Synthetic opioids abused from multiple sources

Editor’s note: This story pairs with “Synthetic opioids affect the mind, body”

A regular doctor. A back-alley pharmacist. From across the ocean, courtesy of the dark side of the Internet. Synthetic opiates can come from anywhere.

According to a survey published in the Journal of Addiction Medicine, 61.1 percent of people surveyed said it would be easier to obtain opiates through their doctor. Twenty-two percent obtained drugs from “pain management specialists,” and an unsurveyed majority of drug users said they obtained their drugs “from the street,” which often means illegitimate drug dealers or black market websites.

Dr. Robert Waldman, head of Detox at the Cliffside Malibu Treatment Center in Los Angeles, said synthetic opiate users will often try to obtain prescriptions from multiple doctors, a tactic that has been mostly thwarted by online prescription profiles.

Waldman also said tightened restrictions on opiate prescriptions have inadvertently punished people who don’t abuse prescriptions. Prescriptions for synthetic opiates like oxycodone and hydrocodone must be filled every month in person, rather than over the phone.

“I have a 91-year-old patient who had a failed back surgery and has horrible pain, and she has to come in every single month to renew her prescription,” he said. “No evidence of abuse, but those are the people who suffer because of the misbehavior of so many.”

Waldman also said opioid users can occasionally obtain the drugs from people who sell their prescriptions. He said a 70-year-old patient was once flagged for redeeming prescriptions for opioids and opioid suppressants. When Waldman confronted her, she said she was selling her pills.

“I’m sure there are prescriptions I’ve written that people have abused, share and sell. You try and curtail it, but it’s hard to recognize when it’s happening,” he said.

He also said synthetic opioids are more dangerous due to their increasing availability. Waldman estimates these drugs are likely available at any high school in the nation, thanks to a common trend of substance abuse in society.

Opioids can also come from self-described “doctors.” Khalil Rafati — a recovered opioid addict, author and founder of health food chain SunLife Organics — said he turned to a “shady doctor in North Hollywood” for opioids and injection instruments while living on Skid Row in Los Angeles.

“You gave him $400 for the ‘visit’ and then he would give you a prescription for buprenorphine and ampoules,” he said.

Waldman and Rafati also referenced online drug trafficking facilitated through the dark web, which is a less secure, less accessible portion of the Internet. BYU cybersecurity professor Dale Rowe said the dark web is one of three portions of the Internet.

Rowe said the Internet consists of the surface web, the deep web and the dark web. The surface web is readily accessible through any browser. The deep web acts as a repository for information databases and can be accessed through special websites and search engines. The dark web, however, is a hidden portion of the deep web that often requires a special browser to maintain anonymity and safety.

“The dark web is heavily anonymized and requires a lot of hoops to jump through to get onto it,” he said. “It’s where a lot of nefarious stuff takes place.”

According to a study by King’s College London, 1,547 of 2,723 live sites on the dark web contained illegal content, including drugs, violence, moneymaking schemes and child pornography.

Although the dark web is only accessible through an encrypted Tor browser, Rowe said law enforcement and the Federal Bureau of Investigation can still track dark web users using technology.

“A few years ago, the FBI put in a piece of malware into the Tor browser that would reveal users’ identities and what they were looking at,” he said.

This malware, along with various crime-fighting tactics, were used by law enforcement in 2016 to close Alphabay — a major Dark Web narcotics site — and arrest one of its founders, Utah resident Aaron Shamo, according to the Deseret News.

Additionally, the Deseret News reported that Park City Police arrested a teenage girl in 2016 connected to the deaths of two classmates. She had obtained synthetic opioid U-47700 — or pink — from Shanghai, China, through a dark web retailer.

Although illegal drugs and services can be obtained through the dark web, Rowe said the hidden side of the Internet can have its uses, primarily for posting classified information from heavily-policed communist nations.

“It’s not all negative out there. There’s a lot of mechanisms for users in restricted countries to talk about what’s happening in times of conflict or when the government is heavy-handed with censorship,” he said. “If there’s a way to be hidden, it’ll be used by both sides. People who have a reason to stay hidden are safe, but others will always conduct things that are illegal.”