Broad
& Liberty ran my piece on the deadly drug carfentanil.
You can read the piece via the link below or the text below:
Paul Davis: 'Gray Death' — Carfentanil, fentanyl's more deadly cousin
Carfentanil, a deadly synthetic opioid drug, is not new to the Philadelphia area.
Deaths
from the drug were first reported in this area back in 2017, and the threat is
growing. The Philadelphia Department of Health issued an advisory health alert
in March of last year.
“In
response to identification of N-Desethyl Isotonitazene in Philadelphia’s drug
checking services of ‘dope’ (illicit heroin/fentanyl) in December of 2022, the
Medical Examiner’s Office partnered with the Division of Substance Use
Prevention and Harm Reduction (SUPHR) to pilot enhanced nitazene surveillance
among drug overdose decedents. To date, four distinct nitazene analogs
(N-Pyrrolidino Etonitazene, N-Desethyl Isotonitazene, metonitazene, and
protonitazene) have been detected in decedent toxicology with potency ranging
from equipotent to 20 times more potent than fentanyl. Concurrent drug checking
has identified two higher potency nitazenes (N-Pyrrolidino Etonitazene and
N-Desethyl Isotonitazene) as well as carfentanil, a fentanyl analog 100 times
more potent than fentanyl, in several samples from the illicit drug supply in
Philadelphia…
A
dope sample collected in January 2024 contained carfentanil. The sample with
carfentanil tested positive for fentanyl, para-fluorofentanyl, xylazine, and
4-ANPP. Carfentanil is a synthetic opioid estimated to be 100 times more potent
than fentanyl and has not been identified in Philadelphia since June 2017, when
carfentanil was found in blood samples of two people who died of unintentional
overdoses.
As
more potent opioids, smaller amounts of dope can lead to unintentional
overdose, especially among people with low opioid tolerance. It is important to
note that to date, these novel substances have only been identified in “dope,”
though caution among persons who use any substances is critical to limit
adverse events. Both nitazene analog and carfentanil overdoses can be reversed
with naloxone (e.g., NarcanTM, ReViveTM), and rescue breathing may be necessary
in instances in which someone also has ingested non-opioid sedatives like
xylazine or benzodiazepines. Additional doses of naloxone doses may be
necessary, and the number of naloxone doses has not been shown to impact
mortality among people who have overdosed. Nitazene test strips are not widely
available.
Due
to smaller amounts typically present in these samples, fentanyl test strips may
be unable to detect the presence of carfentanil, therefore education and access
to naloxone is imperative. For people with opioid use disorder, withdrawal from
nitazene analogs and many novel synthetic opioids has not been characterized in
the literature. Anecdotal experiences from people who use drugs in Philadelphia
suggest that the onset of withdrawal from nitazene analogs occurs more quickly
and with more severity.
Providers treating people using illicit opioids should be aggressive with management of pain and withdrawal symptoms. The illicit drug supply is ever-changing and increasingly dangerous. Novel synthetic opioids in Philadelphia have been first identified through drug checking, and increased drug checking can aid detection and response to emerging substances. Providers (doctors, nurses, social workers, case managers, and peer specialists) should talk to and listen to their patients about their substance use. Providers can discuss the volatility of the illicit drug supply, encourage safer use practices, and ask patients with substance use disorder and history of substance use about their openness to treatment.”
A
retired Philadelphia detective who worked primarily in the Kensington area told
me that he heard about the drug from his street informants back when he worked
narcotics. They told him that carfentanil, called by street dealers and drug
users as the “Grey Death,” was a powerful drug. The former detective told me
that carfentanil, a drug developed as a tranquilizer for large animals, was
deadlier than even fentanyl.
“I’m
worried that carfentanil will take hold in places like Kensington, where the
addicts are craving a more powerful drug,” the veteran detective told me. “The
junkies appear unconcerned about the possible side effects of the drug, such as
an overdose death.”
He
also worried about police officers and other first responders who come into
contact with carfentanil.
“The
carfentanil in powder form can be unintentionally inhaled, causing the cops or
rescue people to die from an overdose.”
The
former narcotics detective directed me to a recent DEA report on carfentanil.
On
May 14, the DEA issued a report called “Carfentanil: A Synthetic Opioid Unlike
Any Other.”
“Over
the past two decades, synthetic opioids have increased the threat of the
ongoing opioid epidemic. Nearly 70 percent of all drug poisonings and overdose
deaths in 2023 involved synthetic opioids, primarily fentanyl. Also, among
these substances is carfentanil, which stands out — at this time — as one of
the deadliest fentanyl analogues. This white, powdery drug closely resembles
other substances like fentanyl or cocaine, but its danger far exceeds that of
nearly any other opioid on the street,” the DEA report noted.
“Carfentanil
is a chilling reminder of how the opioid epidemic continues to evolve and
introduces new threats at an alarming pace.
The
former Philadelphia detective who spoke to me was angry.
“The
drug producers and the drug traffickers know full well that carfentanil is a
deadly drug,” he said. “But they don’t care. These evil bastards only care
about making money, even if their product kills many poor drug addicts.”
Paul Davis, a Philadelphia writer and frequent contributor to Broad + Liberty, also contributes to Counterterrorism magazine and writes the “On Crime” column for the Washington Times. He can be reached at pauldavisoncrime.com.
Note: You can also read my other Broad & Liberty pieces via the link below:
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