Tag: brandon a. dorfman

  • Designer Drugs: My Addiction to Research Chemicals

    Designer Drugs: My Addiction to Research Chemicals

    Chemists create new drugs faster than officials can schedule them, resulting in a drug supply tainted with chemicals that can’t be tested because they don’t really exist.

    My wife came with me to the intake session at the city’s drug and alcohol center even though I had a protection from abuse order pending on the court’s docket. She knew I’d been in recovery and had started drinking again, but she’d only recently learned of the extent of my addiction when I broke down the bathroom door to stop her from calling the police. Why she stuck with me or what she was thinking I couldn’t say; I was too ashamed of what I had done to ask her if she was all right. 

    Instead, I buried myself in the mundane paperwork of medical billing and told the counselor my story while my wife sat mostly silent. For almost two years, I trafficked in grey market drugs for my personal use. An assortment of chemical mixtures was delivered to my door, sometimes within reach of my kids.

    4-FMPH, a Synthetic Analog of Ritalin with a Fluoro Substitution

    The first drug I purchased was 4-FMPH, a synthetic analog of Ritalin with a fluoro substitution. Fifty dollars, plus the cost of shipping, bought me a few grams of the stuff from an unassuming website called “Plant Food USA.” People who know about these types of things remember that site for the scams that it pulled, like selling α-PVP as 2-FMA. These are the risks in a chemical world.

    It wasn’t a clandestine operation, save for what I hid from my wife. I found the site through Reddit and paid with Google Wallet for two-day delivery via the U.S. mail. An unlabeled bag of white powder arrived at my door in a large white priority envelope. I swallowed a portion of it without question and spent the next couple hours worrying about how to throw out the packaging without anyone finding it.

    Before long, the drugs, and the schemes, became more intricate. I tried ethylphenidate, isopropylphenidate, 3-FMA, and Hex-en. Bitcoin became my new banking system, which meant keeping my wife away from our finances and making her think we had less than we did. I’d stay late at work emailing vendors while ignoring her texts for help with the kids. 

    It was exhausting, hiding my habit from her. The day the cops showed up to serve me those papers would have been a relief, had she not been outside with her family trembling in fear. And yet here she was, a week later, sitting in a Medicaid-funded outpatient program listening to a counselor ask me how I was doing while telling old war stories from his days off the wagon.

    His brother doesn’t speak to him, I remember he said. “But that’s his problem and not mine anymore.”

    The Molly Enigma

    Designer drugs, research chemicals, synthetic analogs, and novel-psychoactive substances, as they’re sometimes called, have long been on the periphery of the illicit drug trade. Often, local news channels reduce them to fodder about bath salts and flakka and face-eating zombies. But today, experts are beginning to draw a straight line between the overseas chemists who create these drugs and the overdoses that plague so many people who unwittingly use them.

    ”[It’s] what I refer to now as the Molly Enigma,” said Jim Hall, an epidemiologist at Nova Southeastern University’s Center for Applied Research on Substance Use and Health Disparities. For the past 35 years, Hall has tracked patterns and trends of substance use disorders in southeast Florida for the National Drug Early Warning System.

    “We missed the boat when Molly first appeared, went in the wrong direction, and avoided a lesson which could have predicted the fentanyl crisis,” he continued.

    One of the more well-known designer drugs to hit the scene, Molly is thought of by many to be pure MDMA. According to the DEA and the National Institute on Drug Abuse, however, it’s more likely to be a cauldron’s brew of synthetic cathinones like MDPV, 4-MEC, 4-MMC, Pentedrone and more. My vendors sold all these at discounted rates.

    Somewhere Between Face-Eating Zombie Hysteria and the Fentanyl Crisis

    When looked at alone, most of these drugs lie somewhere between face-eating zombie hysteria and the fentanyl crisis, vanishing from small pockets of the country as fast as they appear. In 2015, around 30 people died in the Pittsburgh area after overdosing on U-47700, an opioid painkiller that pharmacists developed back in the 1970s. Two years earlier, an Oklahoma man pleaded no contest to second-degree murder after accidentally selling a highly-toxic mixture of Bromo-DragonFLY at a party. He purchased it on the web, thinking it was a less caustic drug known as 2C-E.

    But as Dr. Hall explained, taken as a whole, this new trend in substances has its roots at the turn of the decade, when discarded medical research turned up on the web. 

    “We saw the beginning of clandestine manufacturing of these chemicals primarily occurring in China, but also some in Eastern Europe, [and] in the former Soviet Union,” Hall said. “Then the spread first of the synthetic cannabinoids, the K2 or spice into Australia, New Zealand, and then into the European continent. Then to North America, which has also been a sort of pattern of the emergence of these substances rather than first appearing in the United States.” 

    Novel Psychoactive Substances and Drug Tests

    I discovered alpha-Pyrrolidinohexiophenone, or A-PHP, when 2-FMA dried up in a big Chinese ban. Shortly after that, I disappeared from my family for a week. The “Missing” posters that my wife put up finally prompted me to make contact, but only because I was angry that she would do something like that to embarrass me. I didn’t ask about our kids, only why she used such a terrible photograph of me.

    At the time, she made me beg to come home for what I did to the kids, so I told her the things that she needed to hear. Then I spent another night away from the house because everything would be the same regardless. Who knows what she was thinking when she took me back in; I didn’t care to ask her if she was all right.

    Novel psychoactive substances, or NSPs, live in a grey market world, walking a line of legality that’s tough to pin down. MDPV begat α-PVP, which begat A-PHP with the tweak of a molecule. Chemists create new drugs faster than officials can schedule them. The process results in a few hollow legal victories along the way, and a drug supply tainted with chemicals that can’t be tested because they don’t really exist.

    “You can have all these people intoxicated on, say a new form of fluoro-amphetamines, but most hospitals have what are called targeted panels,” said Roy Gerona, a toxicologist at the University of California, San Francisco, who, along with a team of researchers works with the DEA to identify new NSPs as they come on the scene. 

    “So even if the patient comes in and is intoxicated by this new derivative when the hospital tests the patient, it will test negative,” he continued. “They will not confirm the drugs.”

    Gerona, whose work was explored in an article about designer drugs a few years ago, told me how NSPs create a new set of problems for both the legal and scientific communities. The DEA can’t schedule a drug without first showing that it’s both toxic and addictive, something that’s difficult to prove rapidly, he told me. Meanwhile, strict guidelines from the FDA have researchers hamstrung when it comes to identifying new substances quickly.

    “In that six months in 2015, for example, there have already been three generations of synthetic cannabinoids, meaning that by the time that you have developed and validated those methods, the draws that you’ve included in the panel, it’s not popular anymore,” Gerona explained.

    Cathinones: Bath Salts and Antidepressants

    Some of these drugs have actual medicinal properties and can be used as prescriptions, Gerona told me, negating the idea of a blanket ban on them all. The Federal Analogue Act tried to rein in the problem by making any substance that was “substantially similar” to Schedule I or II drugs also illegal. Still, it’s rarely been used or held up in court.

    “Bupropion or Wellbutrin is an antidepressant,” he explained. “Wellbutrin is a cathinone. Cathinones are the active chemicals in bath salts. So, if you schedule all cathinones, then research on a lot of these medicinal chemicals would also be impeded.”

    But that doesn’t mean there’s nothing to be done.

    Building off of his work surveilling such cases, Gerona and his team developed what he calls a “Prophetic Library” of new drugs, hoping to outwit the overseas chemists and lessen the downtime it takes to respond to further incidents. 

    “We thought if people creating these are chemists, we are chemists,” said Gerona. “If they can look at the literature [and] know what tweaks that they can make from publications or expired patents from drug companies, we should be able to predict what they would be potentially doing.” 

    For Gerona and his team, there’s no glory in the task, because publishing their findings would create reference material for more clandestine operations. They’re hidden away until, hopefully, they can help.

    Predicting the future can be a difficult task, because the stories we write, well, they never end. On the day after New Year’s, my wife went to bed, and I went online to buy more A-PHP. For me, I was looking for more of the same, until I noticed she moved all our money to a separate account.

    Not All Right

    I woke her up, intent on throwing her out of the house, and stormed through the place with fire and rage. When she locked herself in the bathroom to call the police, I broke the door down and ripped the phone from her hand. What right did she have to come between me and my drugs?

    When the cops did arrive, I said what they needed to hear and taunted my wife as soon as they left. But I felt ashamed of what I had done. I apologized to her and asked if she was all right.

    The next day she filed that protection from abuse order on me. She wasn’t all right. 

    View the original article at thefix.com

  • Drug Deaths in Black Communities and Our Collective Denial

    Drug Deaths in Black Communities and Our Collective Denial

    “While white addicts receive treatment, drug counseling, and a lenient criminal justice system, there are Black people still behind bars because of mandatory minimums, three-strikes laws, and disparate drug sentencing.”

    “Google ‘Children of the Opioid Epidemic,’” said professor Ekow N. Yankah. The search sent me to a year-old New York Times feature about children born to mothers struggling with opioid use disorder.

    “How tender a picture is that?” he asked.

    The image, a white infant coddled by her mother, was hard to ignore. They stood crouched down on the floor of what could be my childhood home. Mom’s dirty-blonde hair was strewn about, covering her face as she embraced her child. She was asking for forgiveness or redemption or both. I’ve been there.

    “That is a picture of a young woman who, whatever her drug addiction is, is fighting to be a decent mother,” Yankah continued. 

    Yankah, who teaches criminal law at Cardozo Law School and is a board member of the Innocence Project, made his point. “Compare that with what you know of welfare queens and crack mothers,” he said. “Was there any image like this in the collective mind of our society when we talked about crack mothers?”

    It’s a rhetorical question. Images and headlines from the crack-cocaine era remain burned into our psyche. But awareness is not acceptance. So, let’s be honest. It’s no accident that America’s newfound compassion comes during the opioid crisis. Eighty percent of overdose victims are white. 

    “We don’t get to move on by pretending that this is a coincidence,” Yankah said. 

    “People are saying: look, it’s not racism. It’s that we tried the other model and it just didn’t work,” he continued. “As if for 25 years, we tried to lock up a whole community, and when the color of the community switched, we suddenly grew enlightened.”

    There’s Always Been a Cocaine Epidemic

    According to the Centers for Disease Control and Prevention, cocaine-related overdose deaths rose about 216 percent between 2012 and 2017. That’s double the growth rate of opioid deaths for the same period.

    Most of those deaths happened in black communities. Black adults were twice as likely as whites to die from cocaine-related causes. In 2017 the numbers were 8.3 per 100,000 compared to 4.6. And even though overall deaths rose recently, the data shows that black people have always had double the rate of cocaine overdose as their white counterparts. 

    Further data shows that black folks are more likely to develop cocaine dependence or a past-year use disorder. For almost two decades now, we’ve had data that shows cocaine use disproportionately affects black communities.

    But today’s headlines make it appear as if it’s a recent phenomenon. “The Opioid Crisis Is Becoming A Meth And Cocaine Crisis,” wrote Buzzfeed last January. “As the Opioid Crisis Peaks, Meth and Cocaine Deaths Explode,” the Pew Trusts noted in May. The list goes on ad infinitum

    The cocaine epidemic in black communities is not new. 

    Around three-fourths of these fatalities involved fentanyl or other opioids, but we don’t know if the presence of the opioid was disclosed to the user. Officials speculate it could be a contaminated drug supply. More people could also be doing speedballs (a combination of cocaine and opioids).

    Whatever is behind the disproportionate rate of overdose, experts remain stumped — and until recently, no one really cared.

    Because despite the data, and the appreciation for treatment-based solutions, research remains lacking. A PubMed search shows little to no relevant information. Most news outlets have ignored the issue. 

    It’s Just a Cruel Delusion

    “Americans really have the sense that history starts anew with every generation,” Yankah said. 

    “I schematically undermined your family, and then my children look up and say to your children, ‘look, I don’t know why I’m so much better off. I must have worked harder,’” he continued. 

    “It’s just a cruel delusion.”

    At first, systemic racism spared black people from the opioid crisis. Doctors are more likely to label black patients as either addicts or drug dealers, so they are less likely to prescribe opioid painkillers. 

    But opioid use is rising in black communities. Minority-majority cities like Baltimore, Chicago, and Washington D.C. know this better than most. The opioid crisis isn’t white. Over 47,000 people died of an opioid overdose last year. More than 5,000 of those deaths, or 12 percent, occurred in black communities. 

    Black people have less access to life-saving medications like buprenorphine than white people. And due to limited resources, they’re less likely to complete addiction treatment. Even if they do find treatment, almost 90 percent of psychologists are white. As one Philadelphia reporter wrote, it’s difficult to connect in a clinical setting.

    Outside Philadelphia’s federal courthouse this summer, activists gathered in support of SafeHouse. It’s the city’s — and the nation’s — possible first planned safe injection site. Family members lined the building with photos of overdose victims. 

    Every single photo was white.

    “Doing the right thing for the wrong reasons is yet polarizing, divisive, and racist,” Bishop Talbert W. Swan, II told me. Swan, the pastor of Spring of Hope Church of God in Christ, is a civil rights activist and president of the Greater Springfield NAACP

    “The wrong reason, of course, is because the addicts are now considered ‘victims’ because they’re predominantly white,” he continued. “The softer, gentler approach is not because lessons were learned by how America dealt with the crack epidemic, but because of white supremacy and the consistent dehumanization of Black and brown people.”

    Just Say No

    During the crack-cocaine era, murder rates doubled for young black males of all ages. Fetal death rates increased, fathers went to prison, and children, to foster care. Many black urban neighborhoods, which have the highest concentrations of poverty in the country, still bear the scars of those years.

    “America needs to remember that the U.S. government allowed the influx of drugs into inner-city Black America and profited from the death, addiction, incarceration, and destruction of Black families and communities,” said Bishop Swan.

    He continued: “While Nancy Reagan went around the country telling Black people to ‘just say no,’ her husband Ronald Reagan and Oliver North were funneling proceeds from the sale of crack to the Contras in Nicaragua and funding terrorism.” 

    We held black people to a higher standard. Americans preached personal responsibility. But the opioid crisis created victims. We blame Johnson & Johnson, Purdue, Richard Sackler, and our doctors.

    “The government will now ensure that pharmaceutical companies pay [restitution] for the addiction of whites to opioids, but will never pay for being complicit in the devastation to Black families and communities,” said Swan.

    “While white addicts receive treatment on demand, drug counseling, and a lenient criminal justice system, there are Black people still behind bars because of mandatory minimums, three-strikes laws, and disparate drug sentencing,” said Swan.

    We have “collective self-denial” about this disparity, Professor Yankah once wrote. It’s left black people world-weary and bitter. Yankah and Swan agree that contemporary models of addiction treatment are the way forward. Each expressed the need to reflect on our past — not to be cliché — for fear of repeating it.

    “One of the things I got a chance to do once was have a thoughtful conversation with one of the first minority judges who is on the federal bench in Miami,” said Yankah. “He spoke about when heroin was ravaging Miami in the 70s.”

    “People wanted to wrestle with this problem that was hurting their communities until a bunch of politicians started making hay that the heroin problem was a problem with Hispanics,” he continued. “Suddenly all this money for rehabilitation disappeared.”

    Meanwhile, cocaine continues to ravage black communities. Since 2012, cocaine has killed as many, if not more, black Americans as opioids. They die unseen as politicians and policymakers do nothing. There is no New York Times spread, no pharmaceutical company settlement. No one asks about the black children of the cocaine epidemic.

    View the original article at thefix.com

  • In Recovery, on Suboxone, and in the Weed Business

    In Recovery, on Suboxone, and in the Weed Business

    In print and online, I preached cannabis. In life, I practiced therapy and Suboxone.

    I had a few days left on my Suboxone script when I interviewed Justin “Bong King.” He was a professional bong-racer and self-described champion of the competitive smoking circuit. An affable guy, nonetheless his was an image of American cannabis long past, pushed aside by marketing grads and stay-at-home moms who sold branded CBD and touted the benefits of micro-dosing. 

    But Justin drew a crowd, and an entourage to boot. And his natural talent for hitting the fastest gram of weed would corner me into compromising my recovery.

    Throughout my career as a cannabis journalist, I’ve kept silent about my sobriety. Finding freelance gigs is hard enough without the added burden of having to be that guy. Besides, if I learned anything from active addiction, it was how to lie at my job.

    Covering Cannabis Events and Lying About My Sobriety

    But as time passed, I felt withdrawn and disconnected. My recovery had no place in the cannabis industry. Moreover, medication-assisted treatment (MAT) seemed anathema to its goals, according to experts and the news. Rep. Matt Gaetz openly questioned whether buprenorphine and methadone are “a more effective offramp [to opioid use disorder] than medical cannabis.” CNN announced that CBD cures heroin addiction. And the editors of Leafly figured out how to combat the opioid crisis with medical cannabis two years prior.

    After 20 years, recovery had finally become routine. As a cannabis journalist; as an editor in chief — so had my lies.

    Some lies were easy. Weekly therapy appointments usually coincided with editorial meetings or deadlines. I worked from home, my boss was lax, and anyway, I kept hours around the clock. Monthly visits to my psych and 30-day Suboxone refills upped the number of undisclosed appointments I logged, but still, no one seemed to care.

    On assignment was a different story. I covered cannabis expos or dispensary openings — events where the drug laws were lax and the supply was liberal. At a hotel in Hell’s Kitchen, I spent three nights alone avoiding networking galas and after-parties hosted by music moguls turned industry entrepreneurs. In the world’s largest dispensary off the Las Vegas strip, I dodged more questions than I asked when leaving empty-handed. With hand waves and head shakes and less-than-assertive no’s, I passed over pot by lying about my sobriety.

    But face to face with Justin “Bong King,” there was nowhere to hide — no hotel room to run to, no door from which to make a quick exit. There was a crowd around us, boxing us in as he finished his gram smoking demonstration. I shook his hand and stumbled over my words as I signed off the segment on camera.

    It was either a contact high or placebo effect, or maybe just panic anticipating the piss test I would take in the next few days.

    Intensive Outpatient: 12 Steps and Scoring Drugs

    When I had about two months left in my treatment program, I walked out of group for good. It was an intensive outpatient program; a six-month IOP run by Philly’s NHS that championed the Big Book and 90 days. For a minute it worked, but it’s drug rehab mired in a puritan past. The 12 steps are great, but they shouldn’t be a front-line defense.

    Besides, all I did there was make friends and score drugs. Thirty addicts in a room is an excellent opportunity to network and learn.

    By Easter Sunday that year, I felt broken. I was in a dirty motel on Route 1, hopped up on Benzedrex cottons and a $60 baggie of hex-en I purchased online from China. After 20 years of addiction, I had no drug of choice, save for anything that made me high.

    My wife and kids back home slept together in one bed, a little less worried than the last time I disappeared. I was out of work and estranged from everyone. My best friend joined AA and realized I was one of his people, places, and things.

    All I had was my family, and I was losing them too.

    One lie allowed my addictions to grow without the worry of what would happen tomorrow. It’s the lie I told myself when I stole my ex-wife’s Dilaudid two days after her shoulder surgery. It’s the lie that made me laugh when I snorted enough Adderall to make my nose blue. And it’s the same lie that made me indignant when my ex-girlfriend’s brother became angry that I was a sloppy drunk in front of his small children.

    On the Monday after Easter, I drove home before sunrise. It was dark and muggy and difficult to see through my tears and dilated pupils. When I got home, I faced my wife and children and ended the lie that had followed me through two decades of addiction.

    “I can’t stop,” I whispered. That week, I discussed MAT options with my doctor. I’ve been in recovery since that day.

    Cannabis as the Magic Bullet for the Opioid Crisis?

    Tyler Sash won the Super Bowl in his rookie year with the New York Giants. At the time, he didn’t know he only had a few years left to live. A sixth-round draft pick out of Iowa, he overdosed on a combination of methadone and hydrocodone at the age of 27.

    “[He] asked if he could smoke marijuana for his pain like the other players,” recalled his one-time girlfriend, former Miss Iowa and reality-show contestant Jessica VerSteeg. I interviewed VerSteeg when she was promoting a new blockchain-bitcoin something-or-other product in the cannabis space. She recounted Sash’s tragic tale during our interview, explaining how it became the backbone of her business.

    “I wanted to change the way that other people saw cannabis,” she said.

    VerSteeg’s article drew in readers, as did most CEO and celebrity interviews. Her story reminded me of how lonely my secrecy about my recovery had become. I often wished I could reach out and say that I understood. There are millions of people with substance use disorders, and we’re all so alone.

    But like most of the executive class in the cannabis industry, her hot take on opioids ended up being bullshit. Conventional wisdom in the cannabis industry had run somewhat amok on this topic, and it forced me, I felt, into compromising everything.

    There was the DEA agent who was so disgusted with opioids that he became a cannabis executive. Without irony, he told me that more research would prove the plant’s medicinal value. The head of an “innovation accelerator” in my city held a conference on the role of medical cannabis in the opioid crisis. He quoted research showing that states with medical cannabis laws have lower rates of opioid overdose deaths. Cannabis, they were convinced, would solve the opioid epidemic.

    But Where’s the Evidence?

    “Morphine, when it was introduced, was promised to cure what they called alcoholism at the time,” Dr. Keith Humphreys told me. A professor of psychiatry and behavioral sciences at Stanford University, he’s also worked at the White House Office of National Drug Control Policy under Presidents Bush and Obama. “Then, people got addicted to morphine, and cocaine was introduced.”

    He continued: “In general, there’s been this enthusiasm of if we just add a different class of addictive drug on top then that will drive the other addictions out. Generally, what happens is we get more addiction to that drug, and we still have the original problem.”

    I spoke with Dr. Humphreys after reading his research on cannabis laws and opioid overdose mortality rates. Contrary to conventional wisdom, he found the correlation to be spurious at best. It’s alarming — though not unsurprising — to see the industry ignore his findings. Several states, including Pennsylvania, where I live, approved opioid use disorder as a qualifying condition for medical cannabis.

    “I couldn’t recommend something medically without clinical trials, well-controlled by credible groups [and] checked for safety,” Dr. Humphreys said. He explained that in the case of cannabis, there was little more than these state-level correlational studies. “None of that has been done.”

    “I’m amazed and disappointed that we don’t care more about people who are addicted to heroin [and other] opioids, that we would wave through something like [medical cannabis] without making sure that it will help people, not hurt them,” he continued, noting that cannabis has shown no efficacy as either a replacement for or an adjunct to any MAT therapy.

    Listening to Dr. Humphreys made me realize how little I stand up for what I believe. Sometimes, when you’re an addict and you lie so much, you lose any sense of truth.

    Tyler Sash’s family asked Jessica VerSteeg to stop using his name to promote her business. According to a report in the Des Moines Register, they didn’t want his name associated with drugs anymore, neither opioids nor marijuana. VerSteeg refused, repeating the story she told me to several news outlets.

    For two years, I wrote about and reported on the emerging cannabis industry while hiding my ongoing recovery. In print and online, I preached cannabis while practicing therapy and Suboxone.

    Even in recovery, you can still have regrets.

    View the original article at thefix.com