Health officials are warning about a drug 100 times more potent than fentanyl that has caused deaths in 37 states in recent years.
The drug, called carfentanil, is a derivative of fentanyl that was designed to tranquilize elephants, and is the most potent commercial opioid on the market.
There were 513 overdoses from carfentanil between January 2021 and June 2024, hitting states like Florida and West Virginia the hardest, according to a CDC report published today.
But while the overall numbers are low, officials are concerned because the total has increased increased seven-fold in the past year.
This could threaten to reverse a recent drop in drug overdoses seen in the country.
Carfentanil comes in powder, paper, tablet, patch and spray form, and can be inhaled, ingested or absorbed through the skin.
In it’s powdered form, the drug mimics cocaine or heroin, and is often mixed into other illegal drugs like xylazine or counterfeit pills.
As little as 2 milligrams, about one 50th of a pinch of salt, of the drug can be lethal – slowing breathing to dangerous levels, leading to brain damage or death.
The CDC report included data from January 2023 to June 2024, with the number of overdose deaths that were attributed specifically to carfentanil. Four states did not participate in the analysis
This picture shows the lethal doses for an average adult of various opioids like heroin, fentanyl and carfentanil. Carfentanil is 100 times more potent than fentanyl and 10,000 times more potent than morphine
CDC officials said: 'recent sharp increases in overdose deaths with carfentanil detected, although rare, highlight the ever-changing illegal drug supply and threaten progress in reducing overdose deaths.'
According to the DEA, the drug is 10,000 times more potent than morphine and 100 times more potent than fentanyl.
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It's unclear where the drugs are coming from, but the report states that they were likely manufactured illegally, not stolen from legal caches.
In a 2021 drug bust in Southern California, police found 21 kilos of the drug in the home of two US residents, Christine Ponce and Andres Jesus Morales.
Before it hit the streets, carfentanil was originally designed in 1974 to treat large mammals like elephants and bears.
It works on the same systems in the brain as codeine, heroin and oxycodone, and essentially stops or dulls pain. It's highly addictive.
Powdered fentanyls entered the US later than they did in other countries because they were difficult to mix into black tar heroin, which used to be more common, according to the CDC report.
But as prescription and counterfeit pills became more popular in the past few decades, it became easier to sneak these super-potent opioids into the supply.
The CDC tracked the total number of overdose deaths over each year, and compared the amount of those that were caused by illegally manufactured fentanyls (IMF), like carfentanil. Though the overall number of overdoses decreased, they said the number of carfentanil specific overdoses was going up
In 2021, police ceased 21 kilos of carfentanil from the home of a couple in Riverside County, California. It was the largest seizure of the drugs in the area at the time
In addition, dealers often mix the products into their supply in order to make their wares more potent for cheap, which keeps users wanting more, according to the DEA.
The CDC report found that seven in 10 drug overdose deaths in the US in 2023 involved fentanyl or one of its derivatives like carfentanil.
The report used a national overdose reporting system, which gathers data from death certificates, coroner's reports and toxicology reports to summarize drug overdose deaths. The new report included information from 2021 through 2023 for all overdoses, but tracked carfentanil specifically through the first half of 2024.
Of the 251,089 drug overdoses over the two year period, 74 percent were linked to fentanyl or a fentanyl derived drug. In 2023, 63,734 Americans were killed by fentanyl or one of its derivatives.
The report found the overall number of overdose deaths has been going down quarter by quarter in 2023, as has the total number of illegal fentanyl-derived drugs on the streets.
Yet at the same time, drug overdoses from carfentanil have been rising.
Florida and West Virginia were the only two states with more than 20 deaths linked to the drug.
They were followed by Illinois, Indiana, Kentucky, Maryland, Michigan, New York and Ohio, which reported 10-19 deaths from the drug over a 18 month period.
Alexandra Capelouto died after taking fentanyl two days before Christmas in 2019. Alexandra was 19 when she took what she thought was oxycodone to help her sleep
Further, the CDC report said, if carfentanil continues spreading: 'overdose deaths could substantially increase.'
This is of particular concern because this uptick is substantially different than an outbreak that occurred in 2016, where it seemed to be contained within a few states.
The Drug Enforcement Agency (DEA) recommends anyone who has been exposed to the drug seek immediate medical attention.
If someone gets exposed to the drug, the DEA notes that early symptoms may include drowsiness, disorientation, pinpoint pupils, slowed breathing and clammy skin. At this point, they urge the person to call 911.
If left untreated, someone may stop breathing, and the lack of oxygen can lead to breath or severe brain damage.
Professionals or bystanders can use naloxone, an FDA-approved medicated inhaler, to reverse the overdose and avoid the worst outcomes, if they act quickly.
Chuck Rosenberg, who was the Acting Administrator of the DEA in 2016, said of these drugs: 'We see it on the streets, often disguised as heroin. It is crazy dangerous.
Synthetics such as fentanyl and carfentanil can kill you. I hope our first responders - and the public - will read and heed our health and safety warning.'