Emerging Drug Threats and the Whac-a-Mole Theory

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Emerging Drug Threats and the Whac-a-Mole Theory

By Troy Farah 08/22/17

"What does it mean if there are more seizures of fentanyl? ... The metric that should be used is, are we reducing overdose deaths? By that metric, law enforcement and the DEA are failing."

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boy plays whac a mole carnival game
As soon as one drug is made illegal, another similar chemical pops up to take its place.

Every quarter, the federal agency tasked with surveilling American citizens, countering drug smuggling and enforcing the Controlled Substances Act, releases a report detailing their most unique narcotic seizures. The Drug Enforcement Administration's Emerging Threat Reports can be seen as a snapshot of the rising tide of synthetic drugs in the United States—but critics say these reports are too focused on supply and not enough on demand.

Melvin Patterson, a spokesperson for the DEA, says their Special Testing and Research Laboratory discovers new psychoactive substances (NPS) on a “probably weekly” basis.

“Sometimes it’s more lethal, sometimes it’s less lethal,” Patterson told The Fix in a phone call. “[The reports are] a good source of information to get your thumb on the pulse of what’s happening.” 

Records only date back to the first quarter of 2016, but last year’s annual analysis offered some stunning statistics, including 1,299 identifications of fentanyl, fentanyl analogues and other new opioids, accounting for 68 percent of total IDs. Of the 15 distinct fentanyl analogues discovered, 60 percent were identified for the first time.

The DEA has also been discovering more synthetic cannabinoids, drugs similar to cannabis molecules, and cathinones, a class of stimulants sometimes generically referred to as “bath salts.” Also contained in the report are a smattering of hallucinogens and tryptamines, as well as 43 unconfirmed substances.

However, for the general public, these Emerging Threat Reports may be hard to interpret. The PDFs are generally short—only a page or two—and other than categorizing chemicals by class, they don’t describe much beyond that, including the pharmacology of the drug or potential side effects.

Most people probably haven’t heard of substances like dibutylone or etizolam, so they may just see their names as a jumble of alphabet soup.  Even if grandma has heard of “zombie-like” mass overdoses caused by something like AMB-FUBINACA, a synthetic cannabinoid, what is she supposed to do with this info?

Michael Collins, Deputy Director of the Drug Policy Alliance, says these reports use misleading metrics by focusing on seizures. “What does it mean if there are more seizures of fentanyl?” he asked in a phone call. “Does it mean there is less fentanyl on the street or does it mean there is more fentanyl coming in? Does it mean that we’re getting all the fentanyl that’s coming in [or] does it mean we’re getting not enough? It’s just not really clear.”

“The metric that should be used is, are we reducing overdose deaths?” Collins adds.  “By that metric, law enforcement and the DEA are failing.”

Indeed, fatal synthetic drug overdoses are at an all-time high in the U.S., especially from opioids. Death tolls from synthetic opioids (not including methadone) jumped 72.2% between 2014 and 2015 alone.

The vast majority of these substances appear to come from China and India, where loose regulations and cheap labor allow for massive distribution of psychoactive chemicals or their precursors. Even Mexican drug traffickers are getting their fentanyl and methamphetamine from Asian labs.

Patterson says DEA discoveries of new psychoactive substances—that is, chemicals previously unheard of in black markets that could pose a health threat—are on the decline, while synthetic drug use in general continues to rise. He attributes the downturn to pressure put on China to control 116 substances, including 39 synthetic cannabinoids, in September 2015.

“Up until that point, each week we were just seeing more and more and more—that’s where everybody came up with the Whac-A-Mole Theory,” Patterson explains. “Because you know, you prosecute one thing or you just get something controlled and then—boom!—another drug or psychoactive substance would pop up, and it would be chemically just a little different.”

The Whac-A-Mole Theory is a term used by many to describe the way clandestine drug labs have kept ahead of law enforcement by slightly tweaking psychoactive molecules into drugs that aren’t yet scheduled. As soon as one drug is made illegal, another similar chemical appears on black or gray markets.

In January 2017, DEA Administrator Chuck Rosenberg visited China to persuade authorities into banning four fentanyl analogues, including the elephant tranquilizer carfentanil. But Patterson says Americans probably won’t see the effects of this ban until December or early next year. He also adds that the Federal Analogue Act, passed in 1986, has helped drive a recent wave of prosecutions in the nation, which has driven down the variety—but not necessarily the volume—of drug busts.

But despite all this regulation and seizure, drug use and overdose deaths don’t show any signs of stopping—with at least 52,000 overdose casualties, last year was the worst on record. The next decade is projected to be even more deadly.

“There’s all this energy and resources into cutting off the supply of drugs, [but if] there’s one thing that history has shown us is that focus on the supply side is wrong-headed,” Collins says. “Every penny that goes to law enforcement, goes to the DEA, goes toward seizures, is money taken away from things that do work, like treatment and harm reduction.”

Collins says he would rather see funding spent on getting naloxone into the hands of drug users, expanding medication-assisted treatment such as buprenorphine and methadone, and even safe-injection facilities. In some corners of the world, these approaches have corresponded with dramatic decreases in drug abuse.

“One of the frustrating things about the current opioid epidemic is it’s an all-hands-on-deck moment,” Collins explains. “[But] the rhetoric around it is, ‘We’ve got to try every option, put every option on the table.’ And so often what states and the federal government are doing is basically doubling down on some of the policies that we know don’t work.”

Troy Farah is a journalist from the Southwest. His reporting has appeared in The Outline, VICE, Motherboard, LA Weekly and others. His website is troyfarah.com and he can be shadowed on Twitter.

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