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How Worried Should We Be About Fentanyl-Laced Cocaine?

Michelle Lhooq

Michelle Lhooq

Experts discuss whether the dangerous opioid is really as widespread as recent media reports claim.

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In The Festival Harm Reduction Project series, we examine drug use at music festivals and clubs across the globe, and explore what artists, organizers, harm reduction groups, and concert-goers are doing to make nightlife safer.

Last month, the New York City Department of Health and Mental Hygiene issued a warning alerting the public to a rise in overdose deaths linked to fentanyl-laced cocaine. According to the city's press release, 37 percent of the approximately 1,300 people who died of drug overdoses in New York in 2016 tested positively for cocaine and fentanyl, compared to 11 percent in 2015. Per the same report, fentanyl—an opioid pain medication that's cheaper than heroin, and 50 to 100 times stronger than morphine—is getting cut into all kinds of illicit drugs, often without the user's knowledge.

In the corners of nightclubs and on my Facebook newsfeed, my friends erupted into debates. Some warned others it was no longer "safe" to do cocaine, while others expressed disbelief that fentanyl-laced blow was really as widespread as media reports made it out to be.

Wanting to cut through the panic, I decided to reach out to DanceSafe's Founder Emanuel Sferios and Executive Director Mitchell Gomez for some clarity. They told me that in response to the recent news, they've decided to start selling fentanyl drug testing kits on DanceSafe's website this week.

Still, Sferios and Gomez expressed the belief that fentanyl poses a much bigger risk to heroin users than those who do cocaine. "Although on our website product page, we give instructions for people to test non-injected drugs like cocaine," said Sferios, "we expect the vast majority of people purchasing our strips will be using them to test heroin or counterfeit pharmaceuticals, where fentanyl is much more common."

Below, Sferios and Gomez explain whether New Yorkers should really be worried about fentanyl-laced cocaine—and what people can do to protect themselves.

THUMP: Is fentanyl-laced cocaine really something the average club-goer should be concerned about?

Mitchell Gomez: From how few of the fentanyl-cocaine deaths we have seen, this is clearly a fairly rare event. There are a huge number of recreational cocaine users in the United States. If even one percent of the cocaine was laced with fentanyl, we would have far, far more deaths than we're seeing. That said, given the incredibly serious outcome, users should be aware of the risk and do everything they can to mitigate it.

Emanuel Sferios: When people say "fentanyl," they may be referring to fentanyl itself or one of its many analogs. Some of the analogs are even more potent than fentanyl itself.

What are the dangers are of accidentally doing fentanyl?

Mitchell Gomez: Fentanyl, and some of its even more potent analogs, are deadly in incredibly small doses and difficult to test for. We simply don't know why they are ending up in non-opiate drugs. Fentanyl analogues like 3R,4S,βS-ohmefentanyl are nearly 30 times as potent as fentanyl. This means a fatal dose would be somewhere in the neighborhood of 160 micrograms—a dose that in powder form would be invisible to the naked eye.

Emanuel Sferios: That is a tiny spec. People regularly snort a gram or more of cocaine in a night with no problems.

Is fentanyl getting cut into coke, or is it being passed off as coke entirely—the latter presumably being way more dangerous?

Mitchell Gomez: It's being cut in to cocaine and other drugs. A one-gram bag of pure fentanyl would be nearly 400 fatal doses.

Emanuel Sferios: There is absolutely no reason for a dealer to add fentanyl, a synthetic opiate, to cocaine. Cocaine users are not looking for an opiate-type high.

There is absolutely no reason for a dealer to add fentanyl to cocaine. Cocaine users are not looking for an opiate-type high.—Emanuel Sferios, founder of DanceSafe

Without a drug testing kit, what are some signs that you might have taken coke with fentanyl in it?

Mitchell Gomez: Feelings of euphoria and relaxation, sedation, drowsiness, dizziness, nausea, respiratory depression or arrest, and death.

What can you do to protect yourself?

Mitchell Gomez: All recreational drug users, regardless of the substance they use, should be trained on the opiate overdose drug naloxone, and should never be using alone. Even having multiple people all take bumps of a new or untested baggie is potentially problematic behavior. Now that we have a reliable test for fentanyl and related analogues, all users should also be testing their drugs for fentanyl.

Is fentanyl more dangerous than other substances that could get into your coke?

Mitchell Gomez: In terms of potential adulterants, fentanyl and fentanyl analogues are by far the most dangerous things we have seen cut in to cocaine.

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