Image: 2 milligrams of carfentanil next to a penny for comparison.
So we've talked before about the rise of fentanyl analogs in opiate and opioid overdoses, and recently some new players have popped up on my tox reports. Butyryl fentanyl, furanyl fentanyl, para-fluorobutyryl fentanyl/FIBF…all forms of fentanyl that have been slightly tweaked, and all deadly.
But I've been waiting for carfentanil – a form of fentanyl so powerful that NO amount of dilution is safe for human use – to pop up in the areas in which I practice, and the word is that it has arrived. To give you some perspective – the amount depicted in the photo above isn't how much fatal to people, but instead what's needed to incapacitate a 4-ton elephant. Last August, a kilogram of carfentanil shipped from China to Vancouver, BC was seized in transit by local authorities; that's enough product to kill EVERYONE IN CANADA, with enough left over to wipe out all of New York City, as well. (Which begs the question – who the hell needs a kilo of carfentanil? How on earth was the recipient planning to distribute that? Or store it safely?) Words are pretty inadequate to describe the effect of carfentanil-laced heroin on any given population. I'm pretty sure I won't need to wait for tox report to know that carfentanil has tainted the local heroin supply - dozens of fatal overdoses over a short period, or the word that there is just no more room for bodies in the cooler are probably reliable indicators.
First responders, paramedics, EMTs, ER docs, and death investigators – please be very, very careful out there. This is uncharted territory.
On a happier note, I'm pleased to report that Clint, the cat rescued by @project.meow who has micro-ophthalmia, has been adopted! New pic of his handsome self is up at @project.meow. #forensic #pathology #deathunderglass #autopsy #opiates #overdose #heroin #fentanyl #carfentanil #projectmeow