Pure Fentanyl Powder – 20g packet
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Pure Fentanyl Powder – 20g Since 2002 heroin-related overdose deaths have risen six-fold in the United States (U.S.) to almost 13,000 in 2015 (NIDA 2017). Intertwined with the opioid pill epidemic, (Unick et al. 2013, Mars 2014) heroin use rose 63%, from 2002–2013. In 2015 an estimated 833,000 people had used heroin in the last year (CBHSQ 2016) but the magnitude of the increase in heroin use does not account for the even greater rise in overdose deaths. Has heroin become a more dangerous drug?
Four major changes have been documented in the US heroin supply in the last five years: heroin purity has been rising while its price per pure gram is at a long time low (NIDA January 2014, Caulkins and Padman 1993, DEA 2015c, 2016a); heroin is reaching parts of the country previously unfamiliar with its sale (Quinones 2015); heroin ‘source-types’ have proliferated, (Mars et al. 2016, DEA 2016a) and the supply is being contaminated with fentanyl and other synthetic drugs (DEA 2015b).
Commonly, retail heroin is ‘cut,’ either with diluents to add weight and stretch the substance, or adulterants, to improve uptake of the heroin, complement its effects or address a side-effect (e.g. diphenhydramine for itching) (Strang, Griffiths, and Gossop 1997). High levels of ‘cut’ do not necessarily dissuade users from purchasing heroin (Harris, Forseth, and Rhodes 2015), although responses vary: the addition of psychoactive adulterants is appealing to some users while others show hostility (Mars et al. 2016, Harris, Forseth, and Rhodes 2015).
Limited research on preference across heroin products indicates that some users value consistency and swift alleviation of withdrawal symptoms and do not equate purity with potency (Bancroft and Scott Reid 2015). Indeed, the quest for potency has led some to prize the most potent heroin over the purest (Mars et al. 2016) and to seek out heroin implicated in overdoses (Preble 1969, Fernando 1991, Mars 2015). Fluctuation in heroin purity is an independent predictor of fatal overdoses (Darke et al. 1999).
Fentanyl, a synthetic opioid 50–100 times more potent than morphine by weight (CDC 2016), and its analogs, have long been blamed for overdose outbreaks in the US (Hibbs, Perper, and Winek 1991, Wong, Curtis, and Wingert 2008, Schumann et al. 2008, Algren et al. 2013). Powder heroin has been more prone to adulteration than black tar heroin, and its dominance in the eastern states since the 1990s has made it a particular concern east of the Mississippi. (DEA 2015a, Coomber 1999). While toxicological testing for