What is Carfentanil?

Understanding Carfentanil

Carfentanil is an ultrapotent synthetic opioid that has gained attention for its extreme potency and potential dangers. Let's explore what carfentanil is and delve into its potency.

What is Carfentanil?

Carfentanil is an analog of the synthetic opioid analgesic fentanyl, but it is significantly more potent. It was first synthesized in 1974 and was initially used in veterinary medicine as a tranquilizing agent for large and captive non-domestic species. However, due to concerns regarding public safety, carfentanil has been pulled from the veterinary market.

Carfentanil is not approved for clinical use in humans because of its extreme potency. It is approximately 10,000 times more potent than morphine and 100 times more potent than fentanyl, making it one of the most potent opioids known. To put its potency into perspective, 1mg of carfentanil is roughly equivalent to 8 to 10 grams of morphine.

The Potency of Carfentanil

Carfentanil's potency sets it apart from other opioids. Its strength is measured in comparison to other opioids, such as morphine and fentanyl. The table below illustrates the relative potency of carfentanil compared to these opioids.

Opioid Potency Relative to Morphine

• Morphine: 1
• Fentanyl: 100
• Carfentanil: 10,000

Table data from Manitoba Health

The incredible potency of carfentanil presents significant risks and challenges in terms of its use and distribution. Its high strength can lead to severe and potentially fatal consequences, making it a substance of concern for public health and law enforcement agencies.

Understanding the nature and potency of carfentanil is essential in recognizing the dangers associated with its use. The next section will explore the similarities and differences between carfentanil and fentanyl, shedding light on their medical uses and illicit distribution.

Carfentanil vs. Fentanyl

When exploring the world of synthetic opioids, it's important to understand the similarities and differences between carfentanil and fentanyl. Both of these substances are incredibly potent and have significant implications for public health and safety.

Similarities and Differences

Carfentanil and fentanyl are both synthetic opioids that belong to the same class of drugs. However, carfentanil is even more potent than fentanyl. Carfentanil is approximately 10,000 times more potent than morphine and 100 times more potent than fentanyl. This extreme potency makes carfentanil particularly dangerous and increases the risk of overdose.

Fentanyl, on the other hand, is approximately 50 to 100 times more potent than morphine. It is commonly used in medical settings to manage severe pain, especially in patients who have built up a tolerance to other opioids [4]. Fentanyl is available in various forms when prescribed by a doctor, such as injections, patches, or lozenges. Illegally, fentanyl is often sold as a powder, in blotter paper, eye droppers, nasal sprays, or pills resembling other prescription opioids.

Both carfentanil and fentanyl are highly potent opioids that can cause addiction and dependence. The strength of these substances increases the risk of overdose, particularly when they are mixed with other drugs. Naloxone, a medication used to reverse opioid overdoses, can be effective in treating fentanyl overdoses if administered promptly. However, multiple doses may be required due to the potency of fentanyl.

Medical Uses and Illicit Distribution

While fentanyl has legitimate medical uses, such as pain management, carfentanil is only approved for use in veterinary medicine as a tranquilizing agent. Carfentanil's extreme potency and potential for misuse make it unsuitable for clinical use in humans.

Fentanyl, when prescribed by a doctor, can be administered through various methods, including injections, patches, or lozenges. These forms allow for controlled and regulated distribution. However, the illicit distribution of fentanyl has become a significant concern. It is often sold illegally in forms such as powder, blotter paper, nasal sprays, or pills resembling other prescription opioids. This illicit distribution contributes to the rise in fentanyl-related overdoses and fatalities.

Understanding the similarities and differences between carfentanil and fentanyl is crucial in recognizing the dangers associated with these potent opioids. The misuse of these substances poses significant risks to individuals and public health. It is essential to raise awareness, provide education, and implement effective control measures to combat the illicit distribution and use of these dangerous drugs.

Dangers and Risks of Carfentanil

Carfentanil, an ultra-potent synthetic opioid, poses significant dangers and risks to both human and animal health. Understanding these hazards is crucial to raising awareness and promoting safety measures.

Carfentanil Overdose and Toxicity

Exposure to carfentanil can result in severe and potentially fatal outcomes. The signs and symptoms of carfentanil toxicity are similar to those of other opioid overdoses. Due to its extreme potency, exposure to even small amounts of carfentanil can be incredibly dangerous, with the lethal dose estimated to be as low as 20 micrograms if inhaled or absorbed through the skin. Immediate medical attention is crucial in cases of carfentanil overdose, and appropriate treatment should be made available as soon as possible.

Carfentanil as a Schedule II Substance

Carfentanil is classified as a Schedule II substance under the Controlled Substances Act. This categorization is due to its high risk of toxicity and potential for lethal effects. The Schedule II classification indicates that carfentanil has recognized medical uses but also carries a high potential for abuse and dependence. Consequently, strict regulations and control measures are in place to monitor and restrict its distribution and use.

It is important to note that carfentanil is not approved for use in humans and should not be present in any substances intended for human consumption. Carfentanil was manufactured solely for the purpose of immobilizing large mammals, such as elephants, and is considered a chemical weapon [5]. Its extreme potency and potential for harm make it unsuitable and unsafe for human use.

Understanding the dangers and risks associated with carfentanil is crucial for public safety. Strict regulations, education, and awareness campaigns are essential to prevent the illicit use and distribution of carfentanil and to minimize the potential harms it poses to individuals and communities.

Carfentanil in Veterinary Medicine

Carfentanil, an ultrapotent opioid, was historically utilized in veterinary medicine for immobilizing large non-domestic species due to its high potency and rapid onset. However, due to concerns regarding public safety, carfentanil has been pulled from the veterinary market [1].

Historical Use and Purpose

First synthesized in 1974, carfentanil gained notoriety for its ability to immobilize large and captive non-domestic species in veterinary medicine. Its potency, approximately 10,000 times that of morphine, made it highly effective for sedation purposes. Dosages for different species could range from 7-40 µg kg-1, with the most commonly utilized route of administration being intramuscular injection.

Over time, concerns regarding public safety and the potential for misuse of carfentanil led to its removal from the veterinary market. However, it is important to note that alternatives to carfentanil have emerged to address the need for immobilizing large non-domestic species.

Alternatives to Carfentanil

Thiafentanil, a relatively new ultrapotent opioid, has emerged as an alternative to carfentanil in veterinary medicine. Structurally similar to carfentanil and sufentanil, thiafentanil possesses a potency approximately 6,000 times that of morphine. It has filled the void left by carfentanil for the immobilization of large non-domestic species, providing effective sedation options.

Another alternative to carfentanil is etorphine, also known as M99. Etorphine, first reported in the 1960s, is widely used in species with equine-like physiology, such as zebra, rhinoceros, and elephants. With a potency approximately 6,000 times that of morphine, etorphine offers effective immobilization options in veterinary medicine.

While carfentanil's historical use in veterinary medicine has raised concerns, alternatives like thiafentanil and etorphine have emerged to ensure the safe sedation and immobilization of large non-domestic species. These alternatives provide veterinarians with effective options while prioritizing public safety and responsible opioid use.

Carfentanil in Illicit Drug Markets

Carfentanil, a highly potent synthetic opioid, has gained notoriety in illicit drug markets. Its use in these contexts poses significant dangers and risks to individuals who come into contact with it.

Recreational Use and Accidental Overdoses

Carfentanil has been illicitly used for its euphoric and sedative effects. Due to its extreme potency, it is often mixed with other substances, such as heroin or counterfeit tablets, to increase their potency and produce a more intense high. However, these combinations can lead to accidental overdoses, as users may underestimate the strength of the drug.

The illicit distribution of carfentanil or its analogs has resulted in a concerning number of overdose deaths in North America. According to a study, there have been reported cases of death from drug overdoses involving carfentanil, with 15 cases identified. The mean concentration of carfentanil in the blood was 3.39 ng/mL, and in urine, it was 6.07 ng/mL.

Carfentanil-Related Fatalities

Carfentanil has been found in combination with other drugs in cases of drug overdose fatalities. These combinations may include substances such as morphine, diphenhydramine, heroin metabolites, codeine, methadone, cocaine metabolites, benzodiazepines, and methamphetamine [2]. The presence of carfentanil in these mixtures further increases the risk of overdose and fatalities.

The extreme potency of carfentanil poses a significant challenge for overdose reversal and medical intervention. Carfentanil exposure can lead to symptoms similar to other opioid toxicity, making it critical for individuals to receive appropriate and timely medical treatment to prevent fatality.

The illicit use of carfentanil highlights the grave dangers associated with its consumption. It is crucial to raise awareness about the risks involved and educate individuals about the potential lethal consequences of coming into contact with this substance.

Legal and Health Concerns of Carfentanil

Carfentanil, a synthetic opioid, raises significant legal and health concerns due to its extreme potency and potential for misuse. While it is primarily intended for veterinary use, its presence in illicit drug markets poses a grave threat to human health and safety.

Human Use and Health Risks

Carfentanil is not approved for use in humans in Canada, meaning it is not for medical use and should not be present in any substances intended for human consumption. Exposure to even small amounts of carfentanil can be incredibly dangerous, with the lethal dose estimated to be as low as 20 micrograms if inhaled or absorbed through the skin [5].

Due to its potency, carfentanil has been associated with numerous overdoses, especially when mixed with other drugs like heroin or cocaine. The high potency of carfentanil increases the risk of accidental overdose and can lead to severe respiratory depression, coma, and even death. The presence of carfentanil in illicit drug supplies further exacerbates the risks associated with drug use, as individuals may unknowingly consume substances laced with this dangerous drug.

Regulations and Control Measures

Given the significant risks posed by carfentanil, various regulations and control measures have been implemented to mitigate its impact. In many countries, carfentanil is classified as a controlled substance, with strict legal controls in place to prevent its misuse and distribution. Law enforcement agencies and health authorities actively work together to detect and intercept illegal shipments of carfentanil, aiming to prevent its entry into illicit drug markets.

Furthermore, public health agencies and organizations provide education and awareness campaigns to inform the general population about the dangers of carfentanil and the importance of avoiding any contact with the substance. These initiatives aim to reduce the demand for carfentanil-laced drugs and discourage individuals from experimenting with or consuming substances of unknown origin.

By implementing strict regulations, raising awareness about the risks, and enhancing surveillance efforts, authorities strive to protect public health and safety in the face of the carfentanil menace. The collaboration between law enforcement, healthcare professionals, and communities is crucial in combating the illicit use and distribution of this dangerous substance.

References

• [1]: https://www.asra.com/news-publications/asra-newsletter/
• ‍[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283219/
• ‍[3]: https://www.samhsa.gov/find-help/national-helpline
• ‍[4]: https://nida.nih.gov/publications/drugfacts/fentanyl
• ‍[5]: https://www.manitoba.ca/health/publichealth/docs/health-care-guide-carfentanil.pdf
• ‍[6]: https://pubchem.ncbi.nlm.nih.gov/compound/Carfentanil
• ‍[7]: https://www.emcdda.europa.eu/media-library/molecular-structure-carfentanil_en