ECDOH alerts community to presence of carfentanil - a synthetic opioid 100x more potent than fentanyl

Recent lab tests confirmed carfentanil in both a local patient and an unrelated criminal case

Submitted by the Erie County Department of Health

The Erie County Department of Health is alerting the community that recent toxicology testing detected carfentanil in the local unregulated drug supply. As a fentanyl analogue – which means it is a substance that has a similar chemical structure to fentanyl – carfentanil is a synthetic opioid that is up to 100 times more potent than fentanyl. That stronger potency means that a small dose of carfentanil can cause immediate and severe adverse reactions, including overdose or death.

“These recent, unrelated tests confirm what we know about the nature of the opioid epidemic: That using unregulated drugs comes with inherent and unknown risks,” Commissioner of Health Dr. Gale Burstein said. “We are sharing this information with our partners who work in harm reduction, drug treatment and recovery because people who use drugs can take protective measures to reduce their risk of overdose and death.”

Those safety actions:

•Never use alone. Have Narcan and a friend with you who is not using drugs, or contact a service like Never Use Alone (neverusealone.com)

•Have Narcan and know how to use it. Narcan (naloxone) will work to reverse the effects of carfentanil exposure. However, because of its extreme toxicity, more Narcan doses may be required to get a person breathing again. Administer Narcan to restore breathing, but understand that the person may not be responsive or aware enough to speak. If they are breathing, they are alive, and that is the goal.

•Test unregulated drugs. Fentanyl test strips are available for people who use drugs to test for fentanyl. No test is 100% accurate. Fentanyl test strips do not indicate which type of fentanyl or fentanyl-analog, like carfentanil, is present, nor do they indicate the concentration or potency. Carfentanil can be present in such a small amount that it may not be reliably detected through fentanyl test strips alone. Since carfentanil is typically found in combination with fentanyl, people who use drugs should continue to test their drugs and take further steps to reduce their overdose risk. People who use any drugs, especially people who use cocaine, should expect that their drugs contain opioids that could cause an overdose – now possibly including carfentanil – stop their breathing, and lead to death.

•Wash your hands. If you come into contact with any unregulated drugs, wash your hands immediately and thoroughly with soap and water. Powder or drug residue left on one’s hands could be inhaled or ingested inadvertently.

This information is also important for the general public. People across all age groups and demographics use or may use unregulated drugs. Recognizing overdose signs, having Narcan and knowing how and when to use Narcan to reverse an overdose could save the life of a family member, friend, coworker or neighbor.

Erie County offers regular, free Narcan trainings (www.erie.gov/narcan).

The Erie County Medical Examiner’s Office reported 376 confirmed or suspected drug overdose deaths in 2024 as of Jan. 8.

“Though this represents a preliminary 14% decline from the record-high 436 overdose deaths in 2023, each of these deaths is preventable, and each is one too many,” Burstein explained.

History & background

Although carfentanil has some limited veterinary use to anesthetize large animals, like elephants, for surgery or medical treatment, carfentanil that is diverted, stolen or manufactured overseas is added to cocaine, methamphetamine, fentanyl or other unregulated drugs as a cheap, easy to obtain filler substance.

In November 2023, the Erie County Medical Examiner’s Office confirmed the first Erie County opioid-related overdose death linked to carfentanil. Carfentanil has been detected in a handful of fatalities since November 2023.

The New York State Department of Health issued a health alert in June 2024 after community-based drug checking detected carfentanil in Central New York’s unregulated drug supply.

The Erie County Department of Health (ECDOH) offers harm reduction supplies and peer support – call 716-858-7695. Other ways to reduce the risk of harm from drug use:

√ Carry Narcan, and know how and when to use it. Text 716-225-5473 to have Narcan and fentanyl test strips mailed to you for free.

√ Never use alone. Have Narcan and a friend with you who is not using drugs, or contact a service like Never Use Alone (neverusealone.com)

√ Test your drugs for fentanyl even if you think it is cocaine or another substance that is not an opioid. Free test strips available from the ECDOH. Call 716-858-7695.

√ Seek support. ECDOH has peer navigators and a family coordinator; call 716-858-7695. The Buffalo & Erie County Addictions Hotline is available 24/7 with referrals for individuals and their families. Call 716-831-7007.

√ Seek treatment. Local hospital emergency departments can connect patients to immediate medication assisted treatment. Ask for MATTERS Network.