customers. They look at it as if we’re gaining more customers.”
Today, Janssen Pharmaceutical of Johnson & Johnson makes only one fentanyl product—the fentanyl patch. Marketed as Duragesic, it helps relieve chronic pain, including in cancer patients. Patented in the United States in 1986, Duragesic was approved by the FDA for advanced pain treatment in 1990, with medical fentanyl no longer required to be diluted with droperidol. By 2004 it was a certified blockbuster, clearing $2 billion in worldwide sales. But like Purdue Pharma, the makers of OxyContin, Janssen Pharmaceutical engaged in deceptive marketing, suggesting Duragesic had less abuse potential than other opioids. In 2000 the FDA said that this and other claims Janssen made about the patch were “false or misleading,” and four years later the FDA instructed the company to “immediately cease” such claims, including the claim that the patch was less abused than other opioids.
Sales dipped after Duragesic’s patent expired in 2006, and Janssen stopped marketing it two years later, according to a company spokesperson, but the patch is still used in medicine, and different companies sell other fentanyl medical products, including a lollipop. The patch in particular continues to be trafficked on the black market. Not long ago on the Dark Web emporium Wall St. Market, for example, Duragesic patches were being offered for one hundred dollars each, from a vendor called BigPoppa7777.
Even as it devastates communities in North America and around the world, fentanyl remains a critical pharmaceutical product. Overall, fentanyl was prescribed by doctors 6.5 million times in 2015, according to the DEA, a number that dropped to about 6 million in 2016, and about 5 million in 2017. Still producing many medicines, the Janssen division within Johnson & Johnson continues to prosper, today boasting more than forty thousand employees in labs and offices around the world.
Paul Janssen didn’t live long enough to see the mass destruction fentanyl has wrought. Upon his death in 2003, at age seventy-seven, he was widely celebrated as a lifesaving innovator. Obituary tributes noted Janssen’s passion for the country of China. Janssen was the first Western company to set up a pharmaceutical factory there, and in 1993 Paul Janssen became the first non-Chinese person to receive a pharmaceutical honorary doctorate in China. Janssen’s factory was in Shaanxi province, near the excavation site of the famous army of terra-cotta soldiers, sometimes called the Xi’an Warriors, buried more than two thousand years ago with China’s first emperor, Qin Shi Huang, to protect him in the afterlife. When the statues were threatened by mold, Janssen analyzed the damage and provided antifungal sprays developed by his company to save them, even setting up an on-site lab. The soldiers remain one of the most popular tourist attractions in China.
The opioid epidemic sweeping through the United States, Canada, and Estonia undoubtedly would have horrified Paul Janssen, as would the fact that Chinese laboratories today produce most of the world’s illicit fentanyl. According to Andrew Wheatley, spokesperson for the Janssen Pharmaceutical Companies of Johnson & Johnson, Duragesic patches sold in the United States are manufactured in the United States, and those sold outside the United States are manufactured in Belgium, and none of the controlled-substance active pharmaceutical ingredients in either Janssen or Johnson & Johnson products are manufactured in China.
Janssen and other pharmaceutical companies like Purdue are now facing lawsuits from states and other entities around the United States for their contributions to the opioid epidemic, but Paul Janssen continues to be remembered as an unparalleled medical drug innovator. Since 2005, Johnson & Johnson has been giving out a biomedical research award named for him. But the proliferation of illicit fentanyl may alter his legacy. His focus throughout his professional life—up until the day he died, while attending a scientific conference in Rome—was the science and business of creating chemicals to help ease suffering. To his core, Janssen believed in medical science’s ability to benefit humanity. When fentanyl was first synthesized in 1959, nobody could have predicted that it would eventually create so much suffering. Nobody could have known it would become as common as cheap liquor in America’s inner cities and much more deadly, or that anyone with an Internet connection could have it sent to his or her door.
One consequence of the Federal Analogue Act of 1986 , which regulated drugs that hadn’t yet been created, was its effect on science and medicine. Some believed the law derailed development of potentially beneficial treatments and medical drugs by making it difficult for researchers to study new chemicals on human subjects. “The placement of medical research approval within law enforcement, the DEA, is unthinkably stupid and inappropriate, and cannot be tolerated,” wrote Sasha Shulgin in 1993. “We, as the research community . . . have quietly acceded to a non-scientific authority that can oversee and, to an increasing degree, influence the direction of our inquiry.”
Shulgin was easy to dismiss, by some. He wasn’t a medical doctor but rather a psychedelics chemist, who manipulated the structures of chemicals to try to create new drugs. He had a record of pushing the bounds of legality in his studies, and the passage of the Federal Analogue Act meant that most of his new creations would likely be a priori illegal. But those who understood Shulgin’s research knew that he wasn’t just looking for new ways to get people high. He was on a lifelong journey of exploring the relationship between drugs and the human mind. He knew that some new psychoactive substances could have terrible effects, but he also believed many could be lifesaving medicines.
Astronauts take voyages into outer space; psychonauts, by contrast, take voyages into their own psyches, testing new, just-created recreational chemicals that might make them incredibly high—or might make them lose their minds. Many brag about their exploits. Some have done themselves irreparable harm.
Alexander Shulgin, better known as Sasha, who lived to eighty-eight, stood above them all. He took thousands of psychedelic trips, on hundreds of drugs that were never before consumed by humans. Many he invented himself. He spread their gospel to the masses, publishing his recipes in books that became underground best sellers. More than anyone else, he helped create the world of novel psychoactive substances (NPS) we live in today. Some believe Shulgin deserved a Nobel Prize. Others wanted him locked away.
Shulgin first began thinking deeply about drugs as a young man while serving in the Navy during World War II. Aboard a destroyer escort in the Atlantic, he faced terrifying spurts of conflict followed by long periods adrift. To pass the time he read through a giant chemistry textbook, memorizing its contents. In 1944, off the coast of England, his thumb got infected. When his ship arrived in Liverpool, Shulgin was prepared for surgery at a military hospital and given a glass of orange juice he believed contained a powerful sedative. He promptly passed out and slept through the procedure. Only later did he learn there had been no sedative at all. The incident inspired a profound belief that, more than anything, one’s mind determines what happens when one takes a drug.
This lesson stayed with Shulgin when he was a biochemistry PhD candidate at UC Berkeley in 1955. He tried mescaline for the first time and experienced seeing the world around him as if he were a child. The psychedelic, originally derived from cactus plants and still at that time legal, evoked awesome sense memories. Again he wondered: Was this the drug, or was this his mind?
“This awesome recall had been brought about by a fraction of a gram of a white solid,” he wrote, “but . . . in no way whatsoever could it be argued that these memories had been contained within the white solid. Everything I had recognized came from the depths of my memory and my psyche.”
Shulgin soon realized his calling: to explore psychedelic drugs from a scientific perspective, which he began doing during his employment, in the late 1950s and 1960s, at Dow Chemical, the industrial giant that manufactured the crippling herbicide Agent Orange, which was sprayed in the Vietnam war. While under the company’s employ, Shulgin synthesized a biodegradable
