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Facts to Know About Carfentanil

Carfentanil is a highly potent drug that is responsible for a significant number of fatal overdoses. Even small levels of the drug can rapidly lead to an overdose. Street dealers have been known to cut heroin with carfentanil to boost the potency of their product while increasing their profit margins.

In addition, government officials worry about terrorists’ use of carfentanil as a weapon.

What Is Carfentanil?

Carfentanil is a synthetic opioid and fentanyl analogue, meaning that it is chemically similar to the highly addictive and potent drug fentanyl. It is used as an anesthetic in large animals.1

It appears as a white, powdery substance that can be snorted, smoked, injected directly into the bloodstream, or absorbed through the skin.1

Carfentanil is considered one of the strongest opioids available. It is 10,000 times more potent than morphine and up to 100 times more potent than fentanyl. The drug’s high potency makes it especially dangerous to humans.2 Because carfentanil is intended for large mammals, it has not been tested on humans and there is no way of knowing how much carfentanil is lethal.5

According to the Drug Enforcement Administration (DEA), carfentanil is a Schedule II drug, which indicates that it has a high potential for abuse and users can develop both physical and psychological dependence.1

Use With Heroin

Drug dealers may add carfentanil—as well as fentanyl—to heroin that is sold illegally on the streets.1 Since street drugs are not regulated, users may not even realize that they are using carfentanil.3

Even more so than with heroin, carfentanil can dangerously slow breathing and markedly increase the risk of a fatal drug overdose.3,4

The exact number of carfentanil and heroin-related deaths is unknown because many labs do not have experience identifying the drug.5 However, the number of deaths due to all fentanyl analogues, including carfentanil, increased from 3,105 in 2013 to 9,580 deaths in 2015.3 This nearly 300% increase reveals the serious dangers of carfentanil.

Effects of Carfentanil

Carfentanil users may experience a euphoric high similar to other opioids like heroin and prescription painkillers. Other carfentanil effects may include:2,7

  • Pain relief.
  • Constricted pupils.
  • Sedation.
  • Drowsiness.
  • Confusion.
  • Nausea.
  • Slowed breathing.

Long-term use of opioids like carfentanil can lead to:7

  • Pulmonary hypertension.
  • Cognitive problems, such as difficulty thinking clearly.
  • Infections secondary to injection use.
  • Multi-organ damage secondary to injection use and/or hypoxic episodes.
  • Increased risk of seizures.

Abusing opioids like carfentanil can also lead to dependence and addiction.6 People who are dependent on carfentanil may experience withdrawal symptoms when not taking the drug or when attempting to lower their usual dose. People who have developed addiction often compulsively use a drug despite knowing that it is causing serious harm to their health, relationships, and life.

Use as a Weapon

Carfentanil can be absorbed through the skin, which makes it particularly dangerous for law enforcement officials, emergency responders, and anyone that might come in contact with it.1 According to Andrew Weber, former assistant secretary of defense for nuclear, chemical, and biological defense programs, carfentanil’s use as a chemical weapon poses a potential terrorism threat.8

In 2002, Russians used an aerosol version of carfentanil to subdue Chechen terrorists who threatened to destroy a theater in Moscow.5,8 The terrorists took more than 800 hostages in a 3-day standoff.8 Emergency responders used naloxone, a medication used to reverse opioid overdoses, to save hostages. While the strategy was effective in stopping the terrorists, 167 hostages were killed by the gas.5

Israel’s secret intelligence service also used carfentanil during an attempt to assassinate Hamas leader Khaled Mashaal in Jordan in 1997.8

Government officials are concerned about the potential use of carfentanil to knock troops or others unconscious or to harm civilians in a closed environment, such as a train station. They fear that the drug could also possibly be used during assassinations or by terrorist groups like ISIS.8

China has continued to manufacture the drug, which is then exported to the United States and other countries. Fortunately, the United States and China have begun working on stricter regulations to reduce the manufacture and export of synthetic opioids like carfentanil.8


Carfentanil carries a high risk for overdose because of its potency. The drug can rapidly reach toxic levels in the body and can be fatal if not treated in time.1 Unsuspecting heroin users may more easily experience an overdose after unknowingly injecting a combination of heroin and carfentanil.3

Combining carfentanil with other respiratory depressants, including opioids, benzodiazepines, and alcohol, can also increase the risk of fatality.3

Symptoms of a carfentanil overdose can include:1,4,6

  • Constricted pupils.
  • Dizziness.
  • Fatigue.
  • Nausea.
  • Vomiting.
  • Cold, clammy skin.
  • Purple or bluish fingernails and/or lips.
  • Weak or absent pulse.
  • Loss of consciousness.
  • Shallow or slow breathing.
  • Respiratory arrest.
  • Death.

If you suspect that someone is experiencing an overdose, call 911 immediately.6 Treatment for an overdose may include breathing support, fluids, and various medications.7

Narcan, also known by its generic name naloxone, may be administered to counter the effects of a carfentanil overdose. However, because of the drug’s potency, several doses of Narcan may be needed.1,4 Unfortunately, Narcan is not always able to effectively reverse a carfentanil overdose.1

If you are abusing heroin you may be at risk for being exposed to carfentanil and experiencing an overdose. Contact us anytime for assistance finding a substance abuse treatment center that can help you recover from addiction.


  1. Drug Free VA. (2018). Carfentanil.
  2. Drug Bank. (2018). Carfentanil.
  3. National Institute of Drug Abuse. (2017). Research on the use and misuse of fentanyl and other synthetic opioids.
  4. Drug Enforcement Administration. (n.d.). Carfentanil: A dangerous new factor in the U.S. opioid crisis.
  5. Keating, D. & Granados, S. (2017). See how deadly street opioids like ‘elephant tranquilizer’ have become. The Washington Post.
  6. U.S. National Library of Medicine. (2018). MedlinePlus, Opioid abuse and addiction.
  7. U.S. National Library of Medicine. (2017). MedlinePlus, Opioid intoxication.
  8. Kinetz, E. & Butler, D. (2016). Chemical weapon for sale: China’s unregulated narcotic. AP News.

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