Quasi-legal drug 15 times stronger than heroin
Emergency physicians should expect an upswing in what on the surface appears to be heroin overdoses , but are actually overdoses tied to acetyl fentanyl, an opiate that is mixed into street drugs marketed as heroin , a new study suggests.
What is frightening about this emerging street drug is that users themselves may not be aware that they are ingesting it. Acetyl fentanyl is an opiate analgesic with no recognized medical use. It is 5 to 15 times stronger than heroin. Users typically inject it intravenously as a direct substitute for heroin or pharmaceutical grade opioids ,though many are unaware that what they are consuming is not plain heroin . A user who injects pure acetyl fentanyl may suffer severe consequences because of its extraordinary potency.
Acetyl fentanyl is not specifically regulated though it qualifies as an analogue of fentanyl (a medical opiate ). Thus, it exists in a legal grey area in that it is considered illicit for human consumption but if a package is labeled “not for human consumption ” the product is technically legal. A large quantity of acetyl fentanyl would potentially be immune to regulation as long as it was titled, labeled and
stored as a product with industrial or non human purposes.
“Clever ” and well informed drug distribution networks will likely take advantage of the legal loophole and profit by replacing or cutting a highly regulated drug with less regulated one .
One of the many downsides of illegal drugs is you just can’t trust your drug dealer. The trend of adulterants being worked into street drugs to make them more potent is dangerous. The significant potential for overdose of acetyl fentanyl necessitates more medical research and policy reform.
The American College of Emergency Physicians , August 18,2014.