Tox Tuesday: Carfentanil blacklisted in China

May 09, 2017

The United States is facing an increasingly tragic opioid epidemic. In December 2016, the Centers for Disease Control and Protection (CDC) released a report stating that over 33,000 people had died in 2015 due to opioid overdoses, an increase from the previous year. Of those deaths, 9,580 were because of synthetic opioids, such as fentanyl and carfentanil — an increase of 73%.

Carfentanil is of particular concern to experts, as until recently, the highly dangerous substance was freely accessible online from foreign countries — namely, China.

In March 2017, China took a major step towards stemming the flow of deadly drugs to other countries by adding carfentanil to its list of controlled substances. Fentanyl was already on the list. According to the Associated Press, at least 12 companies offered online to export the drug abroad, where dealers use it to cut their supplies of heroin.

The Chinese ban is not likely to completely eliminate the presence of carfentanil abroad, but is expected to help decrease its prevalence.

“This has affected the detection rate in the U.S.,” said Neogen’s Dan Grubb. “Some of the labs we work with are reporting they are starting to see less of the drug, and are beginning to see other analogs show up in their screening.”

Grubb lists several analogs that labs have seen, including:

  • Fluoro-isobutyryl fentanyl (FIBF)

  • Acetyl fentanyl

  • Isobutyryl fentanyl

  • Acrylfentanyl

  • Butyrylfentanyl

  • Furanylfentanyl

  • 3-Methylfentanyl

  • 4-ANPP

  • Despropionyl fentanyl

What is carfentanil?

Carfentanil is an analog of the synthetic opioid analgesic fentanyl. Just a few granules can kill a human. It was originally synthesized in 1974 as anesthetic for large animals, like elephants. The National Library of Medicine states that its “extreme potency makes it inappropriate for use in humans.” The same source cites it as 100 times stronger than fentanyl and 10,000 times stronger than morphine. Activity in humans starts at about 1 microgram.

One article explains that it is so powerful zoo veterinarians typically wear a face shield, gloves and other protective gear — “just a little bit short of a hazmat suit” — when preparing the medicine to sedate animals because even one drop splattered into a person’s eye or nose could be fatal. “Our veterinarians handle it almost like uranium,” Dr. Rob Hilsenroth, executive director of the American Association of Zoo Veterinarians said. “This blows my mind that people are playing with such a dangerous drug.”

One of the reasons governments are racing to control carfentanil, in addition to the dangers it poses as an addictive drug, is its potential usage as a chemical weapon. Forms of fentanyl have been known to be used in at least one political assassination attempt, and a gaseous mix was used by Russian forces against Chechen separatists during a 2002 hostage crisis.

The global situation

While the U.S. sees some of the highest usages of opioids in the world, other countries are nervously watching their own drug statistics creep upward.

The United Nation’s National Crime Agency (NCA) has warned that recent deaths in the north of England are due to fentanyl and carfentanil, and that the two are likely to be found more often in the rest of the country as well.

“Whilst initial toxicology revealed fentanyl analogs in a small number of deaths, specific retesting has started to indicate that the influence of fentanyl is greater than first suspected,” said Tony Saggers, head of drugs threat and intelligence at the NCA.

Public Health England, the executive agency of the country’s Department of Health, has issued an official drugs alert, due to rising concerns.

Canada too is gearing up to fight against the invasion of carfentanil after a package of 50 million doses was intercepted by police in Alberta.

Neogen offers forensic drug testing products that can screen over 300 drugs and metabolites in a wide range of forensic samples, including hair, blood, urine, oral fluid and others. For more information, click here.

Category: Toxicology