In May 2017, an Ohio police officer assisted on a traffic stop. When he opened the vehicle, he noticed that its interior was coated with white powder. An hour after that traffic stop, some of the substance got on his shirt. When he went to wipe it off with his bare hand, he collapsed to the floor.
He would later say that it felt like his body was shutting down. He heard himself talking, and it sounded weird. The stuff on his shirt sent him into a debilitating, life-threatening overdose.
The substance that was responsible was fentanyl, the mega-powerful opioid that can be lethal at 2 milligrams, which in quantity resembles grains of table salt. If it weren’t for a few doses of naloxone, which is used to reverse opioid overdoses, that officer would have died.
Fentanyl and its analogs are fueling the latest iteration of the opioid epidemic, the deadliest drug scourge in U.S. history. Previous waves of this crisis were driven by the willful ingestion of prescription medications like OxyContin and illicit drugs like heroin. Now, fentanyl and its chemical cousin carfentanil are claiming lives, but most of those cases are due to accidental exposure.
Fentanyl was responsible for 46 percent of opioid deaths in 2016, a threefold increase from 2010, according to The Journal of the American Medical Association (JAMA). What this means is that synthetic opioids have overtaken prescription medication as the largest killer in the ongoing opioid crisis.
What’s more, there are newer classes of opioids, far stronger than fentanyl, that authorities believe could help drive more overdose deaths into the near future.
Fentanyl was intended for the pain management treatment of cancer patients. It was developed by a Belgian doctor in 1960 and was approved for medical use in the U.S. in 1968. The fentanyl patch for people with cancer pain is included in the World Health Organization’s List of Essential Medicines, which details the safest and most effective medicines needed in a health system.
Fentanyl comes in the form of a lozenge or lollipop, nasal spray, patch, and injectable solution. It also comes in tablet form, to be placed under the tongue or between the cheeks and gums.
Like other opiates, fentanyl binds to the opioid receptors in the brain, which produces a surge in dopamine levels that impact reward areas. This gives users a profound sense of euphoria and relaxation, much like heroin.
Fentanyl is cheaply produced as a powder or counterfeit tablets for illicit use. Drug dealers use it as an additive in heroin and cocaine to stretch their product. For example, instead of selling a gram of heroin for $55 in a state like Florida, a dealer can “cut” the heroin with fentanyl and move it for the same price. Experts say that because there is a shortage of heroin, fentanyl is being included more and more. The result is a product that, despite being adulterated, is even more powerful and potentially lethal.
It also helps that the white powder form of fentanyl is typically indistinguishable from cocaine or heroin.
However, dealers have turned to substances more powerful than fentanyl to endow their product with even more potency, enough to kill a large animal let alone a human being. Some have even taken to formulating designer drugs laced with outrageous amounts of different drugs.
Gray death. It has an ominous name that often delivers on its promise. Gray death is an astonishingly potent mixture of substances that resemble concrete mixing powder. Medical experts have not been able to detail all of the specific contents that compose this drug cocktail. It is known that two of the primary gray death substances are heroin and fentanyl. A third added ingredient, carfentanil, makes it stronger than fentanyl. Carfentanil is one of the most powerful, commercially available opioids.
Carfentanil is increasingly being mixed with heroin despite the fact it is only supposed to be used as a tranquilizer for large animals such as elephants, moose, and buffalo. Its toxicity has been compared to nerve gas, and it is obviously not intended for human consumption.
Carfentanil, which is 10,000 times more powerful than morphine, is so potent that even touching a small amount of it can trigger overdose or even death. In fact, the U.S. Drug Enforcement Administration has issued warnings to law enforcement agencies about the dangers of fentanyl and carfentanil exposure. The federal agency issued warnings to officers and emergency service workers to take appropriate measures when handling substances.
“Carfentanil is surfacing in more and more communities,” warned a DEA official in a 2016 statement. “We see it on the streets, often disguised as heroin. It is crazy dangerous.”
An opioid called 3-methylfentanyl is four times as potent as fentanyl and is also being added to heroin. The designer drug acrylfentanyl is also more powerful than fentanyl.
Another synthetic opioid painkiller, sufentanil, is said to be five to 10 times more potent fentanyl. The U.S. Food and Drug Administration (FDA) recently approved a medication that contains 30 micrograms of sufentanil, setting off new fears that it could make the enduring opioid epidemic worse. Medicines that contain sufentanil are used in hospital settings to treat episodes of acute pain like a gunshot wound or a shattered bone.
When carfentanil, sufentanil, or fentanyl is present in a batch of heroin, a single dose can cause death. For people addicted to heroin, it’s not a matter of “if” they will be exposed to one of those deadly synthetic opioids, it is only a matter of “when,” particularly if they live in certain regions.
If you suspect that you or a loved one is addicted to heroin and faces the possibility of accidental exposure to carfentanil, sufentanil, or fentanyl, then it is critical that you are aware of the signs and symptoms of addiction.
The signs of heroin intoxication can include shortness of breath, dry mouth, dilated pupils, disorientation or confusion, droopy and lethargic appearance, and fatigue. Addiction can manifest as observable compulsive behaviors that center on obtaining and using heroin even in the face of adverse health, professional, or legal consequences. Those behaviors include:
These days, heroin is more likely to be cut with a dangerous synthetic opioid now more than ever, making fatal overdose almost certain. The best chance you have at avoiding such a tragic outcome is by entering into professional addiction treatment.
When people become addicted to heroin, especially when it is laced with substances like fentanyl and carfentanil, it is vital that they undergo medical detoxification, the first step of professional treatment. Detox will rid your body of the heroin and opioids safely and comfortably. You will receive medications and around-the-clock care to ensure that the chemistry of your body and brain are restored.
A typical detox consists of three stages:
The next step after detox is to receive ongoing care at a treatment facility. At Ocean Breeze, you will have the option of enrolling in a partial hospitalization program (PHP) or an intensive outpatient program (IOP). If you have been exposed to heroin that has been cut with fentanyl or another powerful opioid, PHP will be your best, most effective option. In PHP you will have access to intensive therapeutic treatment and clinical services. With IOP, you will receive comprehensive addiction treatment while you live at home. These programs will help you get to the root cause of your heroin addiction. You will also be armed with effective strategies to prevent relapse.
Heroin addiction can be pernicious and menacing. Thus, aftercare is a critical hedge against relapse and re-addiction. After detox and ongoing care, it is recommended that you engage in aftercare through an alumni program. Such a program will allow you to stay connected, inspired, and supported by a recovery community that consists of individuals who are dedicated to achieving lifelong sobriety. They know the dangers and threats of heroin and the health complications that can result from opioid addiction.
At a large enough dose, heroin can be lethal. With fentanyl, sufentanil, and carfentanil, lethality can come with just a few grains. These synthetic opioids are ridiculously dangerous, especially carfentanil. Two milligrams of carfentanil, which is equal to about 34 grains of salt, is enough to sedate an elephant. That amount can also kill a human being.
The symptoms can present themselves within minutes of exposure. Multiple doses of naloxone will be needed to reverse an overdose. The U.S. Justice Department recommends that overdose victims be given a dose of naloxone every two to three minutes until they resume breathing on their own for 15 minutes or until emergency medical services (EMS) arrives.
These days, taking heroin can mean exposure to fatal substances that far exceed fentanyl in potency and lethality. Professional addiction treatment from Ocean Breeze Recovery can save your life. A licensed and experienced staff will help you chart a course to sustained recovery, safely and effectively.
Call 855-960-5341 anytime, day or evening, for a free consultation with one of our knowledgeable addiction recovery specialists. They can help you locate the right treatment option. You can also contact us online for more information.
Analysis | See how deadly street opioids like 'elephant tranquilizer' have become. (n.d.). Retrieved from https://www.washingtonpost.com/graphics/2017/health/opioids-scale/?utm_term=.a4e76a68903d
DEA Issues Carfentanil Warning To Police And Public. (n.d.). Retrieved from https://www.dea.gov/press-releases/2016/09/22/dea-issues-carfentanil-warning-police-and-public
Heroin overdose: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from https://medlineplus.gov/ency/article/002861.htm
Lieber, M. (2018, May 01). Synthetics now killing more people than prescription opioids, report says. Retrieved from https://www.cnn.com/2018/05/01/health/fentanyl-opioid-overdose-study/index.html
McDonell-Parry, A. (2018, November 05). Could New Drug Approved by FDA Make the Opioid Epidemic Worse? Retrieved from https://www.rollingstone.com/culture/culture-news/opioid-fda-dsuvia-sufentanil-approved-752252/
Mettler, K. (2017, May 16). 'I was in total shock': Ohio police officer accidentally overdoses after traffic stop. Retrieved from https://www.washingtonpost.com/news/morning-mix/wp/2017/05/16/i-was-in-total-shock-ohio-police-officer-accidentally-overdoses-after-traffic-stop/?utm_term=.322b3e5bfbf4
National Institute on Drug Abuse. (2016, June 03). Fentanyl. Retrieved from https://www.drugabuse.gov/publications/drugfacts/fentanyl
Traffic stop almost turns deadly for ELO officer. (n.d.). Retrieved from http://www.morningjournalnews.com/news/local-news/2017/05/traffic-stop-almost-turns-deadly-for-elo-officer/
Why would anyone cut heroin with fentanyl? It's cheap, these researchers say. (n.d.). Retrieved from https://www.nbcnews.com/storyline/americas-heroin-epidemic/why-would-anyone-cut-heroin-fentanyl-it-s-cheap-these-n943796
American Pain Society. (2014 December) Journal of Pain. The Fentanyl Story. Stanley, T. Retrieved from https://www.jpain.org/article/S1526-5900(14)00905-5/pdf
Science Direct. (2017) Fentanyl Derivative. Designer drugs including bath salts and spices. Dasgupta, A. Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/fentanyl-derivative
National Training and Technical Assistance Center. Naloxone Toolkit. Administration of Naloxone. Retrieved from https://bjatta.bja.ojp.gov/tools/naloxone/Naloxone-Background