Thread by @DrDavid_IDEM

All #fentanyl analogs in the black market are a product of drug regulation/prohibition.

Imagine making choc chip pancakes and finding that your spouse refused to buy choc chips so you find something that looks like choc chips and use those instead. Well, those were laxatives 🧵

https://twitter.com/drdavid_idem/status/1630340008686104581

2. I’m sure that analogy isn’t the greatest, but let’s talk about “true” fentanyl. The ingredients to make true fentanyl are no longer easy to access or buy because govt regulation restricted who can purchase those ingredients… and now cartel labs can’t find those ingredients.

https://twitter.com/drdavid_idem/status/1590374170474315777

3. The solution to this problem for cartel labs is to use alternative ingredients that LOOK like the normal ingredients for making true fentanyl. So like the pancakes made with chocolate laxative, fentanyl made with alternative ingredients are no longer the “true” product.

4. Fentanyl synthesized using alternative ingredients are known as fentanyl analogs - essentially chemical siblings/cousins of “true” fentanyl. Many of them were designed and patented decades ago as pain meds but achieved no commercial success and are not used clinically today.

https://twitter.com/drdavid_idem/status/1590374190703865860

5. Although the history of many fentanyl analogs date back to the 1960s-80s, they became prevalent in the illicit drug market (black market) in the 2010s.

6. Originally, “true” fentanyl was being diverted (stolen) from legitimate pharmaceutical/clinical sources and was used as an additive to heroin. This was popular in the late 2000s - early 2010s. Then the govt started strictly regulating Rx fentanyl supplies to prevent diversion.

7. With Rx fentanyl supplies being strictly monitored by the US govt, the black market would circumvent regulation by smuggling Rx fentanyl into the U.S. from other countries… and then other countries’ govt started regulating their Rx fentanyl supply.

8. At this point cartels couldn’t easily purchase Rx fentanyl supplies from anywhere, so the solution to this problem was to buy all the ingredients and illicitly manufacture their own fentanyl - which would have dangerous impurities in it due to no quality control.

https://twitter.com/drdavid_idem/status/1590374180356517888

9. Then the US govt and others started regulating the ingredients of “true” fentanyl. Cartels and clandestine labs could no longer find/purchase the necessary ingredients to make true fentanyl so they started using alternative ingredients, which would produce fentanyl analogs.

10. Once world govt caught on to what clandestine labs were doing, they would regulate the alternative ingredients and the black market’s solution to this was to just find other alternative ingredients similar to the last alternative ingredient, producing newer fentanyl analogs.

11. This has been an ongoing cycle since 2010. Govt Regulation ➡️ cartel finds new alternative ingredient ➡️ synthesize new fentanyl analog ➡️ more ppl die ➡️ repeat.

There are countless alternative ingredients to use, so an infinite number of fentanyl analogs can be made.

12. This concept of circumventing govt regulation by making drug analogs that mimic a “true” version of a drug is nothing new - it’s known as designer drugs and it was popular for illicit manufacture of party drugs, but now we see designer drug opioids, amphetamines, and benzos.

13. To the U.S. legislators and lawmakers, when you think about the next steps of addressing the drug epidemic, consider that strict regulation has done more harm than good in the U.S.

14. Govt regulation restricted access to safer Rx supplies for ppl that truly need them and opened up the market of pain patients to the cartels’ deadly fentanyl analogs.

Ppl with addiction and recreational users are also left to buy this deadly drug supply - 108k dead in 2021.

15. The black market has always found a way to evolve how they maintain a steady drug supply and circumvent govt regulation, constantly staying 2 steps ahead of the U.S. govt.

It’s like watching Tom and Jerry, guess which side is Jerry 🐭.

16. For any legislator that’s not familiar with #HarmReduction, check out the linked RT. It’s an initiative more state and local govt should adopt as a supplemental solution to address the drug epidemic. I’d be happy to point you to experts that can further educate you about it.

https://twitter.com/drdavid_idem/status/1566458414007558150

17. For the legislators out there that love to fund #lawenforcement here’s another way you can help… fund drug crime labs to help track illicit fentanyl supplies.

https://twitter.com/drdavid_idem/status/1590374199407050753

18. If any other experts in this field want to add to this or correct me on any of it, feel free to do so. I’ll take your reply and add it to the thread.