How Did Fentanyl Go From Saving to Taking Lives?
Unlike the myth of the “crack baby,” fentanyl’s danger is real and documented exhaustively in communities across the United States. No one needs statistics to know something’s wrong when ERs see more than a dozen overdoses a night and wealthy, famous people like Prince and Tom Petty are killed.
You might be thinking both musical geniuses died with a needle in their arm like the dead 60s rock stars who went to Rock ‘N Roll Heaven.
There is indeed a helluva band up (or down) there but neither Prince nor Petty intentionally ODd. It’s doubtful either star even knew they were taking deadly fentanyl, although Tom Petty had been prescribed, and was wearing a fentanyl patch because — get this — he had been performing for weeks with a broken hip. Prince too suffered from extreme hip pain after his years of performing. In Prince’s case, after two years, Minnesota authorities still haven’t located the “helpful friend” who sold Prince capsules he thought were Vicodin for his pain. In reality they were adulterated fentanyl.
It takes very little fentanyl to OD, and it takes a lot of Narcan to reverse the overdose. Because illegal fentanyl comes in so many forms, strengths, and concentrations, taking any counterfeit pill or capsule much less shooting up the stuff is literally like playing Russian Roulette.
Mathematically, it’s likely that the mega-powerful synthetic opioid is the primary reason that U.S. life expectancy has declined for the past three years in a row. Drug overdoses are now the leading cause of death for Americans under age 55. More than 72,000 Americans died from a drug overdose in 2017 and the drug responsible for the biggest increase? Fentanyl.
As cartoonist Scott Adams said when his stepson died from a fentanyl overdose last October, fentanyl was a tragedy on the level of the Vietnam War. For reference, the Vietnam War lasted more than 19 years and took the lives of more than 59,000 American soldiers. Fentanyl is taking more lives much faster.
Mr. Adams is considered conservative and supports President Trump, so we on the left are socially prohibited from considering his opinions or the human tragedy his family endured and his true statement — on the part of some — must be discounted, again, by those who care more about their political affiliation than human lives or morality. Scott’s stepson was wearing a fentanyl patch when he was found unresponsive; Scott said he had never even heard the word fentanyl before Justin — Justin Miles, that’s Scott’s stepson’s name and he was only 18 — died.
Right now, fentanyl is touted as an excuse to build (or receive funds to build) a wall along the U.S. southern border. The President and news reports have stated, correctly, that border agents seized 2,400 pounds of fentanyl in 2017, enough to kill every human in the U.S. and then some. I’m pretty sure if I (or actual law enforcement) could show Mr. Adams that this poison was coming mostly through the U.S. Mail and shipping containers, he’d say stopping that would be the way to stem the tide …
2,400 pounds is a tiny fraction of what is coming into the U.S. through the U.S. Mail and through the Canadian, not the Mexican border. The term for illegal fentanyl is illicitly manufactured fentanyl (IMF) and it and related opioids in the same chemical family are made by dozens of labs in China. The U.S. isn’t the only country that has suffered from this scourge; Canada lost 4,000 people to fentanyl last year, proportionally worse than the U.S. loss of life. The Canadian government has been trying diplomatically to stop the flood from China for years — with no success.
El Chapo isn’t a fentanyl Lord. Yan Xiaobing is.
When Bloomberg caught up with Yan last year, Yan said it was simply a “misunderstanding” that led to his September 2017 charge by Mississippi federal prosecutors for “leading an empire built on the manufacture and sale of drugs related to fentanyl.”
The Justice Department’s announcement of charges against Yan and another Chinese druglord/illicit pharmaceutical manufacturer, Zhang Jian, and their many accomplices in China, Canada, and the U.S., reveals the true source of the drugs that killed over 33,000 Americans in 2017.
How did Yan get fentanyl to U.S. distributors and dealers again? Over the border?
But fentanyl? In addition to being a killer, it is also on the World Health Organization’s “list of essential medicines.” It is there for its use as a surgical anesthetic and as a pain reliever for people with chronic, severe pain.
Like nearly all products produced by modern big pharma, fentanyl has a good face and a terrible one, much like its antidote Narcan. I've previously written about the Narcan scam. Narcan (Naloxone) is well-known to first-responders and available over the counter in nearly every state. It is an overdose reversal drug that saves lives.
Lives that should never have been at-risk in the first place.
Patents, greed, idealism, addiction-shaming, and exploitation all play a role in this murder mystery. Fentanyl is the weapon, but the man who invented it wanted to save lives.
At the time of his death, Dr. Paul Janssen, a Belgian doctor and pharmaceutical research chemist, held more than 100 patents for life-saving medications. His company, Janssen Pharmaceutica, is one of the world’s largest, employing 40,000 people worldwide. Dr. Janssen is credited with 8 medicines on the WHO “Essential Medicines” list, among them fentanyl. One of the others, which his team synthesized shortly before fentanyl, is haloperidol, known to psych patients and others worldwide as Haldol.
This is the part of the story where idealism comes into play. Dr. Janssen’s father was also a doctor. When Dr. Paul, as he is fondly known, was in high school, his four-year-old sister fell ill with meningitis. In a time before antibiotics, she quickly worsened and died. Dr. Paul vowed he would pursue medicine to save lives.
“Hurry,” Dr. Paul was known to say to researchers in Janssen labs. “There’s so much work to be done — patients are waiting!”
Dr. Paul also came into labs asking brightly, “What’s new?”
His idealism, commitment, enthusiasm, and drive built Janssen Pharmaceutica and led the teams to create hundreds of new medicines.
The methods they used focused on lab-based chemical synthesis from basic chemical building blocks. In the case of fentanyl, Dr. Paul’s goal was to improve the effectiveness of a morphine-like synthetic opiate by making it more fat-soluble. This tactic produced fentanyl’s incredible strength: 50 to 100 times stronger than morphine. Other benefits to fentanyl’s chemical design included low impact on heart function, which is why it was adopted as surgical anesthesia, especially for heart and vascular surgery.
All of Dr. Paul’s many synthetic medications were just that: synthetic. His deep understanding of chemistry led him to engineer these medications to perform the desired task as quickly and efficiently as possible.
Another 20th Century chemist who founded his own company, less wealthy and perhaps less well-known than Dr. Paul — but perhaps in the long-term — more influential, was Percy Julian. Percy Julian’s primary method of synthesizing medicines began with natural plants. He was from a prior generation to Janssen, but in fact, had more patents than Janssen accumulated. Unlike Janssen, Julian’s drugs were not addictive and his plant-based work process seems to have produced safer medications as well.
Dr. Paul Janssen wanted to help patients and save lives: no question.
He sold Janssen Pharmaceutica to Johnson & Johnson in 1961, about a year after fentanyl was invented and patented.
Most people can sense there’s “something wrong” in the way medicine is developed and used in western medicine, especially in the U.S.
Patents and the approval process both affect how medicine gets to patients — or the streets. The process results in massive pharma profits, enough even to justify continuing in the face of multiple state lawsuits and multiple $multi-million judgments against Purdue Pharma and others responsible for the OxyContin debacle.
Early in its history, the U.S. Food and Drug Administration had ethical employees and board members. A new employee of the FDA in 1960, Frances Oldham Kelsey, opposed stiff and ongoing pressure from the William S. Merrell Company, which wanted to market a European anti-nausea drug for pregnant women called thalidomide.
No one knows for sure how many babies were born with congenital limb defects, including missing arms and legs, from thalidomide in the countries where it was legally sold. Europe, the Middle East, and Asia were all affected by thalidomide-caused birth defects. About 10,000 babies were born missing limbs or with other severe deformities in Germany alone, according to the BBC.
Janssen Pharmaceutica under its new owners Johnson & Johnson, campaigned heavily for fentanyl to be marketed in the United States starting in 1960. Although the drug was quickly adopted in Europe for anesthesia in concert with another drug that reduced its potency, droperidol, fentanyl was not okayed for use in the U.S. until 1968. One man bore responsibility for barring its use, Dr. Robert Dripps, a professor of anesthesiology at the University of Pennsylvania. Dr. Dripps felt that fentanyl was too strong and could cause many abuse problems. When fentanyl was approved for anesthesia in the U.S., it was in a ratio of 50:1 with droperidol, and it stayed that way until 1972, when Dr. Dripps’ objections were dropped and wider use began.
Dr. Paul Janssen personally met with Dr. Dripps to convince him to drop his opposition.
People with access from the medical profession were the primary abusers of fentanyl until it went off patent in 1981.
And the money-making machine left the station. Once a medicine goes off patent, only its delivery system can be patented, not the actual chemical.
A California company developed the patches depicted in this article’s header — they’re now sold by Johnson & Johnson. By the 90s, another small company perfected Actiq fentanyl lollipops for severe pain (officially, terminal cancer patients). When surveyed in 1999, more than 80% of Actiq lollipops were being prescribed “off label” for patients who weren’t dying of cancer.
One Actiq patient ended up having every tooth removed from the terrible combination of slow-release addictive opiate and the heavy dose of sugar these pops, sold on the street as “Perc-a-pops” provided him.
This is how idealism, medical ethics, patent law, and pharma greed took fentanyl’s first victims.
And then there were more.
In the U.S. in 2015, 11,000 people died from fentanyl overdoses.
In 2016, 22,500 died from fentanyl.
In 2017, 33,000 did.
The increase did not come from previous sources: illegally diverted prescription drugs (patches and “perc-a-pops”), local illicit chem labs or localized Mexican drug operations. In the late 1970s, about 100 people in California died from an early outbreak of fentanyl-laced heroin that came from a single dealer. In the late 80s, another similar outbreak occurred in Philadelphia.
Fentanyl is so strong (100 times stronger than morphine) that just a few grains will get somebody high. The amounts required are so small that yes, it’s easy to send it through the mail, pack it in tiny toys in shipping containers, or smuggle in a makeup case in a purse.
And like so many other products made in Chinese factories, it’s not hard to make. It’s easy to make fentanyl-analogues too, to get around laws and legally say, “This isn’t fentanyl.” That’s why Mr. Yan said the federal drug charges were “just a misunderstanding.” It’s what Chinese leaders have been saying to U.S., Canadian, and European leaders for years.
I’m sure a little money here and there helps the process along. After all, Dr. Robert Dripps the principled anesthesiologist (1911–1973) died clearing the way for full fentanyl use in the U.S. And principled Frances Oldham Kelsey, the woman who saved countless U.S. babies from horrific congenital defects, eventually retired.
We can see dozens of articles talking about how beloved Dr. Paul was the most influential pharmaceutical chemist of the 20th century and has saved so many lives and not all are written by Johnson & Johnson. Janssen’s methods are taught and reinforced in chemistry classes and medical research labs. His company is the model for so many of today’s successful entrepreneurs, as often even featured here on Medium. He developed new, innovative products, patented them and then sold his company for a fortune to Johnson & Johnson.
Yes, world-leader and massive money-maker Johnson & Johnson. You may have heard something about the baby powder thing.
This morning, Johnson & Johnson announced it is increasing U.S. drug prices for its 20 top-selling medications because the company estimates it will need to pay out $100 billion in awards for all the cancers its asbestos-laden baby powder has caused. Court proceedings have already proven that the company knew its baby powder contained asbestos for decades.
As to the street dealers? Their counterfeit pills and adulterated heroin are killing tens of thousands.
My daughter asked me the obvious question, “Mom, why would dealers sell counterfeit fentanyl pills or put it into coke or heroin if it can so easily kill people?”
$1,000 worth of heroin bought in Mississippi could earn a dealer a profit of $4,000. U.S. dealers can buy $1,000 worth of Chinese fentanyl and make a profit of $7.8 million.
We addiction shame young athletes whose doctors prescribed addictive opiates for injuries. Developing tolerance and running out of prescriptions, opiate addiction is so strong that even the most moral person can turn to street dealers for pills pressed from fentanyl and powdered milk or dextrose, heroin cut with fentanyl, stolen fentanyl patches or ripped-off Actiq fentanyl lollies (I’m told they’re a delicious raspberry flavor).
No one thinks to addiction shame somebody who is so addicted to money they will say and do anything for it, including turning their back on the Hippocratic oath and lying to colleagues just to turn a buck.
People think Ted Bundy was a terrible serial killer. He is credited with killing around 30 young women, including a 12-year old girl. Bundy was addicted to necrophilic sex and unspeakable actions with the body parts of his victims.
What are we to say about a company like Johnson & Johnson which knew intimately how powerful and addictive fentanyl was and is? This company also knew it was mining talc laced with carcinogenic, toxic asbestos for decades and selling it as baby powder. The company knew women were putting the powder on their genitals. About 20,000 women were diagnosed with ovarian cancer in 2017, and 13,000 of them died.
Johnson & Johnson says its baby powder is safe. Research says otherwise and has even identified how many women got cancer and potentially lost their lives due to using the toxic product.
At the end of his career of rape and serial murder, Ted Bundy kidnapped 12-year-old Kimberly Leach while she was walking home from school. Her decomposing body was discovered under a shed a few days after her murder.
Can anyone imagine somebody blaming Kimberly for what Bundy did to her?
I will lay good money just as pictured above with the baby that there will be comments on this article that women who used Johnson & Johnson baby powder did not need to use it, and that people who died from fentanyl overdoses including Prince and Tom Petty, should have known better.
All in service of one addictive substance — a substance far stronger and deadlier than fentanyl itself. A substance that makes entire companies and all who work for them, as well as people who take oaths of office, swear on Bibles, and make all kinds of other promises and vows, say and do things they would never do if this all-powerful, insanely addictive substance wasn’t guiding and directing their every move.
It’s a substance that just represents “an agreement to pay.”
In November, the FDA approved a new opioid that is 1,000 times stronger than morphine (100 times stronger than fentanyl): Dsuvia or sufentanil. The military reportedly wants it for battlefield use because it works so quickly. The 60 other Chinese labs that weren’t charged by U.S. prosecutors have already made much stronger and varied similar substances and sell them as fentanyl all the time.
Maybe we won’t need to worry about fentanyl much longer. We can just build that wall, be totally safe, and those addicts deserved what they got anyway.
Just tell me one thing: since your life revolves around money — exactly who is the addict? And these companies have all the same rights as people.
But none of the same responsibilities.
