Gray death is a slang term which refers to a potent mixture of

synthetic opioids Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid us ...

, for example benzimidazole opioids or fentanyl analogues, often sold on the street as a proven substance. However, other substances such as stimulants have also been laced with opioids that resulted in

deaths Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...

Etymology

The first batch of gray death had a characteristic gray color.

Detected samples

Samples have been found to contain

heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...

fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine ...

carfentanil Carfentanil or carfentanyl, sold under the brand name Wildnil, is a very potent opioid analgesic which is used in veterinary medicine to anesthetize large animals such as elephants and rhinoceroses. It is typically administered in this context ...

, and the designer drug

U-47700 U-47700, also known as U4, pink heroin, pinky, and pink, is an opioid analgesic drug developed by a team at Upjohn in the 1970s which has around 7.5 times the potency of morphine in animal models. U-47700 is a structural isomer of the earlier o ...

. A mixture of drugs misleadingly called

2C-B 2C-B (4-Bromo-2,5-dimethoxyphenethylamine) is a psychedelic drug of the 2C family. It was first synthesized by Alexander Shulgin in 1974. In Shulgin's book '' PiHKAL'', the dosage range is listed as 12–24 mg. As a recreational drug, 2C-B is so ...

had been laced with fentanyl in

Argentina Argentina (), officially the Argentine Republic ( es, link=no, República Argentina), is a country in the southern half of South America. Argentina covers an area of , making it the second-largest country in South America after Brazil, th ...

Deaths

In February 2022, 24 people in Argentina died after using cocaine cut with

Dangers

As with other illicit narcotics, gray death carries a higher risk of serious adverse effects than prescribed opioids due to the unknown and inconsistent composition of the product. As such, even experienced opioid users risk serious injury or death when taking this drug mixture.

Treatment

Reversing a gray death overdose may require multiple doses of

naloxone Naloxone, sold under the brand names Narcan (4 mg) and Kloxxado (8 mg) among others, is a medication used to reverse or reduce the effects of opioids. It is commonly used to counter decreased breathing in opioid overdose. Effects begin within ...

. By contrast, an overdose from morphine or from high-purity heroin would ordinarily need only one dose. This difficulty is regularly encountered when treating overdoses of high-affinity opioids in the fentanyl chemical family or with

buprenorphine Buprenorphine is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), ...

. The greater

affinity Affinity may refer to: Commerce, finance and law * Affinity (law), kinship by marriage * Affinity analysis, a market research and business management technique * Affinity Credit Union, a Saskatchewan-based credit union * Affinity Equity Partn ...

of these substances for the

μ-opioid receptor The μ-opioid receptors (MOR) are a class of opioid receptors with a high affinity for enkephalins and beta-endorphin, but a low affinity for dynorphins. They are also referred to as μ(''mu'')-opioid peptide (MOP) receptors. The prototypical � ...

impedes the activity of naloxone, which is an antagonist at the receptor. Increasing the dosage of naloxone or its frequency of administration may be required to counteract

respiratory depression Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (''hypo'' meaning "below") to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia ...

History

The substance first appeared in America and was thought to be a unique chemical compound before being identified as a mixture of drugs.

References

External links

* {{Drug use Designer drugs Drug culture English-language slang History of South America Adulteration Issues in ethics