Is there really plastic in street drugs?

Opioid use comes with risks, from the potential for physical dependence to the possibility of overdose and death. Recently, public health officials have raised a red flag regarding a new danger: the possibility that illicit opioids may also contain harmful plastics. More specifically, research has found the industrial chemical BTMPS in fentanyl, which on its own is already an extremely dangerous drug¹.

Below, we explain the hazards of BTMPS, why it might be appearing in fentanyl supplies, and how people can stay safe.

A quick background on the BTMPS drug link

BTMPS is an industrial chemical that is typically used as a protective coating on plastics. The name is an abbreviation of bis (2,2,6,6-tetramethyl-4-piperidyl) sebacate, which is the chemical formulation. Normally sold under the brand name Tinuvin 770, BTMPS is applied to plastics as UV ray protection and to keep the plastic materials from breaking down².

BTMPS was first identified in the illicit opioid supply chain in the United States in the cities of Portland, OR, and Philadelphia, PA, in June 2024. This initial discovery inspired researchers at the University of California, Los Angeles David Geffen School of Medicine to start looking into BTMPS in the illicit supply chain more broadly³.

Scientists obtained samples of fentanyl from nine community-based drug-checking programs across U.S. states and territories, including California, Pennsylvania, Delaware, Maryland, Nevada, Washington, and Puerto Rico. One third of fentanyl samples from nine community drug checking programs tested positive³.

Subsequently, the U.S. Drug Enforcement Administration (DEA), in collaboration with the Center for Forensic Science Research and Education’s Novel Psychoactive Substances Discovery program, issued a public health and safety report about the issue. The report revealed that BTMPS had been detected in all regions across the country⁴.

Why is the industrial chemical BTMPS in fentanyl?

BTMPS has no known psychoactive or sedative effects, so likely added on purpose to “cut” the drug”⁵. Cutting involves mixing drugs with other substances, often cheaper fillers or additives, to stretch supply and maximize profits. For example, fentanyl is sometimes cut with a bulking agent, like baking soda⁶. Fentanyl can also be cut into other drugs, which is why people are encouraged to use fentanyl test strips to identify this danger.

Dangers of BTMPS consumption

The National Fire Protection Association has a rating scale used to classify how dangerous a chemical substance is, with zero being the least dangerous and four the most. BTMPS ranks a three on this scale². Exposure to it from medical devices or laboratory equipment has been linked to eye damage, skin irritation, and reproductive defects.

In animal studies, BTMPS can cause serious health issues, including heart damage, eye damage, and sudden death if consumed in high enough doses.

However, the health impacts of BTMPS on humans from ingesting contaminated drugs are not well known. This makes its appearance in drugs like fentanyl extremely concerning⁷

 Local health departments have provided anecdotal reports of the possible consequences of human consumption in the context of illicit drug use, including the following⁸:

• Blurred vision
• Conjunctivitis (pink eye)
• Tinnitus (ringing in the ears)
• Nausea
• When injected, localized burning and skin irritation at the site of injection
• When smoked, throat irritation, cough, and coughing up blood

BTMPS might also make it harder to treat opioid overdose. The chemical has calcium channel blocking properties, which interfere with the body's ability to maintain steady blood pressure and regulate heartbeat². Overdoses involving calcium channel blockers are often challenging to treat because doctors must administer extra medications to increase blood pressure and heart rate, which can be difficult to stabilize. For patients taking prescribed calcium channel blockers for conditions like high blood pressure or heart disease, the risk is even greater².

Protecting yourself and others against BTMPS exposure

Although it's impossible to identify the industrial chemical BTMPS in fentanyl by sight or smell alone, it's been suggested that the drug can have a chemical-like or fishy smell⁹. However, the only way to know for sure if fentanyl or another illicit substance contains the chemical is to have it tested through a drug-checking program designed to protect public health.

Beyond using drug-checking services where available, other harm reduction strategies that can be used to stay safer in the fentanyl crisis include the following¹⁰:

• Avoiding the use of more than one drug at a time
• Taking only a small amount of a drug upon first use
• Having another person present when using drugs
• Keeping naloxone (Narcan®) on hand when using illicit drugs
• Using fentanyl test strips

Ophelia is committed to ongoing research and public health awareness. We also have a dedicated clinical care team available to address individuals’ needs.

For patients struggling with opioid use disorder (OUD), one option is medications for addiction treatment (MAT). Considered the gold standard of care for OUD, MAT takes a whole-person approach to treatment, combining the use of medications with counseling and behavioral therapies.

Ophelia removes typical geographic, logistical, and financial barriers to MAT access by making it available virtually. You can meet with your clinical care team and determine whether a prescription for Suboxone, a medication used in MAT programs, is right for you. If you’re a good candidate, the prescription is sent to your local pharmacy for pickup. The Ophelia team continues to provide ongoing medical support, seven days a week.