US DEA steps up warnings about "crazy dangerous" carfentanil

The US government has issued a fresh public warning about the risks of carfentanil, a super-potent opioid linked to an outbreak of overdose deaths.

"Carfentanil is surfacing in more and more communities [and] has been linked to a significant number of overdose deaths in various parts of the country," said Chuck Rosenberg, acting administrator of the Drug Enforcement Administration (DEA).

"We see it on the streets, often disguised as heroin," he added. Carfentanil's presence in the illicit supply chain raises real concerns that - as with fentanyl - criminals may end up using the drug in counterfeit opioid painkillers.

The "crazy dangerous" drug, generally used as a large-animal tranquilizer - is 10,000 times more potent than morphine and 100 times more potent than fentanyl, which can itself be lethal at doses of just 2mg, depending on route of administration and other factors.

The DEA has issued the following advice to first responders and members of the public who fear they may have come into contact with the substance:

Exercise extreme caution. Only properly trained and outfitted law enforcement professionals should handle any substance suspected to contain fentanyl or a fentanyl-related compound. If encountered, contact the appropriate officials within your agency;

Be aware of any sign of exposure. Symptoms include: respiratory depression or arrest, drowsiness, disorientation, sedation, pinpoint pupils, and clammy skin. The onset of these symptoms usually occurs within minutes of exposure;

Seek IMMEDIATE medical attention. Carfentanil and other fentanyl-related substances can work very quickly, so in cases of suspected exposure, it is important to call EMS immediately. If inhaled, move the victim to fresh air. If ingested and the victim is conscious, wash out the victim’s eyes and mouth with cool water;

Be ready to administer naloxone in the event of exposure. Naloxone is an antidote for opioid overdose. Immediately administering naloxone can reverse an overdose of carfentanil, fentanyl, or other opioids, although multiple doses of naloxone may be required. Continue to administer a dose of naloxone every 2-3 minutes until the individual is breathing on his/her own for at least 15 minutes or until EMS arrives; and

Remember that carfentanil can resemble powdered cocaine or heroin. If you suspect the presence of carfentanil or any synthetic opioid, do not take samples or otherwise disturb the substance, as this could lead to accidental exposure. Rather, secure the substance and follow approved transportation procedures.