mimic drugs that come from nature. But monkeying around with chemicals can rot your liver, cause kidney failure and send you into a seizure.

Image: 
Colored test tubes with warning labels.
The FDA can't keep up with every compound that escapes the lab.

Seven months ago, two emergency medical services workers arrived to find my husband passed out on the floor from a heroin overdose. The scene was chaotic. All I knew at that point was that he was unconscious. I screamed to a member of the building staff, “Call 911!” When the EMT workers arrived, they lifted him and discovered a used needle lying on the floor where his crumpled body had been.

Once he was secured into their vehicle, the female EMT walked determinedly towards me on the sidewalk. With a tremble of fear and anger in her voice she said, “Next time you call 911, report that an IV user has AIDS. If the spike had pierced my skin, it would’ve put my life in danger.”

My heart raced and I burst into tears, “I didn’t know about the needle!” I cried. “He’d been sober for 17 years.”

After that heroin overdose, he’d injured himself so badly that he needed surgery. The ER doctor gave him fentanyl in the recovery room. I begged the doctor for another solution but he whisked me out the door saying, “Don’t worry, standard procedure.”

Sadly, my husband confessed later that his relapse began a month earlier, right after a doctor gave him one Xanax for anxiety during a consultation. As he continued to use and had a few more close calls, I began to panic. I thought of all the heroin that has been cut with fentanyl and all of the prescription pills — Vicodin, Xanax, Percocet — that he’d gotten from the various doctors each time I got him to a hospital.

With opioid overdoses at staggering numbers and no solution in sight, another contributor to this mounting crisis is the growing list of synthetic drug compounds. Amateur “bathtub” chemists are busy making and selling designer drugs while the legal system struggles to keep up.

First a drug must be identified, then there is a time lag before newly discovered chemicals can be banned. Meanwhile, there seems to be an endless list of ingredients that are being sold legally just by including a warning: Not for human consumption.

This year, NMS Labs, a major private facility outside Philadelphia, has reported 105 overdose deaths related to the synthetic opioid U-47700, aka "Pink." It is eight times the strength of heroin.

As of Monday, November 14, the Drug Enforcement Administration (DEA) published in the Federal Register a Final Order to temporarily add Pink, in all forms — including ethers and salts — to Schedule I of the Controlled Substances Act. The DEA is allowed to ban drugs for two to three years when there is reason to believe it is an immediate threat to public safety.

U-47700 dates back to 1973 when Jacob Szmuszkovicz, a scientist working for Upjohn Pharmaceutical Company, was asked to create a pain reliever similar to morphine but without the risk of addiction and danger of slow breathing. But after testing it on mice, U-47700 showed it had the same negative effects as morphine. Upjohn still valued it for research and patented it, but it was never tested on humans.

The Fix spoke to Dr. Gerald O’Malley, a board-certified emergency medicine physician, medical toxicologist, and author of over 100 scientific papers related to medicine and toxicology.

Dr. O’Malley said, “When you talk about the most common modified drugs you’re actually talking about chemicals that people have developed over the years to manipulate certain receptors in the body. They mimic drugs that come from nature. But monkeying around with chemicals can rot your liver, cause kidney failure and send you into a seizure.”

It’s easy to whip up methamphetamine, according to Dr. O'Malley. A young guy was even caught on a New York City subway with a meth lab in his backpack. Flakka, another type of stimulant, is a chemical cousin of cathinone, the amphetamine-like drug found in what’s sold as “Bath Salts.”

In 1984, chemistry professor John W. Huffman and a team of researchers began developing synthetic cannabinoid compounds that were similar to marijuana. They were created for research on multiple sclerosis, HIV/AIDS and chemotherapy. He came up with 450 options. They were all named after him using the initials JWH.

Huffman developed these drugs only for scientific research of diseases. But, almost two decades later, some of his drugs began showing up in clubs in Europe with the names Spice and K2.

“The chemicals had somehow gotten out of the lab,” said O’Malley, “and people began using them for their hallucinatory and stimulant effects. They caused seizures, blood clots, and kidney failure. There’s no quality control and no Federal Drug Administration oversight. No one is checking the amount of a drug that exists in each dose. Some kid in a T-shirt in a garage somewhere starts spraying chemicals all over dried vegetable materials. Then mixes it up, puts it into little packets, and sells it.”

So, somebody buys a packet of K2, or any of the other 500-plus names for synthetic marijuana, smokes a joint, and has fun. They go back and buy another package from the same seller without knowing that this time it was made with different materials.

The Centers for Disease Control and Prevention (CDC) publishes frequent reports in its Morbidity and Mortality Weekly Report (MMWR). It offers a weekly review of new dangers in the drug world.

O’Malley said, “You’ll read about a virus outbreak in Arizona, or lead contamination in Michigan, or a new batch of altered marijuana in New York that left 40 people permanently blind because someone added legal but dangerous chemicals like windshield wiper fluid.”

One of the most frightening chemicals is levamisole. It is a veterinary product for deworming animals that is often mixed with cocaine. “When the DEA makes a bust,” O’Malley said, “they find 85% of the confiscated cocaine in the U.S. is contaminated with levamisole. It causes inflammation of your blood vessels. Horrible stuff.”

If you Google "levamisole and cocaine," dozens of grotesque images fill your screen—blackened ears and toes, noses rotted off, angry red skin lesions covering legs, arms, backs. I had no idea how lucky I was. For years, I snorted and shot coke.

There are many conflicting views on what should be banned and what should be legal. O’Malley said, “With legalized marijuana, there’s a lie that’s been perpetuated by those that are making all the money. It is a drug and you have to treat it like a drug. The THC content of some products can approach 70% to 80%. That’s not your dad’s marijuana. The joint you smoked in high school might have contained 10% to 15% THC.”

National Center on Addiction and Substance Abuse CEO Dr. Samuel Ball said in a video posted by Tech Insider that the risks of legalizing marijuana outweigh the possible benefits. "While it may be safe for some adults to be using [marijuana] in a controlled way, for teens it really isn’t because the brain is still developing and it is much more susceptible to addiction."

O’Malley agreed: “Seth Rogen and all of these guys running around smoking pot all day, they have the ability to still remain creative because when you have 10 or 15 people on your creative team, yeah, you can still maintain some level of creativity and still smoke every day. But if you’re a 15-year-old high school kid and you’ve got a term paper due next week and you get high every day, guess what, you’re not going to write the term paper.”

Kent Runyon of Novus Medical Detox Center sees promise in new state laws that will outlaw any drug that mimics an already illicit substance. “Banning broader classes of drugs is the only way to prevent manufacturers from skirting the law with constant reformulation,” he told me. “It also means law enforcement can charge and convict those who make and sell the drugs.”

Runyon believes a long-term solution will require coordinated efforts across multiple fronts; beyond new laws, he calls for public education and expanded access to drug treatment.

“What we’re trying to get both practitioners and patients away from,” he said, “is making opioids the first choice for pain, whether it’s a dental procedure, or other minor medical procedures. In the past, no interim steps were taken before jumping to an opioid solution.”

After six hospital stays, including two detoxes, my now ex-husband is in a methadone program. I’m not feeling optimistic. I’ve seen many heroin addicts go that route and they appear just as wobbly on methadone as they did on heroin. They still slur words and nod out during a conversation.

Runyon said, “If a methadone clinic is doing good work, a patient should not behave that way. Methadone should be given at a moderate dose to prevent withdrawal and allow the patient to function. The problem is that addicts often take drugs on top of the methadone. Their underlying mental addiction makes them continue to chase euphoria. That’s why any medication-assisted treatment should always be done in conjunction with counseling and therapy.”

O’Malley said, “You have these very powerful and addicting pills like Vicodin and Percocet floating around, unsupervised. You have these waxes, candies and brownies that are 70% THC. You get a patient rolled into the ER, they are unconscious, their heart rate is 140 and their blood pressure 290 over 130, their pupils are pinpoints. All these conflicting symptoms and you don’t know what’s going on because you don’t know what they took. They don’t know what they took. And if one chemical is banned, there will always be another. Heck, even brake fluid.”

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Dorri Olds is an award-winning writer whose work has appeared in many publications including The New York Times, Marie Claire, Woman’s Day and several book anthologies. She is currently working on a book scheduled for release in 2019. Find Dorri on Twitter, Facebook, and LinkedIn.

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