Americans has skyrocketed. Most NPS are made in China, and since China lacks an analogue act of its own, drugs there usually must be banned one at a time, as they are discovered. (There are three United Nations international drug treaties—from 1961, 1971, and 1988, to which China, Russia, the United States, and most other world powers are signatories—and they also operate the same way, without an analogue act.) Thus, brand-new drugs that are automatically covered by US laws start off perfectly legal for manufacture and export in China, although in 2019 the country banned all fentanyl analogues.
The United States seems just as susceptible to new drugs as countries like Sweden, which lacks an analogue act. While Sweden has been devastated by dangerous analogues such as cyclopropylfentanyl, acrylfentanyl, and acetylfentanyl, the United States has been hit particularly hard by carfentanil, the veterinary tranquilizer that can be one hundred times more potent than fentanyl and five thousand times more potent than heroin. Carfentanil was responsible for killing more than eleven hundred Ohio residents between July 2016 and June 2017 alone.
At this point in the cat-and-mouse game between legislators and rogue chemists, warns Julijan “Sidney” Picej (an expert on new drugs who is from Ljubljana, Slovenia), the rogue chemists are so desperate for new products that they’ll try anything. “Good combinations are long gone. Their approach to finding a new flagship product is, ‘Anything goes, as long as it’s not fatal if you use it the first three times,’ ” he said. “It’s difficult for users and researchers to get any info, since the molecule was literally synthesized for the first time three weeks ago.”
In the mid-1980s, it wasn’t clear whether these types of “synthetic heroin” would become a plague or simply fade away. A University of California at Davis pharmacology professor named Gary Henderson studied the chemical impurities in China White and concluded that a single chemist was responsible for all of it. “Most likely he made a few grams of the drug—millions of doses—and then shut up his shop,” he told journalist Jack Shafer in 1985.
Henderson became the scientist doctors turned to when their overdose patients had strange blood samples, and the DEA consulted when it turned up inscrutable chemicals. He had already been researching fentanyl for years; his lab focused on how it was used to dope racehorses, whose urine turned up traces of it. He worked to develop a technique to identify fentanyl and began to understand the nature of the drug, including its potential for chemical manipulation. “Perhaps hundreds,” he said, when asked how many fentanyl analogues would be possible. “Maybe thousands.”
Henderson was way ahead of his time when it came to predicting the horrors not just of fentanyl but of NPS generally. “It seems we are still watching reruns of The French Connection while there is someone out there using a computer to search the chemical literature looking for new drugs to synthesize,” he told the US Senate’s Budget Committee in July 1985, a statement that was remarkably prescient. He coined the phrase designer drugs, defining them as “substances where the psychoactive properties of a drug are retained, but the molecular structure has been altered to avoid prosecution.” Often synthesized from common chemicals, they were skillfully marketed under attractive, exotic names, he added. His ١٩٨٨ paper “Designer Drugs: Past History and Future Prospects” is nothing less than prophecy, speculating accurately not just on the future of NPS chemistry but on the implications for law enforcement. “In the view of this author,” he wrote, “it is likely that the future drugs of abuse will be synthetics rather than plant products. A single gram of any very potent drug could be synthesized at one location, transported to distribution sites worldwide, and then formulated (cut) into many thousand, perhaps a million, doses. . . . Preventing the distribution of such small amounts of the pure drug will be exceedingly difficult. . . . In fact, any success we may have in curtailing the distribution of natural products such as opium, coca, and marijuana and preventing the diversion of pharmaceuticals will only stimulate the development of potent synthetic substitutes.”
*** Schedule I drugs have “no currently accepted medical use and a high potential for abuse,” while Schedule II drugs have “a high potential for abuse, with use potentially leading to severe psychological or physical dependence,” according to the DEA.
**** The United Kingdom went even further with an analogue act thirty years later, in 2016, when it enacted the Psychoactive Substances Act, which sought to ban anything that could get a person high, with medicine, alcohol, cigarettes, and caffeine specifically exempted. The purpose of the bill was to combat “legal highs,” such as synthetic cannabinoids and ecstasy knockoffs, which had been sold lawfully in head shops—but the bill had unseen ramifications. The Church of England and the Catholic Church were worried that using incense in services could lead to prosecution, and the bill’s implementation was delayed over concerns that the difficulty of defining psychoactive might make the law problematic to enforce. Ultimately it was implemented and did successfully remove “legal highs” from store shelves, but the long-term ramifications aren’t yet fully understood.
The 1989 police action comedy Tango & Cash, starring Sylvester Stallone and Kurt Russell as narcotics detectives with outsize opinions of themselves, may not have gotten great reviews, but it did inspire the name of a new fentanyl product, which began killing people in the northeastern United States in early 1991. The deceased included residents of New York City, Newark and Paterson in New Jersey, and Hartford, Connecticut. Almost all of the drug called Tango and Cash seemed to originate from an open-air drug market in the Bronx, near 138th Street and Brook Avenue, described in the Hartford Courant as, “a kind of regional wholesaler to dealers from cities around the Northeast.” Paramedic Steven Harbeson recalled a sudden, dramatic increase in Hartford overdose calls. Before the opioid-antidote Narcan was available as a nasal spray, first responders would inject it straight into the vein. “Many of the heroin users back then would leave a vein available for EMS,” he remembered. Over the weekend beginning February ٢, ١٩٩١, Tango and Cash caused a dozen deaths and more than one hundred overdoses.
The New York Times quoted a thirty-nine-year-old heroin user named Richie, who was pursuing the drug despite its toxic effects. “When an addict hears that someone O.D.’d, the first question they ask is: ‘Where’d they get it?’ Because they want to find some of it for themselves.”
The deaths continued. During 1991 and 1992, 126 people in the Northeast died from this new fentanyl product, which was also sometimes called China White. More than twenty of the deceased came from Philadelphia. “Some of the Philadelphia junkies died so swiftly that syringes were still embedded in their arms,” reported the Baltimore Sun. Alpha-methylfentanyl, even though it had been scheduled in 1981, was discovered in some of the Tango and Cash batches. (News reports from this era weren’t always clear about whether the drugs involved were fentanyl or a fentanyl analogue like alpha-methylfentanyl, so the term fentanyl is used below to reference both.)
For almost two years, police remained stymied in their search for the drug’s source. But then in December 1992, they received a valuable clue from a Boston drug dealer named Christopher Moscatiello. In the midst of a fentanyl sale, he mentioned to a customer that his Wichita, Kansas, supplier had nearly died from a fentanyl overdose. Moscatiello didn’t realize it at the time, but the customer was actually a DEA agent.
DEA began pursuing the tip, despite the fact that Kansas seemed an odd place for a fentanyl laboratory, since the Midwest wasn’t yet associated with deaths from the substance. But it turned out the supplier in question had Eastern ties. He was a Pittsburgh businessman named Joseph Martier. In August 1992 paramedics responding to a 911 call found Martier passed out in a storage building near Wichita, having overdosed on fentanyl. In February, 1993, the DEA arrested Martier and raided his facility, alleging that his was the country’s only lab making
