Fentanyl, Inc.. Ben Westhoff
aerosol gas into the building, intending to knock out the hijackers before forcing their way in. The guerillas were killed, but so were about 120 of the hostages, who were already weakened by days without food or water. Some died en route to the hospital.
Though authorities initially declined to say what chemical agent had been used, the Russian health minister and a Russian newspaper later identified it as 3-methylfentanyl. Subsequent analysis of survivors’ clothing indicates it was possibly a chemical cocktail containing numerous drugs, including carfentanil.
Russia claimed that the gas used was nonlethal and intended to simply put both the rebels and the civilians to sleep. Though some praised the Russian effort for saving the majority of the hostages, many international observers criticized it as a type of chemical warfare that not only violated international treaties but also was based on foolhardy science.
“There is no way known to medical science that can put a large number of people to sleep without killing a sizable percentage of them,” said Harvard biology professor Matt Meselson. “In medicine you are dealing with one patient. You can see when he is asleep and, assuming your hand isn’t shaking too badly on the valve, you probably won’t kill him. But the military objective is different. You have to put 100 percent of the people to sleep—not 50 percent, not 70 percent—and you have to put them to sleep fast. There isn’t any way to do that effectively and safely.” Analysts continue to worry that fentanyls could be used in large-scale attacks, particularly by terrorists, considering that a tiny amount can do such damage. In January, 2019, Massachusetts senator Ed Markey wrote letters to the State and Defense Departments, warning of the possibility of such an attack on Americans. “To my knowledge, no such strategy exists at present for addressing the threat fentanyl poses,” he wrote.
In 1988, an international treaty scheduled 3-methylfentanyl—effectively outlawing it in much of the world—but by the early 2000s it had begun catching on as a street drug in Eastern and Northern European countries such as Estonia. The small former Soviet satellite, known for its brisk economic growth, already had a large heroin problem, but the heroin supply from Afghanistan was squeezed after the Taliban banned opium poppy farming in 2000. Fentanyl and 3-methylfentanyl began to take off, likely entering the country from Russia, which it borders. Over the next decade a thousand or more Estonians died from fentanyl and 3-methylfentanyl overdose, a startling number for a country of only 1.3 million.
Though the heroin supply has reemerged, the destruction from fentanyl and 3-methylfentanyl continues in Estonia. “The dealers realize it’s easier to traffic and package fentanyl than heroin . . . and so they strictly control the market in favor of fentanyl. Even though drug users themselves say they would prefer heroin, it’s simply not allowed [by dealers] in Estonian markets,” observed Aljona Kurbatova, head of the Infectious Diseases and Drug Abuse Prevention Department at Estonia’s National Institute for Health Development.
A 2016 study showed Estonia to have the highest increase in drug-overdose deaths in the world, and the entrenchment of fentanyl and 3-methylfentanyl there serves as a portentous warning for number two: the United States. Despite hopes that the crisis has peaked, experts believe fentanyl and its analogues could be just picking up speed. Fentanyl is also threatening to become an epidemic in other countries. Australia saw 232 deaths from synthetic opioids like fentanyl in 2017, and the number is believed to be surging. The UN Office on Drugs and Crime (UNODC) reported that the most common method of illicit fentanyl use in Australia seems to be extracting the drug from pharmaceutical products such as transdermal patches and that this is also the case in Germany. While Europe’s problem with fentanyl is smaller than North America’s, a sharp uptick in deaths indicates the crisis may also be spreading to the United Kingdom, which according to one survey buys more fentanyl from the Dark Web than any other European country.
Even aside from fentanyl, fentanyl analogues have triggered a crisis in some countries. In 2016, Sweden suffered forty-three deaths associated with acrylfentanyl, an analogue discussed in scientific literature during the 1980s but unknown in Sweden until it started killing people. In 2017 another analogue, cyclopropylfentanyl, caused more than seventy deaths there. Now, because of the fentanyl analogues, fentanyls as a class have displaced heroin as the number-one killer drug in the country. The analogues there are purchased almost entirely over the Internet, from China.
Other European and Eastern European countries are also starting to see fentanyls from China, but that’s a fairly recent development. Until recent years, European fentanyl was procured locally—stolen from pharmacies, for example, or harvested from patches in hospital waste—or received from Russia and its Eastern bloc neighbors.
Russia itself imports vast quantities of ecstasy and synthetic cannabinoids from China, and the country has widespread public-health problems with drugs including heroin and “bath salts.” Russia also harbors a huge psychonaut community, whose members create new drugs and discuss them on Internet message boards. It’s difficult to gauge whether Russia suffers from widespread fentanyl addiction, because its data reporting is very poor. The country has undoubtedly been producing the synthetic drug for a long time, however, both legally and illegally. Before the dissolution of the USSR, it was producing fentanyl for its army. “It was included as a painkiller in the emergency kits for Soviet Union soldiers,” said Roumen Sedefov of the European Monitoring Centre For Drugs and Drug Addiction. “After the Soviet Union collapse, we think there may have been huge stockpiles of fentanyl, in Lithuania and other countries, and a lot of it was diverted into Europe and sold on the illicit market. This may have fueled, partly, the epidemic here in Europe.” William Leonard Pickard, a famed LSD chemist now serving a life sentence for conspiring to manufacture and distribute LSD, studied the Russian fentanyl epidemic in the 1990s while a student at Harvard’s Kennedy School of Government. He uncovered Mafia-run laboratories in Azerbaijan, where chemists who were winners of the Russian chemistry olympiad synthesized fentanyls including 3-methylfentanyl. They were imprisoned, but he feared that other out-of-work chemists formerly employed by the Soviet Union could spread fentanyl far beyond the country’s borders.
The fentanyl analogue 3-methylfentanyl has never been used as a medical drug. There is no legitimate need for anyone to have it, with the exception of official forensic labs in places like Estonia, where tiny quantities are needed to verify the types of street fentanyl that are killing people. Still, numerous Chinese labs make it for illicit use.
Though 3-methylfentanyl has likely killed thousands of people, its inventor, Thomas Riley, who died in 2005, appears to have been unaware of the fallout. His widow, Phyllis Riley, doesn’t believe he knew the drug was used illicitly. One of his former colleagues, retired University of Mississippi pharmacology professor Marvin Wilson, was Riley’s coauthor, along with Danny B. Hale, of a 1973 paper about 3-methylfentanyl published in the Journal of Pharmaceutical Science. Wilson acknowledged, to me, that drug peddlers could have learned about 3-methylfentanyl from their paper. “Chemists of the [DEA] believe that any competent chemist could make the substance after reading Dr. Riley’s description in the chemical literature,” concurred a 1980 New York Times article on the subject. Wilson recalled they weren’t much concerned with its abuse potential. “Because it was so potent, a lot of us at the time thought that it probably won’t get into the abuse channels, because it would be so potentially dangerous, and small changes in the dose could have dramatic effects on the body. We weren’t thinking of it as a new heroin.”
The conflict between legitimate medical science and illicit drug chemistry has come to the forefront as NPS have spread. Not just fentanyls, but deadly hallucinogens, synthetic cannabinoids, fake ecstasy, and other stimulants have all gotten their starts in scientific labs. Academics say nothing can stop legitimate scientific creations from crossing over into the realm of abuse—without stifling science. Nonetheless, the trend has caused some outraged family members of overdose victims to demand that the university-sanctioned creators of these drugs be held accountable.
“We as scientists just haven’t been able to differentiate the receptors that lead to abuse from those that are associated with the analgesic,” Wilson laments. “And that’s a conundrum. Scientists come up with knowledge, and people choose to use that knowledge in different ways. Some beneficial, and some not so beneficial. But to not continue the scientific endeavor, certainly is not a good option for mankind either.”