Editor’s Note: Today’s guest post comes from Bilal Abbas, MPA, MSW. Bilal graduated with the MPA from Rutgers University in Newark and the MSW from Columbia University in New York City in 2018. He works at the Albert Einstein College of Medicine/Montefiore Medical Center as a Research Coordinator, facilitating research related to heroin or opioid use treatment.
For over half a century in New York City, heroin bags have been distinctly branded with unique markings, including with rubber stamps. From the seller’s viewpoint, stamps create brand loyalty and identify a superior product that yields more psychoactive effects. Heroin-using communities also utilize stamps to identify potentially lethal supplies and raise awareness through word-of-mouth messaging. In the 1990s, users identified and alerted others about supplies, which had caused a number of overdoses and which they suspected to be contaminated with lethal adulterants including scopolamine. [1-3]
Fentanyl has been of increasingly paramount importance in tens of thousands of preventable deaths among Americans since 2013. Fentanyl seizures in the US increased 7-fold from 2012 to 2014, while overdose deaths involving fentanyl and its analogs increased almost 47 percent from 2016 to 2017. [4] A 55 percent increase in fatal overdose was observed in New York City (NYC) between 2015-2017, and in 2017, 55 percent of overdose deaths involved fentanyl. [5]
Due to the availability of rapid fentanyl test-strips, the novel study described in this post, Exploring fentanyl prevalence in New York City, used an exploratory framework to examine and understand the fentanyl contamination in NYC stamped heroin. Examining fentanyl prevalence in NYC heroin by stamp or “brand” can raise awareness about tainted supplies and can help to reduce opioid overdoses. My team collected samples of used and discarded heroin glassine bags in NYC neighborhoods known for heroin use and sealed them within a separate plastic bag to avoid cross-contamination.
We then used fentanyl test strips, which use immunoassay technology to quickly and reliably detect the presence of fentanyl and its analogs, to test trace amounts of heroin in each bag. According to the American College for Medical Toxicology (ACMT), it is a near scientific impossibility to overdose on fentanyl from airborne or transdermal exposure. Therefore, there were no safety risks involved in executing this study. [6]