Tyler Cowen is an economics professor, but on his podcast Conversations With Tyler his dialogues — with people like Margaret Atwood, Malcolm Gladwell, and Michael Pollan — explore nearly everything under the sun. I was the first to talk to him about hip-hop, though! It was a dream come true to appear on the show, and he fired questions at me, one after another in quick succession, about fentanyl, the opioid crisis, dive bars, why OutKast doesn’t get back together, and whether or not Taylor Swift is overrated. He even demanded my pick for the greatest hip-hop album of all time. Great fun!
This is an excerpt from Fentanyl, Inc.: How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic about Paul Janssen, the Belgian chemist who created fentanyl. He died in 2003, before fentanyl began killing more Americans annually than any drug in history.
In 1953, Paul Janssen founded his company, Janssen Pharmaceutica, initially working out of the third floor of his father’s building. “We didn’t even have a calculator, let alone a computer for the simplest calculations,” Janssen wrote in 2000. “To reduce expenditure we economized by performing simple tests on pieces of gut from newly slaughtered rabbits, which I collected early in the morning from a butcher in Turnhout.”
Despite its modest beginnings, the company hit the ground running with its discovery of a drug called ambucetamide, used to alleviate menstrual pain. Janssen would also invent loperamide (Imodium), for diarrhea, as well as chemicals that became critical to the fields of psychiatry, mycology, and parasitology. To spur his company’s ascent, he recruited star Belgian scientists from the Belgian Congo, after the political upheaval there that would lead to the country’s independence and the end of colonial rule. He was soon managing a large staff—its members called him Dr. Paul—but still closely involved with creating new chemicals. He literally daydreamed about molecules. “I often watched him at meetings,” wrote Sir James Black, a physiology and medicine Nobel laureate of King’s College London, “when bored with the proceedings, finding solace inside his head as he doodled new chemical compounds!”
One of these new chemicals was fentanyl, which Janssen and his team first synthesized in 1959 by experimenting with the chemical structure of morphine.
Derived naturally from the resin of the opium poppy, morphine was chemically isolated at the dawn of the nineteenth century by German pharmacist Friedrich Sertürner, who named it for Morpheus, the Greek god of dreams. By Janssen’s time it was the reigning pain reliever. Janssen began subtly altering parts of its chemical structure to create new compounds. He tested the effectiveness of these creations, including fentanyl, on lab mice, placing the mice on hot plates and slowly turning up the heat. A sober mouse would normally lick its paws when this happened—to cool them down. Under the influence of these morphine derivatives, however, the mice got worked up and tried to escape.
He developed many morphine derivatives, but fentanyl was particularly profitable for Janssen Pharmaceutica. Doctors found it superior to morphine because of the way it acted. Like morphine, it bound with a receptor in the brain (which we now call the “mu” receptor) to cause pain relief. But fentanyl came on faster, was much more powerful, and wasn’t as likely to cause nausea. “Fentanyl,” Janssen later wrote, “made it possible for the first time to perform lengthy operations and, together with its successors, heralded a revolution in the operating theatre. Without this compound and its analogue, sufentanil, open-heart surgery [as performed today] would not be possible.”
The drug was a revelation, and it went on to become the world’s most widely used anesthetic. Janssen Pharmaceutica was purchased by American behemoth Johnson & Johnson in 1961, and Paul Janssen continued working for the company, tasked with developing other types of fentanyl, referred to as analogues. But almost from the start, fentanyl’s potential addictive dangers were recognized, and it was placed under international control by a United Nations agreement in 1964, leading countries including the United States and the United Kingdom, in 1971, to schedule it—that is, to ban its recreational use. Indeed, its euphoric qualities would prove too much for many users to resist. “Fentanyl is a good medicine but a bad drug,” Justice Tettey, chief of the Laboratory and Scientific Section at the United Nations Office on Drugs and Crime, summed up later. “It has excellent pain relieving properties, but is liable to abuse and can rapidly lead to dependency.”
Despite fentanyl’s quick success as a painkiller in Europe, during the 1960s it was almost blocked for sale in the United States by the Food and Drug Administration. One vocal opponent to the drug’s approval was University of Pennsylvania anesthesiology professor Robert Dripps. A rare outlier who believed fentanyl’s high potency could lead to abuse, he eventually agreed to a compromise after being lobbied by Paul Janssen himself: fentanyl would be available, but only when diluted with another drug called droperidol, a sedative—also patented by Janssen—that was believed to mitigate fentanyl’s detrimental effects. A ratio of fifty parts droperidol to one part fentanyl produced a “bad high” when taken recreationally, Dripps and Janssen agreed, and thus was unlikely to be abused. The FDA approved this combination in 1968. Fentanyl’s success boosted Janssen’s bottom line, which drove him and his colleagues to develop many other fentanyl analogues. Some, like alpha-methylfentanyl, were never turned into medicines that were sold. Others, however, made it to market, including sufentanil—used in long-lasting surgeries—and carfentanil, a veterinary medicine that is the strongest fentanyl analogue ever made commercially.
This week I was on Fresh Air, speaking with Dave Davies about Fentanyl Inc. It was a highlight of this hectic, wonderful week of the book’s release, which included a reading at the St. Louis County Public Library, pictured above. Next week I’m in Washington D.C., New York, and Boston, and you can see all of my tour dates here.
Today, The Atlantic published an excerpt from Fentanyl, Inc, entitled, “A Poison Factory in Plain Sight.” It’s about a Chinese chemical company called Yuancheng, pictured above, which operates out of a dilapidated hotel in the city of Wuhan. Employing hundreds of perky, recent college graduates as salespeople, it sells fentanyl precursors to Mexican cartels, American consumers, and anyone else who wants them. Fentanyl precursors are the main ingredients needed to make fentanyl, and are fueling the epidemic here in the United States; Yuancheng appears to sell more of them than any other company in the world. I’m very proud of this piece, and reporting it was quite an adventure. Yuancheng was one of two Chinese drug operations I infiltrated for Fentanyl, Inc. The book also describes my harrowing journey into a Shanghai lab, which synthesized fentanyl analogues and had Scarface-style mountains of drugs lying around.
Yesterday I testified on Capitol Hill in Washington D.C. about fentanyl and China, before the U.S.-China Economic and Security Review Commission, a bipartisan, bicameral congressional-advisory commission. I spoke about my findings from Fentanyl, Inc., in particular that China is subsidizing the production and export of fentanyl and fentanyl-like drugs. You can read more information about the hearing here, and even watch it on C-SPAN. It was a bit nervewracking but also exciting, as it was the first time I’d revealed my findings publicly, that China offers tax rebates and other subsidies for the drugs that are fueling the opioid epidemic in the U.S. and elsewhere.
The first Fentanyl, Inc. review has arrived, from Kirkus. It’s a starred review (!) and you can read the whole thing here. If this entices you, the book is now available on Amazon at a heavy discount.
“Compelling…Fascinating… [Westhoff] seamlessly blends past and present in his profiles of Belgian chemist Paul Janssen, who was responsible for fentanyl's initial development in 1959; police officers; politicians; LSD drug kingpins, and St. Louis street dealers. . . . Drawing material from official reports, drug databases, scores of interviews, and years of personal research, Westhoff presents an unflinching, illuminating portrait of a festering crisis involving a drug industry that thrives as effectively as it kills. Highly sobering, exemplary reportage delivered through richly detailed scenarios and diversified perspectives.”
Many exciting things are happening in anticipation of Fentanyl, Inc.’s September 3 release date in the U.S. The UK cover is above; the book comes out there, and in Australia and New Zealand, on October 10. I’m thrilled that the back covers will have an endorsement from James Fallows of The Atlantic, an expert on China and many other subjects:
This is an exceptionally useful and well-timed book. I hope anyone concerned about this era’s new addiction epidemic will read it and put its messages to use. Ben Westhoff very skilfully combines pharmacology, politics, law enforcement, and gripping international intrigue in his account of America’s number-one public health problem. I hope Fentanyl, Inc is widely read and influential.
My new book Fentanyl, Inc.: How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic comes out September 3, 2019 in the U.S. In the UK, the release date is October 1, 2019, and for Australia and New Zealand it is October 10, 2019.
Here’s the Amazon page.
My fall book tour is also taking shape. To receive information about it sign up for my mailing list.
I talked about my upcoming book about fentanyl and new drugs (due out next year on Grove/Atlantic) publicly for the first time recently. with Ben Kissel on his podcast Abe Lincoln's Top Hat. The interview gets into my infiltration of Chinese drug labs, as well as the opioid crisis and new drugs like K2 and Spice. Thanks a ton to Ben for having me on!
Original Gangstas was used as the source material for a three-episode series on the Tupac and Biggie murders for the popular podcast, Last Podcast on the Left. The guys were very funny, and I am extremely grateful for their support. Not coincidentally, Original Gangstas just had a third paperback printing.
Meanwhile, I'm in edits on my next book, due out next year on Grove/Atlantic. The book discusses the opioid crisis and focuses on the rise of fentanyl and other new drugs (like K2 and Spice), and for it I traveled all over the world, meeting everyone from addicts to kingpins. The most harrowing part was infiltrating drug operations in China, where most of these chemicals are made. I'm very proud of this book, so stay tuned for more updates and please subscribe to my mailing list at the bottom of this page.
“Scrupulously researched with many incisive revelations, this may be the best book ever written about the hip hop world.”―S. Leigh Savidge, Academy Award nominee and co-writer of Straight Outta Compton
“An elaborately detailed, darkly surprising, definitive history of the LA gangsta rap era.”―Kirkus Reviews (starred review)
“An airtight and unflinching book. Original Gangstas is as resolute as the people and ideas it sets out to profile, and that is no small feat.”―Shea Serrano, New York Times bestselling author of The Rap Year Book