United States Drug Enforcement Administration

Over the past two decades, synthetic opioids have increased the threat of the ongoing opioid epidemic. Nearly 70% 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. 

Carfentanil is a chilling reminder of how the opioid epidemic continues to evolve and introduces new threats at an alarming pace. 

What is Carfentanil?

Carfentanil is a synthetic opioid originally developed for veterinary use, more specifically to tranquilize large animals such as elephants. It is extraordinarily potent and not approved for human use. In fact, it is estimated to be 10,000 times more potent than morphine and 100 times stronger than fentanyl. 

Because of its strength, a nearly microscopic amount of carfentanil can induce a powerful, and often deadly, effect in humans. 

In an effort to increase drug potency and profits, carfentanil has been found mixed with other drugs or pressed into pills that look like prescription painkillers. This increases the likelihood of fatal overdose and poisoning deaths, especially among users who are unaware they are ingesting such a powerful substance.

Increasing Prevalence

DEA, local law enforcement, and first responders have recently seen an increased presence of carfentanil in the illicit drug market, which has been linked to a number of overdose deaths in various parts of the country. According to the CDC, deaths involving carfentanil increased approximately sevenfold – from 29 deaths from January to June 2023, to 238 deaths from January to June 2024. Carfentanil has now been detected in 37 states.

The current rise in carfentanil prevalence is reminiscent of previous surges observed in late-2016-2017 and 2019-2020. During these periods, the DEA noted significant increases in carfentanil encounters. During this current wave, DEA laboratories have tested more than 100 kilograms of carfentanil mixed with fentanyl, fentanyl-related substances, and other drugs in calendar year 2024 alone. This is larger than the three previous calendar years combined, which totaled approximately 87 kilograms of seized material containing carfentanil. 

The majority of carfentanil seizures throughout 2024 were in a pill or tablet form, not the typical powder form previously encountered. This trend is concerning due to:

• Increased Risk of Overdose: The extreme potency of carfentanil significantly increases the risk of overdose and death, even with a single pill.
• Deceptive Appearance: Within the past year, more carfentanil is being pressed into pills that resemble prescription medications, leading to unintentional consumption by individuals who believe they are taking a less potent drug.

Overdose and Treatment Challenges

Exposure to carfentanil can cause respiratory depression or arrest, drowsiness, disorientation, sedation, pinpoint pupils, and clammy skin. The onset of these symptoms usually occurs within minutes of exposure. Its rapid effect on the central nervous system leaves little time for life-saving interventions.

Treating an overdose involving carfentanil is extremely difficult. While naloxone is widely used as an emergency antidote for opioid overdoses, it may not be effective against carfentanil in normal doses. Multiple, high doses of naloxone may be required, and even then, effective reversal of an overdose is not guaranteed.

Raising Awareness and Staying Safe

Public awareness is critical to preventing overdoses and poisonings involving synthetic opioids. Anyone who might encounter illicit substances, including powders and fake pills, should be aware of the potential presence of carfentanil.

Public education and increased awareness are needed to combat the devastating impact of synthetic opioids, like carfentanil.

Remember that One Pill Can Kill. To protect yourself:

• Avoid Illicit Drugs and Fake Pills: Refrain from using illicit drugs, as they may contain carfentanil without your knowledge. Never take a pill that was not prescribed to you by a doctor and dispensed by a licensed pharmacist.
• Seek Help: If you suspect someone has been exposed to carfentanil or is experiencing symptoms of overdose, call emergency services immediately and administer naloxone, if available.
• Stay Informed: Understand the dangers of carfentanil and educate your loved ones about the risks associated with synthetic drugs.