According to a recent CDC report, overdose deaths from carfentanil, a drug far more potent than fentanyl, are on the rise. While the U.S. has struggled with the opioid crisis for years, with thousands of fatalities annually, there was some good news on December 5 when the CDC’s Morbidity and Mortality Weekly Report indicated a decrease in opioid overdose deaths and a slight drop in deaths from illegally made fentanyl.
However, the report also highlighted a concerning “reemergence” of carfentanil, a synthetic opioid responsible for an alarming seven-fold increase in deaths, threatening the progress seen in tackling the crisis. In the first half of 2023 alone, deaths from carfentanil surged by more than 720% compared to the same period in 2024. This problem spans 37 states, with eight states—New York, Maryland, Florida, Illinois, Michigan, Ohio, West Virginia, and Kentucky—reporting over 20 deaths each due to carfentanil.
Carfentanil, less known to the public than fentanyl, remains a rare cause of overdose deaths, with 513 related fatalities between January 2021 and June 2024. But experts warn that the sharp rise in cases is worrisome. Carfentanil, originally developed in the 1970s and used as a tranquilizer for large animals, is significantly more potent than other opioids. It is not used for human pain relief and is about 100 times more potent than fentanyl and 10,000 times more so than morphine. Even a small amount can cause overdose and death, as it binds strongly to mu-opioid receptors in the brain, making it extremely hazardous.
Exposure to carfentanil can lead to respiratory issues, coma, and even death. The smallest exposure can trigger serious reactions, and while naloxone (Narcan) can reverse overdoses, treating carfentanil cases can be challenging due to its potency and rapid action, often requiring multiple naloxone doses. Without proper treatment, patients may not survive.
Though carfentanil has no official medical use for humans, it has infiltrated the illegal drug market. Often, users are exposed to it accidentally as it is mixed with other substances, particularly fentanyl. From July 2023 to June 2024, nearly 87% of carfentanil overdose victims also had illegally made fentanyl in their system, distinguishing this trend from earlier outbreaks in 2016 and 2017, which saw fewer occurrences of fentanyl involvement.
The current outbreak is more widespread compared to previous ones, affecting 37 states, and presents significant challenges in controlling the drug supply. Despite these concerns, exposure to carfentanil remains less common than fentanyl, though the situation remains delicate. If carfentanil becomes more prevalent in the drug market, there could be a significant increase in opioid overdose deaths, potentially reversing recent progress in the fight against the opioid crisis.
