Carfentanil is a synthetic opioid and an analog of the extremely potent prescription painkiller fentanyl. Their shared opioid traits are where the similarities end, though.
Fentanyl, while very dangerous and involved in tens of thousands of overdose deaths in the United States, still at least has limited medical usefulness. It is prescribed to treat people with terminal cancer or patients who have not responded to other opioid medications.
Carfentanil, on the other hand, has absolutely no medical use for humans because it was never intended for human use. Carfentanil was originally synthesized in the early 1970s for use as a pre-surgery sedative for animals weighing thousands of pounds, such as elephants and buffalo.
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As one might imagine, it takes an incrementally small amount of a drug meant to knock out a massive animal to kill a person. A lethal dose of carfentanil can be measured out in micrograms, which is why it is being used more and more frequently by illicit drug manufacturers to cut drugs like heroin, as carfentanil is easier and cheaper to create; only a minuscule amount is needed.
Because of this, the majority of the people who end up taking carfentanil don’t even know it and will use what they believe is heroin, only to end up overdosing on carfentanil, sometimes immediately.
How Does Carfentanil Work?
Technically speaking, as an opioid, carfentanil works in the same way that other opioids do, dramatically altering the opioid levels in the brain and central nervous system to relieve pain and produce intense feelings of sedation and relaxation.
The human body naturally produces opioids, which are a type of neurotransmitter or brain chemical that helps to regulate and manage feelings of pain and stress caused by pain, slowing down activity within the central nervous system to block nerve signals carrying these feelings from reaching the brain.
Like its analogs, carfentanil mimics these natural opioids and enters the brain to bind with what are known as opioid receptors, activating them over and over again to stimulate them into overproduction, flooding the brain and nervous system with an excess of opioids.
Carfentanil also produces the same secondary effect like most other opioids. It creates a spike in the levels of a different neurotransmitter called dopamine, which is located in the limbic system or “pleasure center” of the brain. It causes feelings of intoxication and euphoria when released in excess. This is the process behind the “high” that people associate with opioid abuse.
However, because carfentanil is nearly 100 times stronger than fentanyl and 10,000 times more potent than morphine, it is far more likely that the user would overdose almost immediately before actually feeling any of the drug’s effects.
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What Are the Signs of Carfentanil Addiction?
It can often be difficult to spot the signs that someone is engaging in substance abuse or the early stages of dependency or addiction. People generally are not looking for an overall pattern of behavior, or they may otherwise dismiss individual abnormal behaviors.
The issue with spotting the signs of carfentanil abuse and addiction, however, can be challenging for entirely different reasons. Because it is so incredibly lethal and takes effect so rapidly, you are, unfortunately, more likely to identify the signs of a carfentanil overdose rather than an addiction.
However, if someone has been taking very small and extremely diluted amounts of carfentanil, they may be able to avoid an overdose, but will still most likely quickly become addicted. Some of the signs of carfentanil abuse that have been observed include:
- Rapid, significant weight loss
- Periods of confusion
- Severe gastrointestinal issues
- Depression and suicidal behavior
- Slurred speech
- Constant scratching
Once someone reaches the point of addiction, usually they will exhibit certain behaviors that are consistent with a substance use disorder, including using compulsively, experiencing cravings and withdrawal when not using, becoming isolated and withdrawn, and attempting to hide their use from others. But it is more likely that someone will notice the more extreme side effects of carfentanil abuse before some of these more subtle behaviors.
While many opioids are currently in circulation, it cannot be stressed enough about how deadly this cheaply produced drug is. In 2002, rebel soldiers stormed a Moscow theater and trapped 800 people for 60 hours. Russian troops released gases containing the deadly Carfentanil and killed more than 120 hostages. As the gas fumes filled the theater, hostages, and soldiers began collapsing immediately.
Carfentanil is often disguised as heroin on the street, and it can kill you instantly if you are not prepared for it. Even those who use the drug with tolerance can overdose instantly. As such, the carfentanil withdrawal symptoms are incredibly intense and have been dubbed some of the most painful someone can experience.
Carfentanil withdrawal symptoms usually consist of:
- Increased heart rate
- Increased blood pressure
- Low appetite
- Stomach cramping
- Mood swings
- Body aches
- Runny nose
- Watery eyes
A Spirit airlines pilot and his wife were found dead after a drug overdose in their Ohio home. Their cause of death was determined to be a combination that contained carfentanil. Carfentanil is one of the most deadly drugs to brush the planet, and overdosing is not only common; it’s expected.
If you know someone who is using opioid drugs, the likelihood of their street drugs containing these cutting agents is high. You must become aware of the symptoms of an overdose and know what to do in case a situation occurs.
Carfentanil overdose symptoms include:
- Loss of consciousness
- Will not respond to outside stimulus
- Awake, but unable to speak
- Slow or shallow breathing, erratic, or stopped altogether
- Bluish skin tone
- Choking sounds that sound like gurgling
- Limp body
- Pale face and clammy skin
- Slow heartbeat or pulse
If you suspect an overdose, don’t wait, call 911 immediately. The faster you reach out for help can determine if someone lives or dies. Listen to the instructions the operator provides and stay calm.
What Is Involved in Carfentanil Addiction Treatment?
Effective treatment for nearly every addictive substance starts with medical detoxification, which is the process of clearing any trace of drugs and alcohol, as well as any associated toxins, from someone’s system. This is done to help stabilize the individual in detox as well as treat acute intoxication.
Detox is especially crucial in the case of carfentanil, as getting it flushed out of someone’s system as soon as possible is critical to keep it from causing any more damage than it may have already done.
Opioid withdrawal, while uncomfortable and often painful, does not typically present any potentially life-threatening withdrawal symptoms. However, carfentanil withdrawal can sometimes manifest more dangerous, atypical symptoms. No one should ever attempt carfentanil detox alone or without the supervision of an experienced medical detox team.
A medical detox professional can help manage possible complications and implement medication-assisted treatment (MAT). This is a part of an opioid tapering schedule that carefully weans someone off carfentanil using significantly weaker, safer opioid alternatives, such as Suboxone or buprenorphine.
After detox is finished, the next phase of carfentanil addiction treatment is ongoing care in an addiction treatment program. Detox is essential to ensuring someone’s health and safety in the short-term, but it must be followed up with a rehabilitation program that fully addresses the issues behind someone’s addiction. This helps to ensure they can learn to positively manage their addictive behaviors and maintain long-term sobriety.
Treatment can take place in an inpatient or outpatient program, depending on the client’s needs. Either option involves creating a treatment plan that will include a combination of different therapies and modalities that have been evaluated as the most effective.
Some common treatment plan elements include relapse prevention planning, behavioral therapy, EMDR therapy, addiction education classes, and more.
How Dangerous Is Carfentanil?
Because of its incredible strength, it’s almost impossible to overemphasize the dangers of carfentanil use. The toxicity of the substance has been compared to nerve gas, and rightly so, as it has actually been used as a chemical weapon.
In its powdered form, carfentanil is essentially identical in both texture and appearance to heroin. There is almost no way for someone to tell if the heroin they’re about to ingest has been cut with a sufficient enough amount of carfentanil to cause a potentially fatal overdose until it’s too late.
An opioid overdose means the nervous system is so overloaded with opioids that it slows down to the point of respiratory depression. This means that someone experiencing an overdose will have dangerously slow and shallow breathing, or may otherwise stop breathing completely, resulting in organ failure, brain damage, coma, and death due to lack of oxygen.
While opioid overdoses are generally treated by emergency medical services through the use of the overdose reversal drug Narcan or its generic, naloxone, it may not be enough to successfully treat a carfentanil overdose.
The danger of addiction, in the case of many substances, is the physical and mental damage it does over time. But the danger of carfentanil is the immediate, lethal impact of just a single use.
Carfentanil Abuse Statistics
- In 2017, nearly 30,000 overdose deaths in the U.S. involved synthetic opioids, including fentanyl and carfentanil.
- The United States legally manufactures less than a single ounce of carfentanil a year, which supplies all of the zoos and large animal vets in America.
- An eyelash weighs about 60 micrograms. A user only needs to take one microgram of carfentanil to feel its effects.
National Institute on Drug Abuse. (2016, June). Fentanyl. Retrieved from https://www.drugabuse.gov/drugs-abuse/fentanyl
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
U.S. National Library of Medicine. (n.d.). Carfentanil. Retrieved from https://pubchem.ncbi.nlm.nih.gov/compound/carfentanil#section=Top
World Health Organization. (2017, November). CARFENTANIL Critical Review Report - WHO. Retrieved from http://www.who.int/medicines/access/controlled-substances/Critical_Review_Carfentanil.pdf
O'Donnell, J, (June, 2017). Overdose Deaths With Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017. Medscape. Retrieved August, 2019 from from https://www.medscape.com/viewarticle/899334