What is fentanyl?
Fentanyl is a synthetic opioid that is 100x more potent than morphine and 50x more potent than heroin. Legal fentanyl is prescribed to patients much like morphine, for extreme pain. It was developed in part to ease pain for cancer or post-surgery patients. However, the amount made far exceeds the need for the number of such patients. 1 in 3 patients prescribed to it become addicted and still more is diverted to illicit use.
What are IMFs?
IMFs stand for Illicitly manufactured fentanyl and fentanyl analogues. That term is meant to refer to all fentanyl that is made, sold, or distributed for any un-sanctioned use. IMFs are what have been found in nearly every type of street drug and are the cause of the majority of US drug-related deaths, accounting for over 30,000 US deaths in 2017 alone.
The term IMFs include fentanyl analogues because there are an endless number of slight variations that can be made to fentanyl’s chemical composition in order to evade regulations while maintaining the same addictive opioid effect. One example is carfentanil, the strongest known analogue, which is 5,000x more potent than heroin and is lethal at .02 grams.
Why are they so deadly?
The lethal dose of fentanyl is very small, the size of a few grains of sand. According to the DEA, 2mg is enough to kill, compared to 30 milligrams of heroin. The way dealers cut it into their heroin, cocaine, methamphetamine, or other drugs causes uneven distribution which makes the amount of fentanyl in any given hit or pill unpredictable.
That is why deaths by IMFs are not strictly considered overdoses but are prosecuted as murder, manslaughter, or wrongful deaths. The person consuming it often has no idea fentanyl has been added to their drug, nor how much they are consuming.
IMFs also pose a serious threat to non-addicts. First-time recreational drug users, police, first responders, and the general public are all vulnerable. Examples of fentanyl causing lethal or overdose-like reactions in all of the aforementioned categories have been increasing in frequency, though strides in preventative measures have also been taken.
Where are they coming from?
Production of IMFs have been traced to several global locations including makeshift labs, but the DEA and the European Drug Monitoring agency say the vast majority are made in chemical or pharmaceutical companies in China. IMFs seized coming in through Mexico have also been traced to China or were synthesized using precursor chemicals bought from China.
Until late 2015, Chinese fentanyl, its analogues, and precursor chemicals were legal to make, sell, and distribute for export. Under international pressure, China placed fentanyl and at least 35 analogues on their list of controlled substances. Until China follows through on promises to ban the entire category of fentanyl-related substances, chemists can easily make new analogues and continue production. IMFs that have been banned continue to be made by rogue elements within some of these companies, of which there are over 400,000. Enforcing regulations on such a widespread industry is complicated and rife with corruption.