Cocaine, meth and heroin adulteration increases during covid-19

Bit of good news: carfentanil rarely found

These charts show how fentanyl’s presence has increased across the board and to record levels in Ohio’s drug supply — in heroin, cocaine, meth and all other drugs (except marijuana). In 2020, fentanyl or a fentanyl analog was found in more than one-fourth of all illegal drugs in Ohio.

(Marijuana is excluded from the analysis because the state crime labs stopped most testing of marijuana several years ago and because fentanyl-laced marijuana is a myth. Marijuana is the only illegal drug that does not carry a risk of fentanyl.)

The increase in fentanyl from Ohio’s already high level is likely the primary reason overdose deaths have reached record levels this year. The chemical composition of the illegal drug supply — not drug use levels, treatment availability or naloxone access — is the primary driver of overdose death rates, both up and down, in Ohio. This is why extensive drug checking and safe consumption efforts are the best ways to reduce overdose death during an era of drug prohibition. Ohio uses neither of these, which explains why our state’s hard work and substantial spending on overdose reduction has had limited success.

Carfentanil adulteration

In a bit of good news, the drug seizure data show that carfentanil was rarely found in Ohio in 2020. Carfentanil is the most potent and dangerous fentanyl analog. It was responsible for the historic surge in overdose deaths that occurred from July 2016 through June 2017. That was the deadliest period for overdoses in Ohio history until this year, coinciding with the COVID-19 pandemic. This year’s surge is the first since 2016 that appears to be entirely related to the expansion of fentanyl and analogs, other than carfentanil, in the drug supply.

The increase in fentanyl frequency in Ohio is pretty amazing considering how common the drug already was in Ohio. The upsurge in fentanyl — and a corresponding upsurge in overdose death — is probably the result of a shock to traditional drug supply routes caused by covid-19 restrictions.

The disruption is likely temporary and appears to have receded somewhat as drug markets adjust. The level of fentanyl in our state’s drug supply appears to have peaked in June and dropped a little since then. When it becomes easier to supply heroin, cocaine and meth — which consumers generally prefer — fewer deaths will occur. Fentanyl is about 9 times more lethal than heroin or cocaine, but, in a time of drug prohibition, fentanyl wins the day because it’s small, cheap, easy-to-make and easy-to-smuggle. Heroin and cocaine, bulky drugs derived from plants, can’t easily compete with synthetic fentanyls, especially when border controls and human-to-human contact is limited during a pandemic.

Today, in Ohio, a large share of drugs contain nothing but fentanyl or an analog. These fentanyl-only drugs are true mystery substances, sold as heroin, cocaine, meth, Xanax or whatever name is chosen. Even the dealer usually has no clue what is inside a substance– for example, if the white powder confidently sold as “cocaine” actually contains any cocaine at all.

Cause of adulteration

Bottom line: Ohio’s drug supply is more dangerous that ever –and that’s saying something. The drug war and the drug adulteration it causes is slaughtering Ohioans — about 5,000 more dead in Ohio in 2020. Ohio’s drug supply is more fentanyl-packed than in other states and may be the most fentanyl-heavy of any state, the result of our state responding to an increase in prescription opioid deaths with a hard and heavy law enforcement-oriented response that resulted in the fentanyl wave that quadrupled overdose deaths.

The idea of “first, do no harm” was not followed in Ohio. Instead, “the road to hell is paved with good intentions” is the maxim that proved true. These charts should help us understand why the drug war does not save lives; it kills people. The phenomenon is not medical or social or cultural. It’s economic. When you outlaw a common consumer product consumed by one million Ohioans every year, adulteration will occur and more people will die. This is not a side effect of the drug war; it is an inevitable and unavoidable result of a well-intended but harmful policy.

Drug prohibition kills. Always has. Always will. Is doing so right now.

  — By Dennis Cauchon, President, Harm Reduction Ohio

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