‘The deadliest drug we’ve ever known’: author Sam Quinones on how fentanyl saturated the US
For the last nine years, Sam Quinones has been studying the changing face of drug use, sales, and addiction in the United States.
In his new book The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth, he tracks the explosion of synthetic drugs that has hit the streets of America, increasing the danger of drug use and making addictive chemical substances far cheaper and more plentiful than ever before.
He finds that the days when drug production required land and agriculture are gone. Now drugs are being manufactured from toxic chemicals in vast quantities by Mexican traffickers and introduced to users by slipping them into the supply of other substances, like heroin and cocaine.
The Guardian spoke with Quinones about the origins and dangers of synthetic drugs and his theories about the intersection between drug use and homelessness. The conversation has been edited and condensed for clarity.
In your 2015 book, Dreamland, you explored how the opioid addiction crisis took hold in the small towns of America, through pain pills marketed by drug companies and over-prescribed by doctors.How have opioids changed since then?
The opioid epidemic is probably a misnomer by now. It’s actually an epidemic of addiction.
The supply is no longer coming from doctors as much. Now you are finding the drugs that the Mexican trafficking world produces – primarily fentanyl and methamphetamines – everywhere. And that is due to the switch traffickers have made towards synthetic drugs. These drugs do not require a plant to produce – just chemicals.
These are extraordinarily dangerous drugs. Fentanyl is the deadliest drug we’ve ever known on the streets. And meth has the capabilities of truly turning people mentally ill. These drugs are now all over the country and cheaper and more prevalent than ever before.
How does fentanyl fit into the record number of overdoses we’re seeing in the US?
Fentanyl is responsible for over 70% of overdoses in the US. The thing about fentanyl, which is very appealing to the drug trafficking world, is that it is so potent. A very small amount will make you a lot of money. One kilo of fentanyl can be cut and turned into 50 kilos of saleable product on the street. But, because it’s so potent, it also can kill people very, very quickly. A few small specks, similar to a few grains of salt, can make you high and a little bit more than that will kill you.
A fentanyl high lasts for a short period of time compared to heroin. So people who are addicted have to use it several times a day. And every time they use, they run the risk of getting a mix far, far more potent than they can handle. Which means you’re essentially playing Russian roulette several times a day.
How did we end up with so much fentanyl being sold on the streets?
Traffickers are making a drug that they never even knew about 15 years ago. When it first arrived in the US, it was coming in the mail from chemical companies in China. They were making it and sending it to buyers who ordered it on the internet. That has ended because China put in place regulations allowing only a few companies to make fentanyl. But companies still make the ingredients for fentanyl and they ship those to Mexico, where traffickers have figured out how to make fentanyl. They have been shipping it up here in quantities that boggle the mind.
How did this get to drug users? Were they seeking fentanyl?
At first, it was mixed into heroin. They called it heroin, but increasingly it was almost all fentanyl. In later years, street-level dealers began mixing fentanyl into cocaine and methamphetamine as well. It’s a market expansion tool. When you put fentanyl into cocaine, in fairly short order that user will become a fentanyl addict. That addict has to use every day to keep the dope sickness and withdrawals away. Whereas a cocaine user would buy from you every few days or every weekend, this customer has to buy from you every single day. But, of course, you run the risk of killing some of your customers by doing that, because they don’t have tolerances that prepare them for fentanyl.
Your book also looked at some devastating changes in the way methamphetamine is being manufactured. Tell me about that.
For a lot of years methamphetamine was made with a chemical called ephedrine. Ephedrine is a decongestant found in Sudafed pills. It comes from the ephedra plant. The Mexican drug trafficking world industrialized that process and made methamphetimines with it through the 90s and the 2000s. That drug created a very euphoric feeling; it was a party drug.
Finally, in 2008, the Mexican government said only a few companies can possess ephedra and significantly reduced the amount of importation of the chemical. Once the government did that, the trafficking world in Mexico had to find a new way to produce meth. And they found a different way. There are a lot of chemicals. It stinks. It’s complicated. It has one benefit over ephedrine and that is that you can make the precursor many different ways with lots of different legal, industrial, toxic chemicals. The name of this precursor is phenyl-2-propanone, which is commonly known as P2P. With this new method, the government can really never crack down on your meth production the way they did with ephedrine. There are dozens of ways of making it, apparently.
What sorts of chemicals are they using?
All sorts of industrial, toxic chemicals, like lye and hydrochloric acid. There’s a long, long list of things that can be used. But none of these are chemicals you want to put into your body. They’re used for tanning, perfumes, racing fuels.
How did this new formulation of meth change the effects of the drug?
First of all, the reformulation allows the mass distribution of methamphetamine unlike we’ve ever seen before. So it’s now all across the country, from LA to Vermont, including regions like New England where it never existed really before in large quantities.
Along the way though, what I found is that it is accompanied by rapid onset of severe symptoms of schizophrenia, particularly hallucinations. There is incoherent babbling. There’s an extraordinary degree of paranoia. It’s very intense, so you think everybody’s out to get you. No longer is it a party drug. It’s more of a sinister drug, where you kind of turn inward.
How does that affect people’s lives? You believe this changed version of meth is connected to homelessness, right?
What happens is people very quickly become homeless. As this form of meth has marched across the country, we have also seen an enormous increase in mental illness and in homelessness, particularly the encampments that we now have in so many towns across the country. I believe the tent encampments are connected intimately with this kind of methamphetamine. Certainly nobody on this form of meth wants to be in a homeless shelter. Because they’re kind of paranoid and scared of everybody. And so people feel a tent is a little pod where you can be alone away from this nasty world. And I believe it’s all connected. Have other experts confirmed this? There have been no neuroscientific studies on this. So what exactly is happening? I don’t know. Is it because the meth has some new formulation or some new kind of chemical in it? Or, on the other hand, is it simply the fact that it’s so much more potent and so cheap and people are using lots of it? I don’t know. What I’m giving you is the street reporting, from talking to people who have worked in this world most of their professional lives, people who have been addicted to it and people now in recovery.
Can you tell me about Eric Barrera, the former meth addict you met who first highlighted these changes for you?
He had been using methamphetamines since the early 2000s, when Mexican traffickers were almost entirely producing meth using ephedrine. He said he would party all night long and would want to jabber away with everyone. Then, he said, in 2009, everything changed. There was no more of that party euphoria. One night he used methamphetamines and he became scarily paranoid. At his girlfriend’s house, he began stabbing the walls with a butcher knife thinking she was keeping a man inside the walls. He then very quickly became homeless. Up to that point, he had held a job, he had a car and an apartment. Then all of a sudden everything just kind of disintegrates and he ends up on the street.
When I met him, he had been sober for years and was a homeless outreach coordinator for vets. He said, “I don’t know what’s causing this, but I can tell you that every encampment I go through, I see people in the same condition of mental degradation that I went through.”
2009 is exactly the year when the Mexican trafficking world began to switch away from ephedrine meth and toward P2P meth. So I began asking people who worked in the world of methamphetamines what they were seeing. The story is always the same. This stuff arrives and, very quickly, people begin to lose all bearings and the homeless population expands.
Have you gotten any pushback on this theory from those who work with the homeless?
Sure. People want toblame high housing costs for homelessness. They feel that, if you say drugs are the reason for homelessness, then that stigmatizes people who are homeless. I’m not sure I buy that at all. But I found the increases in homelessness happening in areas where housing costs are very high, like Los Angeles, but also in areas where there are no rising costs and where they’ve never had any homelessness, like, for example, the town of Clarksburg, West Virginia.
The story is always the same. This stuff arrives and, very quickly, people begin to lose all bearings