Fentanyl, Inc.. Ben Westhoff
of the China White remained a mystery. Presumably, the recipe had been stolen from scientific literature published by Janssen scientists, and then the drug had been cooked up by rogue chemists. But no China White lab was ever seized, and no one was arrested. There were plenty of guesses, however, including some wild speculation from a famed psychedelic chemist and drug expert named Alexander “Sasha” Shulgin. “Had China been developing some super-potent fentanyl analogues as potential warfare agents? Let the fantasy roll,” he wrote in 1997. “Maybe the Chinese were using second class citizens (the drug-using population of California) as guinea pigs for the initial human trials of their new drugs.” Also suspected were scientists in Russia, which had developed fentanyl problems of its own.
China White represented a fish-crawling-onto-land moment: it was the first popular, illicit drug synthesized by a rogue chemist that was new, rather than simply a copy of something already on the medical market. And thus, alpha-methylfentanyl was the first in a long line of new psychoactive substances that came to include K2, Spice, “bath salts,” and all the other substances this book is about. Back before they were called novel psychoactive substances, or NPS, they were known by another name: designer drugs.
Calling alpha-methylfentanyl China White was smart marketing, as it evoked a desirable type of heroin. What truly helped the product stand apart, however, was the fact that it was legal. Fentanyl itself had been illegal for recreational use since 1971, as a schedule II drug.** And chemically alpha-methylfentanyl was almost identical. But the key word is almost. It wasn’t identical. It had a unique molecular design. And therefore the police were powerless. “You could walk around with a shopping bag full of it and nobody could do anything to you,” observed Robert J. Roberton, chief of the state of California’s Division of Drug Programs.
Other fentanyl variations followed on alpha-methylfentanyl’s heels. In the early 1980s, more troubling reports about users injecting drugs that weren’t quite heroin emerged from California. In 1982 a man named George Carillo was brought to a San José hospital practically immobile, and his girlfriend, Juanita Lopez, came in a week later, also suffering from stiffness, paralysis, and other symptoms similar to Parkinson’s, except Carillo and Lopez were too young to have the disease. A handful of other victims with similar symptoms were soon identified. Eventually their condition was traced back to a new opioid they had injected called MPPP, which was intended to imitate heroin but had been synthesized incorrectly, inadvertently creating a different substance, MPTP, with disastrous side effects. This story at least has a silver lining, as research on the victims catalyzed new discoveries leading to advancement in Parkinson’s research.
It took the DEA six months to schedule a new drug, and by that time new analogues were already popular on the streets. So in 1984 Congress granted the DEA emergency scheduling powers, so the agency could ban drugs immediately. But even this was insufficient to stop the new fentanyl analogues, which sometimes started killing people before the DEA had even heard of them.
And so the US government began regulating drugs that didn’t yet exist. The Federal Analogue Act was signed into law by President Ronald Reagan in 1986. The legislation specifically went after fentanyls and what would become known as designer drugs and NPS. It made anything deemed “substantially similar” to schedule I or II psychoactive drugs—in either effect or structure—automatically illegal the moment it came into being.
However, banning something “substantially similar” proved challenging. Just because chemicals have similar structures doesn’t mean they will affect the human body the same way; in fact, quite often the effects can be dramatically different. Further, the law aimed at psychoactive substances, but what constitutes psychoactive can be debated. A strong cup of coffee can have a powerful impact, as can large amounts of chocolate and sugar.***
The US Federal Analogue Act is still used to prosecute makers of analogue drugs, yet little evidence exists that it has had a strong deterrent effect. In fact, since its enactment the number of new analogue drugs being consumed by Americans has skyrocketed. Most NPS are made in China, and since China lacks an analogue act of its own, drugs there usually must be banned one at a time, as they are discovered. (There are three United Nations international drug treaties—from 1961, 1971, and 1988, to which China, Russia, the United States, and most other world powers are signatories—and they also operate the same way, without an analogue act.) Thus, brand-new drugs that are automatically covered by US laws start off perfectly legal for manufacture and export in China, although in 2019 the country banned all fentanyl analogues.
The United States seems just as susceptible to new drugs as countries like Sweden, which lacks an analogue act. While Sweden has been devastated by dangerous analogues such as cyclopropylfentanyl, acrylfentanyl, and acetylfentanyl, the United States has been hit particularly hard by carfentanil, the veterinary tranquilizer that can be one hundred times more potent than fentanyl and five thousand times more potent than heroin. Carfentanil was responsible for killing more than eleven hundred Ohio residents between July 2016 and June 2017 alone.
At this point in the cat-and-mouse game between legislators and rogue chemists, warns Julijan “Sidney” Picej (an expert on new drugs who is from Ljubljana, Slovenia), the rogue chemists are so desperate for new products that they’ll try anything. “Good combinations are long gone. Their approach to finding a new flagship product is, ‘Anything goes, as long as it’s not fatal if you use it the first three times,’ ” he said. “It’s difficult for users and researchers to get any info, since the molecule was literally synthesized for the first time three weeks ago.”
In the mid-1980s, it wasn’t clear whether these types of “synthetic heroin” would become a plague or simply fade away. A University of California at Davis pharmacology professor named Gary Henderson studied the chemical impurities in China White and concluded that a single chemist was responsible for all of it. “Most likely he made a few grams of the drug—millions of doses—and then shut up his shop,” he told journalist Jack Shafer in 1985.
Henderson became the scientist doctors turned to when their overdose patients had strange blood samples, and the DEA consulted when it turned up inscrutable chemicals. He had already been researching fentanyl for years; his lab focused on how it was used to dope racehorses, whose urine turned up traces of it. He worked to develop a technique to identify fentanyl and began to understand the nature of the drug, including its potential for chemical manipulation. “Perhaps hundreds,” he said, when asked how many fentanyl analogues would be possible. “Maybe thousands.”
Henderson was way ahead of his time when it came to predicting the horrors not just of fentanyl but of NPS generally. “It seems we are still watching reruns of The French Connection while there is someone out there using a computer to search the chemical literature looking for new drugs to synthesize,” he told the US Senate’s Budget Committee in July 1985, a statement that was remarkably prescient. He coined the phrase designer drugs, defining them as “substances where the psychoactive properties of a drug are retained, but the molecular structure has been altered to avoid prosecution.” Often synthesized from common chemicals, they were skillfully marketed under attractive, exotic names, he added. His ١٩٨٨ paper “Designer Drugs: Past History and Future Prospects” is nothing less than prophecy, speculating accurately not just on the future of NPS chemistry but on the implications for law enforcement. “In the view of this author,” he wrote, “it is likely that the future drugs of abuse will be synthetics rather than plant products. A single gram of any very potent drug could be synthesized at one location, transported to distribution sites worldwide, and then formulated (cut) into many thousand, perhaps a million, doses. . . . Preventing the distribution of such small amounts of the pure drug will be exceedingly difficult. . . . In fact, any success we may have in curtailing the distribution of natural products such as opium, coca, and marijuana and preventing the diversion of pharmaceuticals will only stimulate the development of potent synthetic substitutes.”
*** Schedule I drugs have “no currently accepted medical use and a high potential for abuse,” while Schedule II drugs have “a high potential for abuse, with use potentially leading to severe psychological or physical dependence,” according to the DEA.