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What Exactly is Gray Death Heroin?

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Gray Death heroin is a potentially deadly drug that may be a mixture of heroin with synthetic drugs, or it may be only a synthetic drug with no heroin, according to a news article.Heroin typically looks like a white or brown powder or sometimes a black sticky substance, which is commonly referred to as “black tar heroin.”2 However, news reports state this powerful gray-colored powder is concerning healthcare and law enforcement officials.1,3,4 Carfentanil, a synthetic opioid that is a possible component of Gray Death, is thought to be about 10,000 times more potent than morphine, another opioid.1 Because of Gray Death’s potentially very high potency, the risk of overdose is dangerously high.1

If you are someone who buys opioids illegally, you need to be aware that you could unknowingly obtain synthetic mixtures, like Gray Death or others that look identical to what you think you are getting. As the name implies, these mixtures, even in small doses, can be fatal.

A Deadly Mixture

What's It Look Like?

According to news reports, Gray Death can be a powerful mixture of heroin and synthetic opioids, like fentanyl, carfentanil, and U-47700, or it can contain no heroin at all, just synthetic opioids. Although each batch of Gray Death is likely to be composed of somewhat different substances and different proportions of components, the drug typically resembles a concrete mixture.1,3,4

If you are someone who buys opioids illegally, you need to be aware that you could unknowingly obtain synthetic mixtures, like Gray Death or others that look identical to what you think you are getting. As the name implies, these mixtures, even in small doses, can be fatal.

Heroin is produced from morphine, a natural opiate extracted from opium poppy plants.Synthetic opioids, however, are lab manufactured. Fentanyl and otehr synthetic opioids are created not only by pharmaceutical companies but also in illicit laboratories.8 Fentanyl may be mixed with other drugs as a cheaper way to cause a more powerful high.6

Synthetic Opioids

Some synthetic opioids that maybe combined with heroin to make Gray Death include:3-8

  • Fentanyl: This is a synthetic opioid that is 50 times more potent than heroin. It is a Schedule II prescription medication typically used to treat severe surgical pain. Fentanyl is also produced in illegal labs and sold on the street. When fentanyl is mixed with heroin or other drugs, it can lead to deadly consequences because users don’t know how potent the drug they are taking is.
  • Carfentanil: Carfentanil has been used as a tranquilizing agent in veterinary medicine for large mammals and is an extremely potent opioid. According to a news report, a chemist stated that one flake of pure carfentanil can sedate a 2,000-pound elephant. It is 10,000 times more potent than morphine and 100 times more potent than fentanyl.
  • U-47700: Also known as Pink, Pinky, and U4, this is a pink or white synthetic opioid that is often sold in baggies as a loose powder or pressed into a pill to resemble legal narcotics. U4, like fentanyl and carfentanil, is more potent than morphine. U-47700 is a Schedule I drug, meaning it has a high abuse potential and that there are no accepted medical uses.9 Individuals buying it illegally have no assurances that they are getting what they think they are, making its use all the more dangerous.

Dangerous Additions

When you buy heroin on the street, there is no way of knowing exactly what is in it. Dealers may lace it with other drugs, such as the synthetic opioids listed above, without informing the buyer. If you think you have just heroin and use your standard amount, but it is actually Gray Death or another mixture, you can easily overdose. Even if you know that something contains potent synthetics, it can be difficult or impossible to estimate an appropriately reduced dose, especially since batches can vary greatly.

In 2017, more than 28,000 overdose deaths involved synthetic opioids, not counting methadone.8 Since Gray Death contains synthetic opioids, it could have caused some of these deaths. According to a news report, Georgia’s investigation bureau received reports of 50 overdose cases involving Gray Death during a single 3-month period.3 It’s important to be aware of the dangers of this deadly drug mixture.

The Popularity of Gray Death

While you may think that users would flee from a drug thats name implies it might kill you, a news report indicates that is not always the case. Some people may use Gray Death because they are searching for the ultimate high, while others may be desperate to prevent the emergence of withdrawal symptoms, fearing withdrawal more than overdose.1

People who have been using opioids for years (or even decades) may begin using Gray Death, or any other mixture of synthetic opioids, in order to overcome significant levels of opioid tolerance. When an opioid user develops tolerance, they require a higher dose to achieve the desired effects.11 It can be quite expensive to purchase large amounts of heroin in attempts to get high or stave off withdrawal. Synthetic opioids may go for as little as $10 a hit on the street, making it an attractive alternative for opioid-addicted individuals. As stated, this is a dangerous practice, though, since someone can easily overdose.1

People who have been using opioids for years (or even decades) may begin using Gray Death, or any other mixture of synthetic opioids, in order to overcome significant levels of opioid tolerance.

It is also thought that chemists are designing drugs to skirt Drug Enforcement Administration (DEA) regulations.4 These unregulated drugs can be exported more easily from countries like China.4,7 Manufacturers are constantly changing the chemical components in their drugs, which means the buyer is always at risk.

Risks of Use

There is no way of knowing what dose will kill you if you don’t know what you’re taking. In such cases, it’s like playing Russian roulette every time you get high. Synthetic opioids are so potent that experts have advised law enforcement to not touch or inhale synthetic opioids if they encounter them on their job, according to news reports.1 The most concerning exposures to illicit fentanyl and its analogues are when it is inhaled, is ingested, touches mucous membranes, or contacts a skin break (such as through a needlestick). Although a person can also be exposed through skin contact, brief contact is unlikely to cause an overdose.10

On average, about 130 Americans lose their lives to an opioid overdose each day. Since 2013, synthetic opioid overdose deaths have significantly increased.12 If you are buying illegal drugs, even if they appear to be resold prescription pills, there is no way to ensure that is what they truly are. Using opioids will never come without risks.

Short- and Long-Term Effects

Even if you don’t experience an overdose when using Gray Death, using it or any synthetic opioid has both short- and long-term risks similar to using heroin. Short- and long-term risks of heroin use may include:2

  • The acute GHB withdrawal syndrome may include insomnia.Trouble remaining conscious
  • Nausea and vomiting.
  • Itching
  • Dry mouth
  • Depression.
  • Insomnia.
  • Constipation.
  • Stomach cramping.
  • Nausea and vomiting.
  • Irregular menstrual cycles in women.
  • Sexual dysfunction in men.
  • Liver and kidney disease.

If you’re an intravenous user, some additional risks include:2

  • Contraction of HIV and/or hepatitis.
  • Collapsed veins and abscesses.

Signs of Overdose

 There are some signs and symptoms of an opioid overdose that you’ll want to be aware of so that you can seek help for yourself or someone you know. These signs include:13

  • Signs of overdose can include a heartbeat that is slowed or stopped altogether.An extremely pale face.
  • Skin that feels clammy to the touch.
  • Limpness of the body.
  • Purple or blue lips or fingernails.
  • Vomiting or gurgling noises.
  • An inability to speak or wake up.
  • Breathing that is slowed or stopped altogether.
  • A heartbeat that is slowed or stopped altogether.

If you suspect that someone has overdosed on Gray Death or anything else, be sure to call 911 immediately and give the operator all the information you know about the victim and what they took. Remain with the victim until the emergency response team arrives. You will also want to alert the first responders what you think the drug may have been so that they can take the precautions necessary to avoid overdose themselves and can provide the appropriate care.

If you are a long-time opioid user, you may have experienced an overdose before. If so, you may have been resuscitated with a life-saving dose of the drug naloxone, which is marketed under a few brand names, including Narcan and Evzio. One dose of naloxone, however, is not always sufficient to treat an opioid overdose.14 According to a doctor cited in a news article, synthetic opioids, due to their high potencies, could require 5 to 10 doses in some cases to treat an overdose.1 That much is not always available.

If you or someone you know uses heroin or other opioids, consider getting a naloxone nasal spray or autoinjectable that you can keep with you for emergencies.

If you or someone you know uses heroin or other opioids, consider getting a naloxone nasal spray or autoinjectable that you can keep with you for emergencies. Depending on which state you live in, these may be available from local pharmacies or outreach clinics. Narcan and Evzio may be covered by some insurance programs.14 Having naloxone with you could mean that someone will get the most immediate overdose treatment possible, which increases the chance of saving a life. Nonetheless, even if you give the person naloxone, you should still call 911 immediately.

Talk to a pharmacist, health worker, or outreach volunteer about acquiring Evzio or Narcan. It may end up saving your life or the life of someone you love.

Sources

  1. Ryckaert, V. & Rudavsky, S. (2017). Gray Death: It’s 10,000 Times More Powerful Than Morphine.
  2. National Institute on Drug Abuse. (2018). Heroin.
  3. Welsh-Huggins, A. (2017). ‘Gray Death’ Causes Worry.
  4. Nedelman, M. (2017). Gray Death: The Powerful Street Drug That’s Puzzling Authorities.
  5. U.S. National Library of Medicine. (n.d.). Carfentanil
  6. National Institute on Drug Abuse. (2016). Fentanyl.
  7. Drug Enforcement Administration. (2016). DEA Issues Carfentanil Warning to Police and Public.
  8. Drug Enforcement Administration. U-47700.
  9. U.S. Department of Justice DEA Diversion Control Division. (2018). Controlled Substances
  10. Centers for Disease Control and Prevention. (2018). Fentanyl.
  11. Centers for Disease Control and Prevention. (2017). Opioid Overdose: Synthetic Opioids. 
  12. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  13. Substance Abuse and Mental Health Services Administration. (2016). Opioid Overdose.
  14. National Institute on Drug Abuse. (2018). Opioid Overdose Reversal with Naloxone (Narcan, Evzio).

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