All About Carfentanil, an Extremely Potent Synthetic Opioid

Clickbait is no longer a new tactic in sensational journalism, and people scroll right past headlines that include phrases like “jaw dropping” and “you won’t believe.”  Fentanyl isn’t new, either, but it is scary enough that people will still click on headlines that include the phrase “scarier than fentanyl.”  Fentanyl, a synthetic opioid about 100 times as strong as morphine and twice as strong as heroin, causes more overdose deaths in the United States than any other drug.  Meanwhile, other drugs that have entered the illegal drug supply in recent years have the potential to be even deadlier than fentanyl, either because they are stronger or because the medications that reverse opioid overdose do not work on them.  Here, our Miami drug crimes defense lawyer explains the science and laws relating to carfentanil.

How Is Carfentanil Different From Fentanyl?

The oldest opioid drugs, such as morphine and heroin, are derived from the opium poppy.  Many of the opioids commonly used in medicine today are synthetic opioids, which means that they were created in labs instead of occurring naturally in plants, but their chemical structure and effects resemble those of opium poppy-derived opioids.  Some synthetic opioids are very potent; scientists usually measure their potency in relation to morphine.  Fentanyl is about 100 times as powerful as morphine.  Carfentanil has a very similar chemical structure to fentanyl, but it is even stronger.  Carfentanil has about 100 times the potency of fentanyl, which makes it about 10,000 times as strong as morphine.  Fentanyl is widely used in medicine; if you have ever had an outpatient surgical procedure or regional anesthesia, fentanyl was probably one of the drugs that you received.  Its short duration of action makes it desirable for this purpose, because it takes effect quickly and because recovery times after surgery are short.  Carfentanil’s extreme strength makes it unsuitable for most medical uses, however.

Medical and Legal History of Carfentanil

Carfentanil was first synthesized in 1974, and in 1986, it received approval as a veterinary tranquilizer, sold under the trade name Wildnil.  Wildnil was an ideal anesthetic and pain reliever for the largest animals.  Plenty of elephants, hippopotamuses, and rhinoceroses underwent surgery while under the influence of carfentanil and lived to trumpet or rumble about it.

It didn’t take long for humans to figure out that a little bit of carfentanil goes a long way in creatures that weigh less than a tenth of what the target audience of Wildnil weighs.  Carfentanil is currently a Schedule II controlled substance under United States law, which means that it carries a very high risk of abuse or accidental overdose but has at least one legally accepted medical use.  Fentanyl and cocaine are also Schedule II controlled substances.  Cocaine’s legally accepted medical use is as a topical medication to prevent bleeding during eye surgery, whereas carfentanil can be used in tiny doses to visualize the brain’s mu-opioid receptors in a PET scan image.

Meanwhile, authorities realized early on how dangerous carfentanil could be if it entered the illegal drug supply.  Other veterinary tranquilizers, such as ketamine and xylazine, have become drugs of abuse.  For this reason, Wildnil was withdrawn from the market in 2003.  Today, carfentanil-based tranquilizers for large animals are available only in formulations that are harder to repurpose for the illegal drug market.

Reversing Carfentanil Overdose

Carfentanil is an opioid, so it is receptive to drugs that can reverse opioid overdose.  Naloxone, sold under the brand name Narcan, can reverse opioid overdose quickly when administered intranasally; it has rescued many patients from the brink of death.  Naloxone is also effective against carfentanil, although several doses of naloxone may be required, whereas only one is sufficient when the cause of the overdose is less powerful opioids.

An article in the current issue of the journal ACS Chemical Neuroscience describes a monoclonal called C10-S66K which has been effective at reversing carfentanil overdose in laboratory animals.  Clinical trials on C10-S66K will begin in August 2023.  Clinical trials, in which doctors test the drug on human volunteers, are a necessary step before a drug can receive approval for clinical use.

With at least one overdose-reversing drug widely available, carfentanil is less dangerous than xylazine, a non-opioid veterinary tranquilizer.  Narcan only works on opioids, so it cannot reverse respiratory depression caused by xylazine.

Contact Our Criminal Defense Attorneys

A South Florida criminal defense lawyer can help you if you are facing criminal charges for possession of fentanyl analogs or other synthetic opioids.  Contact Ratzan & Faccidomo in Miami, Florida for a free, confidential consultation about your case.

Sources:

neurosciencenews.com/opioid-overdose-antibody-23767/

axios.com/local/tampa-bay/2023/07/31/antibody-treatment-fentanyl-florida-overdoses