Breaking Really Bad, 25 Years Before Walter White–by Josh Bloom (Dupont chemist Michael Hovey synthesizes 3-methyl fentanyl in 1985 and ushers in “designer-drugs” that kill)

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In 1985, a scientist in Delaware decided to make drugs with the goal of getting rich.

We didn’t know it at the time but DuPont organic chemist Michael Hovey had ushered in the modern era of so-called “designer drugs” by cooking up a batch of 3-methylfentanyl in his lab. The batch had a street value of $112 million.

His choice was not arbitrary. It would be hard to pick a drug that gives you a better bang for your buck than 3-Methylfentanyl which, as you can tell by the name, is closely related to fentanyl, a synthetic heroin that is a legal but highly regulated narcotic 50 times more potent than heroin.

Fentanyl is used as a pain patch (Duragesic), an under the tongue (sublingual) lozenge, and as part of a general anaesthesia cocktail. It  is also the drug that is causing the surge of overdoses in heroin addicts, because the lethal dose in humans is estimated to be 2 milligrams— about the same weight as 5 grains of salt. It does not take much imagination to picture a scenario in which some stoned out mutant who is putting together a bag of heroin mixes in an extra milligram or two and kills people.

But, fentanyl is a bag of Skittles compared to 3-methylfentanyl (3MF), which is 100-times stronger. Yikes.

3MeFen3-Methylfentanyl: The seemingly trivial addition of a methyl group (red) is anything but.

Where did “Breaking Bad” inspiration Michael Hovey go wrong? It wasn’t in the synthesis, that was not at all difficult for any trained organic chemist. His error was that he didn’t actually know any drug dealers, so he offered a reward to chemists who could find him one. Fellow DuPont chemists instead alerted security and he was arrested when he tried to sell it to what turned out to be an undercover FBI agent. Four years later, after serving an 18-month federal prison term, he committed “suicide by police” by lunging with a knife at Delaware State troopers who came to arrest him for skipping his state trial on similar charges.

Back to the drugs.

To give you an idea of how powerful 3-methylfentanyl is, let’s play a guessing game: How much did 3MF did Hovey have to make to end up with $112 million worth of the stuff? A wheel barrel full? A thimble full?

While you are guessing, I will do some math, and you can ridicule me in the comments sections if I am wrong, which is all but certain.

Let’s assume that an addict’s dose of fentanyl is half (they are addicts, after all) of the lethal dose—1 milligram. Given that, an “effective” dose of 3MF would be 0.01 milligrams (ten micrograms). Assuming a street price of $5 per bag—about what “heroin” costs now—this means that Hovey would have had to make a whopping 8 ounces of it—the same weight as two lemons. Yep, by using four common chemicals that can easily be purchased from any number of chemical research supply companies for a few hundred dollars, Hovey made a drug so potent that $112 million dollars worth of the stuff could fit in his pocket.

When life gives you lemons, try to get rich and then do something really stupid.

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Stories from his acquaintances say that Hovey had begun to believe that the world was going to end. He told prosecutors that he wanted a large fortune, which he would then to convert to gold, so that he could ride out the coming cataclysm in the Rocky Mountains, and then return when the apocalyptic dust settled. He was partly right, though his was the only world that would be ending soon.

Ironically, Hovey had already made something better to take to the mountains than gold. A gold brick weighs 12.4 kilograms, or 437 ounces. At the end of 1985, gold sold at $323 per ounce, so a brick was valued at a bit over $141,000. His two lemons worth of 3MF could have fetched 794 bricks (1,750 pounds) of gold. That’s an awful lot of weight to carry around.

Addendum: I mentioned Walter White because of the popularity of “Breaking Bad,” but White was a rank amateur compared to Hovey. One gram of crystal meth costs about $100 on the street. The same weight of 3-MF? Over $500,000.

Extra credit!!! Answer this question and you will win our new, doubly awesome ACSH coffee mug. First correct answer posted in comments sections gets the prize. 

Question: WHY WAS WALTER’S METH BLUE? (No internet cheaters, please. I will know!)

Update, 3/10- We have a winner. Congrats to Kailey. Your answer was almost perfect. Here’s the rest:

It was a trick question. Sort of. Walter’s meth should not have been blue. The show’s chemistry was very accurate (mostly), but this “error” was intentional. It was a plot element. The show implied that the blue color was a function of the purity of the meth because they needed a way to distinguish Walter’s meth from the rest, when in fact, if anything, any color would signify that it was less pure, not more. And even if there was a colored impurity, the chances that it would be blue are very small. Impure organic compounds are usually tan, yellow, or brown.

Walter did not add the color, but Vince Gilligan, who wrote and produced the show surely did. If you have seen the show, Gilligan’s regular use of color made the already-extraordinary camera work even more stunning.

Kailey, if you email me at bloomj@acsh.org, I will personally deliver your mug to the post office. Thanks to all of you who played. Let’s do it again some time.

coffee cup ACSH

By Josh Bloom

Senior Director of Chemical and Pharmaceutical Sciences

 

 

 

 

 

 


 

Josh bloomDr. Josh Bloom earned a Ph.D. in organic chemistry from the University of Virginia,  followed by postdoctoral training at the University of Pennsylvania.
He worked for more than two decades in new drug discovery research at Lederle Laboratories,  which was acquired by Wyeth in 1994, which itself was acquired by Pfizer in 2009.

During this time he conducted research in a number of therapeutic areas, including diabetes and obesity, antibiotics, HIV/AIDS, hepatitis C, and oncology. His group discovered the novel antibiotic Tygacil®, which was approved by the FDA for use against resistant bacterial infections in 2005.

He is the author of 25 patents, and 35 academic papers, including a chapter on new therapies for hepatitis C in Burger’s Medicinal Chemistry, Drug Discovery and Development, 7th Edition (Wiley, 2010), and has given numerous invited lectures on how the pharmaceutical industry really works.

Dr. Bloom joined the American Council on Science and Health in 2010 as ACSH’s Director of Chemical and Pharmaceutical Sciences, and has written op-eds for numerous periodicals, including for The Wall Street Journal, Forbes, New Scientist, The New York Post, National Review Online, The Boston Herald, and The Chicago Tribune. In 2014, Dr. Bloom was invited to become a featured writer for the site Science 2.0,  where he wrote more than 75 pieces on topics ranging from to the pharmaceutical industry, medicine, quackery, junk science, or anything else that pissed him off. That’s a pretty long list.


 

 

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Organizational Purpose and Public Trust in Drug and Alcohol Testing

Organizational Purpose and Public Trust in Drug and Alcohol Testing

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http://www.nytimes.com/2014/03/13/opinion/why-arent-doctors-drug-tested.html?partner=rss&emc=rss&_r=0

In 2012 Robert Dupont delivered the keynote speech at the Drug and Alcohol Testing Industry Association annual conference and described a “new paradigm” for addiction and substance abuse treatment of zero tolerance for alcohol and drug use that is enforced by monitoring with frequent random drug and alcohol tests. Detection of any substances is met with swift and certain consequences. He proposed expansion of this paradigm to other populations including workplace, healthcare, and schools. Based on the state Physician Health Program model of “contingency management,” with frequent testing and a point of “leverage,” such as a medical license in doctors, that is used as a behavioral incentive.

The ASAM White Paper on drug testing seems to indicate a desire to liberalize drug testing by utilizing health care providers in the process. Currently forensic drug testing uses a strict chain-of-custody protocol with Medical Review Officer (MRO) review. But if the result of a positive test is “therapeutic” rather than “punitive” this is unnecessary. In the “new paradigm” a positive test simply requires an evaluation at a “PHP-approved” facility.

IMG_9516 Accountability needs to be rooted in organizational purpose and public trust.

A recent article in JAMA, “Identification of Physician Impairment”  suggests that undetected physician impairment  may be contributing to medical error and that sentinel-event and  random alcohol-drug testing could be implemented to address the problem as is being done in the  current “Physician Health Program (PHP)” system.

The most consequential and critical issue for physicians, if this comes to fruition, is who will be in organizational and managerial control of the system and what ideological influences will be guiding policy and practice.   It is concerning that one of the co-authors of this article, Greg Skipper, is a Fellow of the American Society of Addiction Medicine with strong ties to the 12-step treatment industry and drug testing industry.

History shows Lord Acton’s aphorism on absolute power to be repeatedly true.  Corruption is a virtually inevitable consequenphotoce of unchecked power. The only two factors that constrain corruption are moral virtue and deterrence.

Disregard for standards of care and violations of codes of conduct are common.  So too is the use of anything that furthers the agenda.  Pseudoscience, such as polygraph testing, previously deemed by the American Medical Association as an unscientific game of “chance,” and psychometric testing of dubious validity are being used for confirmation of diagnoses.

They introduced and brought to market junk science like the Ethyl Glucuronide  (EtG) biomarker for detecting alcohol use. The EtG was introduced by an FSPHP physician, marketed, and proselytized as an accurate and reliable test for alcohol. After setting an arbitrary cutoff of 100 to prove drinking he ruined countless careers and lives.

As the disaster toll increased it became clear the test was not very good. It became apparent the test was, in fact, very flawed and misguided as using an ultra sensitive poorly specific test for a substance environmentally ubiquitous precludes its forensic applicability.

Hand sanitizer, cosmetics, sauerkraut, and myriad other products were shown to result in an elevated EtG. Sensibly, the majority of drug testing and monitoring programs abandoned it. 

The market for the test decreased dramatically as the only customers left were drug monitoring programs in which the testers had absolute power and those being tested were absolutely powerless–programs like those run by the PHP.

This group has now introduced the Phosphatidylethanol (PEth) test as a confirmation test for EtG and USDTL mScreen Shot 2014-04-05 at 2.08.11 PMarketed it as the PEthStat.  

State Physician Health Programs are now using the EtG  and adding the PEth to confirm alcohol ingestion. And just as they did with the EtG the claims of reliability are grand but without foundation. 
All speculative A=B oversimplified thinking that ignores the myriad other factors involved. The science is empty if you remove the dregs of filler and puff.  And the conflicts of interest are mind-boggling.

Corporate Front Groups and Corruption in Medicine-Forensic fraud, conflicts of Interest and the Erosion of Trust

The ASAM and FSPHP are corporate front groups that have infiltrated organized medicine and gained tremendous sway. Advancing the multi-billion dollar 12-step rehab and drug testing industry agenda control has replaced conduct and ideology has trampled science and reason. As organizations without transparency, accountability, or regulation they have become reservoirs of bad medicine and corruption.

Accountability is  rooted in organizational purpose and public trust.  Unfortunately, humanitarian ideals have been trampled by the imposition of corporate front groups who advance  hidden agendas under guises of science and scholarship  and patinas of benevolence.  Rife with conflicts of interest, these groups obfuscate, mislead, and exploit us to further an underlying political agenda.  Healthcare and medicine has been infiltrated by various groups that pose a serious threat to both the humanitarian and evidence based aspects.

Robert DuPont, Physician Health Programs and Expansion of the “New Paradigm.”

Robert DuPont, The ASAM, FSPHP, Physician Health Programs and the “New Paradigm.”

“With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world.”-Twelve Steps and Twelve Traditions, AA World Services, Inc (1953).

In 2012 Former White House Drug Czar (1973-1977) Robert Dupont, M.D. delivered the keynote speech at the Drug and Alcohol Testing Association (DATIA) annual conference and described a “new paradigm” for addiction and substance abuse treatment. The former National Institute on Drug Abuse Director proposed expansion of this paradigm to other populations including workplace, healthcare, and schools.

Screen Shot 2014-02-07 at 8.38.55 AMAs a substance abuse treatment program that “sets the standard for effective use of drug testing,” the proposed new paradigm is based on the state Physician Health Program (PHP) model

Dupont wants to expand the PHP model to other populations. In an article published in the Journal of Psychoactive Drugs in 2012, he and co-author Greg Skipper, M.D, (Director of Professionals Health Care at Promises Treatment Center) describe the necessity for wider application of this new paradigm. They review the successes of similar programs monitoring commercial pilots, attorneys, probationers, and those in the criminal justice system, and proclaim the “need to reach more of the 1.5 million Americans who annually enter substance abuse treatment, which now is all too often a revolving door.”1 They conclude:

This model of care management for substance use disorders has been pioneered by a small and innovative group of the nation’s physicians in their determination to help other physicians save their careers and families while also protecting their patients from the harmful consequences of continued substance abuse. In fulfilling the professional admonition “physician: first heal thyself,” these physicians have created a model with wide applicability and great promise.1

“Based on abundant evidence, a “new paradigm” for substance abuse treatment has evolved that is the exact opposite of harm reduction. This paradigm enforces a standard of zero tolerance for alcohol and drug use that is enforced by monitoring with frequent random drug and alcohol tests. Detection of any drug or alcohol use is met with swift, certain, but not draconian, consequences.”

Straight, Inc. –Torture as treatment

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In 1981 Dupont made similar claims about Straight, Inc., a non-profit teenage rehabilitation center.   The predecessor of Straight, Inc., the Seed, was started in 1970 in Florida with a start up grant of $1 million dollars from the federal governments National Institute on Drug Abuse (NIDA). Director of NIDA, Robert L. DuPont, Jr. had approved the grant.on the antidrug cult Synanon founded in 1958. Deemed a the “family oriented treatment program,” Dupont encouraged organization and expansion. Targeting the children of wealthy white families they exploited parents fears for profit. Signs for hidden drug use such as use of Visine, altered sleep patterns, and changes in clothing style were used as indications for referral. Any child who arrived would be considered an addict in need of their services. Coercion, confrontation, command and control as the guiding principles,. Submit or face the consequences. .We know what’s right. The idea was to strip the child of all self-esteem and then build him back up again in the straight image. Abused dehumanized, delegitimized, and stigmatized-the imposition of guilt, shame, and helplessness for ego deflation and murder of the psyche to facilitate canned and condensed 12-step as a preparatory step on the path of lifelong spiritual recovery.

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Children were coaxed or terrorized into signing confessions, berated, and told they were in “denial. Inaccurate and false diagnoses were given to wield greater control. Reports and witness accounts now indicate that many of the kids did not even have drug problems but by creating a “moral panic” about teenage drug use they exploited parents fears for profit. Straight, Inc. became the biggest juvenile rehabilitation center in the world. Health officials in Boston cited Straight for treating a 12 -year old girl for drug addiction when her records revealed all she did was sniff a magic marker! Pathologizing normality.

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Methodologically flawed research , deceptive marketing, and propaganda were all used to support the continuation of the program. Designed to be hidden from public view. Straight, Inc. had no regulation or oversight. These programs of torture and abuse resulted in many suicides, suicide attempts, post-traumatic stress disorder and other psychological   and grave psychological trauma. There is a FB page dedicated in memory to all of those who died.

The retrospective five year cohort study they published in 2008 is their flagship study about which they parade an 80% success rate.  It is  methodologically flawed in many ways with missing and incomplete information and misleading interpretation.  It’s all propaganda.

The 2008 Physicians Health Program study inexplicably excluded resident physicians because they “were both younger than the average practicing physician and therefore at higher risk of substance abuse.”  Other than cherry picking to favor success what is the logic behind that.

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More importantly, however, is the 24 that “left care with no apparent referral” and the 48 that “involuntarily stopped or had their licenses revoked.”

It would seem logical that there must have been some major precipitating event leading to the 24 physicians who left care.   And what happened to the physicians who were removed from the programs and had their licenses revoked ?–event that could very well lead to feeling hopeless with no way out and precipitate a completed suicide.

They list only 6 suicides and it appears that the outcome suicide they are using is one that was done while being actively monitored in the program.  If they were removed from PHS or had their licenses revoked and subsequently committed suicide we don’t know.  The outcome seems to be the last recorded clerical status of the monitored physician.

Since this group is now lobbying to use this “blueprint” as a successful model applicable to other populations and may be involved in the assessment and monitoring of a much larger population should the random drug and alcohol testing of all physicians  come to be it is essential that who they are be exposed as well as the validity of the claims they make.   There are no evidence-based reviews of any of the ASAM studies including the junk science of the EtG and PEth tests that will surely be used in any physician monitoring program that were introduced and marketed by Greg Skipper yet he lists no conflicts of interest.     The 12-step evidence is self-evident in the “blueprint.”

Interestingly,  I cannot even find any criticisms of the design of the study and its flaws–only praise and sloganeering.   We need to speak up before the door closes for good..

The vast majority of people know little about Physician Health Programs. They seldom reach the threshold of public attention.

Unless specifically looking for information about them, little treatment community blandishment, there is a dearth of informative in depth analysis

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