The harm-reduction organisation Know Your Stuff announced today that for the first time it has found the synthetic opioid fentanyl in a field sample in New Zealand. It's something everyone who watches the illicit drug market knew was almost certain to happen eventually. Now it's here.
There have already been fentanyl overdose deaths here, but those appear to have been related to fentanyl diverted from legitimate prescriptions. What Know Your Stuff found last month was illicitly-imported heroin that turned out to contain fentanyl.
The organisation offers (in a legal grey area) drug-checking services at festivals and dance parties, using both reagent kits and a portable spectrometer funded by the New Zealand Drug Foundation. That's how this sample was found.
It's rare for opioids to be presented in that context – who takes heroin to a dance party? – but Know Your Stuff spokesperson Wendy Allison believes that drug users who have become aware of the service may now be bringing along substances they have no intention of taking on the day, to have those tested too.
"We thought we'd better tell people because it's the first time we've found it as a substitution for something else," she says.
"This one came into the country. That's about all we can say about it. With things coming through and being bought on the internet now, whether it's been bought as a single sample off some website or whether it's been smuggled in in large quantities is never certain.
"Anyway, it got destroyed. They weren't taking it."
Along with its toxicity – respiratory arrest is the primary factor in overdoses and fentanyl is likely to suppress breathing in far smaller quantities than more established opioids – it's this undeclared presence of the drug that has caused an extraordinary number of deaths in North America and Britain. In Canada it has turned up in almost every black-market drug but cannabis, including party drugs like MDMA.
Know Your Stuff's statement this morning makes several recommendations in response to the discovery. It notes that the most reliable method of testing for fentanyl and its its analogues is a fentanyl testing strip available at The Hempstore and elsewhere.
It also recommends amending the Misuse of Drugs Act to allow DHBs and other services to offer forensic drug-checking services for people who want to check that what they have is what it's supposed to be; making the opioid antidote naloxone more widely available – and pressing ahead on the long-promised Drug Early Warning System.
Although some Health budget was allocated last year for a scoping study for an EWS, there's little sign of progress on the matter – and the result is that, as Allison acknowledges:
"We are the Early Warning System. We don't really want to be, but nobody else is giving out information about things that could be dangerous. While there are a lot of agencies collecting data, nobody's sharing it."
What has happened this year has underlined quite how much that's the case. In January, Know Your Stuff announced that it was finding a new "crap drug", n-ethylpentylone, being presented as the more common party drug MDMA, or Ecstasy. Although, as a crystal or powder, it may be hard to distinguish from MDMA, it's dosed at about a third the quantity: about 30mg as opposed to 100mg. Taking even measured amounts in the belief it's MDMA can be very dangerous – as we saw last month in Christchurch, where about 20 young people presented to ED suffering serious effects from overdosing on n-ethylpentylone.
Police and the DHB announced that the substance they'd taken was not MDMA, but mistakenly conflated n-ethylpentylone with another drug in the cathinone family, mephedrone, which has a different dose profile. Police subsequently corrected the advice – and it's hard not to think that they did so because Know Your Stuff flagged the error.
But although the media are increasingly treating Know Your Stuff as an expert commentator, the system is wary.
"I suspect what's happening is that we're not legit enough yet. We're not the cops, not a DHB, not ESR," says Allison. "Nobody really knows what we are, we're just some rogue organisation that came out of nowhere and people in the corridors of power are not ready to take us seriously yet. Which is a shame, because while they've sat about, we're the ones telling people what's out there."
She says two MPs from different parties have approached Know Your Stuff and are "interested in what we're doing. Nobody else has shown any interest yet."
As it did last year, Know Your Stuff will be presenting this summer's testing data. Last summer, it noted the discovery of cathinones it could not identify being presented as MDMA. Spectrometer sused in the field typically identify the structure of a chemical and match it against a database of known profiles.
Was n-ethylpentylone one of those mystery cathinones last summer? Yes.
"One of the new and unnamed cathinones we found last summer was n-ethylpentylone. The spectrometer detected it as a bunch of different cathinones and we sent the spectrum to The Loop in the UK, who identified it as n-ethylpentylone. We got the Bruker database update which is now correctly detecting it as n-ethylpentylone, but there are two other cathinones we detected that The Loop could not find a match for. They're cathinones but they're not in The Loop's database.
"We've found those two again this year. We still don't know what they are."
The gap may lie in the fact that new substances in Britain tend to be manufactured in Europe, where those in the market here will typically have been made in Chinese factories.
"But until somebody identifies it and puts it in the database, the best we can do is record it as 'unknown cathinone' and say 'we don't know anything about it, please don't take it'."
And they keep coming.
"They do. And as far as we can tell from information from Europe, at a rate of about six a month."