Pol Quintana Mireia ventura The hidden web and the fentanyl problem: detection of ocfentanil as an adulterant in heroin Pol Quintana Mireia ventura

Credit Mireia Ventura Marc Grifell Alvaro Palma Liliana Galindo Iván Fornís Cristina Gil Xoán Carbón Fernando Caudevilla Magí Farré Marta Torrens

Background: the internet and drug supply Internet + non controlled substances = “Legal High/Research Chemical” phenomenon Internet + controlled substances = “Silk road” phenomenon

Background: the fentanyls Ocfentanil Patent 1959 1986 Medical use General anaesthesia, deep sedation, treatment of moderate to intense pain Clinical research stopped 1991 Never licenced as a drug. Active dose 50 µg (0,05mg) 30 µg (0,03mg) Legal status Scheduled Not scheduled

Background: the fentanyls problem Fentanyl use is a major concern in several contries such as USA, Canada, Australia, Estonia Fentanyl derivatives have been detected… In the surface web (butyrfentanil & 4-F-butyrfentanil, 2015) In the hidden web (acetylfentanyl & butyrfentanyl, 2016) Fentanyls have been used to adulterate heroin and other opiates for at least three decades, causing outbreaks of overdoses and deaths.

Why this talk? Case-study featuring an old problem (adulteration of heroin with fentanyl derivatives) in a new context (the hidden web) with a novel substance (ocfentanil)

“The effect is opiate of course, but not exactly like heroin” “For really addicted people there is a difference: the effect is shorter so they are sooner in withdrawal. One person said what alerted him was that when he took this heroin, he was in withdrawal every morning when he woke up.”

Methods

Methods

  Date Sold as Appearance Result Bought in/ sent from Additional features Sample #1 June 2015 Heroin White powder Ocfentanil, caffeine, paracetamol Hidden Web, 4/3/2015 Madrid Vendor: “FrenchConnection” Male, 36 years old Sample #2 October 2015 Not available Ocfentanil, caffeine (27%), paracetamol (33%), heroin (16%) Hidden Web, 5/9/2015 France Vendor: “Europdrugs” Sample #3 Ocfentanil, caffeine (26%), paracetamol (29%), heroin (3%) Sample #4 March 2016 Hidden Web, 10/3/2016 Vendor: Unknown Male, 45 years old

Other reports A British harm reduction organization, WEDINOS, also reported the combination of ocfentanil, paracetamol and caffeine in heroin samples bought from the hidden web. Chest pain, psychosis and agitation reported. One fatality due to heroin bought in the hidden web and adulterated with Ocfentanil.

Presence on the drug market Ocfentanil had never been detected in samples sold trough traditional markets. No web pages or individuals advertising ocfentanil were found on the surface internet or on any of the main hidden web marketplaces. The alert launched by Energy Control quickly spread in both the surface web and the hidden web. Discussion on fora pointed to two specific vendors (FRENCHCONNECTION and EuropeDrugs). Were eventually banned from marketplaces.

2013 4th sample sent to Energy Control (unknown vendor) March 2016 4th sample sent to Energy Control (unknown vendor) Sept 2013 Dutch police seizes batch of ocfentanil, caffeine and paracetamol March 2015 Belgium citizen found dead at home 2013 2013 2014 2015 2016 110 días Energy Control's 3 samples (Europdrugs & frenchconnection) 153 días Wedinos' 6 samples

Discussion We hypothesize that its introduction into the market was done by one unique agent, which did not consider selling the compound through the usual NPS and “legal highs” internet channels. Outbreaks of heroin adulterated with fentanyls might be very challenging if they originate from the internet. Drug testing might prove an useful monitoring tool, as new fentanyl derivatives will certainly emerge in the near future.

Conclusions The drug user community reacted to the adulteration. Although previous research has suggested that adulteration might be lower in hidden web marketplaces, it is indeed a real risk in the Deep Web.

A few questions for the audience… Is the extension of this phenomenon to the hidden web a sign that the fentanyls problem is growing? What was the drive that led to using ocfentanil as an adulterant, instead of other already marketed fentanyl derivatives such as butyrfentanyl or acetylfentanyl? As ocfentanil is not a world-wide controlled substance, why was it not sold as a “legal high” in the first place?

Thanks! Contact Mireia Ventura mireia@energycontrol.org Pol Quintana polquintana@gmail.com With the collaboration of: