It has been recognized that there is an active opioid crisis in our country. Two of the most powerful synthetic opioids that are being seen on the streets are Fentanyl and Carfentanil. They act much like opiates, which are natural opioids, such as morphine and codeine. Both of these substances are illegally manufactured and can result in an overdose very quickly and even death when they are abused. However, Carfentanil is the most potent of the two, with Fentanyl being 50 times stronger than heroin and 100 times stronger than Morphine and Carfentanil being 100 times more potent than Fentanyl and 10,000 times more potent than Morphine. To put this in a clearer and easier perspective, if you have ever been given Morphine by a doctor, then you know the effects of Morphine given at a recommended dose. Now, imagine that feeling 10,000 times over. Pretty crazy, right?
These two substances do have differences as well as similarities. Carfentanil can be sold in many forms such as tablets, powder, blotter paper, and spray. Whereas Fentanyl can be sold in forms such as tablets, lozenges, patches, and injections. However, street fentanyl is most often seen in the form of white or brown powder, clear liquid, or white pills. Some drug dealers will mix either one of these drugs with other illegal substances such as marijuana, heroin, meth, and cocaine. Most often, users don’t know that their drugs of choice even contain the fentanyl.
Carfentanil is not intended for human use, this opioid is generally used as a tranquilizer in larger animals such as elephants. The fatal dose of Carfentanil is unknown, however, if it takes 2 milligrams to kill someone depending on their size, then imagine how little Carfentanil is needed to cause an overdose. Fentanyl has been reported to kill someone in a matter of 2 minutes. which is usually due to the individual experiencing respiratory arrest (breathing has stopped). Neither Fentanyl nor Carfentanil has to be ingested to cause someone to overdose, intentionally or unintentionally.
There are 4 different ways that a person can overdose and not even know it until it’s too late. Both of these substances can be inhaled. The population of citizens that are at the most risk of inhaling either substance are first responders and law enforcement. They can also be ingested by eating them. Although, it is very uncommon due to its potent nature. A third way to unintentionally ingest these substances is through mucosal contact, meaning the eyes, nose, or mouth. This happens when someone touches contaminated hands or gloves and then touches their eyes, nose, or mouth, which can lead to exposure. The fourth and final way is dermal absorption, which is skin contact. Liquid fentanyl can be absorbed through the skin. If an accidental exposure does occur, immediately wash the exposed area with soap and water. Since Carfentanil is even more potent than fentanyl, contact through the skin is extremely dangerous.
Naloxone (Narcan) can help to reverse an overdose, but multiple doses of Narcan may be required to reverse the opioid action, if possible. Medical attention must be sought for the victim immediately as they can still go back into the overdose. The procedure for administering Narcan is to first hit them with a dose. Then get 911 on the line, informing them of the emergency and what you have done thus far. Next, you must rotate the victim to their side, as this will help to prevent them from regurgitating. Do not leave the person’s side until the paramedics arrive. In the meantime, continue to give them a dose of Narcan every 2 to 3 minutes until the person is breathing on their own for at least 15 minutes or until the paramedics arrive on the scene. The symptoms of an overdose of both of these substances are very similar. Symptoms include respiratory arrest (stopped or severely slowed breathing), extreme drowsiness, a stupor, disorientation, pinpoint pupils, pale and clammy skin, and vomiting. These symptoms will most often occur within seconds to minutes of exposure to these opioids.
Carfentanil vs Fentanyl: Which is more dangerous? (n.d.). Drugs.com. https://www.drugs.com/medical-answers/carfentanil-fentanyl-dangerous-3569702/
Jalal, H., & Burke, D. S. (2020). Carfentanil and the rise and fall of overdose deaths in the United States. Addiction. https://doi.org/10.1111/add.15260
O’Donnell J, Gladden RM, Mattson CL, Kariisa M. Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017. MMWR Morb Mortal Wkly Rep 2018;67:767–768. DOI: http://dx.doi.org/10.15585/mmwr.mm6727a4external icon
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