What is Carfentanil? The Latest Emerging Opiate Drug Threat

America’s latest emerging opiate drug threat has a funny name, “carfentanil,” but there is little about this new danger on the streets that warrants laughter. The Drug Enforcement Administration (DEA) says it is “crazy dangerous” and nothing to be trifled with — even by professional first responders in protective gear, but what is carfentanil?

Carfentanil (also spelled “carfentanyl”) is a synthetic drug that is closely related to the prescription painkiller, fentanyl, only 100 times stronger. By comparison, fentanyl itself is 100 times more potent than heroin. But carfentanil, unlike fentanyl, was never intended for human use. Sold under the brand name “Wildnil,” the drug is legally used only as a tranquilizer for elephants and other very large animals.

The fact that the carfentanil drug is the latest contributor to overdose fatalities in America’s runaway opiate epidemic is nothing short of alarming.The drug reportedly has been surfacing in communities across the country, most recently in Nassau County, New York. Often the drug is used to lace batches of heroin as a cheaper, easier substitute for drug smugglers, and because it is virtually indistinguishable from heroin in its powder form, it ends up in the hands of unknowing drug users.

This article will educate readers on everything they need to know about carfentanil and its dangers, including who may be more at risk of coming into contact with the frightening drug.

The Dangers of Carfentanil – What to Know

In September 2016 the DEA alerted the public and law enforcement nationwide about the dangers of carfentanil, a drug with a potency that is 10,000 times greater than that of morphine. The carfentanil drug’s lethal dose range for humans is unknown, but even a few of the tiniest granules, either absorbed through the skin or accidentally inhaled as airborne powder, can prove life-threatening, according to the same DEA alert mentioned above.

“This stuff is so deadly, you could die before you get high,” one source from the Wayne County, Michigan medical examiner’s office told the Detroit Free Press. (Michigan is one of a number of states in the Midwest to have seen recent outbreaks of carfentanil-related deaths. Ohio and Indiana were hit especially hard in August 2016, according to a drug threat warning posted by the National Institute on Drug Abuse.)

That extremely high level of potency at least rules out the danger of developing an “addiction” to carfentanil: you can’t really get hooked to something that is so “crazy dangerous” it can kill you upon first contact, even in the most minute of quantities. The real and more imminent danger, however, is the fact that carfentanil is on the streets in the first place. That means it can fall into the hands of addicts looking for the next more intense high.

“There’s lots of misinformation on the street,” Dr. Edward Zawadskzi explained. Dr. Zawadzski is the medical director at Beach House Center for Recovery. “You tell an addict that this is 100 times more potent than fentanyl, and they’ll say ‘sign me up.’”

Addicts are not in their right mind when they are chasing the next ultimate high, after all. By way of illustration, Dr. Zawadzski described the lengths to which fentanyl addicts in his care once went to dull their pain. Fentanyl often comes in the form of a patch. Dr. Zawadzski has seen those with severe addiction to the drug use multiple patches at the same time. In some cases, they will even lick the patches — or worse, put the patches in their anus, since the rectal area “absorbs things almost immediately.” People whose opiate addiction has driven them to this level of desperation are naturally going to be more susceptible to the offer of a high like they’ve never before experienced.

In South Florida, where prescription painkillers — and increasingly, fentanyl — are still the rage for people with substance use disorders, Dr. Zawadzski suspects he has treated a couple of people who may have dabbled in carfentanil. (At best he can only speculate here … The bulk of the clients he sees have addictions to Oxycontin and Percocet.)

The reason carfentanil and fentanyl can kill you is because they (like other opiates) cause respiratory depression. The more potent the opiate is, the faster the onset of that depression will be — and the more severe.

What makes fentanyl compounds like carfentanil deadlier than heroin is their different chemical structure. All opiates bind to opioid receptors in the brain, producing morphine as a byproduct. The difference, as explained in a segment of PBS Newshour, is that fentanyl compounds like carfentanil more easily pass through fatty tissue in the brain, with the result that they get to those opioid receptors much more quickly than heroin can. And fentanyl, in the words of the same report, “hugs the receptor so tightly that a tiny amount is enough to start the molecular chain of events that instigates opioids’ effects on the body.”

Side Effects of Fentanyl Compounds, Like Carfentanil

Respiratory depression is only one of a number of adverse effects of fentanyl compounds, like carfentanil. Side effects can include:

• Nausea
• Vomiting
• Constipation
• Altered heart rate
• Slowed breathing rate
• Confusion
• Hallucinations
• Weakness
• Sweating
• Itchy skin
• Constricted pupils
• Seizures

Still other fentanyl-related effects are indications of a life-threatening overdose. They include:

• Difficulty swallowing
• Extreme fatigue
• Dizziness and fainting
• Respiratory and/or cardiac arrest
• Non-responsiveness to painful stimuli
• Severe confusion
• “Obtundation” (altered level of consciousness)

The fact that fentanyl and carfentanil are significantly more potent than even heroin means that in cases of overdose, more of the emergency antidote medication, naloxone, will be necessary to revive the victim.