What is Carfentanil?
Synthetic opioids have been at the forefront of the drug overdose crisis for the past two decades. An estimated 70% of all drug poisonings and overdose deaths in 2023 involved a synthetic opioid such as fentanyl. A new synthetic opioid has risen in the market, carfentanil. What is carfentanil? Carfentanil is another synthetic opioid originally developed for veterinary use and is not safe or approved for human consumption.
Carfentanil is one of the deadliest fentanyl analogues on the market. It is one of the strongest opioids in existence. In 2016, carfentanil was found to be connected to many overdose deaths. Today, the substance is becoming more commonly found in street drugs. It is extremely potent and causes extremely dangerous side effects when consumed.
The DEA has since seen an increased presence of carfentanil in the illegal drug market and has been linked to numerous overdose deaths across the country. According to the CDC, deaths involving the opioid carfentanil have increased about sevenfold since it first appeared on the market.
What is Carfentanil?
Carfentanil is a very potent synthetic opioid that is used for anesthesia and to tranquilize large animals such as elephants. It is not approved for any human consumption. This is because touching or inhaling even the smallest amounts can be deadly to humans. A dose as low as 2mg is able to sedate a full-grown elephant and in turn, can also kill up to 50 people.
The synthetic drug is 10,000 times more potent than morphine and about 100 times stronger than fentanyl. It is so potent, the substance has the potential to be absorbed through the skin, making accidental ingestion very possible.
It comes in a white powder that can resemble other substances such as fentanyl, cocaine or heroin. It is also cheaper than fentanyl. When it comes to illegal street drugs, carfentanil is often mixed into heroin and cocaine due to the similarity of appearance. This makes it so the substance is more potent as well as easier to smuggle in smaller amounts, making it less likely to get confiscated. This also means those who believe they are taking heroin or cocaine can accidentally be ingesting large amounts of carfentanil without knowing.
Prevalence of Carfentanil in the Drug Market
Due to its appearance as a white powder, it can easily be mistaken for other drugs like heroin or cocaine. Within the past year, it has been found to be pressed into pills that resemble prescription medications, which can lead to unintentional consumption by those who believe they are taking a less potent drug.
Because it is cheaper to manufacture and its high potency, carfentanil is regularly added as filler for other illegal substances such as heroin and cocaine. This combination is also referred to as grey death. It is used as a cheap filler to help boost the potency of a drug and has created a market for other synthetic fentanyl derivatives in the illegal drug market. This can easily lead to misuse, addiction and overdose.
History of Carfentanil
Carfentanil street names include c.50, Drop Dead, Grey Death, or Serial Killer. It was first created in 1974 by a team of chemists working at Janssen Pharmaceuticals. The synthetic opioid entered the illegal drug supply in the US around 2013 and has only gained more and more traction. By 2016, carfentanil was reportedly linked to a significant number of drug deaths. It is now a growing problem in the US and contributing to the opioid overdose epidemic.
Ohio has reported some of the first opioid overdoses that involved carfentanil. In Cincinnati, Ohio, the state had more than 508 overdose deaths related to carfentanil in 2019. It has increased significantly since 2016, when there were only 30 related overdoses reported.
In the US, overdose deaths involving fentanyl analogues like carfentanil doubled between 2016 and the first half of 2017. There was another reported significant increase, which resulted in an estimated 700% increase from 2023 to 2024. Currently, carfentanil overdose deaths are more widespread, with 37 states having now reported deaths due to the synthetic opioid in the first half of 2024.
Dangers and Risks of Carfentanil
- Increased risk of overdose due to extremely potent nature.
- Respiratory depression
- Drowsiness and extreme sleepiness
- Disorientation and confusion
- Decrease responsiveness
- Delirium
- Sedation
- Pinpoint pupils
- Nausea and vomiting
- Weakness
- Visual disturbances
- Muscle stiffness
- Constipation
- Naloxone might not be completely effective in reversing an overdose and may require multiple doses over a longer period of time.
- Consuming even the smallest amounts can lead to overdose, making accidental overdose very common.
- Has been found to be mixed with other drugs and pressed into counterfeit pills that look like prescription painkillers. This increases the likelihood of an overdose and poisoning.
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Carfentanil vs Fentanyl
Carfentanil and Fentanyl are two different types of synthetic opioids. They both work similarly to activate the opioid receptors in the central nervous system. Both are also synthetically made substances with no natural ingredients.
Fentanyl has been the primary driver in the US overdose epidemic because it is more prevalent in the drug supply chain. However, more and more cases of carfentanil overdose are popping up at an alarming rate.
Carfentanil is an illegal substance that is used for veterinary purposes. It is an illegal street drug. Fentanyl is FDA-approved and effective in treating pain after surgery, cancer-related pain or severe chronic pain. It is both a prescription medication and an illegal street drug.
Both drugs can cause respiratory depression when abused. However, because carfentanil is such a powerful and potent substance, even a small dose can cause a fatal overdose.
Ways to Prevent Carfentanil and Opioid Overdose
- Expanding education about the risks and dangers of illicit drug use and the potential of drugs containing dangerous substances such as carfentanil.
- Making fentanyl test strips more available to all.
- Increases access to naloxone to help reverse opioid overdose.
- Expanding access to prevention programs that can provide other medications for opioid use disorder.
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Treatment for Opioid Use Disorder
Carfentanil is one of the deadliest synthetic opioids on the street drug market. It is generally produced outside the US and smuggled into the country. It is more potent than fentanyl and even the smallest amounts can cause immediate overdose, addiction or death. Because it is often mixed with other substances like heroin or cocaine, the best way to avoid carfentanil is to avoid heroin or cocaine altogether.
Professional behavioral health programs such as Hotel California by the Sea provide treatment for opioid use disorders and for those who have become addicted to opioids such as fentanyl or carfentanil. We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based methods such as CBT, DBT and EMDR therapy. Hotel California by the Sea is dedicated to helping our client reach their goals in recovery and overcome their addiction.
References:
https://www.dea.gov/stories/2025/2025-05/2025-05-14/carfentanil-synthetic-opioid-unlike-any-other
https://www.therecoveryvillage.com/carfentanil-addiction/side-effects
https://www.addictioncenter.com/opiates/carfentanil
