7 Things to Know About Carfentanil

Pharmacists should know about the rising popularity of carfentanil, a drug more powerful than fentanyl and often so potent that one dose of naloxone isn’t enough to reverse an overdose.

Here are 7 basic facts pharmacists should know about the drug:

1. Carfentanil, which is also known as Wildnil, has an analgesic potency that’s 10,000 times stronger than morphine and 100 times more potent than fentanyl, according to the US Drug Enforcement Administration (DEA).

2. It’s often used to tranquilize large animals, like horses.

3. In several states, law enforcement has found carfentanil popping up in overdose cases where the drug was mixed into heroin or disguised as heroin, The Associated Press recently reported.

In one case in Ohio, a man was indicted in a case involving the death of an individual, plus 9 other overdoses in a span of a few hours. The man was accused of passing off carfentanil as heroin, The Washington Times reported.

In addition to being mixed with heroin, carfentanil is also being sold in pill form, NPR reported.

4. This past summer, the CDC released a summary noting several high alerts for public health departments, health care professionals, first responders, and medical examiners. One of the new developments was the “widening array of toxic fentanyl-related compounds being mixed with heroin or sold as heroin, including extremely toxic analogs such as carfentanil.”

The CDC noted that carfentanil was created in 1974 and isn’t approved for human use because of how powerful it is.

5. Hamilton County, Ohio, has been hit hard by carfentanil.

The Hamilton County Heroin Coalition released a statement in July 2016 about the analgesic showing up in local supplies of heroin. It highlighted a “significant” increase in the drug in emergency rooms starting July 13, 2016.

Akron and Columbus, Ohio, also saw increasing prevalence of carfentanil. In Akron, for example, there were 25 overdoses, including 4 deaths, in a 3-day period.

The coalition also noted that medical personnel and first responders shouldn’t handle substances without protection like gloves and masks, since carfentanil can cause them harm just through touch or inhalation. Field testing of suspected heroin was even suspended “due to the unknown composition of street drugs.”

Hamilton County Health Commissioner Tim Ingram told NPR that carfentanil produces a longer-lasting high, and so it may take 2 or 3 doses of naloxone to revive an individual. He’s working on providing a more concentrated version of naloxone now in the area, NPR reported. He also said he expects to see more and more synthetic opioids become an issue.

6. The DEA told NPR that carfentanil is often imported from China or sold online through Chinese sources, but it’s also entering the United States through Mexican drug traffickers and being sold at a high profit.

7. In 2002, the Russian Special Forces mistakenly sprayed an aerosol containing carfentanil in a building that was under the control of Chechen terrorists who were holding hostages. The aerosol was so powerful that more than 100 of the hostages died from exposure to the chemicals.