Health officials are warning about a drug that is 100 times more powerful than fentanyl and has caused deaths in 37 states in recent years.
The drug, called carfentanil, is a derivative of fentanyl designed to tranquilize elephants and is the most powerful commercial opioid on the market.
There were 513 carfentanil overdoses between January 2021 and June 2024, hitting states like Florida and West Virginia the hardest, according to a CDC report released today.
But while the total numbers are low, officials are concerned because the total has increased sevenfold in the past year.
This could threaten the country’s recent decline in drug overdoses.
Carfentanil is available in powder, paper, tablet, patch and spray forms and can be inhaled, ingested or absorbed through the skin.
In powder form, the drug mimics cocaine or heroin, and is often mixed with other illegal drugs such as xylazine or counterfeit pills.
Just 2 milligrams, about one-fiftieth of a pinch of salt, of the drug can be fatal — slowing breathing to dangerous levels, which can lead to brain damage or death.
The CDC report included data from January 2023 to June 2024, showing the number of overdose deaths attributed specifically to carfentanil. Four states did not participate in the analysis
This photo shows the lethal doses for an average adult of various opioids such as heroin, fentanyl and carfentanil. Carfentanil is 100 times more powerful than fentanyl and 10,000 times more powerful than morphine
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CDC officials said, “The recent sharp increase in overdose deaths involving carfentanil, while rare, highlights the ever-changing illicit drug supply and threatens progress in reducing overdose deaths.”
According to the DEA, the drug is 10,000 times more powerful than morphine and 100 times more powerful than fentanyl.
It is unclear where the drugs came from, but the report states that they were likely manufactured illegally and not stolen from legal warehouses.
In a 2021 drug bust in Southern California, police found 21 kilos of the drug in the home of two U.S. residents, Christine Ponce and Andres Jesus Morales.
Before hitting the streets, carfentanil was originally designed in 1974 to treat large mammals such as elephants and bears.
It works on the same systems in the brain as codeine, heroin, and oxycodone, essentially stopping or soothing pain. It’s very addictive.
Fentanyl powders entered the U.S. later than in other countries because they were difficult to mix with black tar heroin, which used to be more common, according to the CDC report.
But as prescription pills and counterfeit pills became more popular in recent decades, it became easier to put these super-potent opioids into supply.
The CDC tracked the total number of overdose deaths during each year and compared the number of deaths caused by illegally manufactured fentanyls (IMF), such as carfentanil. While the overall number of overdoses decreased, they said the number of carfentanil-specific overdoses increased
In 2021, police seized 21 kilos of carfentanil from a couple’s home in Riverside County, California. It was the largest drug bust in the area at the time
Additionally, dealers often mix the products into their offerings to make their wares cheaper, leaving users wanting more, the DEA said.
The CDC report found that seven out of 10 drug overdose deaths in the US in 2023 involved fentanyl or one of its derivatives such as carfentanil.
The report used a national overdose reporting system, which collects data from death certificates, coroner’s reports and toxicology reports to summarize drug overdose deaths. The new report included information from 2021 through 2023 for all overdoses, but specifically tracked carfentanil through the first half of 2024.
Of the 251,089 drug overdoses in the past two years, 74 percent were related to fentanyl or a drug derived from it. In 2023, 63,734 Americans were killed by fentanyl or one of its derivatives.
The report shows that the total number of overdose deaths in 2023 decreased quarter over quarter, as did the total number of illegal fentanyl-derived drugs on the streets.
But at the same time, carfentanil overdoses have increased.
Florida and West Virginia were the only two states with more than 20 deaths from the drug.
They were followed by Illinois, Indiana, Kentucky, Maryland, Michigan, New York and Ohio, which reported 10 to 19 deaths from the drug over an 18-month period.
The CDC report also distinguished overdoses based on different geographic regions. IMFs, the bars in life blue refer to deaths associated with fentanyl or its derivatives
Alexandra Capelouto died after taking fentanyl two days before Christmas in 2019. Alexandra was 19 when she thought it was oxycodone to help her sleep
Furthermore, the CDC report said that if carfentanil continues to spread, “overdose deaths could increase significantly.”
This is particularly concerning because this uptick is substantially different from an outbreak that occurred in 2016, when it appeared to be contained to a few states.
The Drug Enforcement Agency (DEA) recommends that anyone exposed to the drug seek immediate medical attention.
If someone is exposed to the drug, the DEA notes that early symptoms may include drowsiness, disorientation, pinpoint pupillary movement, slowed breathing and clammy skin. At this point they urge the person to call 911.
If left untreated, a person may stop breathing and the lack of oxygen can lead to respiratory failure or serious brain damage.
Professionals or bystanders can use naloxone, an FDA-approved medicinal inhaler, to reverse the overdose and prevent the worst consequences if they act quickly.
Chuck Rosenberg, the acting administrator of the DEA in 2016said of these drugs: ‘We see it on the streets, often disguised as heroin. It’s insanely dangerous.
Synthetic substances such as fentanyl and carfentanil can be fatal. I hope our first responders – and the public – will read and heed our health and safety alert.”