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Painkiller Analogues75In 1979–1980, some illegal fentanyl analogues appearedthat were being sold as substitutes for heroin on the street.Suddenly, a series of more than a dozen mysterious deathsoccurred in southern California. Upon autopsy, the victimsstrongly looked as if they had overdosed on heroin; however,no traces of heroin could be found in their bodies. Later,forensic chemists identified a fentanyl analogue (alphamethyl-fentanyl)that was present in all of the victims. As itturns out, alpha-methyl-fentanyl was being sold on thestreets under the name “China White” (Figure 7.2), becauseit resembled (and contained) pure synthetic heroin that wasproduced in Southeast Asia.Later in the 1980s, other fentanyl analogues started to befound in the tissues of heroin users and overdose victims. Onesuch analogue was 3-methyl-fentanyl (see Figure 7.3), which is6,000 times more potent than morphine. This drug was foundin the tissue of 16 overdose victims in Pennsylvania in 1988. Inall, more than 150 deaths have been attributed to overdoses ofillegal fentanyl analogues. It is likely that victims overdosebecause they think they are injecting heroin and are ignorantto the potency of the fentanyl analogues that they are actuallytaking. Alpha-methyl-fentanyl became classified as a ScheduleI controlled substance in 1982, and 3-methyl-fentanyl wassimilarly classified in 1985.Fentanyl analogues often come as a fine or coarse powderthat is either white or yellowish-white (when sold as “ChinaWhite”), tan (when sold as “Synthetic Heroin”), or light brown(when sold as “Mexican Brown”). Other names for fentanyl orits analogues include “Goodfella” and “Tango and Cash.” Drugdealers often cut (dilute) fentanyl analogues with largeamounts of powdered sugar so that the actual drug content isvery small (as low as 1%). When dealers “cook” the fentanylanalogues, the sugar content can become caramelized, giving ita brownish color. The drugs are mostly injected intravenouslybut can also be snorted or smoked.