Law enforcement and healthcare professionals in Maine are preparing for the arrival of a powerful new opioid drug already linked to a rash of overdoses in the Midwest.
Carfentanil is suspected in the weekend overdose of a 24-year-old York man who required six doses of the opioid antidote Narcan to be revived. It may be several weeks before the state crime lab returns results from its tests for the drug.
In the meantime, law enforcement officials are warning drug users and the public that contact with even small amounts of carfentanil can be deadly.
“If you find the substance in your house, call us,” said Sgt. John Lizanecz of the York Police Department. “We’re not trying to arrest anybody. We just want to get people the help they need and stop this drug from coming into the state.”
Carfentanil is a synthetic opioid 100 times more powerful than fentanyl, which itself is 50 times more potent than heroin. It is used as a tranquilizer for elephants and other large animals and can be found in multiple forms including powders, blotter papers, tablets and sprays. The minimum lethal dosage for humans is not known but the drug, which can be absorbed through the skin, inhaled or ingested, is so deadly that law enforcement agencies are encouraged to approach it like a hazardous material.
“They liken it to granules of salt,” Lizanecz said. “Inhaling just a couple of those granules can kill you.”
In September, the Drug Enforcement Administration issued a warning to the public and law enforcement calling carfentanil “crazy dangerous” and “a serious danger to public safety.” The drug is often disguised as heroin, they said, and users may not be able to differentiate it from less potent opioids. There have been no confirmed cases of carfentanil in Maine or the rest of New England, according to Timothy Desmond, special agent with the New England division of the DEA.
“We’re out in front of it, ” Desmond said. “We hope it doesn’t make it here but we’re bracing for it.”
Before it hit American streets, carfentanil was studied for its potential use as a chemical weapon. According to an investigation by the Associated Press, the U.S., Russia, China, Israel and India were among several countries researching the drug’s offensive and defensive applications. In 2002, Russian special forces deployed an aerosol mixture of carfentanil and another anesthetic through the air vents of a Moscow theater where Chechen separatists had taken 800 people hostage. A later study attributed 125 of the 129 hostage deaths to “a combination of the aerosol and inadequate medical treatment following the rescue.”
When carfentanil arrived in U.S. communities, it announced its presence with a deadly spike in overdoses. Last month, officials in Ohio, considered the epicenter of the carfentanil epidemic, declared a public health emergency after the drug was linked to record increases in drug overdose deaths in the state.
“Instead of having four or five overdoses in a day, you’re having these 20, 30, 40, maybe even 50 overdoses in a day,” Tom Synan, director of the Hamilton County Heroin Coalition Task Force in Southwest Ohio, told NPR.
Officials in Indiana, West Virginia and Kentucky are among several states reporting similar spikes in overdose deaths. In September, officials in Cincinnati, Ohio, charged two people with distributing heroin laced with the drug in what might be the first federal carfentanil case.
The DEA is encouraging law enforcement and other rescue workers to be prepared to administer the anti-opioid Narcan, also known as naloxone, to anyone suspected of overdosing on carfentanil. Narcan blocks the effects of opioids and reverses overdoses, though it is reportedly less effective with carfentanil and may require numerous applications.
In April, Gov. Paul LePage vetoed a bill to allow pharmacists to dispense Narcan over the counter to family members and friends of individuals at risk of an opioid-related overdose, saying that “naloxone does not truly save lives; it merely extends them until the next overdose.”
The Maine Legislature subsequently overrode his veto.
Attorney General Janet Mills began providing Narcan to law enforcement agencies in the state this spring using funds from court settlements to pay for the drug.
“Making Narcan available to police agencies is simply part of my responsibilities to law enforcement and is in aid of their responsibility to save lives,” Mills told the Portland Press Herald. “Simple as that.”
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