I’m hoping that you’ll be willing to make a donation to see it continue.
The work that I have been doing over the course of the last year has been by and large on my own time and in order for me to continue doing it…..well look I have to eat and put a roof over my head. While I’m ultimately hoping to secure some sponsorship on the corporate or private level, I need to appeal for donations from wherever and whoever I possibly can.
No Pay Walls
It is important that the information I share reach as many people as possible and it is no exaggeration to say that lives could depend on some of it. For this reason I have not and will not put any content behind a pay wall. Instead I will look for donors and patrons who believe in the work that I am doing and would like to see more of it in the future.
A Matter Of Saving Lives
When I spoke of saving lives I was referring to the lives of the veterans and any others who are living with chronic quinoline encephalopathy, or quinism. There are a great many such people out there who do not know that they have quinism. These are the ones who were told they have PTSD, and are feeling frustrated and hopeless because they aren’t getting better, in fact they seem to be getting worse. They are driven to such despair that they view suicide as the solution, not knowing that the cause of their problems is actually brain damage brought on by a neurotoxic drug.
There are many who have stepped back from the abyss after learning this information but there are many, many more out there who are ready to leap into it. Families and loved ones of those now suffering or those who are left behind following suicide also benefit from the knowledge that what happened was because of a drug. It can help provide a sense of closure for them.
Democracy is also in peril.
In Canada, Australia, and a number of other democratic countries governments are actively working to subvert the rights of their citizens. These governments need to be called out and the people need to know what is at stake for them.
A democracy needs to have checks and balances in place to ensure that government isn’t breaking the law or becoming a dictatorship. Whistleblowers play a vital role in these checks and balances, and so it is vital that they be afforded protection under the law. Otherwise they can face imprisonment for doing the right thing, even if they are ethically and legally bound to do so.
Independent Media Needs Your Support
A free, unbiased, and independent media is another essential in any democracy and is in the greatest need of your support. The mainstream media have continous revenue streams to count on thanks to advertising revenue and government handouts, throwing unbiased and neutral reporting pretty much out the window.
What The Funds Are Used For
First and foremost I need to be able to feed, clothe, and provide shelter for myself so everyday living expenses are the primary need. There are also other expenses that go along with this work that need to be paid, ie internet, membership fees, not to mention the fact that being able to travel would enable me to reach a wider audience.
How To Donate
Enter the amount that you would like to contribute in the section of any article that says Donate then click on the Pay with PayPal button next to it.
Any Amount Is Greatly Appreciated
Whether it’s $5, $10, or even enough to buy a large coffee at McDonalds ($2), any amount helps and is very much appreciated. I understand times are tight and there are plenty of others just as worthy of your donation dollar, but I hope that you will be able to send me a few of your hard earned dollars.
Veteran’s Advocate John Dowe Discusses The Mass Tort Litigation, What’s Ahead In 2020, and Advice For Families Affected By Quinism
With Hosts Marj Matchee & Kentrina Jenkins
In this episode of their new series Marj and Trina talk with John Dowe about his own experience as well as other topics relating to mefloquine and veteran’s advocacy. Look for John in future episodes as he will be a contributor to the show.
In this episode Marj and Trina have a conversation with Todd Gilman, a veteran who literally owes his life to the Calgary Veteran’s Association Food Bank. Hear him tell his story and that of the organization that is much more than a food bank and serves as a model that can be utilized across the country.
This Mefloquine Story is from a post made by Canadian veteran Bruce Given. In it he shares a comprehensive history of his life and experiences as someone with chronic quinoline encephalopathy, or quinism. He has joined the ranks of veterans who are advocates for their brothers and sisters in arms and who speak and defend those that cannot do it themselves.
For context I am including the Veteran’s House post that Bruce mentions at the beginning of the post. As usual any editing I have done is to format and not to content. The words written by Bruce are taken directly from the Facebook post.
This is a follow up to the aforementioned letter in the post from Veterans House Charity. Therefore if you have read it you will understand better as to where & how this summation followed. I am sharing as it has been suggested that others could benifit from my doing so. So dont shoot the messenger but definately feel free to comment & share your personal experience. Lift & remove the stigma involved.
As I read through the letter posted 23rd December, 2019 I felt a need to personalize my response using it as a guide to relate as to my experience as such with Mefloquine. I have shared & forwarded the original letter to my personal medical professionals & the veteran community. This needs to be brought forward to any & all concerned from Dr’s to Health Professionals of all sorts including those decision makers within the health system & policy makers like our Members of Parliament.
I am Bruce given. I was administered Mefloquine while on tour in Haiti from March to September 1995. An additional month dosage upon return from the tour made it a 7 straight month for me taking Mefloquine. I experienced symptoms listed on the manufacture’s product monogram black box warning. It still affects me & my family today. The attached letter is asking you to help me in dealing with this Quinism. I retired after a 24 year career with DND & have an infantry background. The original letter is a lengthy read, however it is hoped that the medical providers providing medical assistance to me & others whether physical or mental treatment will provide a better care and understanding of what it is that I/we are suffering from Quinism & deal with.
I have had the same General practitioner since 2003. I have advised him of my psychological treatments along the route all this time as well including any other treatments. I’m not still convinced that I have convinced him of where it is that I am at because of this neurotoxic drug. I believe this letter is a continued step forward in the right direction to him & others.
Amongst the listed psychological conditions, I also relate to most if not all of them; anxiety, depressed mood, mood swings, agitation, poor frustration tolerance, extremely vivid nightmares, difficulty making decisions, restlessness, confusion, problems with memory and attention, as well as sleep dysfunction.
I concur with the accompaniment of other non-psychological issues including digestive problems/IBS which was an immediate issue with the Mefloquine (in relation, I just had my 3rd colonoscopy a few weeks ago), dizziness, vertigo, tinnitus & other hearing challenges/hearing aids, vision disturbances/focusing difficulties, sensitivity to noise, sensitivity to light, unsteady gait, migraines/occasionally headaches more so , thermoregulation difficulties/night sweats, swallowing issues/acid re-flux problem, levels of sleep apnea unable to balance the issue with the sleep apnea machine, I can’t keep it on my head long enough to be useful…it’s another thing that sits in a box not being used & not helping with the problem after serious attempts to work with it. I had a quadruple by-pass in 2010 & an additional Stent in 2011. Stress is HUGE!
I’m aware that Mefloquine/Larium did not affect all who took the medication, maybe 10% or so (one is too many & some have taken their life because of it. I also have teetered upon that situation on more than one occasion), & know that it has not affected all in the same manner. The degree to which one may be affected also varies between individuals & the ailments reflecting the poisoning from that drug.
Documentation from DND/DVA confirm that my Chronic Myofacial Pain Syndrome relates to my Neck & Both Shoulder Girdles. This pain is with me all day every & I’m only not in cognizant pain when I’m not conscious. Since my return from that deployment to Haiti I have had to take a digestive pill with each meal for the past 25 years & I gather for the remainder of my lifetime. Other issues are also chronic & one compounds the other in relation to how my brain & responses to my surroundings/conditions react within myself & to those around me.
Confounding Diagnosis: I have a diagnosis of PTSD, some of which can be related to OSI from deployments on tour & others in relation to my service in general. I have an infantry background where I believe that exposure to blasts/explosions/transport in armored vehicles etc. which have never been taken into account in relation with Quinism as it hasn’t been a diagnosis as such until recent years. I have never been diagnosed with a TBI as such formally that I can tell. Something that surfaces in this regard are multiples of Mini TBI’s as with the aforementioned of the exposure, use & training in things such as Grenades/Mortars/Karl Gustaf/Heavy Machine Guns/TOW Missiles/Mines & the travel/working relationship to armored vehicles, aircraft whether fixed wing or helicopters. The list of such exposure is huge & varied as was my career.
It’s of interest to note that the screening of past exposure to medications was not apparent to me whether to Mefloquine/Larium or otherwise. I’m not a Dr. & was waiting on medical records. I filed for those medical records through the Library & Archives of Canada (ATIP&PR Section 395 Wellington Street Ottawa, Ontario K1A 0N4) back in October of 2018 & received the disk last week. There were over 700 pages in that documented disk. I found 2 pages that related to my tour in Haiti, (Shy for a lengthy tour I thought) where Mefloquine was mentioned. Bonus as for the acknowledgement where many say they have no records as such, sad. However it is not necessary to prove you have taken Mefloquine if it is on a general record already as to what deployments were issued the drug since 1990 ish. You can still submit to the lawsuit by HSH Lawyers & they will advise you one way or the other. I encourage you to do so.
I have never nor do I personally know anyone who has been part of any study or research into these issues on any national or international scope. I would make myself available for such if able to do so. I have solicited my Dr to look into & advise me of any such studies. If you have been a part of such a thing or know of one up & coming please share that information.
Although I am relating to the veteran side of things, I am also aware that Mefloquine has & is in use with the general population for vacation travel & humanitarian missions around the globe. In the view of vacation travel dosages are of a short-term duration it has been determined that even a single dose of Mefloquine can & does have potential consequences. Be aware! Read & head the warnings labeled. I have been amazed to coincidentally be in contact with professionals outside the military who have taken & can relate to Mefloquine/Larium.
Problems with Consistent Primary care & Consistent Medical Records: I served from 1977 to 2000 in Uniform. An additional time as a civilian employed by DND & a couple of years as a Commissionaire. What I may maintain of my old records is in fact old & prior to my remuster to an Engineering Career. Problems for obtaining any records is a bulk issue with a minimal staff being years behind in fulfilling the request from archives for those records. Still concerned over censorship of those records when I received them.
It has been my fortune to having had a particular Psychological/Psychotherapy Provider who put together much of the associated symptoms which are of medical concerns towards some recovery from those issues. The man was at the end of his varied career that had a huge association with the military, (he practiced on a Base for years), first responders (His son is a Police Officer) & others. With his 40 plus years as a practitioner his knowledge & experience is vast. Thus the advantage of a person educated as such was totally valuable & desirable from a patients perspective. He absolutely helped turn my life around for the better. Thank You Sir!
I’m not sure many providers share in their medical concerns over their psychological treatments with/between other professionals. They are conservative in nature of their profession & limits imposed upon them. That one outstanding Dr. gave me an annual page or two assessment to bring issues to the attention of my General Practitioner which certainly didn’t hurt over the years with either of them. I would like to hear that this is becoming more common place in the way forward for the many rather than the few. I understand there are restrictions & I’m stating responses in a limited manner.
Recommendations for Treatment: Screening for past use of Quinoline anti-malarial medication use. No recollection of ever having been asked this by any practitioner. The point to note here is that if never having been asked is to be prepared to offer up that detail. Since becoming aware of the details over the recent years many of those blank voids have made more sense now as to how or why certain things transpired as they did then.
What type of screening for TBI is there? Who do we ask in relation to this? What do we need to be believed that this is a potential problem & given the benefit of the doubt to follow through on it? I was shocked to know people in more precarious situations had not been tested either. Brock Blaszczyk told me so just yesterday. He’s famous for having spoke up to the PM at the Town Hall Meeting in Edmonton where the PM said “WE are asking for more than they are able to give”, seriously this should haunt that man forever.
I had an initial assessment for Vestibular issues. This was as it was first sent out that it could be yet another issue to look into & treat the effects as such. I have to say that I was not impressed by the assessment & it’s openness to alternative interpretations. It was far from scientific with instrumentations lacking. Since then I have found that there is a more clinical/scientific measurement of such issues & will be pursuing that avenue. I have also forwarded the original letter in its entirety to them. Following upon that the person seeing/testing & treating me also took Mefloquine for 5 weeks on an African Trip & can relate, wow, the world is shrinking.
Although I know my mind has some messes within (maybe a lot), I’m not liable to track the situations in a written/diary format. Like all those New Year’s Resolutions we all fall off of after a while this process follows the same relationship to not being able to keep it up over time.
I think I am capable yet to still recall or have some form of documentation to reflect upon for progression in a positive fashion. I’m old school & an old sort of limitations with my own persona to change everything at once or be able to follow up on all I should have/could have/might have done. I would certainly volunteer for a sleep study. Who does that? Where? How do I get a referral? Perhaps because I was already previously diagnosed with sleep apnea I wouldn’t qualify but there are other sleep issues around those parameters of short & broken sleep, difficulties getting & staying there, night sweats, dreams/nightmares etc.
Referrals to Psychotherapy & Psychology experts is a tough call in so far as who one may be comfortable with is not necessarily the same comfort level with another. I would happily suggest that we all find someone in those professions to be able to find some tools to be able to be more capable to find & work with solutions & tools to deal with the daily/weekly/monthly/yearly issues that hold us back from going forward.
My main point here would be to encourage any & all to link up with a Psychology/Therapist treatment program. The limited number of appointments can be expanded upon by doing the paperwork & substantiating the request. I had intensive therapy with both a Psychiatrist & a Psychologist for some 7 years. I then went without either for another 7 years. At the point of becoming as yet another suicidal statistic I returned to a Psychologist who just happened to save & extend my life & the quality of it. Sadly, he has retired, deservingly, however I have moved on as well & in a better state of mind because of him & the treatments over the years. Regardless if seeing someone at differentiating intervals I think that maintaining some sort of contact with someone as such over the years, if that’s possible, is critical in them being able to professionally make recommendations as to forward progression or what they can view & or gage as a lack thereof.
Having mentioned Substantiation I would like to expand upon where that counts. That is also where our Dr’s have to put more of their emphasis upon the paperwork involved.
Other than checking off the boxes on any particular form a substantiation in the way of a paragraph as opposed to a sentence can convey the requirement to be better understood & assessed as to a necessity rather than a convenience per say to follow through with the request in a positive manner. I can relate substantiation to this in regards to everything from my dentures, where we as veterans have a 7 year span between replacements as opposed to civilians 5 year span (that extra 2 years is a lot of wear & lack of chewing capability etc.), medications in expanding or reducing quantities (cost measures versus patient needs/improvement), replacement medications which eliminated others, & the ability to see more than one therapist & for more than the limited number of treatments.
Deployment that exposed me to Mefloquine was Haiti in 1995! Known to DND/VAC as UNMIH Op Pivot. Its’s not listed amongst the deployments list in the letter but left open to other deployments from 1992-2007. It was accepted by the Law firm HSH Lawyers & I now have proof from my medical documents that I just received.
Page 5 is a Neurobehavioral Symptom Inventory (NSI). This is a standard questionnaire amongst the psychological community & I have filled & filed several over the years between different practitioner’s & it’s an ongoing check up on progress or regression. Paperwork is necessary! Ahead to page 17 it states & I couldn’t agree more that in the absence of medical recognition, veterans, myself included, have experienced considerable frustrations. There have been numerous uplifting moments amongst us that our suspicions to something else being responsible for our conditions not being recognized otherwise are now confirmed. It has filled in several blanks as to what & why we are the way we are.
I knew I came back from Haiti a different person. The problems were much different than the PTSD related conditions of a war-torn country during a war when I had been deployed to Croatia in 92/93 wherein the war was from 1991-1995. I have stated feverishly perhaps that my PTSD symptoms are in fact PTSD & verifiable as such. My emphasis on that does not diminish the renewed emphases on the Mefloquine/Quinism side of things which are also verifiable.
I attributed some of it to the 3rd world conditions there but not all inclusive as to how that was relative. It was around that same year in 1995/96 when the Gulf War Syndrome was headlining the news. I hadn’t just returned from the same theater of conflict but certainly found I could check off the majority of those symptoms as relatable to me personally. Now I know why! I have only been recognizing these symptoms as related there to what’s now becoming more recognizable as Quinism within the past 3-4 years as the advocacy for such has surfaced & grows.
The personal cost has been huge. Divorced the first time after a 24 year marriage, I lost my wife, my kids, my home, my finances, my security, my self-esteem/self-worth, my mind & my soul. I divorced a second time after a 6 year relationship where adding insult to injury I lost anything I had salvaged from the first marriage & invested in the second. I am married yet a 3rd time just within this last year & there remains plenty of difficulties in maintaining that relationship as well. We are however more cognizant as to why & unified on treating the cause.
I’ve had homicidal thoughts in the past but naturally common sense prevailed & they were only thoughts not actions, suicidal thoughts/idealizations came & went & not sure to ever really be totally dismissed, been homeless during second divorce…one of those couch/garage/basement guests, helpless or so I thought for some time, financially ruined/still deep in lawyers debts & emotionally scarred for all of my remaining days.
It always will be a struggle! There is no cure! There are however coping mechanisms. I faced many demons & have more to deal with yet. Health issues & recovery is an ongoing venture with which I still manage to find a reason to continue & while in public try to remain/maintain a normal image within others perceptions as to what normal is.
The Next 60 Years Of Major David McBride’s Life Are Riding On The Answer
This is an update on the story of Major David McBride, the Australian Legal Officer who leaked documents to the press, and now faces the prospect of spending the rest of his life in prison. Sometime this spring he will appear in court again to set a trial date, which could be a number of months after that.
Until then McBride, who is representing himself, will be working on his defense against one count of theft of commonwealth property, three counts of breaching the defense act, and one count of unauthorized disclosure of information. Because of the nature of the evidence there will be portions of the trial that will be held in a closed court and only those with Top Secret clearance could be in attendance. This greatly limited his choice of counsel since very few attorneys, if any, would meet the now extremely criteria. Therefore, Major McBride will be appearing pro se, as his own counsel and is preparing to vigourously defend himself against the charges.
In Defence Of David McBride
McBride will be asserting an affirmative defense meaning that while he will be admitting to the underlying offense, there were mitigating circumstances that limit his culpability. This could be more commonly known as a justification defense, and McBride had plenty of justification for his actions. In fact it could be argued that he was legally obliged to do what he did, as I will show next.
Exceptions and Defences
Public Interest Disclosure
2.69 The types of disclosure protected by the proposed public interest disclosure legislation would include, but not be limited to, ‘serious matters’ related to illegal activity, corruption, maladministration, breach of public trust, scientific misconduct, wastage of public funds, dangers to public health or safety, dangers to the environment, official misconduct (including breaches of codes of conduct) and adverse action against a person who makes a public interest disclosure.94 A person making a disclosure would need to have an honest and reasonable belief, on the basis of information available to them, that the matter concerns ‘disclosable’ conduct under the legislation.95
What David McBride claims to have found is evidence of such ‘serious matters’. Given that he is an experienced attorney and Legal Officer he would have excellent knowledge as to what would constitute a ‘serious matter’, and therefore he could be found to meet the standard of having an ‘honest and reasonable belief’ that the matters were in fact disclosable.
Duty To Disclose
In the course of an officer’s functions and duties 7.16 Secrecy provisions commonly allow information to be disclosed in the performance of a person’s functions and duties as an employee or officer. For example, the Aboriginal Land Rights (Northern Territory) Act 1976 (Cth) provides that secrecy provisions do not extend to a person handling information ‘in the performance of the person’s functions or duties’ under the Act.17
Having had the honest and reasonable belief that the matter was disclosable, it was David McBrides duty as an officer of the court to disclose. He had also made several prior attempts to take the matter the proper authorities only to be told basically ‘you cannot charge the government’. Left with no other alternative, David McBride took the next logical and reasonable action, which was to leak the documents, as he was still bound by his duty as an officer of the court.
2.72 The Standing Committee also considered that it was necessary to protect a person making a public interest disclosure to third parties—such as the media, a Member of Parliament, a trade union or a legal adviser—in certain circumstances. The Standing Committee stated that: experience has shown that internal processes can sometimes fail and people will seek alternative avenues to make their disclosure. There are cases with implications of the utmost seriousness, when disclosure through third parties has been initially necessary and consequently beneficial. … A public interest disclosure scheme that does not provide a means for such matters to be brought to light will lack credibility.98
2.74 The Standing Committee’s final recommendation, however, confined protected public interest disclosures to third parties to very narrow circumstances. A disclosure to a third party external to the public service would only be protected where the matter already had been disclosed internally or to an external authority, but had not been acted on in a reasonable time, and the matter threatened immediate serious harm to public health or safety.100
2.75 The recommendation relating to disclosures to third parties has been criticised as being too limited. Brown, for example, has commented that while it is reasonable to require people to proceed through internal channels or external integrity agencies before disclosing a matter publicly, the requirement that the matter must ‘threaten immediate serious harm to public health and safety’ is too restrictive in that it excludes from protection public interest disclosures to the media regarding major fraud, corruption and major abuses of power. Brown also argues that the recommended provision fails to cover the situation in which the external agency does not adequately address a public interest disclosure, so that ‘even if the Ombudsman had looked at the problem and failed to act, or got it wrong, a public servant who justifiably went public could still be sacked, sued or prosecuted’.101
2.76 In a submission to this Inquiry, Brown stated that the proposed approach fails to contemplate what would occur in circumstances where an official had reason to believe not only that their own agency would not respond appropriately to the disclosure, but that the ability of the relevant external integrity agency to respond appropriately had also been corrupted or compromised.102
2.77 Brown suggested that a better approach would be one that protects publicinterest disclosures to persons outside government: 1) where the matter has been disclosed internally to the agency concerned and to an external integrity agency of government, or to an external integrity agency alone, and has not been acted on in a reasonable time having regard to the nature of the matter; or 2) where a matter is exceptionally serious, and special circumstances exist such as to make the prior disclosure of the matter, internally or to an external integrity agency, either impossible or unreasonable (for example, in some circumstances involving a serious and immediate threat to public health or safety).
Even if the ‘immediate threat to public health or safety’ provision remains now, McBride could still make this argument in front of a judge.
611. For subparagraph 91.1(1)(b)(ii), the prosecution will need to prove that the information or article dealt with by the defendant concerned Australia’s national security. Consistent with the definition of national security in section 90.4, this could include information or articles relating to:
· the defence of Australia (paragraphs 90.4(1)(a) and (e) and 90.4(2)(e))
· activities of Australia’s intelligence agencies, including ASIO (subsection 90.4(2)), and
· Australia’s relationships with other countries (paragraph 90.4(1)(e)).
We do not know the exact number of documents that are in question, that information has not been released. As to the nature of the documents, McBride says that none of them contained information that would be detrimental to Australia’s national security. If anything the documents contained evidence that would prove the government was complicit in wrongdoing or would otherwise be embarrassing to it. If so they would not be subject to classification and as such the documents should be made public.
A person is not criminally responsible for an offence if the conduct constituting the offence is justified or excused by or under a law.
(1) If intention, knowledge or recklessness is a fault element in relation to a physical element of an offence, that fault element must be attributed to a body corporate (the government) that expressly, tacitly or impliedly authorised or permitted the commission of the offence.
(2) The means by which such an authorisation or permission may be established include:
(a) proving that the body corporate’s board of directors (in this case the cabinet) intentionally, knowingly or recklessly carried out the relevant conduct, or expressly, tacitly or impliedly authorised or permitted the commission of the offence; or
(b) proving that a high managerial agent of the body corporate (minister) intentionally, knowingly or recklessly engaged in the relevant conduct, or expressly, tacitly or impliedly authorised or permitted the commission of the offence; or
(c) proving that a corporate culture existed within the body corporate (bureaucracy) that directed, encouraged, tolerated or led to non-compliance with the relevant provision; or
(d) proving that the body corporate (bureaucracy) failed to create and maintain a corporate culture that required compliance with the relevant provision.
(3) Paragraph (2)(b) does not apply if the body corporate proves that it exercised due diligence to prevent the conduct, or the authorisation or permission.
What this section basically says is that if the government committed a crime and either explicitly or implicitly condoned such action, any documents relating to such action are exempt from being classified material.
David McBride Acted In Good Faith
He is well versed in International Law, in fact he’s one of Australia’s leading attorneys on the subject. Having analyzed the evidence he came to the conclusion that crimes had been committed, and it was his duty as an officer of the court to report it to the proper authorities. Major McBride did so, taking his case to about half a dozen different agencies over a two year span, including the ANP. In every instance the same thing would happen, the agency would review the evidence and concur with McBride’s findings. All refused to pursue the matter telling him “What do you want us to do? You can’t charge the government.”
As is allowed for in law, McBride then leaked the documents to the press. Only after having exhausted all other available options did he take the “Nuclear Option”. David McBride has no agenda and no personal axes to grind. He did not make those decisions lightly and took the action he did out of a sense of patriotism, not malice.
The extent to which government secrecy in Australia has risen is alarming to say the least. Democracy is being hijacked by the Australian government and the ransom is simply too high a price to pay for Australians. They need to be held to account and made aware that the people are watching what they are doing.
Canada is on a similar path at the moment, watching as our government attempts to subvert our legal rights and uses the law as a weapon against its own citizens rather than as a shield to protect them.
Leaders from democratic nations will be keeping a close eye on what happens in Australia. It will give them an idea as to what they will and won’t be able to get away with. I’ll be watching along with people from around the world as well, and we will all be standing firmly behind David McBride.
Two members of my family are gone because of fentanyl, one of the most toxic substances on the planet.
For my little brother, who left us far too soon. I’ll miss you, Ryan.
Loves Labor Lost
This is the first time that I have written anything since I lost my younger brother almost a month ago. He was 43 when he passed away as the result of an accidental overdose of fentanyl, sometime in the early morning hours of September 6th. Like millions of others, my little brother was addicted to drugs and had been for a long time. So great was the internal anguish that he had felt, that turned to narcotics to ease it.
I don’t want him to be defined by the way he died, but rather for the man that he was. He was not perfect, but he was one of the kindest, most generous people that I knew. He was loyal to his friends and family, and had many long-term friendships, some going back well over 30 years. He touched a lot of lives and will be profoundly missed by those of us he leaves behind.
I have learned that in the days leading up to his death he had been talking about entering a long-term rehab facility. He was so very tired of the life he was living and wanted nothing more than to get better, to heal physically, emotionally, and spiritually. On the day he died, he was supposed to get together with one of his good friends and together they would look online for long-term rehab facilities located outside of town.
Last year, one of my cousins lost his life to an accidental overdose of the fentanyl analog carfentanil, a drug 10,000 times stronger than morphine. It is so dangerous that many first responders have had to be hospitalized after coming into contact with a person having an overdose.
I wanted to know more about the poison that has claimed two members of my family, so as always, I started looking for some answers. The information I found in a very short amount of time sent a chill up my spine. Apart from the effect that fentanyl has had on my life personally, it also has significant international relations ramifications. The People’s Republic of China manufactures most, if not all, of the precursor chemicals used to synthesize fentanyl. You should also consider this; synthesized by scientists in a university laboratory in China, there is now a fentanyl analog so lethal, that one teaspoon would kill about as many people as the Great Plague did in Europe in the 14th century.
Opioid or Opiate?
To make the distinction, opiates are those drugs naturally derived from the flowering opium poppy plant (ie morphine, codeine). Opioids are a much broader category and include any substance, natural or synthetic, which binds to the brain’s opioid receptors.
Fentanyl will probably be the drug most associated with the opioid crisis, even though that distinction belongs to OxyContin, the Purdue Pharma extended release formulation of oxycodone that has the dubious reputation of starting it.
Although it has gained a great deal of attention 0ver the last decade, fentanyl has been around for a lot longer than that. Dr. Paul Jannsen first synthesized it in 1958 under a patent held by his company, Jannsen Pharmaceutica. It is now owned by conglomerate Johnnson & Johnson, who have lost big dollar law suits brought by women claiming Johnson’s Baby Powder caused their ovarian cancer.
It was a powerful analgesic, some 100x more powerful than morphine, and could also be used for anaesthesia. It would hit the market in the 1960. as an IV anaesthetic with the brand name Sublimaze.
Fentanyl Analogs and Derivatives
A chemical analog is a compound that is structurally similar to another compound on a molecular level, but differs from the original compound to some degree. Not long after Sublimaze was released its popularity would lead to the development of a number of fentanyl analogs and derivatives. among which were Sufentanil, Alfentanil, Lofentanil and Remifentanil.
The strongest analgesic available for human use, it is 5x the strength of fentanyl and 500x stronger than morphine. It is used in hospitals as an analgesic and as an adjunct to anaesthesia under the brand names Dsuvia and Sufenta.
Alfentanil has a potency that is approximately 10-25% that of fentanyl. It’s onset of action is 4x that of fentanyl but only lasts one-third as long. It is used as a short acting anaesthetic.
One of the most potent fentanyl analogs, it is most similar to carfentanil.
Used in a hospital setting, remifentanil is used for sedation, as an anaesthesia adjunct, and as an analgesic, having the brand name Ultiva. It is twice the strength of fentanyl and 200x more powerful than morphine.
Carfentanil is used as a sedative for large animals under the brand name Wildnil. At 100x the strength of fentanyl, it is 1000x more potent than morphine. It started to appear on the streets a few years ago with deadly results. The estimated lethal dosage in humans is 50 micrograms. By comparison, a poppy seed weighs approximately 300 micrograms.
Ohmefentanyl – The most potent and deadly fentanyl analog
Ohmefentanyl was first synthesized in the early 1970’s by scientists in a lab at the Chinese Academy of Sciences in Guangzhou, China. More than 6,000x stronger than morphine, it is so potent that one ounce of ohmefentanyl is enough to kill 175 MILLION people. That being said it is far more complex to synthesize ohmefentanyl than it is to synthesize fentanyl. The process involves more equipment and additional precursors and solvents and, because it is so toxic, it is extremely hazardous to manufacture and can only be handled safely using protective equipment.
Synthesis and analgesic activity of stereoisomers of cis -fluoro-ohmefentanyl
Fentanyl is synthesized using ingredients known as precursors. These precursor chemicals are sold by manufacturers in China, who make tens of thousands of such compounds. These compounds include things such as food additives, veterinary products, pesticides, and the precursor chemicals used to synthesize pharmaceutical drugs, including fentanyl.
The vast majority of the precursors used in the synthesis of fentanyl are sent to Mexico, where most of the illict fentanyl in the US is made. It takes a trained chemist to synthesize fentanyl from scratch, something the Mexican cartels do not have. But, it is easier to make fentanyl using bulk supplies of the precursor chemicals, which is what the cartels do.
On September 17th of this year the DEA announced that it was putting forth a proposal to control three of the precursor chemicals needed to synthesize fentanyl. It’s difficult to say what effect if any this will have since the vast majority of illicit fentanyl is made in Mexico.
The take-home message here is that there are millions of fentanyl analogs that can be made from commercially available chemicals. It is all but certain that many of them will have fentanyl-like properties and that some of these will make even the most powerful analogs today, such as carfentanil and sufentanil, seem like cotton candy.
It just isn’t realistic to think that treaties or international law will end the production and distribution of these precursor compounds. There is simply no easy or effective way of enforcing international agreements amongst sovereign nations. Just look at the current state of international relations.
One way or another these chemicals will continue to be manufactured, the genie cannot be put back into the bottle. The fact also remains that scientists, primarily in The People’s Republic of China, will continue to attempt to synthesize something even stronger.
“NPP is a sensitive products. Why you buy it?” one Yuancheng saleswoman asked me on Skype, before the product was scheduled in China. “I know many people buy it. But I don’t know what it is used for.”
I explained that it was used to make fentanyl.
“I know fentanyl,” she continued, “but why people use it? We Chinese don’t use it.”
It’s highly addictive, I said.
“Yes, I know it is a bad products to person,” the saleswoman admitted, “but I still sell it, so sometimes I feel guilt. NPP is not forbidden in China, so we can sell. I sell it, because I want earn money, earn a living.”
While the DEA proposed making regulatory changes in their announcement of September 17th, similar regulatory changes in Canada came in to effect on May 6th, 2019, when they were registered in the Canada Gazette.
Government of Canada changes regulations to help prevent illegal production and trafficking of controlled substances
With such an extremely high potency, compounds like ohmefentanyl are simply not practical, or safe, for use as an analgesic in human beings. The only logical reason for synthesizing ohmefentanyl would be to use it as a weapon of mass destruction. Granted it would take a huge effort to weaponize it and come up with an effective delivery system, but it is still a distinct possibility.
In May of 2018, the US Environmental Protection Agency (EPA) issued a fact sheet for Federal EPA On Scene Coordinators who respond to any incidents of environmental contamination by fentanyl or its analogs. It is a comprehensive 11 page document, and some of the information contained in it caught my attention. It includes a list of the possible exposure pathways, in other words, the ways that fentanyl could be spread to a population. These include open areas, water/water systems, indoor facilities, and food.
Fact Sheet for OSCs: Version 1.0 05/22/2018 Fentanyl and Fentanyl Analogs
Open Areas: While fentanyl is a solid powder at room temperature, it poses an inhalation or incidental ingestion exposure threat if sufficient powder becomes airborne. Fentanyl can also be dissolved in solvents and fentanyl citrate is soluble in water, which allows exposure in aerosol form. The literature indicates that police officers showed symptoms of opiate exposure after police activities created fentanyl dust/aerosol or when they worked in dusty areas.
Water/Water Systems: Fentanyl in liquid solution creates a possible dermal exposure pathway and is commonly used in many medicinal forms of fentanyl. Literature reviews indicate that aqueous fentanyl may be found as an illicit drug in intravenous form, nasal sprays, eye drops, and vape pen liquids. While fentanyl could enter natural waters or a water system, neither is a likely exposure pathway.
Indoor Facility: Fentanyl could potentially be dispersed as solid particulates or liquid spray (aerosol) inside a building or facility; HVAC systems may be affected. Fentanyl particulates are heavier (less buoyant) than air and will accumulate on lower levels and in utility corridors and/or deposit on surfaces inside a building.
Food: While food is an unlikely exposure pathway, fentanyl can be released as a fine dust or aerosol that may contaminate food.
Before anyone accuses me of giving terrorists and lunatics a great new idea, it is more than likely that someone has already come up with the idea and so have the security agencies that protect us. At least they should have anyway.
It now clearer than ever to me that the only way to eliminate the threat posed by fentanyl and its analogs, aside from banning its production, would be to have it classified as a chemical weapon, and heavily restrict its production and distribution as well as the production and distribution of its precursor chemicals.
The Startling Numbers
This will never happen, it simply isn’t a realistic expectation for a number of reasons. In the meantime, until someone can come up with a workable solution to counter this plague, the number of people killed by fentanyl will continue to rise.
Here in Alberta the statistics are alarming to say the least. In 2016 out of 803 drug and alcohol poisoning deaths 43% (347) were attributed to fentanyl or its analogs. In 2017 it had increased to 59% (565/951) and in 2018 fentanyl constituted 63% of overdose deaths (622/985).
Of these overdoses 80% involved fentanyl mixed other drugs. 50% involved methamphetamine, 25% cocaine, and 5% heroin. Drug dealers will add fentanyl to other drugs in order to increase their profitability, and as a means of attracting and retaining customers. What usually results however is that their customers wind up dead.
Nationally the number is even higher. In 2016 total number of overdose deaths in Canada was 3023, of which 50% were from fentanyl or its analogs. In 2017 it rose to 67% (4120) and was 73% in 2018 (4588). In the first three months of 2019 it was 79%.
The number of overdose deaths increased sharply as well, up 36% from 2016 to 2017 and up 11% from 2017 to 2018.
Trafficking in fentanyl is a very lucrative business. In fact, it is the most lucrative illicit narcotic currently sold. In 2017, 1 KG of pure fentanyl could be purchased for $4,150. That 1 KG could potentially generate $1,600,000 in revenue for the trafficker, a profit of over 38,000%
By comparison, traffickers will only realize a 1,300% profit off of heroin, or $80,000 in revenue from 1KG of heroin purchased for $6,000.
Fentanyl profitability in the US compared to heroin.
It has been more than a decade since media articles began reporting on what was then called an opioid epidemic, and is now referred to as the “opioid crisis”. In North America, fentanyl has become a threat to public safety unlike any illicit drug before, more than heroin, cocaine, or methamphetamine. It is the most potent and most addictive narcotic there is which also makes it the most dangerous.
Putting an end to this crisis will require action on the part of several governments. There is an ever growing population of opioid addicts who require immediate intervention, but there is currently a critical shortage of treatment facilities. Adding the extra capacity would require taxpayer funding, which would then make it a political issue, and politicians are loathe to spend money on projects from which they will recieve no benefit.
There also needs to be the political will to implement a different strategy to combat the problem. At the moment, efforts are geared more towards harm reduction for addicts. Some jurisdictions have opened safe injection sites, where addicts can do their drugs in a sterile environment and with medical intervention available in the event of an overdose.
There is also a segment of the population who believes that the legalization and regulation of all illicit narcotics is the solution. Many will cite Portugal as an example of success.
Portugal in the late 1990’s was dealing with a drug crisis of its own. One percent of its population, 100,000 people, were heroin users and on average more than 350 people a year were dying from a drug overdose. In the early 2000’s, Portugal overhauled its drug laws, decriminalizing small amounts of narcotics for personal use.
The number of overdose deaths has since plummeted, though this is not as a direct result of decriminalization. The Portuguese also recognized that it wasn’t enough to simply decriminalize illicit drugs, they also provided the means for addicts to access treatment, and assisted them as they reintegrated back into society.
If police find you with illicit drugs, you’ll be arrested and taken to a police station where the drugs will be weighed. If the amount is above the strictly enforced threshold limits — designed to be a 10-day supply for personal use, or 25 grams of cannabis, five grams of cannabis resin, two grams of cocaine, or one gram each of ecstasy or heroin — you can be charged as a trafficker. If convicted, jail terms range from one year to 14 years.
If the amount is below the limit, you’ll be sent the following day to the Commission for the Dissuasion of Drug Addiction — even if you’re a tourist. There, you will be interviewed by a psychologist or social worker before appearing before a three-person panel that will offer suggestions aimed at stopping your drug use.
From there, you’re fast-tracked to whatever services you’re willing to accept. If you refuse help, you can be asked to do community service or even, eventually, facing a fine, perhaps even having possessions confiscated and sold to pay the fine.
It’s why Goulão is so quick to point out that Portugal’s success isn’t because of decriminalization. It’s because, in 2001, his country made a commitment to providing whatever its citizens need to be as healthy and as fully engaged in society as possible.
“Decriminalization is not a silver bullet,” he said. “If you decriminalize and do nothing else, things will get worse.
“The most important part was making treatment available to everybody who needed it for free. This was our first goal.”
The precursor chemicals used to synthesize fentanyl and its analogs are manufactured in The People’s Republic of China, and the government places no restrictions on their production or shipping. For the manufacturers the only concern is that they sell their product and make a profit on it, without regard for its end use or the ensuing consequences it may bring. There is also very little likelihood that the Chinese will place any restrictions on the manufacture and distribution of these chemicals, and very little that anyone can do about it. In and of themselves they are not dangerous and do not pose a threat
When I analyze this through the lens of International Relations, I come to some conclusions that many will no doubt disagree with. I may even be labeled as paranoid or a conspiracy theorist, but I will leave it to you to draw your own conclusions.
Strategically speaking it is to China’s benefit that these chemicals be used to synthesize fentanyl. The economic benefit to China is relatively small compared to the strategic benefit. A rapid and dramatic increase in the number of drug addicts within a society will act as a destabilizing force within it, draining resources that could be better used elsewhere.
The Chinese have also lead the way in the synthesis of the most potent and deadly fentanyl analogs, with the potential ability to kill tens of millions of people. There are no conventions banning the research and development of synthetic opioid drugs like there are for chemical weapons or other WMD. Yes, I know that it would be very difficult, and that it would need the proper vehicle for delivery in order to be effective. How are we to know that one hasn’t already been developed, or is being worked on now? Theoretically, they could have already produced enough ohmefentanyl to wipe out half the population of the continental United States. This has the potential to weigh heavily on the global balance of power.
According to Drug and Alcohol Research Connections, a free, bi-monthly newsletter published jointly by three of Australia’s leading drug and alcohol research centres, a 2017 study found that although the number of fentanyl related overdoses is relatively small compared to North America, the number is growing year after year. It is likely only a matter of time before this crisis is visited upon Australia and other countries across the globe.
Anationwide study of the extent and factors associated with fentanyl use in Australia
There are no quick and easy fixes to be found here, and people are going to continue dying in ever growing numbers. Individually there isn’t much that any of us can do either, it is something that must be dealt with on a governmental level and frankly, this gives me little hope that a solution will be found any time soon.
A lot of people will die that didn’t have to, people like my brother, and my heart breaks for the families and loved ones that will be left behind. Share this information with the people you know so that as many people as possible are aware of just how very bad the situation is. It is possible that it might one day save a life, perhaps the life of some one you know and love.