I’ve been investigating a transformation in the illegal drug market and how it has led to this explosion of drug overdoses. “America’s public enemy No. 1 is drug abuse.” The war on drugs starts in the early ’70s. At that time, annually, there were roughly 7,000 drug overdose deaths. Subsequently, that number completely explodes. How could we have invested so much to stop the problem and just have it get so much worse? So when we start looking at this data, I find that it’s fundamentally a synthetic drug problem. Fentanyl is the first example, but it’s essentially a subset of what we know as novel psychoactive substances. They are often lethal. “So this sample was a 19-year-old in Chicago who was found deceased after taking what he thought was Percocet. But we found one of these synthetic cannabinoids that is several times more potent than fentanyl.” When you get that sample, you’re trying to tease out a molecule that maybe hasn’t been seen before? “Yes, we create what is essentially a digital record, a chemical fingerprint, if you will. But then there’s the interpretation. We need to understand the pharmacology of it, the potency of it, to understand how these substances can affect humans.” This is an information-era story. It’s everything from chat groups where people are sharing different ideas, to exchanges between users and suppliers, and then the chemistry know-how is also being shared. One way to appreciate the magnitude of the problem is to see how easy it is to change these molecules. “So this is MDMA and these are all being manufactured to really elicit similar responses. Methylone, ethylone, butylone, dimethylone, we’ve seen all of those. The left side of the molecule in all of these is the same. It’s really the right side of the molecule that’s different.” Why can’t we just outlaw all drugs of a certain class or type, wouldn’t that simply solve the problem? “The challenge is there’s been so many examples and stories of that leading to even more potent drugs. You kind go through this roller coaster of one substance emerging because another has been scheduled, and then you have that going away, a new substance emerging, new substance emerging over time. So do you like the thing that’s dangerous to the power of five, or do you want the thing that’s dangerous to the power of 100?” Understanding the science and the chemistry is vital to at least knowing what we’re dealing with in this supply. And that way, ideally, we could frame public policy that would get at the problem and not make it worse.
