In the News: Fentanyl & Carfentanil

(Summer 2017) Since May 2016, there has been a steady increase in news stories involving fentanyl and, more recently, carfentanil.  These drugs have been linked to a rise in heroin overdoses, drug seizures and general illicit use.  But while you’ve heard the names, what do you really know about these drugs and their impact on the opioid epidemic gripping the nation?  Here are five facts to help you understand why we are hearing about these drugs.

1. Classified as a Schedule II: Fentanyl and carfentanil are both considered to have medical benefits but a high risk of addiction. Fentanyl is typically used to treat long-term pain resulting from cancer or renal failure, used when other forms of painkillers have ceased being effective or used when patients have aversions to needles or problems swallowing pills. Fentanyl is also used to treat small animals for pain.
   
   Carfentanil is not used on humans because it is too potent (see number 3), but instead, it is used to tranquilize large animals such as elephants and bison.

2. Synthetic opioids: Neither of these drugs occur in nature and were first created in laboratories by scientists at Janssen Pharmaceutica. Fentanyl was developed in the 60s and carfentanil, a derivative of fentanyl, was created in the 70s.  Both drugs are in the same family as hydrocodone and oxycodone and mimic the effects of drugs like morphine, codeine and heroin.

3. Highly potent: Drugs designed to ease pain are often compared to morphine to judge their effectiveness. Fentanyl is considered 50 to 100 times stronger than morphine.  Carfentanil is 10,000 times stronger than morphine.  Carfentanil is considered so powerful that humans are advised to not consume the meat of an animal, e.g., bison, sedated with the drug. For comparison to other common painkillers, aspirin is 1/360 times as strong as morphine and oxycodone is 1.5 times stronger than morphine.

4. Relatively cheap: Labs in China are making and openly selling both substances on the black market. Considering how potent these drugs are – fentanyl is 50 more potent than heroin – the cost per dose is cheap compared to heroin.  The price for these opioids makes them ideal candidates to be mixed in with heroin before it is sold on the street – enabling dealers to stretch out their supply of heroin and/or compensate for low-quality heroin.  Dealers have even used fentanyl to create knock-off OxyContin® pills.

5. Deadly: As mentioned at the beginning of this article, both fentanyl and carfentanil are playing a deadly role in the heroin epidemic gripping the nation. From 2014 to 2015, deaths from opioids like fentanyl jumped by 72%. And both drugs are blamed for the spike in deaths in Ohio and neighboring states. First responders also report that the overdose-reversal drug, naloxone, is less effective against these drugs as it requires numerous doses to overcome the effects of an overdose.

The last three items on this list are what makes fentanyl and carfentanil so dangerous to both users and non-users.  For individuals addicted to opioids, these drugs increase their risk of an overdose, especially if they think they are taking a different drug or are unaware these substances were mixed in with the other drugs.  For bystanders, particularly true with carfentanil, even a small granule absorbed through the skin can be fatal, making unintentional exposure risky.

Fortunately, we are not seeing these two drugs on the workplace and in fact, even heroin-positive tests have leveled off according to the 2017 Quest Diagnostic Drug Testing Index.  However, our employees’ families and communities are struggling with these horrors and, as we know, our employees cannot leave all that is troubling them at the door of our workplace.

Being aware of current trends and sharing that information with your employees, family, friends and community can help everyone stay alert to what is going on around them.