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In the vault

by PeakCare Qld on 12th April 2017

Home -> Articles -> 2017 -> April -> In the vault

“The tabloid press would have us believe the drug ‘ice’ is currently the biggest threat to Australian society. But doctors and drug professionals alike will tell you that potentially, the unfettered spread of Carfentanil and the illicit synthetic fentanyls is much worthier of your fear.”
David Caldicott, Emergency Medicine Consultant, Australian National University

Whilst we are busily researching the history and impact of Ice in our communities, through contributions to our Ice Bank, in order to actively respond to the growing issue that ice represents in our communities, we’re warned of the need to be proactive about another far deadlier substance entering the fray.

Carfentanil citrate (carfentanil) is an extremely potent synthetic version of fentanyl, a synthetic opioid similar to morphine. Fentanyl is 50 to 100 times more potent than morphine but it is regularly used in emergency departments primarily for pain relief.

This is the drug that has medical practitioners really nervous. Originally developed in the 1970s as a sedative for wild animals, carfentanil is 10 thousand times more potent than morphine and 20 micrograms equals a lethal dose for humans. Such is its potency that lab technicians employ protective measures to analyse it and must have the antidote Naloxone available at the lab bench when working with the product.

What is really concerning about carfentanil is that it is being used despite having no therapeutic purposes for humans and the clear majority of those who have consumed it have done so involuntarily believing it to be another substance such as heroin. Its use is disguised as a more ‘pure’ form of heroin which enhances the perceived value. The completely synthetic nature of the drug also means that it is not reliant on growth conditions and is easier to smuggle around the world.

Hundreds of Americans died between 2005 and 2007 from a fentanyl/fentanyl related compound. Globally fentanyl use from late 2013 is presenting as far more deadly with 5000 deaths in the US alone in 2014. In Ohio 1,100 people died in 2015. In Australia, the presence of fentanyls has been noted for some time initially through reports of questionable heroin overdoses not responding to standard doses of naloxone. Recently there have been a couple of deaths attributed to carfentanil seizure. The concern is that these types of substances can appear on the streets in an instance.

Working to prevent an epidemic from occurring is the ultimate position which involves engaging with consumers in our communities. The seeming reticence of policy makers in Australia has been an issue to date.

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