This month, Ryan Perry, a Consultant at IB Consultancy, interviewed Mr. David DiGregorio, Director of Hazardous Materials (HazMat) Emergency Response for the Massachusetts Department of Fire Services. His interview brought forth knowledge from his years of experience as part of the HazMat Response Team for the state of Massachusetts and in the current fight against the Fentanyl epidemic that has bombarded the state and country at large. Mr. DiGregorio’s gives a great insight to the issue, the work that is being done to combat the problem, and the outlook for the future.
David DiGregorio currently serves as the Director of the Massachusetts Department of Fire Services Hazardous Materials Emergency Response Division. He retired from the US Army and Massachusetts Army National Guard after 32 years of service in 2014, and served as the Deputy Director of the division from September 2014 through January 2017. He has earned a MS degree in Emergency Management from the Massachusetts Maritime Academy as well as a BS degree and MS degree in Physician Assistant Studies from the University of Nebraska Medical Center. He currently serves on the faculty of the Massachusetts Maritime Academy as a capstone advisor for the graduate level Emergency Management course. David is married with 3 children and resides in Hopkinton, MA.
When did the problem of Fentanyl become so prevalent in the State of Massachusetts?
In 2012, up until 2014, a major substance problem Massachusetts was facing was heroin overdose. Then, in 2014, we started to see a big rise in the number of overdoses involving Fentanyl, making up 80% of all overdoses in the state by the end of 2017. The greatest cause for such a rise in the prevalence of fentanyl? Money.
Recently, fentanyl mixed with cocaine has surpassed fentanyl and heroin exhibits in Massachusetts. Dealers are using Fentanyl as a cutting agent in order to increase their profit margin as high as possible. The profit margin on a kilo of heroin is around $80,000 while the profit margin on a kilo of fentanyl is anywhere from $1.2-1.8 million.
Fentanyl is being cut with numerous prescription drugs and is being sold to those seeking to get high quite often, in Tylenol for example. Often times, dealers are disguising fentanyl as other more common medications such as oxycodone and Xanax. Dealers that are using fentanyl are not only using it as a cutting agent for dangerous drugs such as cocaine and heroin, but mixing it at lethal doses. Instead of the careful and highly precise science behind mixing prescription medications created by experienced Pharmacists, fentanyl is being mixed by eye-ball amounts in a blender with other dangerous substances, with no care to assure a homogeneous or equal amount in each dose.
Who is being affected the most by the fentanyl epidemic?
With heroin, you would see primarily lower socio-economic populations being affected at a rate much higher than the rest of the population. Fentanyl, however, has not discriminated. Rural, urban, upper-class, middle-class, lower-class – the fentanyl epidemic is attacking all segments of society.
An addiction to fentanyl, like most opioids, often begins with prescription drugs. When people run out of their prescriptions, they go to the streets for the same pain relief and high that they got from the prescription drugs, but as I mentioned previously this is much more dangerous. There are people who are taking drugs laced with deadly amounts of fentanyl knowingly, but there are also those who are taking it unknowingly and many times learning the hardest way possible.
As Director of the Massachusetts Department of Fire Services Hazardous Materials Emergency Response Division, what is your role in combatting the fentanyl epidemic?
As Director, I am in charge of a statewide system consisting of six different regional HazMat response units within the Commonwealth of Massachusetts. When fire and even police departments come across an overdose, the HazMat teams are often dispatched in order to determine the makeup of the substance at the scene. We can also mitigate the threat prior to the clean-up team entering the scene in order to ensure that other individuals are not affected by the substance found.
What equipment specifically do you use in response to a fentanyl incident?
When it comes to identifying a substance at the scene of an overdose, there are three different categories of analytical techniques used to determine what the substance is as classified by the Scientific Working Group for the Analysis of Seized Drugs (SWGDRUG):
- Category A: Mass Spectrometry, Raman, Fourier-Transform InfraRed (FTIR)
- Category B: Gas Chromatography, Ion Mobility Spectrometry
- Category C: Lateral Flow Assay, Colorimetric technology
The units used are listed from most complex and precise to the least complex. However, all of them have their advantages and disadvantages, and together they provide an accurate detection of a substance(s).
What is being done to mitigate the threat in the long term?
The state of Massachusetts is attacking both the supply and demand side of the fentanyl issue. On the supply side, lawmakers are creating harsher punishments for dealers. On the demand side, lawmakers are working on programs to prevent and defeat the addiction individuals face. A huge issue for lawmakers is that not all of the analogs of fentanyl are illegal, so it can be difficult to prosecute in some cases. There are also thousands of possible analogs of fentanyl. In my work I have seen around eight different analogs. Once one analog is made illegal, another rises to the surface.
Governor Baker, for his part, has given proper attention to this issue from the start of the epidemic and has worked very hard to pass legislation addressing both sides of the issue. Unfortunately, although any legislation will be helpful, this issue will take a long time to defeat and I cannot imagine it disappearing within the next couple of years.
Going forward, what needs to be done?
The threat of the use of fentanyl as a WMD is real and should be given proper attention by lawmakers, law enforcement and the defense sector at large. The smuggling of fentanyl through Canada and Mexico is also a big issue due to the difficulties with import security. Lastly, fentanyl is the only analog that is associated with legal human use. Carfentanil is only used as a tranquilizing agent for large animals such as elephants and bison. Other strains have no human use and should be completely banned, so that law enforcement can properly tackle this issue head on.