TED Talk:The Designs Of Despair (Part 1)

Added: 2026-06-01

[00:00:00]Welcome to our TED Talk. This is going to be episode one because this one, unfortunately, is going to take several episodes to get you the whole story.

[00:00:11]Today, we're going to just go over a little vocabulary and we're going to go over the basics in case you missed our fentanyl TED Talk. I'm not going to go deep diving into fetty. We've done it several times.

[00:00:24]I'm sure y'all remember fetty.

[00:00:28]Believe it or not, fentanyl is starting to decrease in the United States. As I've always told you guys, things travel east to west. From fashion to music to all trends [snorts] and drugs.

[00:00:45]East to west.

[00:00:48]So, when you want to know what's going on currently in the United States, generally, you're going to look at New York, Pennsylvania, Massachusetts, Ohio.

[00:01:01]Those seem to be the big hotbeds. And then, you drop down to Tennessee and Kentucky.

[00:01:08]You know, I don't know. I always used to think Miami was the big place because I guess I grew up in the Miami Vice era and it just seemed like everything came in through Miami, right? Well, it probably did, but the government also saw that trend and ixnayed that one.

[00:01:27]So, we know how fetty entered. We know how xylazine or tranq entered via Puerto Rico. Puerto Ricans being brought into rehab centers in Philadelphia. Their families moving up to Philadelphia to be supportive of them and the drug followed because the drug is manufactured in Puerto Rico.

[00:01:54]If you're new around here, my first degree is in animal health science. So, I was a licensed AHT in LA County as well as up here for both small and large animals. And my internships were done at Santa Anita Park, Hollywood Park, um racehorses, and then chemo and radiation.

[00:02:20]I left the animal health field and went into fire science for 20 years in fire rescue, then as a tech in ER, ICU, and spent 13 years total there before retiring.

[00:02:40]Currently, I am a patient advocate for newly diagnosed patients of rare and ultra-rare diseases.

[00:02:50]I help them navigate their diagnosis and resume living.

[00:02:56]If they need help with insurances, pharmacies, etc. If they don't understand their doctors, they don't understand labs, I help them with things like that. So, I have let my licenses go because I'm one of those people that flips and just likes to learn, so I've kept up with stuff, but I'm not working. Do I miss it? Yes, every single day.

[00:03:22]Do I argue with myself about getting back into it? Of course, I do every single day.

[00:03:29]But, I don't have time, and I have people who actually need me, and I need to just focus on them.

[00:03:38]But, I see a lot of misinformation, and I see it nowadays in very shocking places. The news.

[00:03:46]I caught our local news last week getting the whole hunk of a virus fiasco wrong on the morning news. Driving to Hubs' office and I'm saying to him, "That's not how it works." And he's yelling at the car and saying the same thing. "These buffoons don't even look up stuff and it's shocking to me and it scares me."

[00:04:19]Our whole health care system scares me anymore. I have seen nurses graduating with less brains than most of the medics I worked with and that's frightening. That's frightening. You have a bigger scope.

[00:04:35]You have a bigger liability in your hands. You have patients' lives in your hands and yet I'm sitting listening to a class, a nursing class, doing rounds, talking about how they could pay extra money to the school and graduate earlier.

[00:04:57]Mi- missing classes.

[00:04:59]That frightens me.

[00:05:01]So, if I can impart some information to you guys, I feel like at least I know you guys have the wherewithal to deal with things in your everyday life.

[00:05:17]You may not be a drug abuser. You may not use something purchased on the street.

[00:05:24]Odds are you know somebody who does.

[00:05:29]You may not know they are, but they are.

[00:05:32]And so, to have the information in your brain, you'll know how to handle an emergency if it arises.

[00:05:41]I also see this dichotomy.

[00:05:44]There are people who quote and quote dumb information down and lose the point, lose the information completely trying to get information to the masses.

[00:05:59]And on the flip side of that coin, I see physicians who are giving awesome lectures, but if you don't know what they're talking about and have had no medical training, you're going to be lost. So that information is going to be wasted.

[00:06:20]I don't like people saying dummying down. It's not dummying anything down.

[00:06:24]It's putting it into vocabulary that is a vernacular. Everybody is speaking it.

[00:06:33]And just in case they don't know what something means and don't have the time to look it up, I will tell you.

[00:06:44]Humans by nature, I don't believe are dumb, as they say.

[00:06:50]I think most people have a thirst for knowledge.

[00:06:55]It's just if they see it useful or not.

[00:07:01]And unfortunately in our day and age, drugs are useful to everybody, even if you don't have them around you now, you just don't realize they're all around you.

[00:07:15]I have watched videos where dealers are talking about the people purchasing their fentanyl, purchasing their meth, purchasing whatever.

[00:07:27]And they are judges, attorneys, doctors, nurses, police officers, pilots, you name it, every occupation that you can think of.

[00:07:43]They're buying it on the street.

[00:07:46]So, while fentanyl use is decreasing back east, it's not really good news.

[00:07:56]For every substance that drops out of fashion, so to speak, one or more will take its place.

[00:08:09]The people who are using those substances drive the trend.

[00:08:15]So, what becomes popular is driven by those purchasing drugs on the street.

[00:08:25]Fentanyl is dropping out of fashion and popularity because there's a lot of tests for it.

[00:08:34]There's a lot of crackdown on importation.

[00:08:38]It's harder to get.

[00:08:41]But, the problem is what's taking its place is even stronger.

[00:08:49]These are designer drugs, meaning that they just are manipulated enough.

[00:08:57]One molecule difference makes it stronger, but undetectable by the government, by law enforcement.

[00:09:12]The problem is that means it's undetectable by the medical profession.

[00:09:17]So, if you overdose, those doctors don't know what they're dealing with.

[00:09:23]Let's get into one little vocabulary lesson that I think confuses a lot of people. And that is what is an agonist, what's an antagonist, and what's a combination? I like to use the key analogy and I think a lot of people do whenever I teach about what the differences are.

[00:09:48]Don't laugh at my drawing.

[00:09:50]So, here's my drawing.

[00:09:51]The blue key on top has the pointy end and it's going for a mu receptor. We have three pain receptors, the opioid receptor, the delta and the mu. The mu, along with dopamine and a whole bunch of fun chemical combinations going on in our body, the mu receptor is the one that makes you feel great.

[00:10:17]Fentanyl binds to a mu receptor. So, that little blue key fits perfectly into the mu.

[00:10:27]That's an agonist. An agonist binds. So, if you have a drug that isn't agonist, it binds to its receptor.

[00:10:40]The green key you can see it's pointed upwards.

[00:10:47]So, it's blocking.

[00:10:49]It's not pointed down.

[00:10:52]That's an antagonist.

[00:10:54]Antagonists or blockers block a specific receptor.

[00:11:00]Many people are on different blockers, calcium channel blockers for your heart.

[00:11:06]They block that channel. That's an antagonist.

[00:11:11]Narcan is the antagonist for fentanyl.

[00:11:18]And then you have this cool little purple and green key that has both. That is called an agonist antagonist.

[00:11:27]Yeah, kind of simple, I know.

[00:11:29]But, what were they supposed to call it?

[00:11:31]The combo? Sounds like a hamburger.

[00:11:34]It acts as both.

[00:11:37]Kind of says it in the name.

[00:11:40]Buprenorphine is the perfect example. It does bind to the mu receptor, but it also contains a little bit of narcan in it. So, it blocks certain aspects of that mu receptor, namely decreased respirations.

[00:12:01]So, buprenorphine is actually starting to get used in like convalescent hospitals for your little oldsters who have bad bone aches and pains, and they deserve to feel okay, but you don't want them breathing less.

[00:12:24]So, you give them bupre no- norphine because they get the pain relief, but at the same time, there's not enough nurses in most con homes to watch all the little oldsters, and you don't have to worry about them stopping breathing.

[00:12:40]So, let's just go over some simple stuff. We have our opioid analogs.

[00:12:46]They're divided into three categories.

[00:12:48]An opioid analog is a synthetic or semi-synthetic product that is chemically manipulated to mimic a natural opioid like heroin, opium.

[00:13:05]So, you have your fentanyl analogs.

[00:13:09]You have your nitazenes, and you have your U series. The U series being those compounds that have names that go U-26G-1- It They're like a a mile long.

[00:13:28]We're going to be dealing with nitazenes for the most part during the next week.

[00:13:35]So, to catch everyone that missed the first TED Talks, fentanyl was developed in 1959 by Dr. Paul Janssen.

[00:13:45]Fun fact, in the '60s and '70s, Dr. Janssen was cranking out things that are now used illicitly like popcorn. He's like the super genius drug daddy. If you're new around here, my first degree was in animal health science. So, from Pierce College. So, I did animal nursing. I did large animal, small animal.

[00:14:12]I did an internship at the racetrack, Hollywood Park in Santa Anita, and then went into radiation and chemo, which was actually brand new.

[00:14:25]I worked as a licensed AHT in LA County and then up here before going into fire science and human medicine and going 20 years in fire rescue and 13 years in an acute care facility doing medic tech work, uh 12 years in the ER and a year and a half in ICU and all other critical care, CVICU, very rarely CCU. I um as a tele tech when needed.

[00:14:56]I tell you this because carfentanil is an analog of fentanyl, so it would fall into this first class, fentanyl analogs.

[00:15:06]Carfentanil we used to use on large animals, and my partner did time working in the LA County Zoo, and for large large animals, tigers, bears, elephants, things like that, they would use it a lot more. We used it with horses.

[00:15:27]Um it is 10,000 times stronger than morphine.

[00:15:32]And it is 100 times stronger than fentanyl.

[00:15:37]An animal that size can handle it. A human cannot.

[00:15:43]Do you think that stops people? Hell no.

[00:15:46]People are using it in small quantities.

[00:15:49]The problem is people buying on the street. You have to really trust your dealer. And besides that, you have to trust where your dealer is buying his stuff from.

[00:16:03]They may not even know. That person may switch. And there's people above that chain. So you really don't know. Even if you trust your dealer, you really have no clue what you're getting.

[00:16:16]So all they do is manipulate one molecule, one bind in the molecule, just move the little shapes around.

[00:16:29]And why? Not only is it stronger, it avoids detection.

[00:16:36]There's no testing.

[00:16:38]So designer drugs are the thing of the future. And unfortunately, that future is here.

[00:16:45]During the fetanyl talk, I told the story about how we found out that fetanyl was being hit on the street so much. It was like 2016 or 2017.

[00:16:59]And I found an article in the San Francisco Examiner.

[00:17:04]And this investigative reporter was talking about these fetanyl cases coming up in San Francisco.

[00:17:14]And so they called China. They called six different pharmacies they found on the internet selling fentanyl.

[00:17:26]And all these pharmacies in China, you could just buy it cheap and they would ship it to you.

[00:17:34]And to avoid customs, they would break the packages up. There was only one pharmacy that wouldn't sell it to the reporter.

[00:17:44]And they actually that pharmacist FaceTimed the reporter.

[00:17:51]And it was because their manufacturing pharmacist was pregnant and they wouldn't allow her to work with the fentanyl. And so they said, "We're sorry, we can't sell it right now." I never forgot that article. I read it out loud to hubs and we just were like awestruck. You've got to be kidding me.

[00:18:12]What's scary is all these designer drugs are easily purchased and not on the super scary dark web or anything like that. Just right there on Google it.

[00:18:24]Uh there's people on Reddit that will tell you.

[00:18:28]I found in PubMed an entire study based on Reddit.

[00:18:34]Believe it or not.

[00:18:36]Because Reddit has all these different subs that are reviewers. People take substances, some new designer compound they'll give the name, they'll give how they found it, how it came to them.

[00:18:53]They'll show pictures.

[00:18:55]And then they'll talk about the effect they achieved with this substance. And it's like a review. It's the same thing as a chicken wing review.

[00:19:07]So, a bunch of doctors got together and went through all these Reddit subs of analogs.

[00:19:16]And they actually base studies on it cuz we're going to be talking about that.

[00:19:21]But today we're just laying the groundwork. So, agencies classified drugs as new psychoactive substances.

[00:19:33]And you know how the government is, they love their acronyms. So, NPS.

[00:19:39]There it is, the NPS, new psychoactive substances.

[00:19:47]They have to meet three criteria to be classified. The first one is its origin.

[00:19:53]Is it from a plant like heroin?

[00:19:57]Is it semi-synthetic or is it fully synthetic?

[00:20:02]The second one is its chemical structure because every single one of these designer drugs or analogs has its own unique structure.

[00:20:14]And third, its psychotropic effects. How does it make you feel?

[00:20:21]Each and every person is recorded what their feelings were, their symptoms, anything.

[00:20:32]From that, the NPS has four main categories.

[00:20:38]One is your synthetic cannabinoids. I hate that word. I don't know why. Maybe it's because English is my second language.

[00:20:48]It's really hard for me.

[00:20:51]So is symmetry.

[00:20:53]Two, psychostimulants.

[00:20:56]So your These are all things that are mimicking. So you have your drugs that are synthetic that mimic marijuana.

[00:21:06]Two, the psychostimulants mimic methamphetamines, any kind of stimulant. Three, your hallucinogens, so anything simulating or mimicking LSD.

[00:21:21]And four are your depressants.

[00:21:24]Ding, ding, ding. Of that, number four is what we want. Those are any substance mimicking a CNS depressant such as an opiate.

[00:21:37]So, number four, there's a subcategory and they're called new synthetic opioids. And of course, we have an acronym, NSO.

[00:21:49]NSOs, out of all four of these classifications, categories, NSOs are the fastest growing.

[00:22:01]So, your non your new synthetic opioids are the fastest growing category of drugs in the world.

[00:22:15]So, the NSOs are classified in two ways.

[00:22:21]Fentanyl and its analogs and your non-fentanyl structured compounds.

[00:22:32]No, they haven't found an acronym that I've seen so far.

[00:22:37]Of these non-fentanyl structured compounds, nitazines are the biggest.

[00:22:46]So, I know I had to write small, but there you go. If you want to screenshot it, this is going to be the basis of what we're going to talk about. We're going to get into nitazines. And I know I promised you a TED Talk last year, late last year on nitazenes. And I am sorry I did not do it. You know, life life life and tiny critters.

[00:23:10]Um if y'all would stop getting sick, I'd appreciate it.

[00:23:15]I'm still waiting for the doctor. She's supposed to call me on him because we sent his poop sample off to Sacramento.

[00:23:22]So, uh I was supposed to hear on Tuesday and never heard, so I called her.

[00:23:27]She was in surgery, so I'm waiting.

[00:23:32]So, we're going to be talking in the next few days all about nitazenes because let me tell you something, the more I read and the more I am still reading, the crazier and scarier it's getting.

[00:23:46]These things are popping up in weed, in vapes.

[00:23:52]I'm not joking you. There was a death of somebody. I will show you the report of somebody instantly OD'd, hit the vape, and it was in the canister.

[00:24:05]Nitazenes.

[00:24:08]It makes me worried because these things are sealed. They look like they come from just a vape company. They're sealed. They're in the little sealed bag. They're sealed in the box.

[00:24:20]You're buying it from a legitimate store.

[00:24:24]Hubs saw that and he was like, "You need to quit." I'm like, "You're not kidding."

[00:24:30]They're putting it in virtually everything.

[00:24:33]People are buying Xanies on the street from someone they've trusted for years.

[00:24:42]And it turns out it's got nitazenes in it.

[00:24:45]And it's not just one nitazene. There's a bunch of them.

[00:24:50]It's simply a classification of drugs.

[00:24:53]I'm literally going to have to buy more whiteboards just to fit them all in.

[00:24:58]But, I think it's really important that we have this talk because these things are creeping into everybody's life, whether they want want it around or not.

[00:25:11]It's to the point that when I go around the complex and I pick up stuff like the kids drop, you know how little kids are. We've got some 8-year-olds that get paid a dollar if they take trash. They'll go around to people's houses and ask, "Can I take your trash for a dollar?"

[00:25:31]Yes, Milo.

[00:25:34]And you know, sometimes things flutter out of their bags because they're kids.

[00:25:39]They're little tiny kids. Sometimes they try and throw it in the big dipsy dumpster and the trash goes falling everywhere and I have to go out and pick it up. Do you know the hubs and I now go around with gloves?

[00:25:53]I go around with gloves just picking up scraps of paper, paper towels, dryer sheets. I don't know what the [ __ ] is on it.

[00:26:03]I don't touch anything without gloves and that's sad. That's what our world is coming to.

[00:26:11]I want you to see this. This was from 2017 and it was a drug report. I It was like, you know, a medical publication I found that was so sad.

[00:26:25]This lady almost died.

[00:26:27]And it's talking about fentanyl and fentanyl analogs and back in 2013, 14 and it's talking about how awful it is.

[00:26:37]Since 2008, poisonings have been the leading cause of injury death in the United States with the majority of these cases caused by opiate analgesics.

[00:26:48]As the use and misuse of prescription opioid analgesics has increased, so have outbreaks of morbidity and mortality from synthetic opioids.

[00:26:59]Recent cases in California were attributed to pills with the street name Norco containing fentanyl and various amounts of acetaminophen and hydrocodone.

[00:27:10]From March to April 2016, 12 fentanyl-related fatalities and 40 additional cases of toxicity were reported in Sacramento and Yolo counties in Northern California because of different Norco pills containing fentanyl with and without hydrocodone.

[00:27:30]Additional cases were identified in the San Francisco Bay Area.

[00:27:35]One pill with an M367 imprint, which is what Norco comes with, was analyzed in the San Francisco outbreak and contained acetaminophen, fentanyl, promethazine, and cocaine.

[00:27:50]That's insane.

[00:27:52]Patient specimens from these cases also contained hydrocodone. Although the pills in the California outbreak are being called Norco on the street, they may or may not contain the hydrocodone and acetaminophen found in brain brand name Norco pills.

[00:28:11]Now, remember this is 2017 that this was published. Many novel psychoactive substances are produced in China and then enter the US market for pill production and sale. So, it's the powder coming in, then pressed into the pills here. Sometimes with brand names.

[00:28:31]I've seen Xannies, the Norcos, Tylenol 3. You name it, it's out there.

[00:28:38]Since more than 100 psychoactive substances, including six fentanyl analogs, were banned by China on October 1st, 2015. Novel synthetic opioids such as U-47700 and W-18 have entered the market replacing more established and outlawed drugs. Initially, these novel synthetic drugs are not scheduled as controlled substances for months until the DEA has enough abuse and overdose death cases to warrant action.

[00:29:18]So, the government can't outlaw them until they have so many cases.

[00:29:26]And that means people have to die.

[00:29:29]And labs have to find these substances.

[00:29:34]That's what's scary. And they're talking about six fentanyl analogs banned in China in 2015. There are thousands that they've manipulated.

[00:29:49]This was the case of this woman. A 41-year-old woman presented to the ED for a depressed level of consciousness.

[00:29:56]Staff carried her out of a colleague's vehicle because they were carpooling to work when she became unresponsive. She had pinpoint pupils, was minimally responsive to a sternal rub. 2 minutes after arrival, she received naloxone, Narcan, one dose intravenously, after which she woke up and was able to answer questions.

[00:30:23]2017.

[00:30:26]It has exponentially increased.

[00:30:30]I don't think I can emphasize how important these TED Talks are going to be.

[00:30:38]We're going to talk about three specific compounds.

[00:30:45]And I really think they're going to become household names very shortly.

[00:30:50]The third one, I'm still reading up on.

[00:30:53]I've never dealt with it in a street form. I didn't even know people requested this [ __ ] okay? But then again, I never thought anyone would use xylazine.

[00:31:05]So, y'all get ready.

[00:31:07]I'm going to try and make it as layman-friendly, but at the same time as information-packed as I can.

[00:31:19]Battie, you'll be there? I'll be there.

[00:31:24]So, I hope you're going to be there, too.

[00:31:27]Milo will be here.

[00:31:29]Don't worry.

[00:31:30]Does he ever leave?