Fentanyl residue may increase overdoses, UCSF doctor says

SAN FRANCISCO (KGO) -- Sidewalks cluttered with mattresses, broken chairs and even a sofa is a common scenario in San Francisco's Tenderloin District.

"Everyday, we get a complaint that the kids can't walk by," yells a police officer as crews begin to remove the items.

Now, there's a different concern on these streets, making sure that the fentanyl that accumulates on little pieces of aluminum foil, the residue, doesn't kill someone.

"This residue remains bio active even though it looks burnt, it's the sugars - the filler if you will - that's burnt, the active product remains, said Dr. Daniel Ciccarone, a UCSF professor of Addiction Medicine.

Using that foil or any smoking apparatus over and over again, may increase the risk of a fatal overdose.

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This could be particularly dangerous to someone who has never tried fentanyl, or a person who has not developed a tolerance for the drug.

When smoked, fentanyl acts differently than heroin.

"The temperature that people are using now to smoke fentanyl, all the heroin would be destroyed, but fentanyl is heat stable, very tough," explained Dr. Ciccarone.

He, along with a team of seven researchers spent three weeks on the streets surveying fentanyl users. They had many questions.

"People sharing pipes, the leftover stuff, what do people do with it, do they collect it, do they share it, do they save it for later," he told us.

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Some fentanyl users revealed that they keep or collect the foil to get high off the residue.

Fentanyl users also told researchers there is a distinction between foil, a pipe and a bong when it comes to delivering a stronger high.

"The bong is the most dangerous. This is rapid and it's a high dose," added Ciccarone.

Users were only surveyed by the research team. No lab work was ever done to determine the potency of the accumulation of the drug.

ABC7 News found people who were willing to show us their equipment.

One man said he uses foil to smoke fentanyl but then switches to a pipe to exclusively smoke meth.

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We asked another now many time he had used one piece of foil.

"I would say, it's been used probably more than 10 times, admitted Fable Idries who frequently smoke fentanyl.

Foil, syringes and other drug paraphernalia are usually included in harm reduction kits, distributed for free by a number of nonprofit organizations as a way to avoid sharing. It has been controversial.

"If smoking is seen as harm reduction then yes, we need clean paraphernalia just like in the days of HIV where we invested syringes exchange," said Dr. Ciccarone.

Idries told us, ironically, some people out here are more concerned about the hypothetical link between aluminum foil and Alzheimer's disease, than overdosing.

However, many of the people who live in these neighborhoods, including children, may have to worry about the litter that may be on their streets, endangering their lives.