There are more people who are dependent on prescription opioids that are switching to heroin. This is one of the main reasons there is a spike in heroin use. Heroin is stronger in potency and often cheaper and easier to get than prescription painkillers such as morphine or OxyContin.
There is an increasing frequency of illegal drug manufacturers cutting their heroin product with synthetic opioids such as fentanyl and carfentanil.
These two substances are cheaper and easier to synthesize. They are lethal at shockingly incremental amounts and able to cause an overdose by being accidentally inhaled as a free-floating powder.
They can be absorbed through the skin and are rarely detected in standard toxicology screens.
They are both significantly more potent than heroin could ever be, but carfentanil is the more dangerous of the two.
Fentanyl first appeared on the scene mixed with heroin and other illegal drugs. Following it was a swell of fatalities from an overdose. It is more than 100 times stronger than morphine. Carfentanil appeared on the drug scene close behind.
Even with all the damage that it has caused, fentanyl does at least have a limited degree of medical use in treating patients who are unresponsive to other opioids or relieving pain associated with cancer treatment. Carfentanil has no medical use for humans because it was never intended for human use at all.
Synthesized in 1974, carfentanil is an opioid that, when sold under the brand name Wildnil, is used to sedate massive animals such as elephants, buffalo, and moose. Carfentanil is 100 times stronger than fentanyl, making it 10,000 times more potent than morphine.
It works the same way that opioids do on humans, activating the neurotransmitters in the brain known as opioid receptors in order block pain signals from reaching the brain and increase dopamine levels for a sense of euphoria and relaxation.
Except it doesn’t get that far in humans before causing an often lethal overdose.
Carfentanil is very difficult to detect in medical screenings and toxicology reports. It is most commonly found in cocaine and heroin. It can also be pressed into pills which can resemble prescription opioids.
The reasoning for adding carfentanil to these drugs is to increase the potency of them and to cut costs.
However, most users don’t know what they bought contains some carfentanil. They then take their regular dose of whatever substance it is, and overdose, sometimes immediately.
There is no overstating the risks of carfentanil use, let alone carfentanil abuse. If you or someone you care about is currently struggling with a carfentanil addiction, seeking medical detox as soon as possible is absolutely critical to avoiding a potentially fatal overdose.
People who inadvertently take carfentanil while using heroin or another substance that has been mixed with carfentanil are far more likely to immediately overdose rather than feeling any kind of effects.
If it is taken in a minute amount, there is still an unpredictability of knowing how the carfentanil will interact with whatever it has been mixed with.
To put it bluntly, the long-term effects of carfentanil abuse are not well-studied, because most people who use it will overdose or die before enough time has passed to note the long-term effects on the body and brain.
Due to its overwhelming potency and rapid effects, someone is more likely to see signs of a carfentanil overdose rather than carfentanil addiction.
If an individual is lucky enough to have taken an extremely diluted or small enough amount of carfentanil, they will still become addicted almost immediately.
The symptoms are indicative of carfentanil addiction. If you spot them in someone you know, then it is imperative they get treatment immediately. This may avoid permanent mental and physical damage but also avoids the impending danger of both overdose and death.
Unfortunately, similar to fentanyl, carfentanil has found its way into the illicit drug market. Before it was an issue in the United States, it was misused in Estonia and Lithuania, but recently it has been found mixed with heroin in the United States.
Unlike fentanyl, carfentanil does not respond to Narcan, the opioid blocker drug. Carfentanil is resistant to the drug and requires several doses to be effective.
Drug dealers have been mixing the drug to make heroin cheaper and increase profits. Many people using heroin may be unaware that the drug is laced and can result in an overdose.
The dangers are not well-documented like heroin or fentanyl. While the effects are not as well known, there are steps someone can take to protect themselves.
Parents are teens should familiarize themselves with the information available on carfentanil. The DEA issued a guide about exposure, what to do, and the different forms in which the drug comes.
If someone abusing carfentanil is able to successfully make it to an addiction treatment center, the first step is immediate medical detoxification. Treating opioid addiction is a difficult process, especially the withdrawal phase.
It is recommended that someone undergoing opioid detox does it in the care of a professional medical detox center. It is especially important if they want to survive carfentanil withdrawal since they will need a medical maintenance program to wean them from it.
The shock of attempting to stop using all at once can either kill someone or cause them to relapse, which typically leads to an overdose.
The substances used in medical maintenance therapy are meant to help decrease cravings throughout the tapering process. They provide similar effects to stronger opioids, but are significantly weaker and do not pose the same addictive risks.
The medications commonly used to treat people who have become addicted to carfentanil include:
Methadone helps lessen cravings while still blocking the “high” associated with opioid use. It is well-known and has the longest record of use in opioid addiction treatment, and a long-term alternative to those with a history of relapse, It is important to be aware that methadone carries a risk of addiction and its administration requires careful monitoring.
Buprenorphine is what’s known as a “partial opioid,” meaning that it can decrease cravings by taking up space in the brain’s opioid receptors while also blocking the effects of opioids out of them. It has a long-proven track record in the fight against opioid dependence. It has much less potential for addiction than methadone.
This is the brand name for the combination of buprenorphine and another drug called naloxone. On its own, naloxone is incredibly potent when it comes to blocking the effects of opioids, which makes it too strong to be used in maintenance therapy without cutting it with buprenorphine.
Like naloxone, naltrexone completely negates the effects of opioids and carries no risk of addiction. For long-term use, it is available as an extended-release injection called Vivitrol.
Detox can be a difficult and taxing process, but it’s only the beginning of proper carfentanil addiction treatment. Recovery obviously cannot start without detoxing first. It is vital that once the carfentanil has been flushed out from the body that the next step is checking into an addiction rehabilitation program.
Detoxing won’t help to address the ways that addiction rewires the brain. Recovery treatment is crucial to learning how to manage addiction and maintain sobriety in the long-term.
There are many different kinds of recovery treatment programs available, including in-patient residential treatment, support groups, counseling, and even holistic therapy. Each patient will typically collaborate with their counselor or therapist to devise a treatment program that will be most effective for them.
If the dangers inherent in carfentanil use are still not readily apparent, here is another way of illustrating its often fatal potency: it takes as little as a 10-milligram dose of carfentanil to sedate and kill a 15,000-pound African elephant, which is about 75 times the weight of a 200-pound man.
For comparison, the standard paper clip weighs in at roughly 140,000 milligrams. If diluted enough to be scattered in a crowded room, 10 milligrams would easily be enough to kill as many as 500 people. Knowing this, it’s no surprise that carfentanil’s toxicity has been compared to nerve gas.
In its powdered form, carfentanil is all-too-easily disguised as either heroin or cocaine, as all three substances are colorless and odorless, with similar appearance and texture as well. There is no way for someone to tell if the heroin or cocaine they are taking has been cut with carfentanil until it is too late.
If there is a carfentanil overdose, emergency overdose reversal medications such as Narcan may not be enough to save someone. Counteracting a heroin overdose typically requires between one and three doses of Narcan. A fentanyl overdose may require three times that amount, and for carfentanil, Narcan often does not work at all, even when administered immediately following an overdose.
The true danger of carfentanil addiction isn’t what it can do to someone over long periods of abuse, but the immediate deadly impact of just one use.
(June, 2016). Fentanyl. National Institute on Drug Abuse. Retrieved June, 2018 from from from https://www.drugabuse.gov/drugs-abuse/fentanyl
(March, 2016). Opioid Overdoses Treated in Emergency Departments. CDC. Retrieved June, 2018 from from from https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html
Fentanyls: Are we missing the signs? Highly potent and on the rise in Europe. (2015, April 17). Retrieved from from from https://www.sciencedirect.com/science/article/abs/pii/S0955395915000973
DEA Issues Carfentanil Warning To Police And Public. (n.d.). Retrieved from from from https://www.dea.gov/press-releases/2016/09/22/dea-issues-carfentanil-warning-police-and-public
National Institute on Drug Abuse. (n.d.). Emerging Trends and Alerts. Retrieved from from from https://www.drugabuse.gov/drugs-abuse/emerging-trends-alerts
Rzasa Lynn, R., & Galinkin, J. L. (2018, January). Naloxone dosage for opioid reversal: Current evidence and clinical implications. Retrieved from from from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753997/