Research Paper on Carfentanil

Introduction

Drug abuse has been an issue that has affected individuals from all around the globe despite the efforts to curb this issue. Most drugs abused are cocaine, heroin among others. However, studies show that although carfentanil is meant for tranquilizing and sedating farm or wild animals, people abuse this drug. Carfentanil is known to be the most toxic opioids given the report by the Drug Enforcement Agency (U.S. Department of Justice Drug Enforcement Administration, 2016). For instance, carfentanil is known to be 10,000 times more dangerous than morphine and 4,000 times more potent than heroin. When used by humans, a small dose of 1 microgram is adequate to trigger the same response of another drug of about 20 micrograms. In this case, the paper aims at evaluating carfentanil in depth to come up with the best strategy for combating both the distribution and abuse of this drug.

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Drug Overview

According to the report released by DEA on Drug Threat Assessment, the arrival of carfentanil, a fentanyl-related compound in the US markets is a growing factor in the ongoing overdose epidemic (U.S. Department of Justice Drug Enforcement Administration, 2017). Carfentanil (4-carbomethoxy fentanyl) is an analogue drug of the synthetic opioid fentanyl which was initially synthesized by Janssen pharmaceutical in early 1974 and sold under the name of Wildnil (Gladden, 2016). Common street names for carfentanil include "C.50", "drop dead" and even "serial killer". However, when combined with other opioid-like drugs, carfentanil is referred to as "grey death" (George et al., 2010). As a drug that has no distinct odour, carfentanil comes in different forms such as liquid, sprays, patches, powder, blotted paper and even tablets. Even though powdered carfentanil seems to resemble heroin or cocaine, this drug is mostly seized in pink, yellow and brown powder.

Type of Drug and its Availability

As a sedative drug, carfentanil is believed to be manufactured in Mexican cartel labs and also mailed into the US markets from China in small quantities. According to the DEA, carfentanil that enters in the US through the Mexico border is mostly 4 to 6% pure since cartels have already diluted it while the smaller quantities from China are mostly pure, (90%) (U.S. Department of Justice Drug Enforcement Administration, 2016). Carfentanil is available on the streets and sold illicitly like other drugs. In many cases, this drug is added to heroin and cocaine given its state of being odourless. In other words, China and Mexico are countries considered primary sources for carfentanil and other opioids. The DEA reveals that among the deaths reported in these years, 11,045 deaths resulted from opioid overdose (2,275 representing 20.6% had tested positive for fentanyl analogue 1,236 testing positive for carfentanil representing 11.2%). These victims were mostly from Massachusetts, New Mexico, Maine, Rhode Island, Ohio and Wisconsin (U.S. Department of Justice Drug Enforcement Administration, 2017).

Information on the Use of Carfentanil

Carfentanil is an agonist on the mu-opioid receptors mostly in the central nervous system and also suppresses the respiratory system. Ohio has the largest number of individuals who lost their lives from the use of fentanyl analogue including carfentanil in 2016 only (U.S. Department of Justice Drug Enforcement Administration, 2016). For instance, the number of deaths from carfentanil in Ohio rose in September 2016 and went down from October 2016 to February 2017 though peaked again in April where over 218 individuals died from using carfentanil (Gladden, 2016). Just like in Ohio, the number of deaths with carfentanil followed a similar pattern in other states like Los Angeles, New York and Atlanta with most of them registering an increase in overdose deaths with carfentanil from 54 to 77 (U.S. Department of Justice Drug Enforcement Administration, 2017). The transportation of this drug is mostly via people who supply it to heroin or cocaine users without their knowledge. A good example is the case of a man who was caught distributing this drug as heroin in central Ohio, where he faced 20 counts including one death and nine overdoses that occurred within hours of carfentanil usage (U.S. Department of Justice Drug Enforcement Administration, 2016).

Form of Drug and Usual Routes of Administration

Carfentanil is meant explicitly for tranquilizing and sedating animals. However, in humans, this drug is used to adulterate fentanyl, heroin, cocaine and other drugs with a purpose of relaxing one's mind. It is for the fact that carfentanil is and has never been used intentionally given its potency and the harmful potential. Routes of administering carfentanil differ depending on the form in which the drug is. For instance, carfentanil exists in various forms such as liquid, powder, tablets among others. In this case, oral administration of carfentanil which is in liquid form is always injected into the system by the users (George et al., 2010). When in the form of tablets, carfentanil is swallowed orally. This oral route is convenient and applicable where the user wants the drug to be slowly digested in the stomach before entering the bloodstream. However, when in powder form, carfentanil is always inhaled and thus absorbed quickly in the blood. As the fastest mean of getting the drug to the brain, inhalation is the most dangerous route given the fact that carfentanil directly moves to the brain without the system circulation diluting it (Gladden, 2016).

Source: Manchester Ink Link (Robidoux, 2017)

The DEA further reports that carfentanil is also identified in other mixtures along with furanylfentanyl, Antihistamines, caffeine and in other cases, found to have ketamine (U.S. Department of Justice Drug Enforcement Administration, 2016). The DEA reveals that carfentanil has in many instances been distributed in counterfeit prescriptions pills that are sold in the form of Xanax and OxyContin (U.S. Department of Justice Drug Enforcement Administration, 2017). Studies show that the effects of carfentanil in humans are severe and tend to appear rapidly. An example of these symptoms include nausea, clammy skin, pinpoint pupils, dizziness, sedation, respiratory disorders, sudden drowsiness, vomiting and even weak pulse. The DEA assessment and report thus advises on the need to seek medication in case of the above-mentioned signs since the symptoms are dose dependent (U.S. Department of Justice Drug Enforcement Administration, 2016). For instance, high doses rapidly cause severe intoxication and death.

Federal Schedule of Drugs

Federal schedule of drugs looks at the potential at which the drug can be abused and also its medical value before categorizing it. This scheduling aims to control all intoxicating drugs thus preventing the problematic use of drugs depending on the scientific definition of possible drug abuse disorders. In other words, drugs or rather medications that are easily abused are considered as controlled substances and are categorized into 5 schedules (Gladden, 2016). Schedule I consist of substances that have a high potential of being abused yet have no medical use, schedule II controlled substances are classified based on a high potential of abuse and mostly lead to a severe physical or psychological dependence and have an accepted medical use. Schedule III substances are categorized based on their intermediate potential for abuse, schedule IV substances have a less abuse potential while schedule V are those drugs with the least potential of being abused (George et al., 2010).

As an analogue fentanyl, carfentanil falls under schedule II drugs given its nature of being the most potent synthetic opioids. It is also factual that carfentanil is useful in providing therapy for large animals such as elephants yet harmful to humans. Just like cocaine, dihydrocodeine, methadone, metazocine, levorphanol, alfentanil and even dextropropoxyphene that fall under schedule II drugs, carfentanil has an extreme potency which makes it dangerous for use in humans (George et al., 2010). However, in cases of misuse by humans, the schedule II drugs always lead to the increase in the number of fatalities, especially when combined with other substances. Research shows that carfentanil just like other schedule II drugs has enormously contributed to the issue of opioid epidemic not only in Ohio but the United States as a whole (Misailidi etal., 2018). In scheduling carfentanil, the administrative burdens mostly put on research institutions, and veterinary is useful in reducing harm due to the potential abuse of carfentanil.

The Best Strategy for Combatting Sales and Abuse of Carfentanil

Although carfentanil users are innocent victims who take the drug unknowingly, the blame is put on those people who illegally let carfentanil in the country and distribute it. In this case, unless our money is used in interdicting carfentanil from entering our country, then issues of overdose and death will increase. It is, therefore, advisable that our money is used in educating parents who are on the front-line as well as influential in preventing their children from using heroin or cocaine which are mostly mixed with carfentanil, an act that will make carfentanil traffickers lack a market for their product. The money can further be used in purchasing resources for educating parents to warn the youths on the dangers of opioid misuse and addiction and in return reduce the usage of not only carfentanil but other drugs like cocaine and heroin (Gladden, 2016).

Additionally, our money can be used to educate the public about the dangers of using opioid-like carfentanil and the need to raise the alarm in case someone is spotted selling these drugs. This strategy will scare away those who bring carfentanil in the country as they will be afraid of being caught. Arguably, the state can keep the youth from using carfentanil through funding prevention initiatives which through trained prevention specialists can educate the vulnerable population (children and adolescents) on the effects of carfentanil and substance use (Misailidi etal., 2018). Concerning treatment, the state money should be used in providing victims with insurance coverage. On the other hand, the federal money can be useful in curbing the carfentanil epidemic through block grants. Blocking federal grant aid for carfentanil and other opioid-related substances will channel the money on supporting evidence-based programs that will provide education for risks associated with the use of carfentanil (U.S. Department of Justice Drug Enforcement Administration, 2017). The state money can also be used in helping youths with substance use disorder by ensuring they have a life-saving access to healthcare benefits.

Conclusion

Carfentanil is a toxic opioid enough to be fatal yet added to heroin and cocaine by drug dealers. As a result, carfentanil depresses the cough reflex and further constricts pupils besides affecting the central nervous system. In this case, it is the role of the state and the federal government to effectively develop initiatives that prevent drug traffickers from sneaking carfentanil in the country by equipping heavy penalties on them. By doing so, they will have reduced the accessibility and availability of this drug for users who innocently take it.

References

U.S. Department of Justice Drug Enforcement Administration. (2016). 2016 drug threat assessment: Fentanyl-related overdose deaths rising at an alarming rate. Washington, DC: DEA Intel Publication. Retrieved from https://www.dea.gov/press-releases/2016/12/06/dea-releases-2016-drug-threat-assessment-fentanyl-related-overdose-deaths

U.S. Department of Justice Drug Enforcement Administration. (2017). 2017 national drug threat assessment. Washington, DC: DEA Intel Publication. Retrieved from https://ww...