If you have seen recent news stories talking about the surge in U.S. carfentanil deaths, you might be wondering if we are on the verge of a fourth “wave” of the opioid epidemic. While the recent increase in carfentanil deaths is deeply concerning, carfentanil overdose deaths still only make up a very small percentage (< 1%) of total drug overdose deaths in the U.S. In this article we will explain what carfentanil is, why it is dangerous, and what to watch for in the coming months.
Carfentanil is a fentanyl derivative that is used to tranquilize large animals such as elephants. It is incredibly potent with an estimated strength at 10,000 times the potency of morphine and 100 times the potency of fentanyl.
Carfentanil deaths have occurred over the course of the opioid epidemic but these occurrences are generally rare and make up a tiny percentage of total drug overdose deaths. However, in 2016 and 2017, U.S. overdose deaths shot up (~33% increase) and this increase was correlated with a huge increase in carfentanil seizures by law enforcement. It was believed that, over these two years, localized injections of carfentanil into the illicit drug market contributed to a surge in overdose deaths. Five states (Ohio, Florida, Pennsylvania, Kentucky and Michigan) saw big increases in carfentanil seizures and also experienced a higher than average number of overdose deaths over that time.
Since 2017, carfentanil has rarely been mentioned when talking about the opioid epidemic. However, a recent report from the CDC shows that carfentanil overdose deaths are rising at the same time that overall opioid overdose deaths are falling.
Carfentanil accounted for 513 overdose deaths from January 2021 through June of 2024 but only around 100 of these deaths were recorded during the 30 months spanning January 2021 through June 2023, or roughly 20 deaths every six months. The remaining 413 deaths occurred during the 12 months from July 2023 to June 2024. 175 carfentanil overdose deaths were recorded from July 2023 until December 2024 and another 238 carfentanil overdose deaths were recorded in the first 6 months of 2024.
As a percentage of total drug overdose deaths, carfentanil is still a minor contributor (around 100,000 people died from drug overdose each year from 2021 through 2024). However, since it is a fentanyl derivative, it has all the components that make fentanyl so dangerous, plus it has a potency that is 100 times the strength of traditional fentanyl. The sharp rise in carfentanil overdose deaths combined with the fact that these deaths have occurred across 37 U.S. states since 2023 is definitely concerning.
It is much too early to determine if carfentanil use will become more widespread in the U.S. However, if carfentanil use were to spread, then overdose deaths can be expected to rise at an alarming rate. At a potency of 100 times that of fentanyl, even miniscule errors in production or use could result in an individual receiving a lethal dose of the drug. The current surge in carfentanil deaths could come to mirror the prior surge from 2016 - 2017 but, hopefully, early detection will prevent this from happening.
Moving forward it will be important to monitor reported carfentanil overdoses, deaths, and perhaps most importantly, the spread of carfentanil use across the U.S. The 2016-2017 surge was mainly concentrated in a handful of states, if carfentanil becomes widespread across many more states, then the U.S. could expect a surge in drug overdose deaths.
Carfentanil is another example of how potent opioids continue to work their way into the drug supply chain. From Oxycontin to heroin to fentanyl; if a smaller amount of a drug can be used to achieve a similar high then it becomes easier and more cost effective to supply the more potent drug. This is why the Resilient System could have such an incredible impact. By automatically detecting and reversing the effects of an opioid overdose, the system can protect people from changes to the drug supply, particularly when they are unaware that what they are ingesting is incredibly lethal.
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