Deadly Drugs Warning

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There have been a rising number of deaths in Europe and America linked to the use of two opioid drugs – fentanyl and carfentanil – that are reportedly being mixed into heroin.

Now, both fentanyl and carfentanil appear to have arrived in the UK – several people in the northeast of England have died in the past month after using heroin cut with fentanyl and/or carfentanil.

Fentanyl and carfentanil are highly potent, rapidly acting opioid drugs. Fentanyl is 100 times more potent than morphine, while carfentanil is 10,000 times more potent than morphine. In comparison, heroin is 4-5 times more potent than morphine.

Some dealers in the UK seem to be cutting heroin with fentanyl or carfentanil, thereby increasing the strength of their product. A small dose of carfentanil is commonly used legally as a sedative for elephants, bears, and other large mammals.

Taking precautions

It is impossible to tell by sight whether heroin has been cut with fentanyl or carfentanil, but there are some precautions that can be taken to reduce the potential for overdose. However – both fentanyl and carfentanil are potent at such low doses that there is a significant risk of death if those drugs are being consumed, even if harm reduction steps are taken.

The following advice should be passed on to people who use heroin, to reduce the risk of harm from consuming fentanyl/carfentanil:

  • Do not use alone; make sure that someone you trust is present, and equipped with naloxone.
  • Make sure there is sufficient naloxone available. You will need more naloxone to recover from an overdose of fentanyl/carfentanil that you would need for a heroin overdose.
  • Smoke a small amount on foil before attempting to use intravenously. You are very unlikely to die from smoking fentanyl/carfentanil-laced heroin as you would fall unconscious before inhaling the lethal dose.
    • This does not apply if you have already consumed depressants, such as alcohol or benzodiazepines.
  • Like injecting, snorting fentanyl/carfentanil-laced heroin can be potentially fatal
  • If injecting, start with a dose that is one-quarter of what you usually use.
    • Don’t “slam” your hit. Depress the plunger slowly, pausing to allow the familiar dose to take effect. If you feel it is unusually strong or sedating, pull it out.
  • Be aware of the signs of overdose:
    • Sudden disorientation, including nodding into unconsciousness
    • Losing muscle control (particularly in the knees or neck)
    • Cyanosis (skin turning blue)
    • Falling unconscious before removing the needle
  • Being aware of these overdose signs can help you look after someone who is using heroin, and can help them look after you if you overdose – this is why it’s important to not use alone.
  • Also, follow the local news to see if there are reported fentanyl/carfentanil overdoses or deaths in your area.