What You Need to Know About 'Gray Death'

May 12th 2017

Kyle Jaeger

Heroin is cheap and potent. But heroin mixed with other synthetic opioids is often cheaper and even more potent.

As the opioid crisis continues to worsen, the black market is becoming increasingly infused with deadly concoctions that are being attributed to mass overdoses around the country. The latest example is called "gray death," a chalky mix of fentanyl, a powerful synthetic opioid; carfentanil, an elephant tranquilizer; U-47700, a drug developed to deal with extreme pain associated with terminal diseases; and heroin. 

"Gray death is one of the scariest combinations that I have ever seen in nearly 20 years of forensic chemistry drug analysis," Deneen Kilcrease, who manages the chemistry section of the George Bureau of Investigation, told the Associated Press.

Investigators have linked gray death to mass overdoses in New York and North Carolina — and it's been behind overdoses in Ohio, Georgia, and Alabama. But there's a lack of consensus about how to address the issue, as law enforcement and public health officials are just starting to understand the scope of its distribution.

Demand for cheap, potent opioids remains high in spite of media reports and public health advisories about the demonstrable overdose risk.

It's good business for traffickers, too, who are able to spend less on pure-grade heroin — which requires cultivating poppies — and manufacture even stronger opioids in labs, Bloomberg reported


The current law enforcement strategy when it comes to synthetic opioids is to identify new chemical analogs and put them through an emergency scheduling process — making it explicitly illegal to sell, manufacture, or possess them.

But Sanho Tree, a drug policy fellow at the Institute for Policy Studies, told ATTN: that emergency scheduling is a short-term fix that simply leads chemists to develop new versions of the same opioids.

They can temporarily skirt federal law by changing a single molecule, which could make the drug more dangerous. Tree also pointed out that efforts to crack down on drug traffickers coming across the Southern border could create an incentive to create synthetic opioids in labs domestically.


The long-term solution isn't clear cut, but harm reduction advocates have cited research on successful programs such as supervised injection facilities as a means of reducing overdoses and helping addicts get treatment. Nine countries currently have supervised injection facilities, which test the purity of drugs, provide users with clean needles, and have staff on hand to administer naloxone, an anti-overdose drug.

But even these programs highlight another problem associated with synthetic combinations like gray death: it's often so potent that it can require multiple doses of naloxone, or render it ineffective entirely.

"You don't know what you're getting with these things," Richie Webber, an overdose survivor, told the AP. "Every time you shoot up you're literally playing Russian roulette with your life."