Date Rape Redux: Deadly Fentanyl Used for Robberies

In the mid-1990s, an evil new practice – the use of drugs to incapacitate women so that they could not resist sexual assaults – became a serious threat to millions of women. The drugs, most commonly GHB and Rohypnol, (Figure 1) were typically slipped into women's drinks where the drug and alcohol acted synergistically to render victims unconscious. The Office on Women's Health (HHS) estimates that 11 million women in the US have been the victims of this crime, and many of them had no recollection of the event afterward.

Figure 1. Common date-rape drugs. (Left) gamma-Hydroxybutyric acid, Sodium gamma-hydroxybutyrate, and gamma-butyrolactone are all forms of GHB. (Right) Flunitrazepam, aka Rohypnol and "Roofies," is a member of the benzodiazepine class of sedatives. Others include Valium and Klonopin.

It is difficult to imagine a silver lining in this cloud, but there is a small one – most of the women woke up (1). The same cannot be said for the victims of a new, perverse modification of this practice. Recently, police, especially in the New York City area, have been identifying gangs that use fentanyl to incapacitate people who leave bars, alone and are often intoxicated. The victims are then robbed of their phones, wallets, identities, and savings. Worse still, although the practice is relatively new and reliable statistics are not yet available, it seems clear that waking up can no longer be taken for granted. 

A recent article in The New York Post reported on one gang that has been using fentanyl to disable their targets. Kenwood Allen, a gang member, was charged with three murders (on top of two others that he and his gang had already committed in 2022). That's five deaths in 26 victims. Other gangs have also been using the drug in a similar manner dating back to 2022, possibly earlier.

"Mr. Shirley and Mr. Allen [two gang members] drugged the victims, robbed them, and left them on the street, not caring whether they lived or died.”

 Brian Rodkey, assistant district attorney in Manhattan, in an indictment

It's bad enough that illicit fentanyl and its analogs were responsible for more than 71,000 accidental overdose deaths in 2021, but it's especially obscene that this wicked drug (the illicit variety) is now being used as a potentially lethal weapon during robberies. Although this method has been used in only limited cases, I fear that it might catch on. Fentanyl is ridiculously easy to obtain so the possibility of copycat crimes is real.

In some ways, fentanyl is an "ideal" murder weapon, which can be seen by examining how it has been used. According to a recent New York Times article, the robbers smeared fentanyl powder under a victim's nose and offered another fentanyl-laced marijuana. The victims collapsed and died in the street (or elsewhere) while the killers stole everything.

Fentanyl could be a game-changer. And a really bad one.

Perhaps the most disturbing event in this new trend is the case where the victim had fentanyl powder smeared above their lip. Once this happens – and it is not difficult to sneak up behind someone and do this – the result is probably predetermined. The victim, assuming they haven't already inhaled a lethal dose of fentanyl – about 2 mg – might try to rub the powder off with paper or cloth, but this would likely result in even more drug being inhaled and/or some of it entering the mouth, increasing the exposure.

The only "remedy" for this situation (and I used this word lightly) might be if the victim could wipe the powder off with a wet towel. Fentanyl does not penetrate the skin, so a solution of the drug above your lip is a "better" situation than having the powder there. Of course, this assumes that someone who is probably already drunk has the presence of mind to find a wet towel with just the right amount of water to dissolve the drug without having it drip into his mouth while at the same time holding their breath. Or that they even realize what has happened to them. I don't love those odds. Alternatively, the victim could immediately use a whopping dose of Narcan provided that they had any and the ability to self-administer the drug in time. I don't like those odds either. Unless I'm missing something, a few milligrams of fentanyl powder on your face could very well be a death sentence, just like it has been with street drugs.

I know that the anti-opioid zealots we know and love so well absolutely deny any correlation, let alone causation, between the arrival of fentanyl and the crackdown on safer prescription drugs. That's OK. They're entitled to be wrong. Meanwhile, we may have yet another deadly fentanyl-related problem on our hands. No doubt, with more to come.

NOTES;

(1) A group from the Department of Emergency Medicine, Hennepin County Medical Center in Minnesota identified 226 deaths from GHB in the US, Canada, and Britain between 1995-2005. Given the millions of women who were given the drug, it becomes clear that the use of fentanyl to incapacitate victims is far more dangerous.