What became of the needle-spiking scares of 2021 and 2022? Neither a crime wave nor a hoax, it turns out. Veronique Campion-Vincent considers, with meticulous context, the overlooked problem of ostention (life imitates legend) and “pure … aimless, aggressive behavior” – a reality that always seems to be in our analytical blindspot. In the most recent issue of LITERATURA LUDOWA — Journal of Folklore and Popular Culture. Open pdf at: https://doi.org/10.12775/LL.3.2022.004 #sociology #folklore #criminology
Category Archives: Drug and Alcohol Studies
Interview with BuzzFeed’s Lara Parker, October 2022
“Here Are The Symptoms I Wish I’d Known Beforehand”: This 23-Year-Old Had Her Drink Drugged, And She Is Sharing Her Story To Help Others
The problems stemming from ongoing, poor understanding of this public health issue has impacts on practical safety and society-wide policymaking. — PD
“Labeling certain drugs ‘date rape drugs’ is not only inaccurate (any drug can be used this way, including over-the-counter drugs like diphenhydramine, also commonly referred to as Benadryl) but has also been derailing state-level attempts to decriminalize small amounts of drug possession. It has also created misunderstandings when larger drug seizures take place.”
“Baby, It’s Cold Outside” gets the Silent Treatment from Some Radio Stations
The debate over the perennial holiday song “Baby, It’s Cold Outside” heated up this year, rather than just withering away in the face of sheer insignificance, as I had hoped. In fact, the only thing possibly more annoying than nixing a perfectly good song is the ensuing whining about political correctness that it provokes. I’ll grant that it’s hypocritical to single out “Baby, It’s Cold Outside” for criticism. Anybody who enjoys literally any genre of popular music with lyrics should probably start with a bunch of other stuff if they are intent on being censorious.
My book, Drink Spiking and Predatory Drugging: A Modern History (2016) only deals with the newfound discomfort with this song in passing. I haven’t written about it extensively; I’ve only commented to my friends I found the whole campaign against the song wrong-headed. Since then, there’s been some very good writing about the topic. Mainly: listen more closely.
I liked Cammila Collar’s take on this at Medium, which rightly recommends listening closely enough to realize that the female singer is looking for a way to stay, not to leave, and that she’s joking around when she asks, “what’s in this drink?” Collar and other writers on the topic, some of whom I mention in my book, also plead for greater attention to the historical context of the song, where ideas about shame and propriety greatly thwarted women’s desires and leisure activities. In the ensuing years, not surprisingly, role-reversing renditions have emerged, keeping the original lyrics intact. (If you want a little soundtrack for this blog post, I recommend the Lady Gaga and Joseph Gordon-Levitt’s 2013 version.)
Let’s also understand the drugs-and-alcohol-related context of the joke the duet singers share. It’s true, as Collar and others said, that “what’s in this drink?” was a common joke at the time when people wanted to account for their own bolder-than-usual, sillier-than-usual, or more-at-ease-than-usual behavior in all kinds of social settings, not just in potentially romantic or sexual ones. Throughout the song, she’s also mocking and rejecting an expected gender role: appointed schoolmarm of the evening, disciplinarian of the wily male. The song also came about during a new era of pharmaceuticals, and with it a new post-Prohibition sense of ease with alcohol, too — and sometimes a blithe attitude about their combination. And thus, jokes.
In my book, I wrote:
After Prohibition, the liquor industry sought to re-domesticate the image of alcohol as a wholesome accompaniment to a social evening at home. While drinking slowly became more acceptable for middle-class women, the consumption gap [where men drank considerably more than women in the US] of pre-Prohibition returned. In advertising, women were often shown serving alcohol rather than consuming it. In this milder way, women once again seen as limiters and keepers in alcohol-serving environments – not people who were at risk, except under exceptional circumstances, of overindulging themselves, but not the grim-faced disapprovers of the Temperance era, either. A permanent shift had taken place in norms around drinking and women’s propriety. There was, by and large, nothing now deviant about it.[See Lori Rotskoff’s history, Love on the Rocks: Men, Women and Alcohol in Post-World War II America]
Beginning in 2012 and reprised every holiday season since, a sort of silly claim has emerged that the 1944 Frank Loesser holiday tune,“Baby, It’s Cold Outside” is actually “rapey” in part because the dialogue contained the line, “what’s in this drink?” In its own context, this actually makes no sense. First, it’s clearly not a song about someone genuinely worried about being drugged, but simply someone teasing her companion and humoring her own increasing desire to stay with him longer. Her quarrels (and ultimately mocking tone) are with the shaming voices that might disapprove. What it does reveal is both a relaxed attitude about her freedom to go or to stay, and about alcohol itself, and the mild disinhibition that everyone seeks from it. The drink (plus the “half a drink more” that she asks for) seems to make her go through the motions of propriety, in an increasingly joking way, of the what-will-people-think variety without diverting her from what she really wants.
It is difficult, however, for modern ears to pick this up unless you have an understanding of both transitioning gender roles at the time and perhaps a maybe too relaxed attitude about alcohol, drugs, and mixing the two at the time for both sexes. Barbiturates and chloral hydrate still appeared in a number of pharmaceutical products, and at the time there was still generally too little concern about their mixture….While I’ve suggested that this may have a lot to do with lessening fear of alcohol itself and its rekindled association with sociability rather than social pathology, it also has to do with the techno-utopian view of tranquilizers coming onto the market. [pages 89-91]
The mass marketing of tranquilizers in the post-war period (as this song gained popularity) created a halo around these products, and it was not yet common for doctors to warn patients sternly about mixing these drugs with alcohol.
Enthusiasm and ensuing carelessness about meprobamate [Miltown] is difficult to overstate …. Comedian Milton Berle, in the 1950s, once joked with his audiences that he was planning to change his name to Miltown Berle. There were even Miltown cocktails variations on the Bloody Mary and Martini that required a dose of the stuff. No worries! [pages 91-92][Also: See Andrea Tone’s book, The Age of Anxiety]
From a caution-bound contemporary standpoint, such practices (and jokes about them) seem reckless rather than “so very nice.” But that wasn’t how people saw it back then. We don’t have to see drinking, drugs, or even flirting exactly the same way to understand it. Kudos to the stations that have kept it in rotation.
Cosby Trial: Cold medicine in an alleged drugging case is … nothing to sniff at.
Bill Cosby is currently on trial for an alleged sexual assault on Andrea Constand in his home near Philadelphia in 2004. Last year, a previous court case ended in mistrial. In the interim, of course, the world learned of many more allegations against the entertainer over the decades.
At various times, Bill Cosby has claimed to have given women cold or allergy medicine. This was, I’m sure, intended to sound more benign than the Quaaludes (methaqualone) that he admitted purchasing, during a deposition in the civil case Constand brought against him in 2005. He said then that he got Quaaludes to give to women he wanted to have sex with, and also admitted that he didn’t take that drug himself, as it made him sleepy.
But the “cold medicine” pivot doesn’t point to a lack of predatory intent. A little primer about the potentially big effects of diphenhydramine is order.
We commonly know diphenhydramine as an over-the-counter remedy, in the form of a little pink antihistamine; the most well-known brand name of this drug is Benadryl. It can make people drowsy, and in fact many people informally use it on themselves (or even their pets) to coax sleep on an otherwise agitated situation. This is a relatively safe practice if no alcohol is involved, and the dose is kept low. But at doses above the recommended 25-50 mg level, there have been reports of blackouts, feelings of heavy limbs or paralysis, and disorientation. There are also methaqualone and diphenhydramine combination pills; some formulations of these are blue tablets. Higher doses of diphenhydramine alone have been made in blue tablets, as well.
Recently, concern has emerged about nightlife welcoming the “Benadryl cocktail.” For the record, this is an ill-advised mixture. People have been mixing heavier drugs, like tranquilizers, with alcohol for a long time; in the 1950s, the Miltown Martini was much in vogue. I can remember a particularly notorious dorm party at college that involved NyQuil and vodka. Most people’s interest in these concoctions is also voluntary, recreational, and for self-dosing; nonetheless, diphenhydramine can and has been used in a predatory way. Nearly any substance can be pressed into predatory service under the right circumstances. Playing armchair toxicologist, by simply guessing on the basis of a victim’s symptoms, is not wise. To use legalistic language even outside a court setting: you’re piling on additional burdens of proof that are unnecessary if you simply take a broader view of the total circumstances. The question really is: did someone suffer exploitation or assault, in part because they could not consent or resist?
The 2015 criminal complaint against Cosby takes diphenhydramine seriously – and it should. At a high enough dose, Benadryl absolutely could produce the symptoms that Constand described. She said that he gave her three blue pills represented to her as herbal supplements, after she mentioned feeling out of sorts. Quickly, heavy symptoms emerged – dizziness, disorientation, and difficulty moving and staying conscious. She says she was also aware of a great deal of sexual touching during this time but was unable to resist or move away.
The prosecution this time around has a refreshing approach to the drugs aspects of the case — refreshing for being circumspect. It’s an approach, I think, with the practical goal of withstanding limitations the court might have (and did previously) place upon evidence about Cosby’s alleged pattern of behavior over the decades. But the role of drugs in the complaint keeps its sights on the underlying offenses. It takes a notably different tack than previous drugging allegation cases in some state courts and before college disciplinary boards. In my 2016 book Drink Spiking and Predatory Drugging: A Modern History, I identified a common, but often perilous, temptation to make drugs that central issue in assault cases, rather than the assault itself.
The key thing here, for establishing the non-consensual nature of the encounter, is the fact of Constand’s incapacity. The specific charge related to Cosby’s drugging behavior relates to facilitation of sexual assault, that he knowingly offered drugs that would lead to the incapacity and thus could not then argue that the encounter was consensual.
In this way, Cosby’s disassembling is the issue, not whether or not Constand took narcotics, high-dose diphenhydramine, or “herbal” supplements from Cosby. She took something from him, as they both agree, and became disoriented, weak, and only sporadically conscious afterward. This criminal complaint keeps it simple, in other words: Constand was in no state to consent, and the defendant’s behavior with whatever he may have given her strongly suggests consciousness of guilt and intent.
Contrast this approach with the one used in prosecuting and confirming convictions against Jeffery Marsalis, another Philadelphia-area case where the defendant was accused of multiple serial rapes and druggings:
But in trying to establish the likelihood of drugging, the press and the courts seemed at times, disturbingly, to rest their accusations of assault on it. It was a successful gambit for them, but risky. And it once again deferred the question of what right women had to bodily integrity when voluntarily intoxicated, as many of the women also were. So much emphasis was placed on the drugs that Marsalis’ violence—his decision to rape and exploit—seemed like some mechanistically simple and inevitable outcome of his drugging scheme. For instance, the courts belabored how he could have obtained drugs through his nursing and emergency medical technician (EMT) work. But by the time of the Marsalis allegations, in the early 2000s, obtaining drugs for such a purpose was hardly difficult. Benzodiazepines were everywhere. GHB was a popular club drug. Diphenhydramine (which was brought up as a possibility) is available over the counter. Basically, anyone who wanted to drug anyone else would not find many obstacles of a chemical sort. There basically are no barriers to means, nor have there been for a very long time. [p193]
The prosecution made the same mistake when they prosecuted Marsalis for a similar case in Idaho, developing a deep expert witness roster based on a theory of GHB drugging. Toxicology evidence was negative, and was misrepresented by a detective initially, although that wasn’t the only evidence that suggested drugging. But the drugs preoccupation put the conviction in jeopardy during appeal, where Marsalis’ lawyers argued, convincingly to at least some of the appellate judges, who dissented from affirmation of conviction, that the prosecution had made a particular drug scenario the centerpiece of its case, misrepresented the evidence, and then tried to argue that it wasn’t central. Once again, however, the appellate court majority did decide that the central issue was the complainant’s lack of capacity to consent, not an intricate and well-documented road map of chemical predation. A close call, and an example of how a drug-centric shaping of a case, can jeopardize the centrality of assault upon an incapacitated person.
The Cosby complaint takes its unknowns in stride, rather than running from them, headlong into phantom evidence that then weighs down the accuser with absences. It remains to be seen whether this broader-view approach makes a difference.
New Excerpt: What’s in your Halloween Cache?
Here’s an excerpt from the book, Drink Spiking and Predatory Drugging: A Modern History, about the attractions of drug scarelore, especially involuntary drug ingestion as a “problem solver” for frightened parents. It almost always rears its head around Halloween, but never really goes away completely. – PD
The Points Interview: Pamela Donovan
“We’ve thrown off certain old mores over the last few decades, and now the proper girl ideal has been replaced by the smart girl ideal: freedom, but no room for error, and everything’s your fault.”
I did a Q & A about the book project over at the great Points blog. Thanks to Kyle Bridge and everyone at the blog, which focuses on the history of drugs and alcohol.
I am one and you are too? Narcissism, violence, lessons not learned, and the case of the Hot Chocolate rapist
On October 9, 2016, the Daily Mail (UK) reported the death of Harry Barkas, Australia’s so-called “hot chocolate rapist” who was convicted of drugging and assaulting women to whom he offered rides home from nightclubs. At the time, this offender’s exploits were covered as a serial rape case, rather than attempting to shoehorn it into the public drink spiking scare narrative. In Drink Spiking and Predatory Drugging: A Modern History (Palgrave Macmillan, 2016), I wrote about the failure of the press and other public health and safety communicators to learn about the nature of this crime from key American and Australian serial cases like Barkas’. Below, I provide an adapted excerpt from my book that refocuses on misplaced trust, context, and links to a chapter that discusses the dynamics of this crime.
From Chapter 6, Who and Where are the Druggers?
(Other chapters are available as book previews at Amazon.com and Google Books)
[…] Chef John Xydias of Melbourne was accused of drugging, raping, and videotaping 13 women he had met through work. In some cases, he was introduced to his victims by a man named Harry Barkas, who was, at roughly the same time Xydias got caught, accused of being the “Hot Chocolate” rapist. Barkas, who worked in a medical clinic and had access to drugs, approached women as they left nightclubs and offered them a ride home. According to a 2008 Herald Sun article, he then offered them hot chocolate into which he had slipped tranquilizers and sleeping pills, including Rohypnol. Barkas was charged with a string of attacks between 1991 and 2005, and Xydias between 1995 and 2006. Both were in their mid-40s.
Xydias typically met women through the restaurant business, and Barkas sometimes did, too. The Age, a newspaper in Melbourne, reported that one of Barkas’ victims worked at the same restaurant he did and regarded him as “an older brother or uncle.” Xydias drugged and filmed many women while dressing them up and assaulting them. Upon sentencing in 2010, when he was convicted of 86 charges relating to 11 victims, he told the court that the women only lodged charges against him as vengeance for not continuing a relationship with them. Like other such serial offenders, he claimed that the acts were consensual and that the women were heavy drinkers and drug users.
While it may be the case that the reason nearly all of the men [accused of multiple attacks] say the acts were consensual is strictly a legal strategy—when the prosecution has a recording of your raping behavior, there are not that many defenses left—it is possible that pathological fantasy, on some level, has made this claim seem real to the offenders. They often see themselves as decadent nightlife hedonists who push the boundaries—so they think, well, why wouldn’t or shouldn’t their victims be? As in, I am one and you are, too. As edgeplay, they might even consider it relatively tame— “just” drugs. Xydias’ pre-sentence psychiatric report called him emotionally disconnected, as reported by the Sydney Morning Herald. Barkas’ report suggested a narcissistic personality disorder; his ability to be accountable for his actions was limited; he was suspected of many more assaults than he could be charged with due to lack of evidence.
There was some question of Xydias’ relationship to Barkas. Though they were childhood friends and frequented the same venues, they did not, apparently, offend against the same women. Barkas appears to have been more sporadic with his assaults, with a suspected cluster taking place in the mid-1990s and another right before his arrest, leaving a gap of more than a decade, according to the Herald Sun. Although police suspected there must have been more victims in between, that is not entirely clear. Barkas was sentenced to 13 years and Xydias, 28.
The legendary public-place drink spiking, followed by a carry-off and assault, as we have seen, has too many moving parts to really be very common. What we find in its place, much more commonly, is voluntary intoxication followed by misplaced trust, or coevolving with it, and then victimization in a private setting. As with acquaintance rape generally, it is really the moment of misplaced trust that is exploited by the assailant. Intoxication helps, of course, in reducing the ability to resist unwanted sex, and as such, is simply another tool to facilitate an act of violence. Drugging can make detail retention hazy enough that the victim questions what really happened, and may be more reluctant to report it, though this amnesia is not guaranteed, any more than it is with large amounts of alcohol or voluntary drug ingestion. Culture then piles on by blaming women who drink for anything that happens after. On both individual and collective level, the gaslighting begins. Some gaslighters are better at this sort of thing than others. [I continue in the book by talking about the US case of Jeffery Marsalis]
The Opiate Overdose Crisis: An Experiment in Vancouver Suggests a New Approach
Across North America, first responders and hospitals report a deluge of overdoses among heroin users whose drugs are mixed with fentanyl, a strong synthetic opiate or the even more powerful carfentanil, which is used in veterinary anesthesia. Word from Vancouver is that public health workers have used a reagent test for the presence of fentanyl in other street drugs for the clients that they serve.
In addition to the dangers posed by heroin itself, these additives make street doses unpredictable in strength. By volume, the synthetics are much more powerful, and street users depend upon illicit manufacturers and distributors to supply semi-predictable products. Although many street users now expect that the heroin they buy (and sometimes, the cocaine) will contain synthetics, they also have little or no way to know how carefully compounded these drugs are. Judging from the rapid rise in overdoses in recent weeks, the answer is that dosage chaos reigns.
Why Vancouver first? First, British Columbia is treating it as the emergency it is. It declared it as such in April 2016, with the CBC reporting that by June, 71 overdose deaths had taken place and 60% involved fentanyl. But uniquely, the city has a government-funded organization called Insite, a supervised injection site for drug users. Nurses and other clinic workers staff the place, and it is the only program like it right now in North America. Insite also has some health care services, provides clean needles and can respond to overdoses on site.
Drug users bring in their own drugs, and they are free from the risk of arrest while they are there. This also provides an opportunity for drug testing. Consumers of the drugs can learn about the composition of the drugs they are about to inject, while the clinic can gain information about, and report on, trends in purity and composition of street drugs.
Which brings us to the potential of fentanyl test strips. Francine Diep reports in Pacific Standard magazine that fentanyl testing may – emphasis on may – provide some benefit to drug users by detecting its presence. Insite ran a pilot testing program this summer, using the strips for a month on as many samples as they could. 90% of the heroin samples contained fentanyl, and some of the cocaine samples did, as well.
There are two key issues here. First – how accurate the tests are from a strictly scientific viewpoint: what are the rates of type I and II errors, and what is the specificity to the problem of an adulterant like fentanyl as opposed to cross-reactions to other less deadly ingredients? The strips were originally designed to test urine, and in lab settings it has a 6% false positive rate and a 0% false negative rate. Most of the medical consultants on Insite’s project felt that it might do just as well in water-dissolved samples at the clinic. In the abstract, the low false negative rate is good news. The test strip doesn’t react to carfentanil, however.
It should be kept in mind that some users actively seek out synthetic opiate pills, either preferring them to injecting heroin or using them as a bridge at times when heroin is hard to come by. People who buy hydrocodone illegally may be getting fentanyl instead, or a mixture, and again, the unexpected strength can be deadly. It appears that fentanyl in a hydrocodone preparation is what killed legendary musician Prince at age 57 in Minnesota this past spring.
Also, to what extent does a positive result for fentanyl discourage a user from injecting the drugs? Diep notes that few people at the Vancouver site seem willing to throw away contaminated drugs altogether. But staffers suggest they may be willing to lower their intake if they know the powerful synthetic is present. The clinic reports that 86% of the drug samples they tested contained some fentanyl, which implies that at least for the population that uses that clinic, it may be hard to avoid.
Fentanyl is now everywhere. It can be purchased on cryptomarkets online, where either tablets or ingredients can be obtained. Making it is not that difficult, and mid-level distributors can move into manufacture. It can also be diverted from legitimate medical use, as it is often prescribed to people with cancer.
Similar ideas for other cities have been stymied by an insistence on abstinence and prohibition-based approaches and legislation which inhibits or quashes altogether such harm-reduction opportunities, in both Canada in the US. The only recent harm-reduction initiative that hasn’t been aggressively and routinely blocked is overdose-reversal medication like naloxone, which many communities distribute to first responders or make available to the public by prescription.
But as synthetic mixes hit the streets, naloxone is less effective. Reports from Indiana suggest that when carfentanil is present, even five or six doses of naloxone may not reverse the effect. Carfentanil is also powdery and light, posing risks to police and EMTs who respond to places where the drug is present just by touching or inhaling it, in a similar way that methamphetamine making can expose others to risk.
So, the way to think of the new synthetic adulterant problem is: a mess we don’t know how to handle, situated on top of a mess that we do know more about than we are willing to do. You’d think decades of a failed War on Drugs – drugs won, in case you haven’t been keeping up – would demonstrate the need for greater humility and innovation in policy making. The pilot project in Vancouver can save lives and prevent injury, and similar programs could also tell us a great deal about drug adulteration, and how best to protect public health.
Like Many Things, the Promise of Light and Portable Drug Testing Depends Entirely on Context
I noted in my last blog entry on the dubious technology “drink spiking detection” devices — such as coasters, test cards, and other reagent-coated bar ware — that both false positives and false negatives are too high to make the technology useful. I also suggested that if such user-end technology — thus far deployed without much real consumer interest — were to become more popular, the imprecision associated with such products could instill a dangerous reassurance to people situationally suspicious enough to test their drinks, while creating undue fear, accusations, and other kinds of serious ramifications in the case of false positives.
But in another realm, there’s already a darker side to false positives in quick field tests. Nationwide concern in the US is beginning to pick up about the sometimes life-altering problems associated with inaccurate or inconclusive field tests used by law enforcement agencies. Field testing technology for drugs on the scene (say, at a vehicle stop) hasn’t developed much since its inception in the 1970s; it appears that what is new is the recognition that cross-reactions with any number of other ordinary chemicals and compounds produce unacceptably high levels of false positives. The New York Times Magazine reported in July that widely deployed reagent field tests have routinely produced false positives for methamphetamine and cocaine. But enter “field drug test” or “drink detector” into a search engine on line, and you’ll find little recognition of the cross-reaction problems that have been known for years.
Furthermore, the necessary visual interpretation of chemical testing results (it turned blue, it turned sort of blue, it turned light blue…) remains a key moment in decision-making in forensic detection and is fraught with the tendency to over-certainty and over-confidence. This problem has been well-known since the most rudimentary lab techniques were developed in the early 1900s, and remains a problem for cheap, easy field deployables. The cobalt thiocyanate tests used to test for cocaine, for instance, will also turn blue with a number of over-the-counter medicines and cleaning products.
Technically, in order for a positive field test to lead to criminal conviction, it has to be confirmed in a lab by more precise tests. But circumstances rule. Most people arrested for drugs don’t have access to private lawyers or even readily available bail or bond money, and pleas before confirmation are the norm. Some period of incarceration may ensue anyway, just enough to disrupt the stability of more vulnerable citizens. The Times article chronicles the downfall of a Louisiana woman arrested in Houston and saddled with a felony conviction for crack cocaine, which turned out to be a fragment of the over-the-counter aspirin and caffeine pill that she insisted it was. Having lost her steady home and job as a result, she didn’t even realize that she’d been part of a wave of similar exonerations until the Times informed her, years later.
But on-site drug testing can be used by consumers of drugs, as well. In a different context, the technology, even with its flaws, can prevent harm rather than inflict it. There is a well-functioning model out there – and it comes from the rave scene. In rave and electronic music settings, there’s actually a solid network of nonprofit drug testing that can analyze drugs on the spot. The DanceSafe outfit is probably the best known of these harm reduction groups, but the technology to provide such a service is widespread. MDMA, commonly known as Molly or Ecstasy, is one of the more widely adulterated illicit drugs. On August 3, Lauren Frayer reported on NPR’s All Things Considered radio show that on-site testing had been arranged for a larger music festival in the UK. Due in great part to advocacy on the part of researcher Fiona Measham of Durham University, a legal path has been cleared for the process, to encourage event goers to subject their drugs to testing. In the process, they can discuss the results with a trained counselor. In the US, DanceSafe sells testing kits to consumers, but can’t provide on-site testing and counsel due to risk of attendees’ arrests. (This organization and others are advocating for legal and enforcement-practice reform that would enable this service in the US.)
Online drug commerce has advanced the prospect of user-initiated testing, as well. A firm called Energy Control in Barcelona tests any drug sent to it and provides a report. It now receives government support in the interest of harm reduction, although it started out with a single doctor, Fernando Caudevilla, who posted to the now-defunct Silk Road darknet platform, offering testing and advice. The testing is highly precise but not immediate – with at least a few days’ turnaround time. The company takes Bitcoin payments to enhance anonymity.
A number of drug cryptomarkets have emerged in the wake of Silk Road’s closure in 2013, when it was seized by the FBI as part of the indictment of its founder, Ross Ulbricht. The market for online illicit drug transactions is growing rapidly, according to a newly-released RAND report.
So you can assume that there is a latent demand for user-end testing products, for people that use drugs voluntarily, and have the resources to buy them discreetly. People who purchase drugs in hand-to-hand transactions aren’t the same as those who buy on line. It’s unclear whether this sort of simple re-agent technology would be used widely by those who purchase street drugs. Energy Control reported that cocaine was much purer in online samples than street ones, suggesting that a bifurcated market remains — starkly by economic resources — and perhaps also the interest in drug content verification. In any case, having users make contact with neutral testers and advice-givers seems all to the good, in terms of enhancing public health and at the same time adding to the research body of knowledge about illicit drug trends. Increasing awareness of the fallibility of light-and-portable tests — and resisting the “gee whiz” style of reporting on technology — also seems useful to everyone.
What’s in Your Drugs? And Does it Matter if it isn’t what you think? (Part 1 of 2)
Summer Drug Testing Roundup, part 1 of 2:
In mid-July in Yorkshire, England, ITV and other news sources reported that purchasers of “street Valium” got more than they bargained for and a number of them had sought medical attention. The first odd thing was that the drug had turned their tongues blue, and the second was that the drugs’ effects were much heavier than expected. Within weeks, police made an arrest and recovered about 40 more of the suspect tablets.
It appears that the underground compounder making the drugs mixed diazepam (known by one of its commercial names, Valium) with flunitrazepam (known as Rohypnol) or “roofies.” Swiss pharmaceutical giant Roche began blue-dye tagging Rohypnol tabs in response to spiked-drink reports in the United States in the late 1990s. Both Valium and Rohypnol are benzodiazepines, but Rohypnol is stronger. Roche makes both of the name brands, but generic versions are around, as well. Valium is mostly used as an anti-anxiety drug, whereas Rohypnol treats insomnia. (Roche was never all that aggressive in seeking to swim upstream against the negative publicity as it marketed the drug in the US. Rohypnol was too similar to other insomnia drugs anyway, and Roche focused mainly on countering the negative publicity.)
No doubt the purchasers of the illicit drug had expected a Valium-high, but experienced something more anvil-like and presumably suffered some of Rohypnol’s known side effects, such as amnesia.
The recent incident in Yorkshire points up the strangeness of continuing to use the term “date rape drugs” in any meaningful way. References to Rohypnol assume, often without sources or reference, that it is widely implicated in drugging and drink-spiking cases. In fact, Rohypnol is available by prescription in Europe and elsewhere, and it is rarely implicated in predatory drugging incidents. In the handful of cases where anything other than high blood-alcohol levels has been found, none of the commonly labeled “date rape drugs” are among the top substances. Instead, the usual street substances are found, including stimulants. But the moniker “roofie” leapt clear of its origins and took on a meaning of its own.
The Yorkshire Street Valium incident points to a more common problem — adulterated drugs in the illicit market. Up until recently, consumers of illegal or restricted substances had no way to verify that what they were buying was what they thought they were buying. Underground mid-level distributors and wholesalers sometimes employed chemists for verification of samples from larger lots they were negotiating to buy, but the street user was more or less on his or her own. In the US, there have been a number of cases in which seekers of heroin were sold heroin-fentanyl combinations, with sometimes fatal results. Fentanyl is a powerful synthetic opiate, and by weight or volume tends to be considerably stronger than heroin. Also this July, law enforcement in Long Island, NY arrested 24 people in connection with heroin and fentanyl distribution. At least one of the combinations they were distributing seems to have provoked an uptick in overdoses.
But in describing a street preparation as a deadly dose, you have to consider not only the objective effects of a particular dose, but the expectations that the buyer and user bring to the anticipated high. Fentanyl itself is now sought out, on its own or in combinations, by illicit users. Heroin users often expect their purchases to be cut with other things; toxicologists note that most of the time, the adulterants buffer rather than strengthen the effects of the drug. But the haphazard and after-the-fact investigation of the content of illicit substances, as well as a non-transparent supply chain, means that it is difficult to separate effects of the drugs themselves and the drugs’ potential substitutions and additives.
In my book on drugs associated with the “date rape drugs” scare, I noted that there was really no factual basis to label certain popular club drugs like GHB as the preferred weapons of predators. GHB, Ketamine, and Rohypnol – like many central nervous system depressants – have been implicated in specific cases, but any CNS depressant can work, and the labeled drugs are found less often than other widely available drugs (and, of course, alcohol). GHB also presents an interesting conundrum in that it is often not clear whether people who had some in their system were dosed by someone else with ill intent, or whether the GHB was a part of a popular mix of MDMA and GHB sometimes sought out in club settings.
Just to add to the confusion, GHB’s street names are myriad, including Liquid Ecstasy and Cherry Meth. and its effects are seemingly subjective enough to be mistaken for any number of knowingly ingested substances. The underground compounder often finds that GHB is a cheap substitute for other drugs. GHB is also sought out by recreational users for its reputation as a calorie-free buzz mimicking moderate alcohol ingestion. It can be very dangerous, however, in combination with alcohol.
Voluntary drug users clearly might benefit by being able to quickly and easily test the content and potency of their drugs, but for many reasons the market hasn’t reached this potential public yet. In my next blog, I discuss the problems with validity and reliability of home and field drug test kits, and the products that come to market to purportedly fix this problem. Depending on context, testing technology can either aid well-being and safety or undermine it.