Your bag is empty.
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American street drugs are cheaper and stronger than they’ve ever been, and they’re far more likely to kill you. The government’s advice hasn’t changed much since Nancy Reagan, but the drugs have. So survivors and scientists are writing their own rules for the synthetic era. Here they are:
1. Find yourself a genius.
Tajín-rimmed Bloody Marys are flowing at a South Side bar in Chicago, where a crowd forms around Nabarun Dasgupta, Ph.D., an epidemiologist who analyzes street drugs—which he calls the “synthetic soup” that people snort, smoke, and inject. He’s in town for an event hosted by Chicago Humanities on public health in the fentanyl era, but this conversation has a distinctly office hours vibe. Dasgupta, who goes by Dr. Nab, is a recent recipient of a MacArthur Fellowship, the $800,000 “genius grant,” and he’s talking shop with a guy identified here as D, who is in his late 20s, wearing all black. D asks a rather blunt question for a Saturday morning hang: “I have some black tar [heroin]. … I’ve been smoking some off of foil. But it wastes so much. Should I dilute it and snort it?”
It’s a complicated question, involving purity, potency, and bioavailability, and Dasgupta answers without a morsel of judgment. Humbly, he defers to others at the bar with more, let’s call it, hands-on experience. But he allows that the black tar he’s analyzed tends to be lower purity than the far more dangerous white powders.
That way of bringing science to the street is why MacArthur called him a genius. It also says something about the new rules of drugs in America: Faced with lethally potent synthetics, drug users—whether they have a daily habit or a weekend one—are looking for advice to counter the chaos with atomic precision.
2. Assume the bag is lying to you.
Enterprising chemists are stitching together a Frankenstein’s monster of new synthetic compounds, and no one can keep up—not lawmakers, not regulators, and not the users most at risk.
Heroin, which once required endless poppy fields hidden in far-flung places, has nearly disappeared and been replaced by fentanyl, a synthetic that is up to 50 times more potent and can be produced by a small lab at a fraction of the cost. And there isn’t just a single fentanyl: Ban one analogue and illicit chemists add a nitrogen atom here, a ring of carbon there, and a new gray market drug with hard-to-predict effects hits the street.
Even fentanyl is starting to fade, Dasgupta says, as it’s replaced by ungodly potent Terminator opioids like nitazenes and esoteric animal tranquilizers like medetomidine, which causes heavy sedation and a ferocious withdrawal: tremors, vomiting, delirium. He has detected nitazenes in 118 samples sent from 17 states. This is how the synthetic soup is getting made, and it’s a nightmare to navigate.
3. Check what’s in it.
Labs like Dasgupta’s are beating back the chaos with a practice called drug checking. It’s called checking, not testing, because everyone associates testing with the indignity of peeing in a cup for your boss or the cops. Since 2022, more than 20,000 samples have been sent to his lab—from anonymous users, health departments, and anyone interacting with the street—to be studied by chemists and epidemiologists with high-tech forensic machines. Results go back to the sender and are posted at opioiddata.org. It’s like Consumer Reports, but for illegal drugs.
Click on a random sample listed on the site—say, No. 815667 from Schenectady, New York. Labeled “suspected heroin,” it contains zero heroin. The site reports “a messy brew of 7 major substances,” including fentanyl, dextromethorphan, medetomidine, xylazine—a powerful tranquilizer—plus traces of cocaine.
When a toxic batch turns up, Dasgupta’s team tries to get word to whoever can actually do something. “Like ‘Hey, you need to tell your supplier that something is really wrong in this batch,’ ” he says. It’s worked; dealers and users have ditched bad batches.
4. Test everything.
“Word of mouth has spread,” says Morgan Godvin, project director at Drug Checking Los Angeles, a lab that also analyzes street drugs. Her mom died of an overdose, and Godvin survived her own heroin addiction—and four years in federal prison. Now she wants to give other people a chance to make it out alive. “People are seeking us out for club drugs—ketamine, cocaine, MDMA—and unexpectedly other stuff, like bootleg GLP-1s and testosterone.”
Paranoia about contamination has spread, too, fed by teens overdosing on counterfeit pills bought on Snapchat or cocaine users unknowingly taking fentanyl.
For some, that fear has changed the ritual. “People want access to the drugs and medications they want access to, and they want some form of quality control,” Godvin says. “Under the current structure, the best they can do is have us test it.”
A growing number of bars and clubs stock fentanyl test strips, and naloxone vending machines are showing up on sidewalks. Partyers in the know ask, “Did you test this for fent?” But harm reduction in the real world is messy, and not everyone who buys half a gram at the bar is going to dilute some in water and test it before inhaling.
5. Call your lawmakers.
Harm reduction has always lived on the fringe of public health, and it’s finally breaking containment. After Dasgupta visited Chicago, Health and Human Services Secretary RFK Jr., a former heroin user who favors the so-called tough love approach, blocked federal funding for anything deemed to “facilitate” drug use.
That means no funding for services like SafeSpot, an overdose prevention hotline started by Stephen Murray, a former paramedic now in recovery, and expanded by Boston Medical Center. People across the country stay on the line with a trained SafeSpot operator while they use; if the line goes dead, the operator sends an ambulance. Over 1,000 people a month now call. “We have people call us who are unhoused, we have people call us who are attorneys in high-rise buildings, and everything in between,” Murray says.
Checking drugs. Carrying naloxone. Doing drugs on the phone. All forms of harm reduction and the philosophy behind it remain controversial because stopping people from using is not the explicit goal. When D asked about the best way to do heroin, Dasgupta tried to give an honest answer; he doesn’t see it as his place to tell people not to use. If people actually know what they’re using, maybe they start making small adjustments. Over time, that might lead to bigger changes. But the focus is on keeping people alive in the here and now.
“What we’ve heard multiple times, that I didn’t expect to hear, is that drug checking made people feel like there was somebody who cared about them,” says Dasgupta.