Fentanyl, carfentanil and the opioid crisis: where do we stand now?

3.5 out of 5 stars Controversies and carfentanil: We have much to learn about the present state of opioid poisoning. Cole JB, Nelson LS. Am J Emerg Med 2017 Aug 24 [Epub ahead of print] Reference I have argued — both in a post on this blog and a column in Emergency Medicine News — that the idea of a “heroin overdose” is a completely outdated concept that is never coming back. The fact is, when a patient comes in today with a history of shooting or snorting heroin, none of us have any firm idea about exactly what drug or drugs were involved. The chance that such a patient was exposed only to heroin is virtually zero. More likely, the exposure was to some undefinable hodgepodge of fentanyl, carfentanil, U-47700, and Lord knows what else, perhaps with a pinch of heroin thrown it. The authors of this brief, cogent article trace the history of the last 3 decades during which the epidemic of opiate over-prescription, overdose and addiction developed, and supplies of pure unadulterated heroin virtually disappeared. It is only over the last year or so that the fentanyl analogue carfentanil — a drug 100 times more potent than fentanyl itself — has been regularly detected in samples of “heroin.” The authors aptly argue — as I did in the sources cited above — that this should change our mindset when managing opioid overdose patients: “For the foreseeable future emergency physicians, EMS personnel, epidemiologists, law enforcement, and even drug ...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical carfentanil fentanyl opiates opioids Source Type: news