[inaudible conversations] think we are going to go ahead and get started if you can hear me. We are going to get started thanks for joining us. If you want to take a moment to silence your cell phones, it would be much appreciate it. Thanks for joining us. I will be your moderator for this panel for the buck how rogue chemists are creating the deadliest waves of the opioid epidemic. It is my pleasure to introduce been he was once the music editor for the la weekly and both books were extremely well received. He was featured on fresh air as im sure remember a few this is a fresh air kind of crowd. And also excerpt in the atlantic and has gotten wonderful reviews so please help me thank hi themr coming. [applause] we will discuss the book for probably 30 minutes and then about 15 minutes for qanda cystic around at the end if you have questions. Lets start at the beginning i know there are many people that have never heard of fentanyl. Its great to be. You can think of it as synthetic heroin. It is the third wave of the Opioid Crisis. The first began in the 1990s with over prescriptions of pills like oxycontin so there was a sea change in the way doctors started thinking about painting and when that was combined with advertising like Purdue Pharma that convinced doctors opioid or not actually addicted in combination as lead a situation where people were receiving morphine pills than ever before there were still mills and people who have legitimate needs for these pills found out when their prescriptions were finished that they were addicted to so many of them turned to street heroin and they represented the second wave of the Opioid Crisis. Now as of the last five years or so its almost impossible to find pure heroine anywhere it satisfied the same craving as prescription pills like oxycontin and heroin. The biggest difference is that its 50 times stronger and so drug dealers use it as a costsaving measure. A lot of times when people think they are buying heroine, what they are buying is a mixture of heroin and fentanyl and it kills them instantly and that is the epidemic. It is a drug that most people dont even want. Talk about the pitfalls of the process of combining with another drug. What i found fascinating about the book is often the people that are producing the drug dont know how much they are putting in there themselves. It is an important medical drug used in hospitals. So, for women in childbirth it is used in epidurals. For men who are getting colonoscopies and also comes as a pain patch and lollipop used for people with cancer and sort of an endoflife care. But when we hear about all these deaths, we are not hearing about hospital fentanyl. So most al old bill listed in almost all made in china. This fentanyl gets into the u. S. In one of two ways. One is right through the u. S. Mail. The u. S. Postal service, fedex, ups, dhl, they all should fentanyl and other types of fentanyl through the mail. Fentanyl also comes through china through the mexican cartels to hi who in for it, pae it up and send it north through the border and its distributed through the same channel as drugs like heroin, cocaine and meth. When it arrives in the mexican cartels it is usually pretty pure. But they cut it with other cutting agents, stuff like benadryl also cutting agents and then to the border. Even the drug dealers themselves dont know how strong it is. It only takes two grains of rice worth of fentanyl to overdose. Its barely visible to the eye. So, when drug dealers try to mix it up, next heroin with fentanyl it is almost impossible to do. I talked to a former fentanyl dealer that actually used a coffee grinder to mix up the fentanyl and heroin into this is the same coffee grinder you buy in the store and the result of that you get what is known as hotspots and so some batches might be benign while others book is not just about fentanyl or a collapse of drugs which you are calling global psychoactive substances, essentially they were invented in the laboratory and imitate other more familiar drugs that typically come from a plant, the opm, poppy or marijuana. Many were created by legitimate researchers trying to advance sciencscience in one form or an. Can you talk about the process have to go from a legitimate lab to a Clandestine Lab . When you think about traditional drugs, youve got heroine as you mentioned, cocaine, marijuana these all come from natural plants like you say and so its very expensive and timeconsuming to grow the opm poppy and it susceptible to the lawenforcement. Youve got these big fields but these new drugs you are talking about, novel psychoactive substances are all synthetic and they are all made in a lab and that is basically the same thing. These are drugs that because they are synthetic they can be manipulated so for example, fentanyl if you change the structure just a little but now youve got what is known as an analogue of fentanyl and sometimes these analogues are Even Stronger and more deadly than the original itself so now we have literally hundreds and hundreds. A lot of them were invested what you are saying for legitimate medical purposes in the laboratories in the 70s and 80s. They pay too much attention until the internet age and published online the clandestine chemists where the scientists are talking about new drugs for the medical purpose and a repurposed them as recreational drugs many are sold on the dark web. Its not particularly familiar but it emerges as an important way to distribute to these. Can you talk about the dark web and its role . It is basically a disguised internet protocol where it is impossible to find out who is publishing a webpage. Its most famous for these markets that s so everything is illegal under the sun. The most famous is called silk road and was taken down a few years ago. Based in texas, right . Congratulations. [laughter] i wasnt claiming that. But yes, silk road and these other markets of everything from guns to drugs to fake rolex watches, credit card numbers, child pornography. Its like the wild west and its hard to crack down unless there is a sort of human error. The code is basically unbreakable and a lot of times people who are buying and selling communicate the encrypted messages and its very hard to crack and so sort of emerged as the place where these new drugs are bought and sold, and the scariest part is that teenagers are some of the most common consumers using the dark web because they are so technically savvy and it results in situations where these teenagers can go online, go on the dark web, buy drugs using this bitcoin crazy and have it delivered to their door. Some of the dealers on the dark web are socalled and in their anonymity that they were willing to talk to you, a reporter, acknowledging yourself as a reporter, in depth about what they did. I was surprised, i interviewed some dealers and a number of them talked to me and one was actually willing to meet me in person and so this is a dealer who was selling different analogues of fentanyl and so after it was banned, these different analogues were still legal in china so what you would do is order different types of analogues from china, get them sent directly to the home and then repackage them and sell them on the dark web. So what i wanted to know is his storyif hisstory, how she couldy justify this type of action considering. Keep going. You never what is never know what is going to have it on live tv. By the way, the scene in the book where you make the garb to be good dark web dealer in person and he makes his daughter to the meeting was an outstanding scene in the book. Talk a little bit about his rationale for why he did what he did. I was surprised we met at a Fast Food Restaurant and he brought his daughter. He claims to be doing some good in the world and what he does with that, he was an opioid addict himself. Hed been addicted to pain pills for a long time, but they are very expensive and what he said was that the type of fentanyl that he sold was as a nasal spray so he actually made his own nasal spray. He showed it to me it looks like something youd buy at cvs or walgreens except it was much, much stronger than your typical opioid medicine. So, one spray from this nasal spray was the equivalent to taking a big oversized oxycontin pill and what he said as the prices were so affordable that could help longtime addicted opioid users maintain their addiction for a fraction of the cost of buying oxycontin. And he said considering that big pharma and these Companies Like Perdue Pharma, which are now being sued over the country considering the damage that theyve done to the country, he considered this a sort of alternative way for people to maintain their addiction. He was a kind of robin hood figure. He di could see himself that way. The other chapters in the book that really sang for me are the ones you actually went to china, and for me that is what separated this book from just, you know, kind of a report on a the crisis to one that is a wonderful read. Talk about your trips. Thank you for those kind words. Back in 2017 i started reporting on fentanyl in earnest. They said its killing more people than any drug annually in american history, worse than crack at epidemic, meth, heroin, pills, and so i kept hearing all these statistics but no one had ever gone to the source, no one had ever gone to china so i thought where do i start. I dont speak chinese, so i just started looking on google, buying it in china and. On the real web, on the service web. And it may sound silly, but lists of companies came up. Dozens and dozens of Different Companies selling fentanyl in china popped right up. I clicked on the webpages and they had sales people email address is right there. I just emailed them, made a fake email address. I said i was interested in buying fentanyl and that if i came to china would they be willing to show me their lab and lots of them said yes and so in early 2018 i bought a plane ticket and i showed up. First i went to a city that isnt known to most westerners but its the city of 11 million people. Its a chemical manufacturing hub and so they make a lot of legal chemicals. That is mainly what they do. They have a lot of great great universities there and produce scientists and chemists. Most of the them go into legitie fields, but some of the them goo these fields and i found out that there was a Company Making more fentanyl ingredients than precursors than any other company, so these precursors are basically what is driving this epidemic. They are what is sold to the mexican cartels who make the rest of the way and then take it north to the border. Its the equivalent of sudafed. If you heard about the meth crisis, you heard about these backwards meth labs and cooks would go into the cvs and walgreens and come out with all of the sudafed and then they would use it to make math. These precursors are basically the equivalent and without them, the mexican cartels were not in business. They didnt have their own chemists looking at these precursors, so i went to the company and emailed the salesperson and i said i would like to meet you at your company and they said sure we will meet you there at noon. I was actually based on a hotel. I showed up in the lobby. I didnt know what was happening. It didnt look like a Chemical Company but they took the upstairs and showed me they had two floors of the hotel dedicated to their sales staff. The sales staff was basically twentysomething recent college graduates, almost all of them, and there were hundreds of them. They were in cubicles, it looked like a western office and this was considered a good job for someone who spoke english. Exactly. They had a great health plan, they gave people free cell phones, to the employees, they have movie night where everybody went out, and free room and board. It turned out the sale these sae lived in the hotel and all the while they were selling the chemicals for the deadliest drug on earth. In their mind legally or at least producing it legally in china. It was coming was totally illegal in china and although it was illegal in the u. S. , they claimed not to know about the fentanyl problem and so at first, i was dubious that i found out that really sent about doesnt register in china. Even though it makes more than anyone else, the citizens there dont have a fentanyl problem. For the salespeople said yeah, we dont even know what this is or why it is so popular. Popular. Some of them are selling thousands of chemical from the same factory. As it is just another chemical someone is interested in. Exactly. They also claim to sell 10,000 other chemicals. Some of them were maybe real and others sold sometimes but the main moneymakers the salespeople told me wer where the fentanyl precursors and steroids. They sold a lot of and folic steroids which is the same situation. Legal in china but scheduled in the west. You have a very provocative suggestion in the book that you didnt explore too much but its possible that at least in a few people at the upper levels of these operations in china they think this is the kind of reversed opium war situation. If you are familiar with the chinese opium war, there were two of them in the early 19th century and basically england was selling lots and lots of opium to china and the chinese citizens were getting addicted in large numbers. So basically china said we want you to stop doing this, but england refused. They went to war and then in the spoils of war from england was given hong kong and so thats why it was the property of england. Because the trade was so valuable that they couldnt afford to see it and. Exactly. Was making so much money for england. So now some people think of the fentanyl situation as a sort of reversal opium war because now it is china that is selling this opioid and people in the west that are consuming and becoming addicted. Talk about what can be done or what is being done by the u. S. Government with respect to what china is doing a. The u. S. Government was very, very slow to act about the crisis. In fact as recently as 2015, the dea published in their annual report it said fentanyl isnt a drug we really have to worry about. Its too powerful. Users dont like it, and so basically nothing to see here. It was only one year later in 2016 that fentanyl over to caroline and these other drugs to become the deadliest in u. S. History and so since then, theres been a lot of sort of typical war on drugs policy that we have seen, and in my book, i explore in more rational way to battle the crisis, and i believe in something that is done us Harm Reduction to a Harm Reduction is basically this idea that people are always going to use drugs inasmuch as we dont want them to come there is nothing we ca, there is nothinge can try to make it safer. So, there are a lot of different policies geared towards Harm Reduction and one of them is called fentanyl testing strips and so a lot of the reason people buy from fentanyl is because they take other drugs and fentanyl is in it. For example, the singer prince and tom petty died because they took prescription pills that they thought were regular opioid but they were actually cut the fentanyl. The wrapper mac miller died the same way. What these fentanyl testing strips do is you can make a mixture of your drug and that the strips in their so just like a pregnancy test you dip them in and if there is one stripe of thfentanyl, two strikes there is no fentanyl, and studies have shown that when people come and yocomingyou know, drug users art dumb. If they realize that there is fentanyl, they are less likely to use it and therefore less likely to overdose and die. What they said is that it isnt untrue. Users dont like it. They are desperate to get the product they can get. Exactly. There are some instances where it is being sold as fentanyl and for some people it is so powerful that that is actually an attraction, but the vast majority of people only want the drug that they want, and so i also traveled to spain and they have an Amazing Program they are called supervised injection facilities and these are places where the users can legally go and use drugs. They can shoot up heroin are fentanyl, cocaine. It sounds crazy to most americans, but there are doctors and nurses onsite, clean needles, treatment programs. Its basically all dedicated to making sure that people come a, longtime addicted users can use the drugs safely. And theyve never had a death de one of these facilities and anywhere, europe, canada where they have these facilities. But in the u. S. , they are illegal and there are none that are operating legally here. We seem to be much closer to a second possible solution as you suggest in the book which is legalizing marijuana. You point out that the reason that that might cut down on some of these overdoses is something we havent even talked about today which is that there is a synthetic marijuana although it is a misnomer. It isnt marijuana at all. Its usually known as the spice that you can buy overthecounter area to be somewhat mimic the effect of marijuana in the brain but they are more powerful and more dangerous. Can you talk about those a little bit of k2 and spice are basically called a synthetic marijuana but really it isnt the same at all. They react on sin of the same receptors that they send the receptors into overdrive and if so you get stoned, you might get the munchies, might be kind of relaxed, watch a movie. With k2 and spice to your heart starts beating fast, people overdosing people by. The reason that these drugs became popular isnt because people really like them, it is because of drug tests like the kind that employers give to employees and parents give to children. Marijuana shows up on these protests whereas k2 and spice to show up on the drug tests so thats why they became popular. You said part of the positive reaction for the book is that youve been invited to speak to people, officials in washington about what the response ought to be. Can you talk a little bit about what you shared with them . I have been lucky enough to talk to people in the highest branches of federal government,l government, and a lot of people want to do what i expected they would want to do which is to continue more of the war on drugs policy. And if so, do we have a at it is the dea helps take out pablo escobar, the colombian cocaine kingpin. A number of decades ago, but since then, the cocaine hasnt tried that in fact there theree coming out of columbia now then ever before. L. Chabot was put in prison and tried recently, but that hasnt stopped the flow of drugs from mexico. Now china is the next country to be in our crosshairs and i understand better than anybody. I was the first journalists to actually go inside of a fentanyl lab, and we didnt talk about that here coming up to read about that in the book. But i did get to go inside of a loud and watch people synthesizing these type of fentanyl on a scale i could have never imagined. It was very, very nerveracking. My wife wasnt happy about it. [laughter] but, you know, president trump, i will give him some credit. He has made fentanyl part of the trade wars are now hes basically saying that if china cant get these exports to the u. S. Under control, hes going g to put more sanctions on different areas of chinese exports, and so at the same time though, people who commit lowlevel fentanyl offenses are still going to jail and in fact lowlevel fentanyl dealers are being give defended and longer sentences. And the problem with that is is that often these viewers are not these big kingpins we are hearing about. Often they are just addicted users themselves who are dealing to support their habit so those are not the kind of people i think we should be targeting. And its also a very familiar story following the drug were since the 1980s. That might be a good note for us to play upon and that would leave about 15 minutes for questions. Does anybody want to be the first person. We have one microphone kind of in the front and one in the back. Dont be shy. I will be signing books at 1 00 in the attended by two down i believe. You cant miss it. The spam. What advice do you have or how to talk about this with kids who think that its cool . That is a great question. When i was coming up, and i suspect when you were coming up, we cost a lot of the dare one oe program, just to say no and we were told that most all drugs could probably kill you. Unfortunately now thats actually true and the reason is because fentanyl is cut into almost any pill or any power. Its cut into cocaine, meth, heroin like i said, perception pills, about the only drug that you can really trust i would say would be marijuana, real marijuana if you can see it and smell that its probably safe but almost any pill or powder if you have have not checked it, if you havent use used a testing script for example, you have no way of knowing that its in there and it can kill somebody instantly. That is the most Important Message i think to tell kids. And the potency can be wildly rapid. Absolutely, 100 . Yes sir. With all the Media Coverage on the Opioid Crisis and all of the emphasis on big pharma [inaudible] physicians and pharmacists it seems to me that there is insufficient attention paid to the personal responsibility. Could you comment on that . Absolutely. I think when it comes to the Opioid Crisis with the pill, you know, i think most of these doctors were acting in good faith. My dad is actually a doctor, and they were on the line about how these pills were safe now. Doctors legitimately wanted to people not to be confined to agony and so the patients themselves are often just following dr. s orders. So i have all the sympathy in the world for them and they dont have any sympathy for the Companies Like Perdue Pharma which downplayed the risk of addiction. Nowadays things are a little bit different because opioids are not prescribed as much as the board of her. In the early 90s or 2,000, taking their opioid pills away from them is not i dont think a good answer because a lot of these people switch to street here in. I think we might have one in the back. Why dont people just take the pills they can get, why do they switch to fentanyl . Why dont they just take oxycontin and the pills they can get rather than having to switch to these can you talk about the crackdown on legal pills . That is definitely happening in a big way right now. And theres all of these new laws all over the country. I talked to a patient from colorado who was a longtime legitimate opioid user. She had i dont think it was rheumatoid arthritis, but it was a condition she walked into her dr. s office when he and the doctor said before i can write you another prescription for the opioid. Things like yoga, acupuncture. It felt really degrading and like i said, i dont think that its the best answer. Yes sir. Yes, im wondering what you thought about a lot of cultures like particularly rap music among younger kids. If you also as a Marketing Tool it is completely ingrained within the culture. It is very distressing to me so many rappers, i mean houston has been talking about it for a long time. It was basically codeine and cough syrup taken recreationally but that is a much lower level. The lethal combinations are opioids mixed with. They are both sedatives and they kill people. I dont think its great at alle for the rappers or people. I feel like the question is because the culture does develop around a particular drug, and im thinking in particular of ecstacy. Am i the last to know that you could buy it at the club until 1985 . [laughter] totally legal. I didnt know that. There was an entire culture that grew up around it and some would argue that it was a relatively benign one compared to what weve seen today. Lsd, people to realize that. They are fake velocity, take marijuana marijuana as an alternative to some of these painkillers, i dont use marijuana, so i dont know. Is this an alternative to some of the pain killers that might be less addictive than actually provide relief without all the downside to these other drugs. Ive heard people talking about. It is a potential substitute for opioids. I dont know enough about it to say if i think it is a good idea or not. I havent read enough about it. I will say that legalizing marijuana is something that should be done with some caution. And in colorado isnt the first wave of states to legalize marijuana there have been some encouraging signs. Kids are not taking it in larger numbers there are fatalities from people driving while high and it seems like decriminalization is actually something working well in places and have been seeing a lot of positive results from that. Meaning that you are not going to go to jail for it. There are not stores on every block and things like that. You have to approach these things carefully. I think we have one in the back. Relative to the concept you said drug users dont necessarily prefer fentanyl but when you watch documentaries and things like that, these are people that have incomes that if they wanted something that actually was vicodin, oxycontin is people have the type of income. The. The first thing to know is if youre on prescription opioids and you need them legitimately and you are prescribed by your doctor and getting them from a pharmacy, those are safe. There are not instances of those being cut with fentanyl. But if you are playing them off the black market, the dark web from a street dealer or anywhere else, these pills, these legitimate looking pain pills can have the oxycontin logo they can look 100 legitimate but they can be cut with fentanyl tom petty came out of the show and bother some of the stree stf im not mistaken. There were used to be pills that were legitimate but now they are cut with fentanyl and greater and greater numbers. I cant stress enough how important it is to stay away from random blackmarket pills. What was the second part of your question . Mike people there are those that have been using heroine so long that they cant get high from heroine. For a Long Time Coming heroine users are not getting high any more. When they take it and basically it just takes care of their withdrawal symptoms is kind of like a bad flu ive often heard. It simply gets them back to baseline but they are not getting high. Fentanyl however gets them high again because its so much more powerful. You mentioned cases where people always ask me this is the number one question i get. They say why would dealers send fentanyl if it is killing their own client clients, whether they knowingly kill their own clients. I talked to a lot of people about this and they say that when an addicted user fears of an overdose empathize, they dont try to stay away from it, often times they say that must be really good strong batch so they go after that batch and that is the unfortunate reality for a lot of people. I would like to bring the conversation back to marijuana again. Its really hard to do. Can you talk loudly. I have a bit of a head cold. Speech really close to the microphone. I apologize to anyone behind me that a head cold from this microphone. I want to ask about marijuana. As we go on with legalization of the medicinal marijuana, it is obvious that the strains are more potent and people are seeing some side effects and there are some detrimental effects of it. What should we be listening for the legalize all these new drugs. Overnight, the synthetic like p2 and spice it was a case for the stuff you are talking about. So what happened, overnight it stops being the drug dealers and drug manufacturers the problem including fentanyl isnt actually the drug itself. Believe it or not you can take a safe dose of fentanyl and k2 spice, anything. The problem is nobody knows how much the dosage should be. Theres an old saying in toxicology the dose makes the poison. In new zealand all of a sudden people had wellregulated synthetic marijuana and so in the u. S. Like i said it was killing people left and right, people were overdosing but suddenly in new zealand they had a safe version of the synthetic marijuana and there were almost no fatalities. So, that is an example of what happened. It only lasted a year. Everyone freaked out. Theres a lot of what about the children sort of rhetoric into southern new england ended this experiment with legalization. In the ensuing years, see debate of the synthetic marijuana again made by the drug dealers dominated by drug cartels is too strong. It is an isnt dosed properly ad people are dying in the scorers from synthetic marijuana so how can we extrapolate that to the u. S. . The president ial candidate is in favor of decriminalizing ovulate so this is a very hard thing to swallow for a lot of people. It is for me when i first heard about if i wanted to decriminalize opioids we basically said its okay to shoot up heroin and fentanyl. It didnt make any sense to me thats what his argument is if this is an addiction problem and we need to bring these people out of the shadows so when people are being lockethepeopler heroine or fentanyl, the recidivism rates are incredibly high. People get out of jail, get out of prison they are likely to use again that when we bring these people out of the shadows and we provideprovide them with treatm, health care and things like counseling and then well be there signing two minutes from now. Thank you. [applause] [inaudible conversations] the press is still asking the question why did she say there were sanctions, whats happening. So, i called a couple people in the administration, chief of staff, National Security and i said weve got a problem. I said okay this is the deal. Either you will fix it by 5 00 today, or im going to fix it by 5 00 today and it will go a lot better if you will fix it. Nothing happened and then i think it was 4 45 and my friend goes out in front of the press and they ask the question about the sanctions and he says i think she got momentarily confused. So that was it. And i think to loo happened to e television and the fight was getting ready to come on fox. I called my friend and i said can you call me real quick. She called and said whats up. I said i need to put out a statement. She said okay what does it. I said well you just say one sentence. With all due respects respect, t get confused. [applause] she said thats it and i said thats it. I said i will text it to you so you have it in writing. [laughter] so she goes and she does it. Within ten minutes, where he calls me. Im so sorry. You know i love you. I have my tail between my legs. Im so sorry. And i said at what point do you say i am confused . He said i know i shouldnt have done it. Trust me i will make it up to you. I said you will make it up to me and you will go out there and tell them you are wrong and i wasnt. He says i cant do that i said you can and you will. [laughter] and he did and in fairness to him he immediately went out, contacted a reporter but what was surprising to me is how it went like it was a simple moment of me defending myself and how it went viral across the country on tshirts, mugs, everything. And it goes to show so many people have been in a moment. And i hope the lesson you take from that is no one is going to protect your integrity that you. To watch the rest of the talk visit our website, booktv. Org. The. Good evening we are ready to get started perk i am the cure reader of lectures at town hall seattle we are set up in the cafe and our guest i pe
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