WEBVTT - Fentanyl: Actually As Dangerous As They Say 0:00:01.440 --> 0:00:07.720 Welcome to Stuff You Should Know, a production of iHeartRadio. 0:00:11.920 --> 0:00:14.160 Hey, and welcome to the podcast. I'm Josh, and there's 0:00:14.240 --> 0:00:16.119 Chuck and Jerry's here too, and this is Stuff you 0:00:16.160 --> 0:00:18.520 Should Know, the Big Bummer Edition. 0:00:19.320 --> 0:00:23.079 Yeah, not very joky, because we're talking about fentanyl. 0:00:22.760 --> 0:00:23.000 And. 0:00:24.480 --> 0:00:27.960 While a great pain killer, a very effective painkiller, it 0:00:28.000 --> 0:00:30.240 has sadly become the most deadly street drug in the 0:00:30.320 --> 0:00:34.240 United States. And we're going to tell you how that happened. 0:00:34.760 --> 0:00:39.279 Yes, but there's slight silver lining. It is possible that 0:00:39.360 --> 0:00:43.159 it is so deadly and so dangerous that it's actually 0:00:43.240 --> 0:00:46.560 created a decline in its use. At the very least 0:00:46.720 --> 0:00:51.320 a decline in deaths from it has taken place. So 0:00:51.360 --> 0:00:54.520 it is on the decline at least deaths, and we'll 0:00:54.520 --> 0:00:57.640 talk about possibly why that is later on. But yeah, 0:00:57.680 --> 0:01:00.440 we'll talk about the origin of fentanyl. For those of 0:01:00.440 --> 0:01:05.000 you who don't know, it's a synthetic opioid. First, there 0:01:05.040 --> 0:01:07.720 was morphine, which is I think basically one hundred percent 0:01:07.760 --> 0:01:13.280 processed natural opium. Heroin is a kind of a combo 0:01:13.480 --> 0:01:18.640 hybrid between synthetic and natural, and then fentanyl is just 0:01:18.720 --> 0:01:22.200 straight up like a like it just made up. It's 0:01:22.240 --> 0:01:26.559 an analog and it's way more potent than anything anyone 0:01:26.600 --> 0:01:28.600 had ever seen before when it came on the scene. 0:01:29.319 --> 0:01:32.720 Yeah, like a hundred times more potent than morphine, fifty 0:01:32.760 --> 0:01:36.200 times more potent than heroin. Created by a gentleman named 0:01:36.200 --> 0:01:39.680 Paul Janson of the Jansen Company in Belgium, and it 0:01:39.760 --> 0:01:44.039 was originally developed as an intravenous anesthetic, like for surgery. 0:01:44.800 --> 0:01:49.720 And they started out with a synthetic opioid as the 0:01:49.760 --> 0:01:55.400 base called my paradine I guess, and that was developed 0:01:55.400 --> 0:01:57.560 in the nineteen thirties. And so they had this sort 0:01:57.600 --> 0:02:00.760 of my paradiine as the base. They change it around 0:02:00.800 --> 0:02:03.480 a little, I'll alter the chemical structure a little bit, 0:02:03.560 --> 0:02:07.080 because what they wanted was something that had fewer negative 0:02:07.080 --> 0:02:10.960 side effects, something that was safer to use, and they 0:02:11.080 --> 0:02:14.079 were able to do that with fentanyl. I mean it, 0:02:14.880 --> 0:02:17.440 you know, initially worked great. It was had a very 0:02:17.440 --> 0:02:21.080 fast onset, had a very high therapeutic index, which is 0:02:21.080 --> 0:02:24.320 how they measure like the ratio between how effective a 0:02:24.360 --> 0:02:27.400 dose is and how how you could get to a 0:02:27.400 --> 0:02:30.480 toxic dose. So if you've got a high number and 0:02:30.560 --> 0:02:32.960 a greater difference, then that's good. 0:02:33.280 --> 0:02:35.959 Right, And one of the things. I just want to 0:02:36.000 --> 0:02:39.639 say that they messed around with molecularly to make fentanyl. 0:02:40.320 --> 0:02:44.080 They increased its fat solubility, which sounds like who cares, 0:02:44.600 --> 0:02:47.919 But that has two really important effects that make fetanyl 0:02:48.000 --> 0:02:51.280 what it is. One, it allows the drug to cross 0:02:51.320 --> 0:02:55.400 the blood brain barrier faster, which means fentanyl has a 0:02:55.480 --> 0:02:58.960 much faster onset than heroin or morphine. Right, it just 0:02:59.040 --> 0:03:03.360 hits you much fast, and then it crosses back through 0:03:03.400 --> 0:03:06.800 the blood brain barrier more quickly, so the duration of 0:03:06.840 --> 0:03:10.040 the high that you get lasts a shorter time. So 0:03:10.320 --> 0:03:14.840 just that one little tweak fat solubility made this drug 0:03:14.919 --> 0:03:18.960 what it is, because faster onset makes it addictive. Shorter 0:03:19.080 --> 0:03:21.040 duration means that you need to do more. 0:03:22.000 --> 0:03:23.920 Yeah, And then I don't think I've mentioned, but it 0:03:23.919 --> 0:03:26.680 was nineteen sixty was when it first came on the scene. 0:03:27.440 --> 0:03:30.239 Europe starting using it in sixty three. Came to the 0:03:30.360 --> 0:03:34.000 US in sixty eight and approved by the FDA only 0:03:34.520 --> 0:03:39.920 by combining it with a tranquilizing drug called draperidol, because 0:03:39.960 --> 0:03:42.920 they said, you know that combination makes it even a 0:03:42.960 --> 0:03:45.240 lower potential for abuse, so you have to use it 0:03:45.240 --> 0:03:47.640 with that. But over time, that kind of waned, and 0:03:47.680 --> 0:03:50.960 those limitations were lifted little by little until we got 0:03:50.960 --> 0:03:54.280 to the mid nineteen eighties when they had, you know, 0:03:54.440 --> 0:03:58.880 cheaper generic versions available, and it was pretty commonly used 0:03:58.920 --> 0:04:03.160 in surgery, like post surgical recovery with like skin patches 0:04:03.200 --> 0:04:05.560 and lozenges and stuff like that for pain management. 0:04:05.920 --> 0:04:09.200 Yeah, I think still today it's the most common opioid 0:04:09.360 --> 0:04:14.560 used for anesthesia during surgery. And that just sounds like 0:04:14.720 --> 0:04:19.359 madness when you're familiar with fentanyl, the street version, but 0:04:19.520 --> 0:04:23.880 in the hands of like a really well trained anesthesiologist 0:04:23.960 --> 0:04:28.560 with hospital great equipment, it's actually very safe. It's the 0:04:28.600 --> 0:04:30.880 fact that the stuff that you buy in the street 0:04:31.240 --> 0:04:37.560 has a very uneven like dosages means that's why it's 0:04:37.640 --> 0:04:41.440 just so deadly because you're not a trained anesthesiologist, you're 0:04:41.480 --> 0:04:44.480 not using hospital grade equipment. You're shooting up something that 0:04:44.520 --> 0:04:48.040 some dude sold you, and it's just it's just not 0:04:48.120 --> 0:04:50.640 trustworthy and it can kill you because it takes such 0:04:50.640 --> 0:04:53.200 a small amount to create a toxic dose. 0:04:53.839 --> 0:04:59.520 Yeah, it will produce relaxation, feelings, pleasure, sleepiness. You can 0:04:59.560 --> 0:05:06.679 also get nauseous, dizziness, confusion, vomiting, uritary retention, breathing issues, 0:05:06.800 --> 0:05:09.600 as we'll see later on. That's you know, basically why 0:05:09.640 --> 0:05:14.480 you usually od, it's because of breathing issues, and besides 0:05:14.600 --> 0:05:17.880 the overdose risk, which is great, you could also have 0:05:17.920 --> 0:05:22.680 a heart attack, heart failure, mood disorders, immune system problems. 0:05:23.640 --> 0:05:26.279 For all these reasons. It's a schedule two narcotic with 0:05:26.320 --> 0:05:27.719 a high potential for abuse. 0:05:27.960 --> 0:05:31.240 Just a reminder marijuana's Schedule one. 0:05:31.480 --> 0:05:35.800 Yeah, exactly. And most of what we're going to be 0:05:35.800 --> 0:05:39.560 talking about is sort of the illegal, illicitly produced market. 0:05:40.200 --> 0:05:43.320 But there are fentanyl users that do get like the 0:05:43.360 --> 0:05:46.200 real stuff from I'm not sure how they get it, 0:05:46.240 --> 0:05:49.560 whatever connection they have, and they'll just have to you know, 0:05:49.600 --> 0:05:51.240 it's not like in a pill or a powder, so 0:05:51.279 --> 0:05:53.200 it'll be like a patch or something that they might 0:05:53.279 --> 0:05:56.560 freeze and hold in their mouth, or they might remove 0:05:56.640 --> 0:05:58.919 the gel and then eat it or inject it or 0:05:58.960 --> 0:06:02.200 something like that. But usually what we're talking about, the 0:06:02.200 --> 0:06:05.440 really dangerous stuff is the powders and the pills that 0:06:05.480 --> 0:06:08.359 are being made illegally and either brought into this country 0:06:08.880 --> 0:06:10.920 or being made in this country, but usually brought into 0:06:11.000 --> 0:06:11.520 this country. 0:06:11.880 --> 0:06:15.840 Yes, and there's different kinds of different analogs of fentanyl 0:06:17.040 --> 0:06:19.800 that everybody just kind of puts under the umbrella of 0:06:19.839 --> 0:06:22.640 fentanyl when you're talking about illicit fentanyl. But two of 0:06:22.680 --> 0:06:26.480 them that stand out that aren't actually illicit, but they're 0:06:26.600 --> 0:06:30.520 used in the drug market as car fetanyl, which is 0:06:31.040 --> 0:06:34.080 used there's no use for it in humans. They use 0:06:34.080 --> 0:06:38.960 it to sedate rhinoceroses and elephants, and I think it's 0:06:39.000 --> 0:06:42.720 something like ten thousand times more potent than morphine. You 0:06:42.760 --> 0:06:45.680 can get that on the street apparently, although I think 0:06:45.720 --> 0:06:48.280 it's fairly rare. And then sue feentanyl is five to 0:06:48.320 --> 0:06:52.440 ten times stronger than fentanyl. So if you like people 0:06:52.440 --> 0:06:54.720 aren't like it's car fetanyl or sue fentanyl, you're talking 0:06:54.760 --> 0:06:55.560 about fentanyl. 0:06:56.440 --> 0:06:58.960 Yeah, exactly. It doesn't necessarily mean it's the same exact 0:06:59.080 --> 0:07:04.359 chemical structure. It's just sort of a catch all like pitbull, sure, 0:07:05.279 --> 0:07:09.000 the singer no no, no pitbull the dog breed, which 0:07:09.040 --> 0:07:10.119 isn't really a dog breed. 0:07:10.560 --> 0:07:11.240 I didn't know that. 0:07:11.880 --> 0:07:14.960 Yeah, there's all kinds of terriers that people just call pitbulls. 0:07:17.440 --> 0:07:21.600 Well, speaking of umbrella terms in different names, I think 0:07:21.680 --> 0:07:25.600 we should talk about some of the names. The DEA 0:07:25.680 --> 0:07:28.640 says that this is called and the only one I 0:07:28.680 --> 0:07:30.600 could corroborate is the last. 0:07:30.320 --> 0:07:32.520 One, Tango and cash. 0:07:32.600 --> 0:07:37.440 Yeah, so apparently that's fetanyl and cocaine mixed together, and 0:07:37.840 --> 0:07:41.320 or fetanyl and methamphetamine some sort of speed that's a speedball, 0:07:41.760 --> 0:07:43.920 And as we'll see, that's actually proving to be a 0:07:43.960 --> 0:07:47.320 really big problem that's created like a new wave of 0:07:47.360 --> 0:07:48.720 opioid deaths. 0:07:49.160 --> 0:07:52.840 Yeah. Well, speaking of waves, there have kind of been three, 0:07:52.920 --> 0:07:54.920 and this is just sort of an overview of the 0:07:54.920 --> 0:07:57.760 opioid addiction crisis in the US that's been going on 0:07:57.840 --> 0:08:02.640 for you know, ten fifteen years. The first wave was 0:08:02.680 --> 0:08:06.880 in the nineties, and that's when you got prescription opioids 0:08:07.320 --> 0:08:11.840 from your doctor. Those really rose dramatically because they do 0:08:11.880 --> 0:08:14.760 a really good job. But that's also you know, in 0:08:14.840 --> 0:08:18.560 lockstep with fatal opioid overdoses. They doubled between ninety nine 0:08:18.600 --> 0:08:22.240 and twenty ten. And twenty ten was when things started 0:08:22.240 --> 0:08:25.360 to change for a second wave because the government was like, 0:08:25.800 --> 0:08:28.400 you can't be writing all these prescriptions like this to 0:08:28.480 --> 0:08:32.920 doctors and to manufacturers, like you got to change your formulas, 0:08:32.960 --> 0:08:36.199 Like this stuff is way too readily abuse, So you 0:08:36.280 --> 0:08:37.160 got to do something. 0:08:38.160 --> 0:08:42.120 Yeah, and this is really well portrayed in the limited 0:08:42.240 --> 0:08:45.320 series Dope Sick. I can't remember if it was on HBO. 0:08:45.400 --> 0:08:47.480 I want to say you saw it right now. 0:08:47.480 --> 0:08:48.120 I didn't see that. 0:08:48.160 --> 0:08:50.520 Oh man. It is really good, but it's about the 0:08:50.559 --> 0:08:55.880 Sackler family and Purdue Pharma essentially purposely hooking America on 0:08:56.080 --> 0:09:00.520 oxy contin. Yeah, and it's a really good series that 0:09:00.600 --> 0:09:02.520 just punches you in the gut. But it's really well 0:09:02.559 --> 0:09:06.960 done and it covers all that period. The problem was 0:09:07.400 --> 0:09:09.319 this is covered a little bit too towards the end. 0:09:09.960 --> 0:09:14.200 When you take people's OxyContin away and they're hooked on 0:09:14.240 --> 0:09:17.920 OxyContin and opioid, they're going to a lot of them 0:09:17.960 --> 0:09:21.800 are at least turned to whatever opioids are available, and 0:09:21.840 --> 0:09:24.680 that meant that a lot of people who otherwise would 0:09:24.679 --> 0:09:28.200 have never tried heroin took up heroin because they couldn't 0:09:28.240 --> 0:09:29.480 get OxyContin anymore. 0:09:30.120 --> 0:09:33.440 Yeah, and that was the second wave, and fatal overdoses 0:09:33.520 --> 0:09:39.160 of heroin because of that largely quadruple between twenty two 0:09:39.200 --> 0:09:42.480 and twenty thirteen. The third wave is the one we're 0:09:42.559 --> 0:09:44.600 kind of mainly going to be talking about that started 0:09:44.640 --> 0:09:50.359 in about twenty thirteen and mainly centers around illegally illicitly 0:09:50.440 --> 0:09:55.000 produced fentanyl and all the various harmful ways that can 0:09:55.040 --> 0:09:58.560 find your way into your body, even sometimes even if 0:09:58.600 --> 0:10:00.280 you don't want to be taking fentanyl. 0:10:00.600 --> 0:10:05.920 So yeah, So that third wave, the fentanyl opioid death 0:10:05.960 --> 0:10:10.959 wave or fentanyl driven wave, that is that vastly outstrips 0:10:11.080 --> 0:10:13.640 the death rate from the first two waves. 0:10:13.960 --> 0:10:14.440 Yeah. 0:10:14.520 --> 0:10:18.640 So I think in nineteen ninety nine, so this is 0:10:18.679 --> 0:10:22.440 when people are starting to take opioid prescriptions, there were 0:10:23.320 --> 0:10:27.320 two opioid overdose deaths per one hundred thousand people in 0:10:27.360 --> 0:10:31.560 the United States. Yeah, that was nineteen ninety nine. Twenty thirteen, 0:10:31.760 --> 0:10:35.520 the second wave is going on, that was up to eight. 0:10:36.360 --> 0:10:38.680 By twenty twenty two, when the third wave is in 0:10:38.720 --> 0:10:42.560 full swing, it was twenty five people per one hundred 0:10:42.559 --> 0:10:45.960 thousand people in the United States that were dying of 0:10:46.000 --> 0:10:47.760 overdose deaths from fentanyl. 0:10:48.080 --> 0:10:51.360 Yeah. In twenty twenty two, deaths from fentanyl alone were 0:10:51.559 --> 0:10:55.160 seventy six two hundred and twenty six people, or sixty 0:10:55.240 --> 0:10:59.320 nine percent of total overdose deaths and ninety percent of 0:10:59.360 --> 0:11:00.840 the opioid overdose deaths. 0:11:01.040 --> 0:11:01.439 Yeah. 0:11:01.480 --> 0:11:03.439 Apparently it was the problem. 0:11:03.559 --> 0:11:06.240 For sure, And apparently I was like, well, what else 0:11:06.320 --> 0:11:10.040 is anybody oding on? And it seems that meth has 0:11:10.160 --> 0:11:13.680 created a new epidemic of overdose deaths that everybody's like, 0:11:13.720 --> 0:11:14.679 what the hell's going on? 0:11:15.480 --> 0:11:18.280 Yeah, well, Fintanel has hit such a high that it's 0:11:18.320 --> 0:11:24.200 actually had a real impact on US life expectancy. It 0:11:24.280 --> 0:11:26.880 takes a lot to change a number like that, but 0:11:27.200 --> 0:11:29.480 Fintanel seems to have done it. And twenty twenty two 0:11:30.080 --> 0:11:34.920 only opioid related deaths resulted in three point one million 0:11:35.000 --> 0:11:38.160 years of lost life because a lot of these users 0:11:38.160 --> 0:11:40.319 are young. And if you ode it twenty two, they 0:11:41.000 --> 0:11:44.240 calculate the average lifespan and do the subtraction and that's 0:11:44.240 --> 0:11:47.720 your number. So that you know, a lot of middle 0:11:47.720 --> 0:11:53.040 age white people without a college degree are the victims. 0:11:53.559 --> 0:11:56.760 So much so, and this is startling. But from that class, 0:11:56.840 --> 0:11:59.600 middle aged white people without a college degree, they are 0:11:59.679 --> 0:12:03.719 dying earlier on average than their parents did. Yes, that's 0:12:03.760 --> 0:12:04.760 not how it's supposed to work. 0:12:04.840 --> 0:12:07.760 That's just not how it has worked, unless the United 0:12:07.800 --> 0:12:12.199 States is at war essentially. Yeah, and you know, we're 0:12:12.240 --> 0:12:14.760 talking a lot about the US, but the UK and 0:12:14.880 --> 0:12:20.760 Europe sorry, UK tracks fairly closely. Although the numbers are lower. 0:12:22.160 --> 0:12:26.720 It seems to be following like a similar pattern. Although 0:12:26.760 --> 0:12:29.079 I think in some countries. I think estonia is one 0:12:29.120 --> 0:12:32.040 of them. Like you can't even get heroin anymore, everybody's 0:12:32.120 --> 0:12:34.280 just doing fatanmol. Yeah. 0:12:34.320 --> 0:12:37.160 Well, here's the deal though, is researchers have looked at 0:12:37.160 --> 0:12:41.280 these numbers. I think they declared this a public health 0:12:41.280 --> 0:12:45.160 emergency in twenty seventeen, and what they're finding is, and 0:12:45.200 --> 0:12:48.280 this has been coroberated from other surveys and you know, 0:12:48.480 --> 0:12:52.000 metadata studies and stuff, is there aren't more overdose deaths 0:12:52.080 --> 0:12:56.560 because more people are using it. It's not just like, oh, 0:12:56.640 --> 0:12:58.679 well more people are doing it, so more people are dying. 0:12:59.360 --> 0:13:02.160 It seems like it's because this stuff is more dangerous, 0:13:02.160 --> 0:13:05.640 it's getting in places that it shouldn't get because usage 0:13:05.720 --> 0:13:08.880 has actually declined some over the past like eight years, right. 0:13:09.200 --> 0:13:11.880 Yeah. I think the first two waves were driven by 0:13:12.280 --> 0:13:17.960 larger numbers increases in people using prescription opioids and then heroin, 0:13:18.559 --> 0:13:21.080 so that accounted for it. But when fentanyl came on 0:13:21.120 --> 0:13:24.400 the scene, yeah, people stopped using it as much, but 0:13:24.679 --> 0:13:27.640 their deaths just increased, which if you look at it 0:13:27.679 --> 0:13:31.679 from just an outside perspective, like it's just because it's 0:13:31.720 --> 0:13:35.720 so potent and it was rolled out or introduced to 0:13:35.760 --> 0:13:40.880 the drug supply in a really horrific way, as we'll see. 0:13:41.040 --> 0:13:44.839 Yeah, for sure. It also sort of goes in lockstep 0:13:44.920 --> 0:13:48.719 with the income disparity in the United States and the 0:13:49.040 --> 0:13:51.480 client in fortunes for a lot of people in this country. 0:13:52.440 --> 0:13:55.960 Overdosing is basically what they call it is a disease 0:13:55.960 --> 0:14:01.800 of despair. When people are destitute and when they're down 0:14:02.040 --> 0:14:05.680 or depressed or having really hard times. A lot of 0:14:05.720 --> 0:14:09.920 times drugs can be a distraction or if you are 0:14:10.120 --> 0:14:12.480 a casual drug user, it could get worse during that time. 0:14:13.360 --> 0:14:15.880 And they found in twenty seventeen they study counties in 0:14:15.880 --> 0:14:19.960 the US and found that those with the lowest social capital, 0:14:20.400 --> 0:14:23.560 meaning networks that can help people, you know, with financial 0:14:23.560 --> 0:14:26.560 security and achieving goals, they had the highest rate of overdose. 0:14:27.120 --> 0:14:30.400 Yes, so social capital is basically the size of your 0:14:30.440 --> 0:14:31.720 local Kowanas chapter. 0:14:34.400 --> 0:14:35.920 I knew you'd get a joke in theres. 0:14:36.680 --> 0:14:39.280 So yeah, this is I mean, like this whole thing 0:14:39.400 --> 0:14:42.480 kind of rose and lockstep. Opioid overdose sets rose and 0:14:42.520 --> 0:14:46.440 lockstep with these financial crisis that the US found itself 0:14:46.480 --> 0:14:49.640 in over and over again since two thousand and eight. 0:14:50.480 --> 0:14:54.520 Job loss, aws of manufacturing jobs just all of the 0:14:54.560 --> 0:14:57.680 hardship that the United States has gone through since then, 0:14:58.200 --> 0:15:01.000 opioid debts kind of tracked with it, especially at first, 0:15:01.520 --> 0:15:05.160 especially with people basically more people turning to that kind 0:15:05.200 --> 0:15:10.600 of thing as a disease of despair, which is just sad. 0:15:10.760 --> 0:15:13.080 It's just nuts that that's that you can kind of 0:15:13.920 --> 0:15:15.200 connect those two things. 0:15:17.280 --> 0:15:19.520 Should we take a break? Yeah, all right, we're gonna 0:15:19.560 --> 0:15:22.480 take a break, and we're gonna talk about the rise 0:15:22.520 --> 0:15:55.760 of fentanyl right after this. It's stuffish. So one reason 0:15:56.440 --> 0:15:59.560 we've seen a surge in overdoses for something like this 0:15:59.720 --> 0:16:02.640 is something called the iron law prohibition that was coined 0:16:02.680 --> 0:16:05.320 in nineteen eighty six by an economist named Richard Cowan, 0:16:05.960 --> 0:16:08.480 and it's basically saying that, hey, if you ban something 0:16:09.760 --> 0:16:12.440 that people like doing, something's going to come along, and 0:16:12.480 --> 0:16:15.160 it's probably going to be a stronger version. The reason 0:16:15.160 --> 0:16:17.080 they call it the law prohibition is because that's what 0:16:17.160 --> 0:16:19.320 happened when people were like, all right, you're going to 0:16:19.360 --> 0:16:20.880 take our beer, We're going to start making gin and 0:16:20.920 --> 0:16:25.960 our bathtubs and moonshine out in the woods, and the 0:16:26.040 --> 0:16:28.480 rise of crack in the nineteen eighties the same thing, 0:16:28.560 --> 0:16:30.920 and they're basically saying fentanyl is basically the same deal. 0:16:31.320 --> 0:16:34.400 Yeah, and not only more potent, but the fact that 0:16:34.440 --> 0:16:39.160 it's more potent means that less of it can generate 0:16:39.320 --> 0:16:41.920 just as much cash, which also means it's easier to 0:16:41.960 --> 0:16:45.520 smuggle too. And like you said, fentanyl tracks exactly the 0:16:45.560 --> 0:16:49.280 same way. It's really easy to make. I mean apparently 0:16:49.320 --> 0:16:52.240 you just basically, if you have the precursor chemicals, you're 0:16:52.280 --> 0:16:55.000 just making a stew in a pot that you're stirring, 0:16:55.240 --> 0:16:56.720 You dry it out, and there you got a bunch 0:16:56.760 --> 0:17:00.640 of fentanyl. So it's easy to make. You don't require 0:17:01.520 --> 0:17:04.359 tons and tons of agricultural workers and tons and tons 0:17:04.400 --> 0:17:07.680 of acreage to grow poppies that you process into heroin. 0:17:08.240 --> 0:17:12.439 And because the potency is so much more, there is 0:17:12.520 --> 0:17:19.240 a huge cost benefit. Apparently it just accrues to the dealers. 0:17:19.280 --> 0:17:22.320 Though there was a study in the journal Addiction from 0:17:22.320 --> 0:17:26.280 twenty twenty that basically wanted to find out why was 0:17:26.280 --> 0:17:30.200 fentanyl introduced. Was it users who are like, Hey, heroin's great, 0:17:30.240 --> 0:17:33.920 but we need something way deadlier? Was it dealers who 0:17:33.920 --> 0:17:36.560 are like, hey, heroin's great, but this stuff I can 0:17:36.600 --> 0:17:40.880 cut heroin with and like, I'll make a lot more 0:17:40.920 --> 0:17:43.719 money or was it a combination of the two. They 0:17:43.720 --> 0:17:46.600 didn't say definitively, but they made a pretty good case 0:17:46.960 --> 0:17:50.000 that it does seem to have been the dealers looking 0:17:50.000 --> 0:17:53.840 to cut costs because those costs or those savings weren't 0:17:53.880 --> 0:17:55.640 passed on to users. 0:17:56.200 --> 0:17:58.600 Yeah, it's not like, hey, this, we're making the drugs 0:17:58.680 --> 0:17:59.800 cheaper now, so we're just going to give you a 0:17:59.800 --> 0:18:03.440 break this. There was one study that found between twenty 0:18:03.480 --> 0:18:07.399 thirteen and twenty twenty one, the percentage of heroin that 0:18:07.440 --> 0:18:11.399 had fentanyl rows from less than one percent to forty 0:18:11.440 --> 0:18:17.360 percent over what is that eight years? And of course 0:18:17.400 --> 0:18:19.560 it's going to lead to a huge number of overdoses 0:18:19.600 --> 0:18:22.880 because a you've got these batches that are coming out 0:18:23.000 --> 0:18:25.600 that the you know, the potency has got a pretty 0:18:25.680 --> 0:18:29.040 dramatic range from one batch to another sometimes. Yeah, and 0:18:29.080 --> 0:18:31.560 then people you know, for a long time, I think, 0:18:31.640 --> 0:18:33.720 you know, the word is finally out now and we're 0:18:33.720 --> 0:18:35.199 going to talk about that a little bit later. But 0:18:36.119 --> 0:18:38.720 people that were heroin users thought they were getting heroin 0:18:38.880 --> 0:18:41.240 and knew how much heroin to take safely. 0:18:41.480 --> 0:18:44.560 Yeah, And one reason why is because these dealers were saying, 0:18:44.600 --> 0:18:48.920 if I sell you heroin mixed with fentanyl, I have 0:18:49.000 --> 0:18:51.080 to use less heroin because it's going to be just 0:18:51.119 --> 0:18:53.199 a potent or more potent. But I can charge you 0:18:53.280 --> 0:18:56.320 heroin prices even though I'm paying way less for the 0:18:56.359 --> 0:18:59.600 fentanyl that I'm using here. And yeah, people were caught 0:18:59.640 --> 0:19:03.399 by some prize. The fact that it was duplicitous is 0:19:03.480 --> 0:19:06.560 just awful because it's like, hey, good luck getting acclimated 0:19:06.560 --> 0:19:09.159 to this there. It's gonna be a rough transition. But 0:19:09.240 --> 0:19:11.320 if you look at it from a business standpoint, the 0:19:11.480 --> 0:19:15.480 rollout of fentanyl into the American and European drug supplies, 0:19:15.760 --> 0:19:18.479 it had terrible marketing, like it had zero marketing. It 0:19:18.520 --> 0:19:20.879 was just all of a sudden there people started dying 0:19:21.119 --> 0:19:23.520 and it took the authorities investigating what the heck was 0:19:23.560 --> 0:19:26.360 going on for people to figure out that it was fentanyl. 0:19:26.680 --> 0:19:29.240 That's how it was introduced. It was just so reckless. 0:19:29.960 --> 0:19:33.879 I mean, I'm talking about heroin dealers being even more 0:19:33.960 --> 0:19:37.280 reckless than they normally are. That's what happened with fentanyl 0:19:37.280 --> 0:19:40.440 being introduced. It just suddenly popped up. No one said 0:19:40.440 --> 0:19:41.480 anything about it first. 0:19:42.200 --> 0:19:45.000 Yeah, and by the way, when I said safely do heroin, 0:19:46.359 --> 0:19:49.879 I'm hope unclear than that there's doing heroin is never safe. 0:19:50.280 --> 0:19:53.919 I just met heroin users would know how much they 0:19:53.960 --> 0:19:57.080 can take without overdosing, right, yeah, okay, I just wanted 0:19:57.080 --> 0:19:58.359 to make sure people do what I was. 0:19:58.640 --> 0:19:59.760 I think that was worth mentioning. 0:19:59.800 --> 0:20:03.159 Yeah, okay, good. So the other you know, problems with 0:20:03.280 --> 0:20:06.760 ventanyl is that it has a really intense rush when 0:20:06.800 --> 0:20:08.800 it's first used. Apparently it's more of a head rush 0:20:08.840 --> 0:20:11.600 than a body rush, so it can be a little 0:20:11.640 --> 0:20:14.359 more you can be a little more active as a 0:20:14.440 --> 0:20:17.080 user than maybe doing heroin and just like passing out 0:20:17.080 --> 0:20:20.440 on your couch for hours and hours. It's also dangerous 0:20:20.440 --> 0:20:23.119 because the high is only an hour or two, so uh, 0:20:23.560 --> 0:20:26.439 you know, heroin high lasts longer, so that short duration 0:20:27.119 --> 0:20:29.960 is gonna you know, have people using more frequently, and 0:20:30.000 --> 0:20:33.440 every time you use ventyl it's just another chance to overdose. Basically. 0:20:33.560 --> 0:20:36.679 Yes, it's a great point. Yeah, and that has to 0:20:36.720 --> 0:20:39.240 do with that fat solubility. Again, I said it before 0:20:39.280 --> 0:20:40.119 and I'll say it again. 0:20:40.640 --> 0:20:43.000 Yeah, I mean it can happen like a fentanyl overdose 0:20:43.040 --> 0:20:44.399 can happen in seconds, right. 0:20:45.119 --> 0:20:48.239 Yes, because the onset is so quick, which makes it 0:20:48.359 --> 0:20:51.080 that's another reason that it's so deadly too, is you 0:20:51.119 --> 0:20:53.120 don't have time to be like, oh man, there's frau 0:20:53.160 --> 0:20:55.479 through on my buddy's mouth. I better call nine one 0:20:55.560 --> 0:20:58.320 one because there's good Samaritan laws in my state. It's like, 0:20:58.680 --> 0:21:01.200 oh my buddy just injected fentanyl and now they're dead. 0:21:01.720 --> 0:21:04.760 I mean, it's it's not that fast necessarily, but compared 0:21:04.760 --> 0:21:07.439 to heroin, it is. And yeah, I think it's measured 0:21:07.440 --> 0:21:08.800 in like seconds. 0:21:09.000 --> 0:21:12.159 Yeah, it certainly can be. Another thing that makes it 0:21:12.200 --> 0:21:15.040 more deadly is that people started changing how they used it. 0:21:15.720 --> 0:21:18.960 Among people who died from illegal fentanyl overdoses, the portion 0:21:19.000 --> 0:21:23.040 who injected dropped forty two percent over just a two 0:21:23.080 --> 0:21:27.840 year period between twenty and twenty twenty two, and they 0:21:27.960 --> 0:21:30.840 generally started smoking it that jumped to seventy nine percent. 0:21:31.920 --> 0:21:36.679 I believe people also can snort the powder, but just 0:21:36.760 --> 0:21:39.440 the fact that people aren't injecting it as much kind 0:21:39.480 --> 0:21:43.680 of you know, if you connect the dots, somebody might 0:21:43.720 --> 0:21:46.840 dive into using it a little quicker, if they're like, hey, 0:21:46.880 --> 0:21:49.680 just snort this thing instead of hey, shoot up this thing. 0:21:49.840 --> 0:21:52.600 Yeah, because that's a big barrier for a lot of 0:21:52.640 --> 0:21:56.320 people who are like I like drugs, but I'm not 0:21:56.440 --> 0:21:58.840 gonna stick a needle in my arm. That just seems 0:21:58.920 --> 0:22:01.679 like such a a horrible road to go down that 0:22:01.760 --> 0:22:05.080 it will give people second thoughts. But smoking something geez, 0:22:05.320 --> 0:22:08.040 I like marijuana, I like smoking crack, I might as 0:22:08.040 --> 0:22:10.639 well try smoking fentanyl. It's just much less of a 0:22:10.640 --> 0:22:11.680 barrier to overcome. 0:22:12.400 --> 0:22:14.919 Yeah, And if you're smoking it or snorting it, it 0:22:14.960 --> 0:22:16.720 doesn't stay in your body as long as if you 0:22:16.720 --> 0:22:19.639 shoot it, so again, just another case of it wears 0:22:19.680 --> 0:22:22.879 off quicker and you're gonna want to use it again, 0:22:22.960 --> 0:22:25.000 and that's just another overdose opportunity. 0:22:25.119 --> 0:22:28.119 Yes, yeah, I mean it's crazy if you think about it, 0:22:28.160 --> 0:22:31.600 because most other drugs that you smoke you could conceivably 0:22:31.720 --> 0:22:35.399 overdose on. But fentanyl, even though you're smoking it and 0:22:35.440 --> 0:22:38.320 not injecting it, there's still a really good chance that 0:22:38.400 --> 0:22:41.560 you could overdose and die from just smoking it. That's 0:22:41.680 --> 0:22:43.800 kind of mind boggling, but it's accurate. 0:22:44.880 --> 0:22:46.639 Yeah, And you know, we're talking about smoking it and 0:22:46.680 --> 0:22:49.600 snorting it and like powder and a bad kind of stuff. 0:22:50.200 --> 0:22:54.600 But the real danger now, and the real problem all 0:22:54.640 --> 0:22:56.560 of it is, of course, but the real, real scary 0:22:56.600 --> 0:23:01.280 thing is the fact that these are generally sold and 0:23:01.640 --> 0:23:05.280 the us CAS's pills. I think by late twenty twenty one, 0:23:05.280 --> 0:23:07.439 more than a quarter of the fentanyl seized was in 0:23:07.520 --> 0:23:10.800