Bathtub Heroin

What’s so surprising about the current “epidemic” is that no one is talking about the exact cause nor are they talking about the obvious solution to this problem.

First lets talk about what is actually causing the overdoses. It’s more nuanced and complex than the media has advertised thus far.

It’s simple economics of supply and demand. When the doctors stopped handing out prescriptions for opiates, opiate addictions weren’t just going to stop. The heroin that was once only found in certain parts of certain large American cities started flowing into places it had never been before as soon as the pills dried up but heroin alone is not that dangerous. Back in my addiction days (12 years retired), a junkie was relatively safe from overdose. The only people that would typically overdose were either those that were those suffering a relapse or first timer users both of whom wouldn’t know their right dose.

The reason there are so many overdoses now is directly related to the chemical that’s being cut into the dope in increase purity. Let me explain. A big time dealer buys several kilos of heroin from a Mexican cartel. That dealer will usually cut the kilos by adding 15–30% of inactive ingredients to increase his overall supply. He, then, breaks the kilos up into quarters and sells them to various mid level dealers. The mid level dealer will cut the quarters by another 20 to 40% with inactive ingredients and break the quarter kilos into ounces. The ounces get pushed out to the street dealer. The heroin will get cut with inactive ingredients yet again so, by the time it gets to the junkie, the purity level is between 10 and 30%. This is a tale as old as the War on Drugs.

However, something has changed. Street level dealers have found a “hack”, if you will. They have found cheap, generic, Chinese Fentanyl on the dark net markets or made in homelabs. Fentanyl is cheap, really cheap, and it’s A LOT (10x) stronger than heroin. The street dealer can mix in the Fentanyl by just 10% of total volume and bring the heroin’s purity up to 50 to 75%. The problem is that no one knows exactly how much Fentanyl has been weaved in from dealer to dealer. This is why the overdoses are happening.

To explain in narrative terms:

Meet Jake. He is 26 years old and has been a heroin addict for three years. He gets his dope from a dealer named Steve. Steve is the guy he’s always got it from. One afternoon Jake awakens to find that he did too much dope the night before and he’s pretty much out. He makes a quick call to Steve to precure another sack but there’s a problem. Steve is out of stock until he “re-ups” tomorrow. Jake starts to panic but, just like all addicts, Jake has a backup plan. He calls Charles, a guy he was introduced to awhile back, that also deals. Charles tells him that he’s got a large supply of “some good shit, man” and to swing on by. Jake runs over to his house, buys the dope and then heads straight back to his apartment.

Jake pulls out his rig and readies his dose. He knows his dose. He’s been on the same 40mg shot for a couple of weeks. He ties off and injects himself. The euphoria hits. It’s amazing. His eyes roll back in his head and the ecstasy overtakes him, he nods out, and then… he overdoses. No one else is home and he dies. Why did he overdose? He overdosed because Charles adds a touch more Fentanyl to his batch of heroin than Steve does and neither Jake or Charles would have been aware of this. That “touch more” is just enough to inadvertently overdose Jake.

This is the story in my home state of Kentucky and the neighboring states of Ohio, West Virginia, and Tennessee. Heroin is not killing people. Prescription drugs are not killing people. It’s generic Fentanyl being cut intio the heroin in varying amounts that’s taking addicts to their graves. No one knows their right dose from dealer to dealer.

Opioid addiction is very old. There are signs of opium poppy cultivation going as far back as 3400 B.C. in Mesopotamia. It’s out lasted any and every law that’s tried to control or contain it. In modern day America, the fire of opioid addiction has turned into a raging inferno tearing through the heartland and the only response the government has is to continually throw tea cups of water on it. Every time they put a part of the fire out, it comes right back raging stronger and more volatile than before. The War on Drugs hasn’t got a prayer. I think we can all agree that it’s time for a new approach.

If this situation sounds familiar, that’s because it’s happened before. Think of the current state of opiates like state of alcohol during the U.S. Prohibition in the 1920's. How many bathtub gin deaths were there during Prohibition? No one can know for sure but estimates are as high as 105,000 in the seven years of the Alcohol Prohibition. Bathtub gin was a homemade alcohol that would wildly vary in potency and ingredients. While all alcohol is effectively poison, when methanol is used rather than ethanol (as was the case in the majority of these deaths from bathtub gin) the potency and toxicity rate is substantially higher. Methanol was used because it was cheaper and stronger than ethanol… the same reasons Fentanyl is used in heroin today.

I could offer up the solution to this crisis but you’re reading this on Medium.com so obviously you aren’t a moron. I’m sure you’re smart enough to infer how to solve the this problem. And if you need any more persuading….