Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic. It is 20 to 40 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic and Sublimaze, among others.
The Drug Enforcement Administration (DEA) is a United States federal law enforcement agency under the U.S. Department of Justice tasked with combating illicit drug trafficking and distribution within the U.S. It is the lead agency for domestic enforcement of the Controlled Substances Act, sharing concurrent jurisdiction with the Federal Bureau of Investigation, the U.S. Immigration and Customs Enforcement, and U.S. Customs and Border Protection. However, the DEA has sole responsibility for coordinating and pursuing U.S. drug investigations both domestically and internationally.
A drug overdose is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically it is used for cases when a risk to health will potentially result. An overdose may result in a toxic state or death.
Speedball, powerball, or over and under is the polydrug mixture of a stimulant with a depressant, usually an opioid. The most well-known mixture used for recreational drug use is that of cocaine and heroin; however, amphetamines can also be mixed with morphine and/or fentanyl. A speedball may be taken intravenously or by nasal insufflation.
Carfentanil or carfentanyl, sold under the brand name Wildnil, is an extremely potent opioid analgesic used in veterinary medicine to anesthetize large animals such as elephants and rhinoceroses. It is typically administered in this context by tranquilizer dart. Carfentanil has also been used in humans to image opioid receptors. It has additionally been used as a recreational drug, typically by injection, insufflation, or inhalation. Deaths have been reported in association with carfentanil.
Xylazine is a structural analog of clonidine and an alpha-2 adrenergic receptor agonist, sold under many trade names worldwide, most notably the Bayer brand name Rompun, as well as Anased, Sedazine and Chanazine.
Lacing or cutting, in drug culture, refer to the act of using a substance to adulterate substances independent of the reason. The resulting substance is laced or cut.
The drug policy in the United States is the activity of the federal government relating to the regulation of drugs. Starting in the early 1900s, the United States government began enforcing drug policies. These policies criminalized drugs such as opium, morphine, heroin, and cocaine outside of medical use. The drug policies put into place are enforced by the Food and Drug Administration and the Drug Enforcement Administration. Classification of Drugs are defined and enforced using the Controlled Substance Act, which lists different drugs into their respective substances based on its potential of abuse and potential for medical use. Four different categories of drugs are Alcohol, Cannabis, Opioids, and Stimulants.
Medetomidine is a veterinary anesthetic drug with potent sedative effects and emerging illicit drug adulterant.
The Sinaloa Cartel, also known as the Guzmán-Zambada Organization, the Federation, the Blood Alliance, or the Pacific Cartel, is a large, international organized crime syndicate based in the city of Culiacán, Sinaloa, Mexico that specializes in illegal drug trafficking and money laundering.
The US federal government is an opponent of the illegal drug trade; however, state laws vary greatly and in some cases contradict federal laws.
U-47700, also known as U4, pink heroin, pinky, and pink, is an opioid analgesic drug developed by a team at Upjohn in the 1970s which has around 7.5 times the potency of morphine in animal models.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. It has been called "one of the most devastating public health catastrophes of our time". The opioid epidemic unfolded in three waves. The first wave of the epidemic in the United States began in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The second wave was from an expansion in the heroin market to supply already addicted people. The third wave starting in 2013 was marked by a steep 1,040% increase in the synthetic opioid-involved death rate as synthetic opioids flooded the US market.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
The United States Centers for Disease Control and Prevention has data on drug overdose death rates and totals. Around 1,106,900 US residents died from drug overdoses from 1968 to 2020, around 932,400 from 1999 through 2020 and around 93,700 in 2020. Of every 100,000 people in 2020 in the US, drugs killed 28. Opioids were involved in around 80,400 of the around 109,200 deaths in 2021. Synthetic opioids other than methadone were involved with 70,601 deaths in 2021. Around 111,000 people died in 2022. Around 108,300 in 2023.
Harm reduction consists of a series of strategies aimed at reducing the negative impacts of drug use on users. It has been described as an alternative to the U.S.'s moral model and disease model of drug use and addiction. While the moral model treats drug use as a morally wrong action and the disease model treats it as a biological or genetic disease needing medical intervention, harm reduction takes a public health approach with a basis in pragmatism. Harm reduction provides an alternative to complete abstinence as a method for preventing and mitigating the negative consequences of drug use and addiction.
New Jersey's most recent revised policy was issued September 7, 2022 pursuant to P.L.2021, c.152 which authorized opioid antidotes to be dispensed without a prescription or fee. Its goal is to make opioid antidotes widely available, reducing mortality from overdose while decreasing morbidity in conjunction with sterile needle access, fentanyl test strips, and substance use treatment programs. A $67 million grant provided by the Department of Health and Human Services provides funding for naloxone as well as recovery services. This policy enables any person to distribute an opioid antidote to someone they deem at risk of an opioid overdose, alongside information regarding: opioid overdose prevention and recognition, the administration of naloxone, circumstances that warrant calling 911 for assistance with an opioid overdose, and contraindications of naloxone. Instructions on how to perform resuscitation and the appropriate care of an overdose victim after the administration of an opioid antidote should also be included. Community first aid squads, professional organizations, police departments, and emergency departments are required to "leave-behind" naloxone and information with every person who overdosed or is at risk of overdosing.
Since 2017, the number of fatalities in California attributable to synthetic opioids has increased by 1,027%. Fentanyl has been to blame for 20% of deaths among California's teenagers and young adults. California is taking legal efforts to tackle the opioid issue, including patrols, assistance grants, and education.
Daniel Chretien Comeaux is an American federal agent who currently serves as Special Agent in Charge (SAC) of the Drug Enforcement Administration's (DEA) Houston Field Division since 2021. Comeaux leads the DEA's efforts in 12 offices spanning 118,000 square miles across Texas, which encompasses over 16 million people.
Hanhong Pharmaceutical Technology Co. is a Chinese drug manufacturer. The company, its owner Du Changgen and some of its employees are indicted by the United States Justice Department for crimes relating to fentanyl, xylazine and methamphetamine production, distribution of synthetic opioids, and sales resulting from precursor chemicals. The indictments accuses Hanhong of exporting large quantities of fentanyl precursors and non-opioid additives like xylazine, to drug traffickers in Mexico and the United States. Its owner Du Changgen is the head of the Du Transnational Criminal Organization, which is listed on the United States Attorney General’s Consolidated Priority Organization Target (CPOT) list, which according to the DEA is a list of the leaders of the most prolific drug trafficking and money laundering organizations, having the greatest impact on the United States illicit drug supply.
