Forensics, Fentanyl & New Drug Detection

What you don’t know can kill you. Consider America’s drug overdose epidemic, which according to CDC estimates, claimed over 100,000 lives in 2022. Many of those deaths resulted from fentanyl, a synthetic opioid that often masquerades as heroin, but can be up to 50 times stronger in its effects.

Analogs of fentanyl distort the math further, with some ranging up to 5,000 times stronger than the substance they purport to be. Forced into the illegal marketplace, without regulation, street users may not know what they’re consuming until it’s too late; forensic examiners and law enforcement agencies may miss crucial evidence.

Forensic chemists, toxicologists, laboratory professionals, and law enforcement officers all face significant challenges in detecting, identifying, and analyzing new and dangerous substances. This is an urgent situation. A new, non-opioid drug, xylazine, is now being included alongside fentanyl and its analogs: it is resistant to opioid overdose medications like Narcan, has a wide range of deleterious side effects, and often hides “underneath” fentanyl and other opioids during traditional forensic analysis. Xylazine, also known as tranq, almost certainly contributes to an increase in overdose deaths, though the full extent remains unknown, largely because of its newness.

The traditional forensic laboratory is not set up to detect, identify, and analyze new and dangerous drugs and chemicals. But more are coming. Collaborative solutions are needed. To learn how the public health, natural science, and forensic science communities are fighting back, read on.

Meet the Expert: Edward Sisco, PhD

Dr. Ed Sisco is a research chemist within the Surface and Trace Chemical Analysis Group at the National Institute of Standards and Technology (NIST). The Group is one of eight groups within the Materials Measurement Science Division and supports the NIST mission in Safety, Security, and Forensics with projects ranging from developing and standardizing contraband screening technologies to nuclear particle analysis and forensics. They perform basic research in developing new technologies for detecting trace particles and thin films on surfaces, sampling, instrument optimization, and development of standards.

Dr. Sisco’s research has focused on mass spectrometry systems for forensics, homeland security, and other applications. He has extensive knowledge in traditional mass spectrometry systems (GC-MS, LC-MS, IC-MS), secondary ion mass spectrometry (SIMS), and ambient ionization mass spectrometry (AI-MS) such as DART-MS, DESI-MS, DEFFI-MS, etc. His current research focuses on addressing measurement challenges in forensic chemistry, providing fundamental measurements to address the opioid epidemic, and increasing awareness of the advantages of implementing AI-MS in screening and laboratory environments.

The Challenges of New Drug Detection

“Identifying and analyzing new drugs of abuse is one of the biggest challenges facing the world today,” Dr. Sisco says. “And it’s not necessarily just drugs. It’s also chemicals. Xylazine wasn’t on the radar as a drug of abuse. It’s been around for decades and is only now being used in that way. How do we figure out what’s going on, and what the next thing might be? How do you find something you don’t know to look for?”

The challenges in new drug detection are myriad. Many potent new drugs can be present in only trace amounts, making them hard to detect, and able to ‘hide behind’ their other, more well-known, counterparts. Their structure, too, may be difficult to identify with traditional lab techniques, methods, and technologies. Analogs, which differ slightly in their molecular makeup, can fool the most basic detection processes. These challenges are magnified by a general lack of uniform reporting requirements and a significant backlog of cases in the average drug chemistry laboratory.

“On the toxicology side, the biggest need is in technology,” Dr. Sisco says. “Right now, the technology that is often used is very narrow-focused. Many labs are only looking at very specific drugs or panels of drugs.”

The standard tech in most labs can’t do exploratory analysis, where scientists would be able to look for these new drugs. Upgrading requires new funding and additional expertise. Especially in forensic settings, where findings are incorporated into casework, procedural barriers make major changes difficult.

But some scientists are beginning to rethink the role of the forensic laboratory, and its capacity for the type of independent, exploratory analysis that could exist outside the strict rules set out for casework, and aid in new drug detection.

The Rapid Drug Analysis and Research (RaDAR) Program

The National Institute of Standards and Technology (NIST) has been working towards a collaborative solution with its Rapid Drug Analysis and Research (RaDAR) Program. Started in October 2021, in partnership with the Maryland Department of Health and the Maryland State Police, the program pulls in samples from a range of different sites (needle exchanges on the public health side, for example, and crime scenes on the law enforcement side) and performs a thorough analysis. NIST uses an instrument that can detect almost all present substances on a sample in a matter of seconds, through a technique known as direct analysis in real-time mass spectrometry (DART-MS), and then sends the results back to the submitting agencies.

“By October of last year, we’d expanded to all needle exchange sites in Maryland, and multiple law enforcement task forces, giving us coverage of the entire state,” Dr. Sisco says. “Since then, we’ve brought on four additional states, and we’re expanding into at least another four or five states in the coming months.”

Most of the buy-in so far has come through state departments of health, where there appears to be more interest in this type of exploratory analysis and fewer burdens of jurisdiction and procedure. But law enforcement agencies are coming into the program, too.

“There is some red tape in terms of putting agreements in place,” Dr. Sisco says. “The two big things are data sharing—ensuring that we provide data in a safe and secure manner—and then ensuring the anonymity of the people donating the samples. We don’t want to collect any personally identifiable information. Everything we do is blinded: we know nothing about the people who are submitting the samples, and we make sure we keep it that way.”

Pulling in samples from diverse settings allows scientists to collaborate around new drug detection and map the spread of new and dangerous analogs. It saves lives: in public health settings, this information can inform users about potentially lethal drugs on the street and in their community; in law enforcement agencies, officials can better know what to look for. However, the expansion of the program has its limits. NIST is a research and development laboratory, and it’s not equipped to handle tens of thousands of samples coming in every day.

“Our goal is to establish this new type of measurement, and new capability, then work with the states and cities to transfer that into their laboratories, so they can do it on their own,” Dr. Sisco says. “We’re starting to do that now with a few states, where they’re adopting the technologies and methods that we’ve developed, to bring it in-house eventually. That would allow us to also standardize the data and the reporting, so that information is comparable across states, across regions, across the country.”

The Future of New Drug Detection

Scientists at NIST are also working on the safe handling of potentially hazardous substances. Carfentanil, an analog of fentanyl, can be 100 times more potent than fentanyl, and thus 5,000 times more potent than heroin, making it potentially lethal if accidentally inhaled. Simply the possibility of its presence makes investigation and analysis dangerous: first responders and scientists have to assume the worst, and take precautions. Scientists at NIST are participating in the development of new forms of training to assist with this.

“We use videos, lasers, and other types of visualization tools to help us look at how powder moves in an environment,” Sisco says. “Then we mock up either people manufacturing narcotics, or opening evidence, and make training videos that help law enforcement and forensic scientists ensure that what they’re doing is safe, to prevent exposure to these new drugs that might be coming out.”

Today, the scourges are fentanyl and xylazine, but in three to six months, it could be something else. Scientists are focusing on not just fighting the last war, but also the next one. That means increasing their findings’ objectivity and accuracy so they can make definitive claims when analyzing a sample. It also means spreading best practices and capabilities to more labs.

“As we get more of these new technologies, new algorithms, and standardizing data practices in place, we can get to the point where we can detect these new drugs much quicker,” Sisco says. “That way we’re not waiting weeks or months to know there’s something new on the street. Instead, we can find it in days.”

The future could see more calls to move the laboratory into the field in different capacities. Laboratory-type setups in needle exchanges would benefit users and health departments; at the borders, they could assist in drug detection and enforcement.

“We’re probably five to ten years from really solid technologies that provide the kind of comprehensive analysis and standardized reporting needed out in the field,” Dr. Sisco says. “But I think we’re going to get there.”

For now, the main focus is on doing exploratory analyses in the lab. The technology for it exists right now: it’s already being used to find new medicines or methods of diagnosis. Bringing that technology into the forensics space is just a matter of funding, will, and expertise. It can help close the gap between introduction and detection when the next dangerous substance first comes on the street. The narrower the gap, the more lives that can be saved.

“This is a problem that’s not going away any time soon, unfortunately,” Dr. Sisco says.