The American heroin epidemic has become more dangerous, as reports of heroin laced with carfentanil are being reported throughout the country.
Carfentanil is the most potent opioid used commercially, 10,000 times stronger than morphine. It is a version or analogue of fentanyl, the painkiller that most recently made headlines with its role in the death of pop star Prince.
Carfentanil can slow breathing significantly. It’s not approved for human use but is used commercially to sedate large animals, such as elephants. About 2 milligrams can knock out a nearly 2,000-pound African elephant.
Many users may not know they are even taking the drug, officials have said, as dealers are cutting heroin with fentanyl analogues to give it a boost and stretch their supply.
Its potency is deadly, and it’s causing concern for those fighting the heroin epidemic, as recent overdose outbreaks in Ohio, Indiana and Florida have been linked to the drug.
Public health warnings
In July, officials in Hamilton County, Ohio, issued a public health warning (PDF) after seeing 35 overdoses, including six deaths, in a three-day period.
On Tuesday night, Hamilton County Heroin Task Force Director Tom Synan said, emergency crews responded to at least 20 non-fatal heroin overdoses on the west side of Cincinnati. Those followed a weekend in which there were at least 30 heroin overdoses in the same county.
Hamilton County usually sees about 25 overdoses in an average week, so these numbers represent a huge increase.
More than half of the overdoses Tuesday night happened within a 30-minute time frame, according to Synan. Officials think the large number and short time frame may be connected to carfentanil.
Most of the weekend’s heroin overdoses were laced with the tranquilizer, according to Synan. There were no deaths so far in the recent outbreaks, he said, and that may be because first responders administered naloxone intravenously. Naloxone reverses the effects of opioids, like heroin.
Across the state line in Jennings County, Indiana, there were 11 heroin overdoses during the same time period on Tuesday, according to Sgt. Stephen Wheeles of the Indiana State Police.
It is not clear whether the Indiana and Ohio overdoses are connected, but officials are investigating the possibility.
This month, a seizure of carfentanil in Manatee County, Florida, coincided with an increase in overdose deaths there.
Little data to track the drug
The Drug Enforcement Administration does not track carfentanil cases separately. Most states flag a handful of fentanyl analogues in postmortem testing, but very few labs across the country are equipped to test for it or have any reference materials to help identify it. The University of Florida Forensic Toxicology Lab is currently developing a new test to identify the drug.
Like fentanyl, carfentanil is dangerous not just to users but to anyone who comes into contact with it. Grains of it can be absorbed through the skin or inhaled.
According to the DEA, most fentanyl analogues in the United States are being manufactured in China and transported through Mexico.