The strange history of Fentanyl

So a new heroin variant is hitting it big. This is a fascinating bit of reporting, and the sort of thing you’ll never see in a “real” news outlet. Buried in a story going over the new distribution and overdose spikes, there’s this:

Fentanyl’s official—if not always legal—use extends from the medical to the military. It has been tested, and occasionally used, as an agent of chemical warfare.

In 2002, Chechen Islamic separatists stormed a large theater in Moscow that was showing a production of the popular musical Nord-Ost. Around 50 heavily armed Chechens, some with explosives strapped to their bodies, took around 850 people hostage, including the cast and crew, and demanded that the Russian military abdicate Chechnya or hostages would start dying. After three days of standoff and negotiation, Russian soldiers blasted a mystery gas through the theater’s ventilation system, incapacitating the rebels and the hostages, and then raided the building. The mission was not entirely successful. Between 115 and 200 of the hostages died—depending on whose numbers you believe—but only one, according to Dr. Andrei Selt- sovsky, chair of the Moscow health committee, died from gunshot wounds. The other 114 to 199—including 17 cast members of Nord-Ost, two of them child actors—were killed by the gas.

The Russian government tried to keep the chemical composition of the gas secret: Doctors on the scene complained that they could not treat hostages because police wouldn’t tell them what they’d been gassed with. But four days later, Health Minister Yuri Shevchenko announced that the gas was a derivative of fentanyl. (For the chemists among you, it’s widely believed—but has never been confirmed—that the Russian gas was Kolokol-1, which contains 3-methylfentanyl. That’s a derivative of fentanyl that’s more commonly made in clandestine labs and sold for recreational use than regular pharmaceutical fentanyl. In other words, the type of fentanyl you’re buying on the street is probably the same type used by the Russian military.)

The United States has also toyed with fentanyl as a chemical weapon. In 2003, Guardian columnist George Monbiot reported that the Bush administration had been trying to “wriggle free” from the US commitment to the 1925 Geneva Protocol on chemical weapons so it could use them in Iraq. (Never mind, Monbiot writes, that “the point of this war, or so we have endlessly been told, is to prevent the use of chemical weapons.”) According to Monbiot, Donald Rumsfeld’s office confirmed the decision had been made to use chemical “riot-control agents” in Iraq. Rumsfeld himself had been arguing against the Geneva Protocol, telling Congress’s Armed Services Committee that “there are times when the use of nonlethal riot agents is perfectly appropriate.” (Though the deaths of the Moscow hostages could hardly be described as “nonlethal.”)

Reports from Penn State and the Lawrence Livermore National Laboratory detail research done on behalf of the Department of Justice and the Marine Corps on the use of fentanyl for “less-than-lethal targeting.” The LLNL report declares fentanyl “an uncommon and very powerful drug” that could be fired at enemies as a projectile or “dispersed as a smoke… into an air duct or office building air conditioning system.”

Rumsfeld was CEO and president of the US pharmaceutical firm G.D. Searle & Company from 1977 to 1985. By 2003, Searle had merged with Monsanto, which then merged with Pfizer—a major manufacturer of fentanyl.

Also, the sort of insider drug business dealings I haven’t heard about. I just don’t know the right people, do I?

Here’s another theory: The fentanyl entrepreneurs—whoever or wherever they are—are trying to introduce China White heroin to the West Coast’s longtime black tar heroin market, breaking a hallowed drug-market convention.

Hmmm…so basically the idea is to gas people with a kind of synthetic heroin in order to knock them out with a slight overdose? Seems pretty dangerous to me.

About 200 russian theatergoers would agree with you. Legendary fuckup by the FSB (?) there.

Uh…yeah. The Russians killed 15% of the 850 hostages with the gas.

Yes, Kong, I noticed that. It’s right there in the quote. My point is that the idea is dangerous on its face, without any need for practical tests.

It makes me wonder how prevalent prescription abuse of fentanyl is, which the article doesn’t really address. You’d imagine that it must be far more tightly controlled, but I remember an episode of Intervention from a couple years ago where a woman was going through fentanyl pops like crazy, for joint pain and dislocation caused by “electric fields” (later proven to be psychosomatic when she finally got treatment).

I was on fentanyl patches for a while for severe back pain. Did a good job of helping me manage the pain, but it was really hard to get things done. I’d sleep for ten hours, wake up, have breakfast and an hour later fall asleep in my seat. It was also crazy expensive and I didn’t have insurance so I was very happy when I was able to get off it.

I was on Fentanyl after being in a coma. It was good at managing pain but gave me wicker awful nightmares and as you said - you were just sleeping all the time. Unlike some of my other pain meds it was not easy to come off of. I"d use it again for pain management, but not unless I’d exhausted a lot of other options first.

Another problem is when you take a hot shower. You get a booster dose which you don’t want as the patch then runs dry too early.

Wait - doesn’t Fentanyl cause respiratory depression? That’s one of the major side effects, your lungs just go “Fuck it man, we’re taking a few hours off.” I can only imagine the heroic levels of bronchodilators you had to be on as well if they’re giving you Fentanyl.

Never had Fentanyl. Strongest thing I’ve ever been given was Dilaudid, while in the hospital for pancreatitis. They first tried giving me morphine for the spasms/pain, lots of it actually, and it did next to nothing. One Dilaudid injection, though, and I was down for the count. It was hard to move, I slept within only a few minutes, and had crazy hallucinatory dreams. They administered a dose to me every 4 hours, and when I was awake I would say words that were not the words I meant to say, talk about things I had dreamt but never happened and not realize it. It also took me a really long time to get my body to pee, even if I had to go really bad. Didn’t have any problems withdrawing from it after leaving the hospital. I purposely started to turn down every other of the 4-hour injections towards the end of my stay to wean off of it slowly and not abruptly, though, so I’m sure that’s why.

I can’t imagine something stronger than that. No wonder it kills so many people.

Pretty much all heavy pain meds do. Fentanyl is just worse for some people. For me at the time, Fantanyl was the prefered pain med for ICU and I was in indescribable pain. My lungs were so swollen they were squished out between my ribs (plus I had pancreatitus).

Matthew - IV Dilaudid does that to me too! I have to be cathed for ~5 days before my body gets attenuated enough to be able to pee again.

I was able to use this article as a major plotpoint in a Cthulhu campaign tonight. So…uh…thanks!