In the first edition of this series of clandestine lab response, we covered methamphetamine-related clandestine lab responses and some sampling/manufacturing methods. Today, we are shifting towards the ever-growing opioid issue, specifically discussing heroin and fentanyl along with various other drugs.
First, let’s start with some background of current and past trends in the illicit and pharmaceutical field in the world of opioids. What exactly is heroin, and how did it become the largest used narcotic in the U.S today? Heroin, a schedule 1 narcotic, is currently banned in all 50 states due to having no medicinal use; it is extremely addictive.
In the early 2000s to late fall of 2006, pill and fentanyl patches/devices were the common trend among heroin users in small doses in fentanyl abuse, but pills have constantly remained in the mix of opioid usage. Currently, oxycodone, hydrocodone, meperidine, hydromorphone, and propoxyphene are the largest abused painkillers in the southern regions of the united states, reported by active street users. Heroin is an illegal opioid derived from the Opium Poppy, commonly referred to as the “King Poppy,” stemming from its crown-like shape on top.
These plants are farmed from countries in Asia and the middle east; Afghanistan is one of the world’s largest exporters of poppy seeds. Opium poppies are best grown in hot, mountainous regions around the world. A key area contributing to most of the world’s production is the “Golden Triangle” in Southeast Asia, specifically Laos, and in the “Golden Crescent” region in Afghanistan and Pakistan. An estimated 704,000 acres of area planted in Afghanistan are used to mass-produce poppies each year.
Poppies go through various growth stages, but when used to start heroin manufacturing, each plant must be touched twice by human hands. In this process, the bulbs must be sliced with a razor, or other sharp objects, to “bleed out” the poppy’s milk. This is allowed to drip until it transforms into a brown thick syrup. It is then collected, scraped, and sold by the pound at current market prices as a precursor element, where it then starts the traveling process. The remaining plant bulbs are then cut open and scraped to be sold for their internal contents.
Opium alkaloids come from these plants and their contents. The “six opium alkaloids” which occur naturally in the largest amounts are morphine, narcotine, codeine, thebaine, papaverine, and narceine. Of these, the three phenanthrene alkaloids are under international control: these are morphine, codeine, and thebaine.
They are all three used in the drug industry; thebaine is usually converted into another derivative, which is more useful medically. Of the other three not under international control, narcotine and narceine have scarcely any medical or other uses. Opium alkaloids are a leading contributor to illicit substances used and popularized by famous rappers who influence the general public by encouraging their use.
Many songs promote the use of illicit substances such as molly, speed, coke, and lean. Poppy seeds are also commonly sold wholesale to bakers or in stores such as World Markets and grocery stores for their baking uses. One common trend is to mass purchase seeds from stores to make “Poppy Seed Tea” in private residences. When completed, this process is equivalent to a small milligram dose of an opioid similar to the effect of morphine.
Oxycodone: Has the greatest potential for abuse and the greatest dangers. It is as powerful as heroin and affects the nervous system the same way. Oxycodone is sold under many trade names, such as Percodan, Endodan, Roxiprin, Percocet, Endocet, Roxicet, and OxyContin.
Hydrocodone: It is used in combination with other chemicals and is available in prescription pain medications as tablets, capsules, and syrups. Trade names include Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Tussionex, and Vicodin. Sales and production of this drug have increased significantly in recent years, as has its illicit use.
Meperidine: (Brand name D Demerol) and Hydromorphone (Dilaudid) come in tablets and Propoxyphene (Darvon) in capsules. Still, all three have been known to be crushed and injected, snorted, or smoked.
While these common substances are found daily, illicit pill labs are on the rise and are starting to show a “quick sell” for small-time drug manufacturers. Pill presses, capsules, and binding agents are relatively inexpensive and are sold worldwide and are considered novelty items, making them readily available to start the manufacturing process from home.
The pill manufacturing process is a simple as using an illicit substance, proportioning said substance with a cutting agent, adding a binding agent, and pressing in a manual pill press. So, how do they affect hazardous materials teams? Simple. Heroin has been identified by several major law enforcement and watchdog agencies as one of the most trafficked items on the drug market today. Heroin comes in many forms and is mainly imported into the United States via cartels to border cities, then sold country-wide.
Heroin comes in many forms, and hazardous materials technicians should distinguish between the differences in the appearances of each type in the event of being requested to do product sampling or product identification. Spectroscopy techniques are currently being used to intercept packages from US post offices and US CBP Customs facilities to help identify suspected packages containing heroin and fentanyl, sometimes without actually opening the suspected container.
Pill presses being used to mimic synthetic opioid substances such as oxycodone, which are snorted, and injected. Oxycodone, when injected, is considered to be the most dangerous route of administration. “Oxycodone is a prescription opioid, which is also described as a narcotic. It changes how the brain senses and responds to pain, but oxycodone can also cause a sense of euphoria, which is why it has been noted as one of the most widely abused opioids on the public market.” One of the most well-known brand names of oxycodone is OxyContin.
Drug traffickers smuggling products into Mexico needed to perform the manufacturing process often originate from southeast Asia or South America and deliver Mexico’s precursors for completion. Heroin is an opioid, which is a central nervous system depressant and is often mixed with other depressants such as cough syrup (codeine), oxycontin, and oxycodone are reported by users to be the closest thing to heroin that can be purchased from a pharmaceutical company to be crushed, distilled, and injected to give the same effects as heroin. These are some examples of synthetic based opioids that are reported as on the rise by street-level users. (Synthetic opioids are any human-made opioids that are produced cheaper and quicker than illicit substances).
Once all the needed precursors are in place, and the manufacturing process has begun, various types of heroin are the result. Due to the drug and process’s extreme popularity, we will not dig deep into the manufacturing process. We know many of the same precursors used in the manufacturing of methamphetamine are used in the product of heroin (lime, sulfuric acid, rat poison, bleach, drain-o). There is a current rivalry between markets, with Asia being the leading exporter for many years until famous drug lord Pablo Escobar traveled to learn and share methods of producing quality grade heroin from overseas nationals, and has since dominated the market.
Common heroin varieties are Mexican Black Tar, Brown, and White heroin streaming into the US from the south. Southeast Asian white heroin has been a major player in the heroin industry, affecting the US for years until the flood of “Mexican Heroin and Mexican Meth.” There are 2 types of labs that responders will encounter when making entry to perform air monitoring, mitigation, and evidence collection. The following substances may be found in production or storage.
Milling Lab: A milling lab, where synthetic opioids are mixed with binders or other illicit products to create a street-ready product, and has particles present than can cause exposure.
Production Lab: An illicit lab used for the manufacture of a chemical by using precursor elements to create an illegal substance; milling labs may be present to support cutting operations. These labs combined commonly run to push a finished product onto the streets.
Black Tar Heroin: Black tar heroin is manufactured in Mexico and brought to the US the same as other illicit substances, and appears dark black similar to that of roofing tar or freshly paved asphalt. This dark coloration comes from the manufacturing process and results from an impure product, with black tar being no more than 30% pure at its best. Due to its chemical makeup, black tar heroin must be diluted, dissolved, and then be injected into the user’s preferred injection site. Black tar heroin is known to cause clogging of needles and is regarded as one of the most dangerous to use. It is mainly found in the western states of the US.
White Heroin: White heroin is regarded as the most popular type on the market with origins in Afghanistan and Southeast Asia marketing the first known strands of the white heroine, but Mexican cartels quickly learned to adapt, seeing the market potential for white heroin in the US. The cartels have since paired with overseas nationalists to learn the best manufacturing procedures to ensure a better product. The term “China White,” “Snow White,” and “Snowballs” have begun emerging to describe white heroin cut with fentanyl, which has become the most popular combination to be cut. White heroin color and appearance vary greatly on the cutting agent used and often appear to be a darker shade or even dirty in view. White heroin, when used, can be snorted, injected, or smoked as it is mass-produced and is found all over the US, meaning it is more readily available.
Brown Powder Heroin: Brown is commonly seen as a less acidic form of heroin and commonly is smoked over injection due to the chemical makeup. Brown being the weakest of the market options, is less used due to the overall weakness but is still an alternative often seen as a cheaper option depending on its being sold. Brown Powder Heroin is found in the southeastern states, all along the US/Mexico border,
Heroin, regardless of method of use, shows specific tell-tell signs of use. Heroin users must use every 4-6 hours to avoid becoming “dope sick,” otherwise known as withdrawals. These withdrawals are extremely violent on the body, leaving users to do whatever is necessary to get their next fix. How do you identify that someone is using or suspected of using?
Signs and symptoms to look for include multiple injection points or sites, extremely pinpoint pupils not reactive to light, ptosis (heavy eyes), extremely raspy voice, and finally, “the nod.” “The Nod” refers to the deep stage of opioid use with heroin, where the patient will slowly fall asleep while in mid-sentence, stop talking and start snoring only to resume a conversation. Patients have been noted responding violently when surrounded, and report a feeling of something crawling on their skin, only to have nothing on them. This is a common complaint seen amongst users, and these signs should be identified upon patient contact.
MDMA: 3,4-methylenedioxy-methamphetamine (MDMA) is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception. MDMA was initially popular in the nightclub scene and at all-night dance parties (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly.
While MDMA mentioned here isn’t an opioid, it is a synthetic produced product commonly found in the party/college scene and frequent heroin use. MDMA is commonly used in tablet, capsule, powder form, or even in a liquid state for use. MDMA is commonly referred to as “Molly” due to its chemical composition and is used as a hallucinogenic to alter the mind, much like LSD.
MDMA, while being popular in the party scene, is often found with heroin due to its rapid effectiveness and 3-6 hour strength, but is commonly taken in 2 doses to increase its hallucinogenic state that it produces to increase the “rush of the party,” With these above mentioned illicit substances, how can you tell the difference? There are various ways to conduct field testing, and one of the easiest used for product identification is the Polytesting System of Narcotics Identification.
“The NIK® Polytesting System was designed to identify substances suspected of being illegal drugs rapidly. Users of the system begin with a general test and, through a series of tests, can presumptively identify major drugs of abuse.” NIK public safety offers testing solutions in various test formats, dependent on the users’ product requiring testing.
As one of the fastest testing solutions for roadside interdiction, it should not be used as an “end all be all” for testing. It is used to offer initial screening, and further sampling should be conducted if in mass quantities or forwarded to a lab for analysis. Most state law enforcement agencies will conduct this transfer and handle follow up results. Using the NIK testing series, the user will select a test kit specifically for the suspected substance and test in a series of kits using a general series test and moving to specific product tests for identification. Much like colorimetric tubes, when testing for a specific narcotic, the testing pouch is opened, and the substance is placed inside and sealed with a clear slide on the tab, and the pouches contain one, two, or three chemical ampoules inside. This eliminates the need for measuring, mixing, and dispensing of reagents. Just place a small sample of the suspected drug in the pouch, break the ampoules, and watch for the color change. A positive color indicator on the pouch will help to interpret the reaction. This is a tried and trued testing system used by many law enforcement and hazardous materials teams. This is by no means an endorsement for the NIK brand, just one that has been used successfully in person.
Testing options include general screenings, opium alkaloids, methamphetamine, specific heroin testing (White, Brown, Black), marijuana, hash, hash oil, GHB, and ketamine, to name several popular screening tests.
The popularity of Mexican meth/heroin is increasing daily, but decreasing is the quality of the product and an increase in cutting agents. A cutting agent is “any chemical used to dilute the quality of a drug by using a compound less than the drug itself.” Cutting agents can range from brake fluid, strychnine (a white crystal based substance commonly found in rat poison and extremely toxic) to fentanyl cut in dangerous, unproportioned amounts. When the final product is ready, oftentimes, it is cut before even traveling to the US by an unknown compound. Fentanyl is currently being seen in large amounts nationwide and is increasingly being found in more and more shipments. Cutting is done to increase profit margins and often will cause an increase the range of thousands of dollars.
If a street-level dealer receives 3 kilos (2.2 pounds per kilo) of Mexican brown heroin, at wholesale rates of $26,200 each (current market pricing in a major city in the southern US as of publication), and decides to expand his profits, he can sell a gram of brown heroin at $60-90 per unit uncut. But, if he chooses to cut the drug, he will increase into the thousands depending on the quantity he can then make simply by splitting the product’s makeup from 1 to 2 parts. Take the 6.6 pounds of brown heroin, and lay it out. If he chooses to cut the product with fentanyl, he will obtain 6.6 pounds worth, for example, and use it as the cut.
If he chooses to sell grams and divide them for packaging, he can make 2,993 individual grams for straight brown heroin. If he cuts with fentanyl at 6.6 pounds, there are now 5,443 grams total (2,993 grams in 6.6 pounds)l. When he cuts the product at 0.5 grams each (0.5 heroin, 0.5 fentanyl), he can increase his total output from an original 2,993 grams to 5,986 grams total simply by changing it from 1 gram of brown heroin to 0.5 brown heroin/0.5 fentanyl to equal 1 gram listed as “1 gram of brown heroin” without the buyer even knowing that it has been cut, thus doubling the original amount purchased.
This has allowed the dealer to go from $60 a gram, selling 2,993 grams total, to 5,986 grams increasing his marginal gain from $179,580 to $359,160. 1 kilo (2.2 pounds) of fentanyl has been reported to be manufactured in pill form of up to 1 million pills, per a DEA directive. A rising trend among the party scene and the college-aged crowd is capsules, with heroin/fentanyl cuts and LSD/MDMA as a popular party drug due to their discreet size and quantity potential.
As a hazardous materials team, this is where proper PPE and sampling equipment must pair with opioid knowledge when dealing with milling/production labs. Cutting of products impacts those making entry/being in this atmosphere dealing hands-on with these products. Fentanyl is transdermal, meaning it is absorbed through the skin. At just 2 microns, fentanyl has proven to be deadly on its own; thus, when dealing with large amounts in cutting labs, responders need to be aware of issues associated with sampling in these labs. Known analogs of fentanyl include: “Carfentanil, Acetyl Fentanyl, Butyryl Fentanyl, Remifentanil, Ocfentanil, Sufentanil, p-Fluoro Fentanyl, Furanyl Fentanyl, Valeryl Fentanyl, and 3-Methyl Fentanyl.” Testing can be conducted using BTNX strips, which detect the presence of fentanyl and its analogs, as mentioned, and are being used on the street by users currently to test their own product before administering it to themselves.
If they are prepared to test, why are; ’t you? When conducting bulk sampling of fentanyl, a visible amount must be available for testing. This can be done using colorimetric tubes, which come at a low cost, easy to use, and proper training. Raman Spectroscopy and Infrared Spectroscopy are alternative options with detection ranges from mid-to mg, both maintaining a large reference library to provide a wider spectrum with specific property identification. In cases where less than 10% of the sampling material is available, users will find issues conducting testing using devices such as TruDefender, HAZMATID-ELITE, or ThermoFisher Scientific. As previously stated, the US Customs and Border screening agents currently employ Mass Spectrometry to screen suspected packages with fentanyl compounds or without making contact with the product.
If just 2 microns of Fentanyl is lethal, consider cutting agent quantities at 6.6 pounds, and you have a huge risk hazard with a quantity of that size. Directive CFR 29 1910.134 specifically addresses respiratory protection standards directed towards FIT testing, proper respiratory protection selection, and maintenance. An additional DEA recommendation of PPE for entry into suspected fentanyl labs for prolonged operations is available at the link provided. The DEA recommends level A for fentanyl lab entries, but this has been a large discussion amongst the hazardous materials community and should be discussed as a part of your pre-incident planning.
With proper training, responders can respond to smaller situations using P100 filters on a half mask or respond with full SCBA as depending on your protocols. Many law enforcement agencies have adopted an elastomeric half-mask air-purifying respirator using multi purpose P100 filters and nitrile gloves with a minimum thickness of 5 mils (0.127mm). This is changing times and a new phase for the hazardous materials community due to so many unknowns. You can view the DEA.’s response guide to fentanyl here:https://www.dea.gov/druginfo/Fentanyl_BriefingGuideforFirstResponders_June2017.pdf
29 CFR 1910.134 can be found here:
Please address this with your respective agency on PPE selection, establish a working mitigation plan with law enforcement, and evidence processing plan should be included to collect evidence, secure it, document it, and transport it for testing. Double bagging should be required and clearly labeled “SUSPECTED FENTANYL” or dependent on your agency mitigation plan to label evidence for the chain of custody matters. Recently, a SWAT team made entry into a suspected illicit lab to serve warrants, and when in the breaching stage of entry, deployed a flashbang device into the residence, disturbing an unknown white powder which was seen covering a large portion of the room, and it was unknown if it was disturbed by the actual deployment of the device, or if a suspect inside dispersed the powder onto the floor/surrounding areas.
11 officers were transported due to fentanyl exposure and shortly released. Since this event, many law enforcement, fire, and EMS agencies have begun providing better PPE to responders in dealing with these types of responses. So, ask yourself, if just a drop of powder can take down 11 men, what will it do to your crew with your current PPE or response plan? Are you prepared?
When responding to any clandestine lab, whether stationary inside a structure or mobile, you should always consider the likelihood as time moves on where you will encounter a cutting agent such as fentanyl. You should, at a minimum, plan to be exposed to it. Another great resource mentioned before in the first clandestine article is your local HITDA (High-Intensity Drug Trafficking Areas) task forces, who offer specialized training on illicit substances, has developed a mapping tool for law enforcement and hazardous materials mitigation teams as well as EMS agencies to report overdoses in their jurisdiction, which can aid in the tracking of overdose trends and if available for logging, what illicit substance was used in the overdose.
“The ODMAP provides real-time overdose surveillance data across jurisdictions to support public safety and health efforts to mobilize an immediate response to an overdose spike. It links first responders on scene to a mapping tool to track overdoses to stimulate real-time response and strategic analysis across jurisdictions. It is a mobile tool, capable of being used in the field on any mobile device or data terminal connected to an agency CAD system”. You can access the link here:http://www.hidta.org/odmap/.
So, as a review, a problem we deal with every day originates over 10,000 miles from where it began. We can prepare or be behind the eight balls. Establish plans, make calls now, assemble for training, and prepare for this to impact your community. Many said it would not reach where we are today and marked it off as a fad, but are luckily adapting to changing times.
As a side note for responding to incidents involving fentanyl or possible fentanyl analogs, a handy and user-friendly application available for IOS and android is FentaTIPS, provided by the wonderful folks over at emergencyresponsetips.com! The app is super user-friendly and provides a ton of information for the user to address any questions that may arise while operating at an incident involving fentanyl or other opioids. Please check out the app, and leave them a 5-star review, as they offer more to the hazardous materials community via podcasts and subject matter expert input on opioid response.
Sources: U.S DEA, hitda.org, hitda.org/odmap, drugfreeworld.org, unodc.org, emergencyresponsetips.com, regionalcounterdrugtrainingcenter.org, Atlanta-Carolina HITDA, NIKPublicSafety.com, Draeger, https://www.btnx.com/.