The U.S. Drug Enforcement Administration put the synthetic opioid U-47700 on its most restrictive list of controlled substances Monday, calling it an imminent threat to public health. The action comes as Anderson County is poised to enact its own ban on these types of drugs.
The drug, which has some morphine-like qualities, has been linked to at least 46 deaths in the United States in a period of about a year, including 10 deaths in neighboring North Carolina. Federal DEA officials believe the nationwide death toll may be much higher, but say the presence of U-47700 may be overlooked if a person is also testing positive for more commonly known drugs, such as heroin or the painkiller oxycodone.
In Anderson County, Coroner Greg Shore believes U-47700 may be responsible for at least one recent fatal overdose. He sent toxicology samples to the South Carolina Law Enforcement Division, and when the agency's testing didn't reveal anything, he sent samples to a private lab in Pennsylvania. He is waiting for results.
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"Our drug testing in the field and SLED's testing didn't identify any substances," Shore said. "But we know based on the case study that we have done that this death is likely linked to drug abuse or drug use. There certainly are new compounds that we haven't seen, and when we run into them, we do our best to get them identified. We went through this same kind of scenario with Lamar Jack."
Jack, an Anderson University basketball player, collapsed on the court during practice in the fall of 2011.He died a few days later at the age of 19. Toxicology tests later revealed he had ingested JWH-018, a chemical found in synthetic marijuana. The product was legally sold as "bath salts" before Jack's death and others led to a nationwide ban.
Because he remembered Jack's case, Anderson County Councilman Francis Crowder became intrigued when he first heard about a new deadly drug, U-47700, a few weeks ago. Crowder, who is 82, is known for building and retiring from a successful software company in Greenville. But before he did that, he earned a degree in chemistry and his fascination with the field never left him. He began to research U-47700. The drug is also sometimes called "pink" or "pinky," but DEA officials say its users call it simply "U-4."
"This is definitely not something we need in our community," Crowder said. "We want to do whatever we can to protect our young people, and we want to make sure our county ordinances have the maximum penalties we can have embedded in them for anyone who gets caught selling this stuff."
The Anderson County Council is expected to conduct a second reading Tuesday on a measure that would prohibit using, possessing, distributing or advertising synthetic opioids such as U-47700 in this part of the Upstate. The council approved the first reading of the regulation in early November before the DEA ban, and needs two more approvals before the local ordinance is considered final.
U-47700 was used in pharmaceutical research in the 1970s. It was labeled a "research chemical" and was not considered acceptable for human consumption.
But in recent years, the designer drug has been produced in foreign labs, especially in China. In the last few days, the drug has been available for purchase online for $40 or less. It is sold in powdered form, in sprays, or in counterfeit tablets made to look like other drugs, said Russ Baer, a DEA spokesman.
"U-47700 is one of the synthetic opioids that we are still trying to wrap our arms around," Baer said in an interview this month, before the DEA's action Monday. "We believe it poses an imminent hazard to public health and safety.
"In many cases, the user may not even know he or she is taking it. It is sometimes combined with heroin or fentanyls so that those drugs can be illegally produced more cheaply. U-47700 is dangerous, it is deadly, and it is readily available through predominantly foreign vendors."
Wally Davies, the medical director of emergency services at AnMed Health, said opium or opiate derivatives can become "very, very potent" in the body even at low levels.
"You're talking about something that depresses the central nervous system," Davies said. "It causes the brain to slow down, the body to slow down and the pupils to get smaller."
When a patient who is believed to have overdosed is brought into the hospital's emergency department, doctors often administer naloxone hydrochloride. The drug, also known by the name Narcan, can reverse the effects of an overdose.
Davies said he knows of no one who has come into AnMed's emergency department after overdosing on U-47700. But he acknowledged the drug's recreational use is so new that the synthetic opioid may not show up on a standard toxicity screening.
"We have to use a patient's history to help us if that person screens negatively," he said.
Officials at the Anderson Police Department and at the Anderson County Sheriff's Office said they were unaware of any cases they have had that are linked to U-47700.
"I am smart enough to know that if it is in North Carolina, it is here," said Lt. David Baker of the Sheriff's Office. "It is just a matter of time before we know for certain. If something presents as a certain kind of drug that we are familiar with, like heroin, we aren't going to necessarily test that drug to see if it is laced with something else. For bath salts, for example, that was something people could spend $20 to get on the street, and we might have to spend $2,000 to find out what it was."
The scheduling the DEA enacted Monday makes U-47700 temporarily illegal as a street drug. The temporary ban will last at least two years. The DEA can seek to have the ban extended for a third year if the agency needs more data to determine whether U-47700 should be permanently identified as a a drug with no medical purpose and a great potential for abuse.