Synthetic Opioids


Synthetic opioids are substances that are synthesized in a laboratory and that act on the same targets in the brain as natural opioids (e.g., morphine and codeine) to produce analgesic (pain relief) effects. In contrast, natural opioids
are naturally occurring substances extracted from the seed pod of certain varieties of poppy plants. Some synthetic opioids, such as fentanyl and methadone, have been approved for medical use.

Clandestinely produced synthetic opioids structurally related to the Schedule II opioid analgesic fentanyl were trafficked and abused on the West Coast in the late 1970s and 1980s. In the 1980s, DEA controlled several of these
illicitly produced synthetic opioids such as alpha-methylfentanyl, 3-methylthiofentanyl, acetyl-alpha-methylfentanyl, beta-hydroxy-3-methylfentanyl, alpha-methylthiofentanyl, thiofentanyl, beta-hydroxyfentanyl, para-fluorofentanyl, and 3-methylfentanyl.

As of 2013, there has been a re-emergence in the trafficking and abuse of various clandestinely produced synthetic opioids, including several substances related to fentanyl. Some common illicitly produced synthetic opioids that are currently encountered by law enforcement include, but are not limited to, acetyl fentanyl, butyryl fentanyl, betahydroxythiofentanyl,
furanyl fentanyl, 4-fluoroisobutyryl fentanyl, acryl fentanyl, and U-47700.

Synthetic opioids are believed to be synthesized abroad
and then imported into the United States.

What do they look like?
Clandestinely produced synthetic opioids have been
encountered in powder form and were identified on bottle
caps and spoons, detected within glassine bags, on digital
scales, and on sifters which demonstrates the abuse of
these substances as replacements for heroin or other
opioids. These drugs are also encountered as tablets,
mimicking pharmaceutical opioid products. Clandestinely
produced synthetic opioids are encountered as a single
substance in combination with other opioids (fentanyl,
heroin, U-47700) or other substances.

How are they abused?
Abuse of clandestinely produced synthetic opioids parallels
that of heroin and prescription opioid analgesics. Many of
these illicitly produced synthetic opioids are more potent
than morphine and heroin and thus have the potential to
result in a fatal overdose.

What are their effects?
Some effects of clandestinely produced synthetic opioids,
similar to other commonly used opioid analgesics (e.g.,
morphine), may include relaxation, euphoria, pain relief,
sedation, confusion, drowsiness, dizziness, nausea,
vomiting, urinary retention, pupillary constriction, and
respiratory depression.

What are their overdose effects?
Overdose effects of clandestinely produced synthetic
opioids are similar to other opioid analgesics. These
effects may include stupor, changes in pupillary size, cold
and clammy skin, cyanosis, coma, and respiratory failure
leading to death. The presence of triad of symptoms such
as coma, pinpoint pupils, and respiratory depression are
strongly suggestive of opioid poisoning.

Which drugs cause similar effects?
Some drugs that cause similar effects include other
opioids such as morphine, hydrocodone, oxycodone,
hydromorphone, methadone, and heroin.

What is their legal status in the United States?
Several synthetic opioids are currently controlled under
the Controlled Substances Act. Recently, the DEA temporarily
placed U-47700 and several other substances
that are structurally related to fentanyl, such as acetyl
fentanyl, butyryl fentanyl, beta-hydroxythiofentanyl, and
furanyl fentanyl, in Schedule I of the Controlled Substances
Act. Other synthetic opioid substances may be
subject to prosecution under the Controlled Substance
Analogue Enforcement Act which allows non-controlled
substances to be treated as Schedule I substances
if certain criteria are met.

The DEA has successfully investigated and prosecuted individuals trafficking and selling these dangerous substances using the Controlled
Substances Analogue Enforcement Act.

SOURCE: A DEA Resource Guide 2017 Edition