US issues warning on fentanyl abuse

As illicit use of the deadly drug fentanyl spreads rapidly in North America, a US narcotics buster is urging the region to put the drug’s precursor chemicals on a list of internationally controlled substances.

“The spread [of fentanyl] has been so rapid that it is now a national emergency,” said Luis Arreaga, Deputy Assistant Secretary of State for International Narcotics and Law Enforcement Affairs.

“Some of these drugs are used to sedate elephants. That gives you a sense of how strong they are and how deadly and devastating they can be if used in humans,” he said.

Fentanyl, used medically as a painkiller, is 100 times stronger than heroin. In the US in 2015, over 20,000 people died of overdoses related to heroin or fentanyl. The number is higher than road accident fatalities in the country, he said.

The use of fentanyl and its derivatives as illicit drugs is also at epidemic levels in Canada and Mexico, he said.

As an illicit drug, fentanyl, which often appears in tablet form, is manufactured in China. Some believe it is also produced in Mexico, Mr Arreaga said.

“I am not aware of fentanyl being a problem in Thailand. But Thailand understands they need to support us, and ensure they themselves do not become victims of the problem,” said Mr Arreaga.

Mr Arreaga came to Thailand to attend the Bangkok III Conference, an international conference on synthetic drugs, last week. Representatives from China, Mexico, South Korea, Africa and Thailand have backed efforts to control the drug, he said.

While fentanyl itself is internationally controlled under the Single Convention, an international drugs treaty, the two most prevalent precursor chemicals used to illicitly manufacture fentanyl are not controlled by any convention, he said.

He said the Commission on Narcotic Drugs’ likely move in Vienna this month to put the substances on the control list will be a critical measure to prevent the fentanyl threat from crossing other borders.

Praphon Angtrakool, deputy secretarygeneral of the Food and Drug Administration, said fentanyl is controlled as a narcotic under Schedule 2 of Thailand’s Narcotics Control Act.

There is no fentanyl production in Thailand and the FDA is the only agency importing the drug to the kingdom, mostly from Europe.

Each year, the FDA has to project demand for fentanyl and inform the UN before placing import orders, said Mr Praphon.

Any hospitals or medical clinics that want to use the drug must seek permission and strictly report on its use, mostly for cases of severe pain such as cancer patients or patients who undergo major operations and cannot use morphine, he said.

Fentanyl is imported in the form of injected drugs and patches; there are no fentanyl pills.

The FDA deputy secretary-general said whether to put its precursor chemicals on the control list will depend on the extent of the threat, whether the substance is used in the pharmaceutical or other industries, and the impact of such controls.

“In the past, we listed pseudoephedrine as a controlled drug as we had problems with the methamphetamine epidemic. That drug could be synthesised from pseudoephedrine.

“The ban did not affect patients as other cold medicines equivalent to pseudoephedrine were still available,” he said.