Fourthly, fentanyl’s potency-to-weight ratio is a smuggler’s dream. America’s annual heroin consumption was estimated at 45 tonnes in 2019. (23) Fentanyl is 25 times more potent than heroin. Several passenger carloads could satisfy American illicit opioid needs for a year. Initially, fentanyl’s shorter-lasting buzz and horror-show morbidity turned-off older heroin consumers. They preferred heroin. Smugglers dictated the heroin-to-fentanyl transition.Rand avoids Big Pharma’s role in fentanyl’s rise. Rand discusses only fentanyl’s displacement of heroin, not legal opioid’s fostering of illegal opioid demand.Although legal fentanyl accounts for a small fraction of opioid abuse, it’s worth reminding that a huge legal fentanyl industry exists. Johnson & Johnson, Archimedes, Orexo and Teva manufacture tonnes of fentanyl pills, lozenges, lollipops and skin patches. In 2015 US doctors wrote 6.5 million prescriptions for fentanyl wares. (Political pressure lowered this to 2.5 million a year.) (24) Additionally, Pfizer sells a river of injectable fentanyl-citrate to hospitals for anesthesia and extreme pain relief. The Dark Web abounds with ads for stolen corporate fentanyl products. Diversion happens all along the supply chain. (25)
Fentanyl and Harm Reduction
Harm Reductionists blame the opiocalypse on fentanyl. This dodge begs three counter-points:
· Illicit fentanyl trafficking pre-dates Harm Reduction.
· For 50 years well-founded predictions of fentanyl’s imminent displacement of heroin were repeatedly made by narcotics experts to the oligarchic circles sponsoring Harm Reduction.
· IF Harm Reduction is failing because of the presence of fentanyl or other Novel Psychoactive Substances THEN Harm Reduction will forever fail because said commodities aren’t going away.
Footnotes
1. Rand Corporation. The Future of Fentanyl and Other Synthetic Opioids, 2019, p. 59.
2. Shulgin, Alexander. Drugs of Abuse in the Future, Clinical Toxicology, 1975
3. Westhoff, Ben. Fentanyl, Inc. How Rogue Chemists are Creating the Deadliest Wave of the Opioid Epidemic, Atlantic Monthly Press, New York, 2019, p. 37-41.
4. Ibid p. 43.
5. Rand p. 57-8 and 71.
6. Ibid p. 57-8 and 71.
7. Westhoff, p. 51.
8. Ibid p. 128-9.
9. Ibid p. 142-3.
10. Ibid p. 94; see also Rand p. 56.
11. Rand p. 60-1.
12. Ibid p. 58-9 and 62.
13. Ibid p. 62.
14. Ibid p. 62.
15. Ibid p. 62-3.
16. Drug Enforcement Administration (DEA). Fentanyl, January 2023; see also Rand p. 63.
17. Ibid; see also Rand p. 66.
18. Rand p. 68.
19. Westhoff p. 11.
20. Rand p. 70.
21. Ibid p. 65.
22. Westhoff p. 33 and 37-8.
23. Rand p. 70.
24. Drug Enforcement Administration. Fentanyl, January 2023
25. Westhoff p. 53.