The Current

Fentanyl once thought too 'risky' to become a widely used drug, says author

Author Ben Westhoff discusses his new book about how fentanyl was the drug nobody saw coming — until it became a scourge on North American streets.

New book looks at origins of fentanyl and how it became deadly part of opioid crisis

Fentanyl has been related to more than half of all opioid-related deaths in Canada over the last three years. (Drew Angerer/Getty Images)

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Nobody foresaw fentanyl's impact on the illicit market because it was simply "so powerful," says a journalist who has investigated how the drug became a deadly part of the opioid crisis.

"It's 50 times stronger than heroin, and it only takes about two grains of rice worth to overdose and die," said Ben Westhoff, author of Fentanyl, Inc.: How Rogue Chemists are Creating the Deadliest Wave of the Opioid Epidemic.

"Authorities just thought that people wouldn't engage in such risky behaviour."

But they hadn't counted on fentanyl being discovered by long-term heroin users, he said. Sustained use meant that these drug users weren't able to get high from heroin anymore; it just got rid of their withdrawal symptoms. 

"But fentanyl is so much stronger that it gets them high again, and that's part of the reason it broke through," Westhoff told The Current's interim host Laura Lynch.

A man walks past a mural by street artist Smokey D. about the fentanyl and opioid overdose crisis in Vancouver in December 2016. The death toll rose in the years that followed. (Darryl Dyck/The Canadian Press)

According to government statistics, there were 12,813 opioid-related deaths in Canada between January 2016 and March 2019. For each year, an average of 67 per cent of deaths involved fentanyl or a version of it.

Westhoff's new book traces the rise of the drug from its beginning as "a legitimate hospital drug" developed by Belgian chemist Paul Janssen.

"For a long time it was used in open heart surgery, and it's still very important today, used in colonoscopies for men, epidurals for women in childbirth," he said.

The drug first made its way into the illicit market in 1979 in California, he said. Authorities began to encounter cases of overdoses, where the victims had heroin paraphernalia with them and track marks on their bodies, but no heroin in their systems.

"This was the first appearance of fentanyl, and at the time it was completely unknown as a street drug," Westhoff said.

The opioid crisis has claimed thousands of lives in North America, but its toll has not been so severe in China, says author Ben Westhoff. (CBC)

Decades later, the drug is now one of the deadliest elements in North America's opioid crisis, fuelled by imports from China, where Westhoff said almost all illicit fentanyl is made.

Westhoff said the drugs can reach the U.S. and Canada via smuggling operations run by drug cartels in Mexico — or simply through the post.

"It's surprisingly easy to order these drugs online," he said. "You can find these chemical companies and they will send it directly through UPS, FedEx or the regular mail system."

Westhoff visited fentanyl lab

While researching for his book, Westhoff posed as a prospective buyer went undercover to visit a fentanyl lab outside of Shanghai.

"I was expecting to see a sort of underground facility, a seedy place with guys holding AK-47s, guarding the door — but it wasn't like that at all," he said. 

He described the building as looking just like a regular suburban office park, with a big fountain and a parking lot out front, and no indication what its purpose was.

But inside he found a big lab, busily making drugs like fentanyl and synthetic cannabinoids.

"I just couldn't believe the volume being produced. There was huge piles of these drugs that were drying out. There were other huge glassware that was synthesizing the chemicals before my eyes," he said.

"And it was all on the up and up, too — all of it was legal according to Chinese law."

China has its own drug problems — a lot of people are addicted to meth and heroin and even ketamine, but fentanyl is not a big problem.- Ben Westhoff

Westhoff says that in the past, China has tried to control the production of fentanyl by banning specific formulas. But rogue chemists then tweak the molecular formula to produce a slightly different version — called an analogue — that is perfectly legal, but could be an even more powerful drug.

In May, China went a step further and banned all analogues of fentanyl, but Westhoff said enforcement has lagged behind.

"It's one thing to have these laws on the book, but there isn't the infrastructure, there aren't the people on the ground who are enforcing these laws." 

Naloxone kits can prevent death from overdose. (Flora Pan/CBC)

China has repeatedly downplayed its role in the West's fentanyl crisis. 

Liu Yuejin, vice-commissioner of the China National Narcotics Control Commission, told a news conference last month that China has not discovered a single fentanyl-related smuggling case since May 1, when it classified all fentanyl-related products as controlled substances.

But Westhoff said the Chinese government may not be acting because the effects of the drug are not so severe at home.

"China has its own drug problems — a lot of people are addicted to meth and heroin and even ketamine, but fentanyl is not a big problem in China," he said.

"That's why a lot of people believe they're not devoting the resources to crack down on this industry."

'Crack down' on China won't solve problem

Westhoff doesn't think the solution is to "crack down on China."

"Even if we get China to control this industry, it's just going to migrate to other places, including India where there's already a lot of fentanyl being made," he said.

He told Lynch that "we have to start at home."

"We need to work on figuring out why so many people are using these drugs, how we can help them do it more safely, and how we can reduce the demand," he said. 

Written by Padraig Moran with files from Reuters. Produced by Geoff Turner.