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Carfentanil Re-Emerges: Fentanyl Analog Detected in 12 States

Carfentanil, the potent fentanyl analog used in veterinary medicine as a large animal tranquilizer but not approved for human use, has been identified in urine drug tests 35 times in 12 states in 2023, according to a Millennium Health Signals Alert released on Thursday.

About 100 times more potent than fentanyl, carfentanil was detected in a urine drug test screening just once in 2022, according to Millennium Health, a specialty lab that provides medication monitoring services via urine and oral fluid drug testing.

“The results of our analysis add to growing evidence that carfentanil may be making a comeback,” Millennium Health Chief Clinical Officer Angela G. Huskey, PharmD, CPE, said in a statement emailed to Addiction Professional.

Carfentanil was associated with a large spike in synthetic opioid overdose deaths reported in 2016 and 2017, but detections of the fentanyl analog declined sharply with the onset of the COVID-19 pandemic in 2020. The lone carfentanil detection reported by Millennium Health in 2022 came from a specimen submitted from Philadelphia County, Pennsylvania.

In August 2023, the Ohio Bureau of Criminal Investigation’s drug chemistry lab detected carfentanil in 3 separate drug cases submitted from Trumbull County law enforcement agencies. The Central Ohio Major Drug Interdiction Task Force also seized 3 kilograms of carfentanil in Franklin County in September, according to a release by the office of the state’s attorney general. Eleven additional states have reported carfentanil detections.

Despite the re-emergence of the potent fentanyl analog, Millennium Health’s Dr Huskey said recent detections are still well below the spike of 2016-17 for now.

“Although any increase in carfentanil detection is concerning given its lethality, the number of detections in 2023 is substantially lower than in peak years,” Dr Huskey said. “Fortunately, this means there’s still time to increase awareness about its dangers. We are closely monitoring carfentanil trends in our data and will provide updates as warranted.”

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