There's an Emerging Street Drug to Be Feared

A synthetic opioid you've likely never heard of is quietly surfacing in street drugs across the US, and it makes fentanyl look weak. The New York Times reports that "orphines," an experimental opioid class first developed in the 1960s and abandoned because of dangerous side effects, have now been detected in illicit supplies in at least 14 states. Researchers say they can be about 10 times stronger than fentanyl and don't show up on standard tox screens or when using fentanyl testing strips. As Jan Hoffman writes, "Sometimes the classic signature of overdose, 'the foam cone'—froth from the nostrils and mouth—does not even have time to bubble up."

Hoffman explains that orphines likely emerged as traffickers hunted for new products amid global crackdowns on fentanyl; there's some speculation that a 2018 article in the Journal of Medicinal Chemistry that referenced them may have brought them to the attention of "rogue chemists." The most common version, cychlorphine, is turning up in fake pills and powders, often mixed into other drugs without users' knowledge and sometimes as the sole drug present in fatal overdoses. Naloxone can still work, but multiple doses may be needed.

In a March report on orphines, the Hill spoke with Timothy Wiegand, president-elect of the American Society of Addiction Medicine, who described the source of the drugs: "Most of these are coming from either South Asia, China, places where there's a lot of chemical supply companies. It isn't coming just like somebody in their bathroom, making it like methamphetamine, from a couple of products or in the US. It's coming from international, multilevel drug distribution networks, some of the cartels or other isolated networks."