They call it gunpowder - Page 2

Extra strong heroin is said to be causing a rash of overdoses, but San Francisco officials are in the dark

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"There's a new batch of heroin in town—people are dying," says Johnny Lorenz, community activist and member of San Francisco Drug Users Union, a members-based organization advocating drug-friendly policies and giving a voice to drug users, who say they are often marginalized and seen as not caring about their community.

Lorenz, a former heroin addict, says a friend recently died from heroin-related causes. Whether it was gunpowder heroin that actually caused his death is unknown.

Wheeler and Lorenz say many people have died from the extra-strength heroin, yet no official records have turned up. The Medical Examiner's Office hasn't noticed an increase in heroin-related deaths, but Administrator Bill Ahern admits it was 90 days backlogged on toxicology reports.

The police and medical examiner's lack of knowledge doesn't surprise Mary Howe, executive director at Homeless Youth Alliance. She says heroin-related overdoses are indeed a real problem, and she personally knows heroin users who have recently died from overdose, but "unless you actually care about helping drug users you wouldn't know." And to receive a toxicology report from the medical examiner's office takes a couple months, adds Howe.

Wheeler and others are currently waiting on toxicology reports to find out what exactly is in the heroin making it so strong. Without a toxicology report there is no way to be certain about the cause of death or the makeup of the drug.

According to SF Medical Examiner's 2009-2010 annual report, nine out of the 141 people that died from narcotic analgesics related deaths were found with traces of heroin, down from previous years. However, finding out if heroin is the cause of death can be tricky. According to the report, the unique metabolite that identifies heroin, 6-monoacetamorphine, is very short lived and can metabolize in the body while the person is dying—leaving only traces of morphine or codeine.

Worse, a drug user buying heroin off the street will never know what exactly he or she is shooting.

"No one ever knows what's in the heroin," says Lorenz, adding that the label "gunpowder" has become a loose term for a stronger heroin. Lorenz, who spent the majority of his 20s doing heroin, remembers that gunpowder heroin at one time used to be a specific reference to a higher grade heroin from Columbia, off-white or grayish in color and crystal-like—resembling gunpowder.

Others say gunpowder heroin is black tar heroin mixed with fentanyl, a synthetic opiate that can be up to 100 times stronger than morphine. Some disagree entirely and say the overdoses aren't specific to any one type of heroin.

"Whatever people are calling it—it is strong," says Wheeler adding that people rarely overdose from of a bad batch of heroin; they overdose from a good, strong batch. "In a world where the drug supplies are unregulated, this is what happens."

If it is black tar heroin mixed with fentanyl, that could explain why hospitals aren't reporting an increase in overdoses, says Jan Gurely, doctor at a local homeless clinic. She suggests that the people aren't making it to the ER's—they are only making it to the morgues.

"'Gunpowder is very dangerous," says Dr. Gurely. "It takes a phenomenal amount of antidote vials to reverse the overdose."

Naxolone unbinds every molecule of heroin from receptors in the brain, reversing an overdose. The problem with naxolone is when too much is administered the overdose victim goes into withdrawal and comes to sick and vomiting. With a normal heroin overdose only half a vial is needed, but multiple vials are needed when dealing with gunpowder, she adds.

"A person could die on you with a vial in your hand," Dr. Gurely said. "Most people don't walk around with six or seven vials of Narcan."

Comments

First, thank you to the Bay Guardian for printing this story about the recent reports of stronger-than-usual heroin in SF. Harm Reduction programs in SF have been working extremely hard to spread the word and ensure that people have naloxone in case they witness an overdose. As the article states, we have received nearly 100 reports of people using their naloxone to reverse an overdose since January. The majority of the overdose situations that were reported to us involved this stronger heroin (some refer to it as gunpowder, some don't).

I am concerned with Dr. Gurley's statements in this article:

"'Gunpowder is very dangerous," says Dr. Gurely. "It takes a phenomenal amount of antidote vials to reverse the overdose."...With a normal heroin overdose only half a vial is needed, but multiple vials are needed when dealing with gunpowder, she adds. "A person could die on you with a vial in your hand," Dr. Gurely said. "Most people don't walk around with six or seven vials of Narcan."

Of the 100 reports of naloxone use by our trained participants, not one required an unusual amount of naloxone and almost all specified that "gunpowder" or especially strong heroin was used. All of the overdose reversals reported back to us required one or two doses of naloxone to successfully revive the person. Also, we never recommend the use of "half a vial" to reverse a "normal heroin overdose." The recommendation is that 1cc of injectable naloxone is used (a full vial) and after 2-3 minutes, a second dose is administered if necessary. With intranasal naloxone, a dose of 2ccs is administered nasally, and after 2-3 minutes a second dose of 2ccs can be administered if there is no response.

We wish that Dr. Gurley had checked with us to see if in fact we were getting reports of an unusual amount of naloxone use per overdose instead of making misleading statements to the press.

We would also like to thank the drug users of SF for reversing nearly 100 overdoses (and these are just the ones that have been reported back to us) in the last few months. You are life-savers.

--Eliza Wheeler
DOPE Project, SF

Posted by DOPEProject on Jun. 22, 2012 @ 1:17 pm

..."heroin users who say they are often marginalized and seen as not caring about their community."
Shame on those who marginalize and claim heroin users don't care about their community. Why, in my community heroin users generously shoot up on the street, leave used syringes in open sight, bring wonderful humanity-enchancing heroin street dealers onto the corners, and conduct the petty rip-offs so necessary to feed a daily habit right out in plain sight. Give me a break--shooting heroin is all about distancing yourself from what you term unacceptable, i.e. straight society. It isn't about including yourself in any community except the one that gets you high. I don't marginalize someone for shooting heroin, but I reserve the right to dismiss anyone who does it and then whines about others not caring. Hello? Get real, citizens.The only justification for clean/safe needle exchange is to serve as a gateway to becoming clean. Stay safe, but start working on the issues that make you an addict; set a schedule, stay with it and sooner rather than later get clean and non-addicted. Once, clean/safe needle exchange starts selling the idea that the user will need to stop using, the program will gain approval. With rare exception, the shooter of street smack is a sorry example of someone on the wrong path.

Posted by Guest on Jun. 26, 2012 @ 12:56 pm

you clearly have zero concept of what drug addiction is... it's too bad, because ignorance, like yours continue to be create a culture that demonizes drugs and drug addicts without any concept of the disease of addiction. Until drug prohibition is overturned and drug addiction is treated as a medical and psychological issue rather than a moral issue, which it is not, then people like you will perpetuate a climate of fear and intolerance to those who suffer from a horrible brain disease that is addiction. If heroin was legal, it would not be sold on the street, it would be pure and affordable therefore reducing overdoses drastically and eliminating the need for criminal activity to feed a habit. Legalize, educate, and treat !

Posted by Guest on Nov. 01, 2012 @ 11:25 am

Junkies can be maintained on heroin pretty easily. But can the same be said for stimulants, meth and cocaine? I don't think so.

Posted by marcos on Nov. 01, 2012 @ 11:37 am

and continue in their normal lives. Rats given the ability to auto-administer Cocaine stop cleaning themselves, stop eating, and die. That said, I'm pretty sure the problem with drug abuse needs to be addressed on a more basic level than prohibition.

Posted by lillipublicans on Dec. 02, 2012 @ 2:49 pm

Look at history- people fought tooth and nail to get an effective system in place to screen drugs before they hit the market- today we have the FDA. It is not without its faults and issues, but the fact is that it prevents Big Pharma from flooding the market with all kinds of drugs that are potentially harmful.

If you legalize heroin- what would be the rational to prevent Big Pharma from putting out vaccines and other drugs without going through testing? Or pain killers that are even more harmful than Heroin? At least when you get a prescription for a drug nowadays, you can be reasonablly confident that the drug went through multiple trials and testing prior to being released. If you essentially toss away the FDA and its regulations, you open the market back up to Big Pharma again and good luck with that.

Posted by D. Native on Nov. 01, 2012 @ 12:25 pm

It *is* still a prescription drug in many countries.

Posted by lillipublicans on Dec. 02, 2012 @ 3:58 pm

Aspirin is a derivative of Salicylic acid, the active ingredient in white willow bark and morphine-based drugs have been around for centuries.

Posted by Lucretia Snapples on Dec. 02, 2012 @ 4:10 pm

The article has very little actual evidence that there is a rash of OD's going on. The only"proof" is anectodal testimony from drug users- not the most reliable population. Further, as is typical with articles int he SFBG- it tries to slam the City, the cops and hospitals for not caring enough to try and stop all this. If the cops, the hospitals, and the ME are all not seeing this spike- the question should be does it really exist? Not why doesn't the City care more.

Posted by D. Native on Nov. 01, 2012 @ 12:20 pm

The "gun powder" name is a marketing gimmick... Unlike the East Coast "Stamps" (Philly, Detroit, New York, Boston) and the South (St. Louis, Florida, New Orleans, etc)

They all have powder (light brown/tan powder heroin #3 & white heroin #4) with potency ranging in 20-70% purity. Usually street stamps in New York/Philly for $10 you get a "stamp" glassine envelope folded up and taped with an ink stamp/logo. This is mainly so junkie's know the potency. Each stamp usually has a count of (.05 gram) with a potency of 30%.

The West coast is totally different on the other hand... being run by Mexican gangs. They all have black tar heroin #1. The exception is San Francisco.... goto LA, Portland, Seattle, Vancouver, Salt Lake, etc... Mexican's sell $10 ballons which inside have a wrapped up tiny ball of tar. Usually .1-.2 g for $10 the potency is usually 20-50% (rarely 50).

Like I said though, San Francisco is the exception... The Blacks run the dope game in SF and further cut the mexican tar.... Bringing what would usually be $60-$100 per gram to $20-$50.. While East Coast it costs as much as $75-$200 per gram.

Now the gun powder... That's tar that's hardened with lactose... after that who knows what pharm's they put in it. Garbage

Posted by Guest on Dec. 02, 2012 @ 2:24 pm

Back in the day when I was (ahem) closely aware of the problem of heroin addiction, the Mexican "tar" came in polyethylene bag material, the balloons had the same stuff cut with milk sugar (as you say) and there was also "Persian" which needed to be catalyzed with lemon juice to cook, China White and its imitation, Fentanyl all coming in paper bindles.

And no dealer would knowingly get his customer more high than normal without charging for it.

Not to glorify my drug experience, heroin is a really stupid drug because just like cocaine it takes out more than it gives you in the end.

Posted by This space intentionally left blank on Dec. 02, 2012 @ 2:46 pm

u have no idea what your talking about, nice try buddy. I'm a expert in the sf gp scene and i used to live in nyc

Posted by Guest on Dec. 18, 2012 @ 12:18 am

You bougie yuppies with fake black glasses and iphones dont give a crap about us. all you want is your twitter offices to be free of meth heads and dope heads in the tenderloin. you all think were the problem. the problem is INTOLERANCE and were here to stay. some come on in and make yourselves at home!!!!

Posted by Junkie and proud of it on Mar. 23, 2013 @ 12:45 pm