Just when you thought the current wave of opioid-based drugs couldn’t get any worse, or more dangerous, along comes one little number that is so powerful , even those who think they’ve seen it all are alarmed and confounded. We’re talking about carfentanil, which is an analog of the synthetic opioid analgesic fentanyl, and it’s extremely potent. In fact, researchers estimate that carfentanil is 10,000 times stronger than heroine and morphine, and 100 times more powerful than fentanyl, making it the most potent commercially used opioid anywhere.
Originally used to sedate elephants and other large animals, carfentanil is suspected in an alarming upsurge of overdoses in several states, where authorities say they’ve found it mixed with or passed off as heroin. The appearance of carfentanil adds another twist to the fight against opioid painkillers in a country already awash in heroin and fentanyl cases. Although the source of carfentanil is difficult to track down, the U.S. Drug Enforcement Administration believes it is primarily manufactured in China and Mexico, and shipped in to or carried into the United States. It’s also believed to be so dangerous that even touching the residue against your skin can be enough to cause a severe, life-threatening overdose.
It’s So Lethal That First Responders Wear a Hazmat Suit When Intervening
Carfentanil is so powerful that zoo veterinarians typically wear a face shield, gloves and other protective gear — “just a little bit short of a hazmat suit — when preparing the medicine to sedate animals because even one drop splattered into a person’s eye or nose could be fatal”, said Dr. Rob Hilsenroth, Executive Director of the American Association of Zoo Veterinarians. Officials say drugs used for animals have showed up in street drugs before, but carfentanil is so new on the investigative scene that most state’s crime labs don’t even have a standard for comparing samples.
In some suspected carfentanil cases, emergency responders have had to administer multiple doses of the overdose antidote naloxone — often known by the brand name Narcan — to save people, but even the antidote might not be enough.
One of the factors making carfentanil so dangerous stems from the fact that its production process is not regulated. Synthetic opioids with clinical applications, such as prescription pain pills, are synthesized in a tightly controlled environment. Each pill contains the same amount of the active ingredient, meaning that a patient knows how much he or she is taking. This is not the case for synthetic carfentanil. The drug is synthesized in illicit laboratories in China, which are not regulated for safety or quality. That means that the amount of active opioids in one batch of carfentanil may vary widely. For drug dealers adding carfentanil to heroin or other opioid drugs, this means that the dosage cannot be controlled.
Finally, carfentanil is particularly dangerous because many opioid users do not even realize they are taking the drug. Dealers have been mixing carfentanil into heroin in an attempt to make it more powerful. Unfortunately, this can cause heroin users to inadvertently take the drug without realizing its true potency.
Carfentanil and Heroin Overdose: Where to Go From Here
Thus far, carfentanil has popped up in several municipalities across North America. In Akron, Ohio, 250 people overdosed on heroin during a three-week period in July. More than 20 of these overdoses were fatal. The spike in heroin overdoses was linked to a batch of heroin that had been laced with carfentanil. So what can be done about the rise of carfentanil in the United States and Canada? Public health officials stress the need to tackle the larger problem of opioid abuse in this country. Expanding access to treatment resources, improving education about the consequences of opioid abuse, increasing the availability of opioid antagonists such as Narcan, and boosting public awareness about the scope of the heroin overdose problem are important steps to take. Only with concerted public effort can we fight back against carfentanil and other synthetic opioids.
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