Medical examiner office to carry Narcan, citing concern over carfentanil

Official: "It's so potent that if we come in contact with it, we can get overdose symptoms."


By Naseem S. Miller
Orlando Sentinel

ORANGE COUNTY, Fla. — Carfentanil, a synthetic chemical mixed with heroin that is showing up across the nation and in Florida, is so powerful that the Orange-Osceola Medical Examiner's office has decided to prepare for its dangerous effects on staff who conduct autopsies.

The ME has carrying naloxone, the drug that reverses the effects of opioid overdose, in case employees unexpectedly come in contact with carfentanil in the cadaver.

Carfentanil is 100 times more potent than fentanyl and 10,000 times more potent than morphine.
Carfentanil is 100 times more potent than fentanyl and 10,000 times more potent than morphine. (Photo/NPR)

"It's so potent that if we come in contact with it, we can get overdose symptoms," said Dr. Joshua Stephany, Orange-Osceola Chief Medical Examiner. His office is one of the first in the state to carry naloxone for this purpose.

"There has been nothing else really that we've had to prepare ourselves for on an immediate basis," Stephany said.

Carfentanil is a fentanyl-related compound that has been used since the 1970s by veterinarians to tranquilize large animals like elephants. It is 100 times more potent than fentanyl and 10,000 times more potent than morphine. And unlike fentanyl, which is used in medicine to treat severe pain, carfentanil is not meant for human consumption.

Its illegally manufactured form has been showing up in the United States since July, usually mixed with the heroin supply. Experts say that's not because users are seeking the drug; at some point in the supply chain, the compound is mixed with heroin to cut costs and increase profit.

"Fentanyl drugs are much cheaper than heroin," said Danny Banks, the special agent in charge for FDLE Orlando Region. "A pound of fentanyl is a fraction of the cost of actual heroin. It's all money and greed driven. ... And we're trying to see where these drugs are getting introduced to the streets."

Banks has also equipped his lab, which is the largest FDLE lab in the state, with naloxone in case his staff comes in contact with carfentanil.

"I've lived my entire life in Central Florida and I've never seen more toxic and deadly drugs than the fentanyls," he said.

According to a recent investigation by the Associated Press, carfentanil can be purchased easily online from at least nine companies in China. The drug is a controlled substance in the United States, but not in China, according to the AP.

The lethal compound has shown up in more than 400 cases of drug seizures in the United States this year, according to the Drug Enforcement Administration. Ohio has had the highest number of such cases at 343, followed by Florida at 34, and Kentucky with 14. Indiana and Illinois account for the rest of the cases, according to the DEA.

The Florida Department of Law Enforcement said carfentanil has shown up four times this year in drug samples that are submitted by local law enforcement agencies to FDLE labs for analysis -- in Fort Myers, Tampa and Jacksonville.

And local officials worry that it won't be long before the chemical starts claiming lives in Central Florida.

"Drugs that are seized aren't analyzed immediately, so I'd be cautious in saying that it's not here yet," said Banks. "I'm confident that if it's not here now, it'll be here shortly."

Orange County deputies and Orlando police officers began carrying naloxone earlier this year to save lives and curb the spike in area's heroin-related deaths. But the opioid overdose antidote may not be enough to reverse the effects of carfentanil in unsuspecting users.

When the compound first showed up earlier this year in Ohio's Hamilton County in the local supplies of heroin, the county recommended that law enforcement officers and first responders stop field-testing suspected heroin.

"Take this as a dire warning to all, if you choose to purchase and use any forms of heroin," said Hamilton County Coroner, Dr. Lakshmi Sammarco to the community, in a July press release. "Don't count on Narcan to be able to reverse the effects of carfentanil."

Copyrights 2016 The Orlando Sentinel 

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