Law-enforcement officials and anti-drug advocates are warning about a new synthetic opioid far more powerful than heroin and bracing for a potential deadly impact should it arrive on Long Island.
The drug, carfentanil — which is 5,000 times more powerful than heroin per dose — has caused deaths in Ohio, Kentucky, Michigan and California, federal officials said.
Federal Drug Enforcement Administration officials issued a warning in September, alerting law enforcement and the public about the dangerous nature of the drug. Local officials here say they fear that the potentially lethal drug could be trafficked into current heroin and fentanyl markets along stretches of Interstates 70 and 80 that pass through Pennsylvania and New Jersey before getting to New York.
Carfentanil is 100 times stronger than fentanyl, the most powerful opiate available for use in medical treatment, Drug Enforcement Administration officials said. A single drop of the drug, which is used to tranquilize elephants and other large animals and is not intended for people, could be enough to kill drug users. It would also pose a threat to first responders rushing to save overdose victims because carfentanil can be absorbed through the skin and can be accidentally inhaled.
Jeffrey Reynolds, president and chief executive for the nonprofit Family and Children’s Association in Mineola, said carfentanil reminds him of what fentanyl was a few years ago: a problem in other parts of the country that many believed would not come to New York.
“We know these drugs can move into populations very quickly,” said Reynolds, noting that fentanyl now outpaces heroin as the drug of choice among users. “Believing we’re immune and thinking it’s not going to come here is making some of the same mistakes as in the past.”
Carfentanil can come in several forms, including powder, blotter paper, tablets, patch and spray, DEA officials said.
Overdose deaths are rising on Long Island, where a record 442 people died of opiate overdoses in 2015 — up from 403 a year earlier — with heroin, oxycodone and fentanyl responsible for a majority of those deaths, the latest data show.
Complete numbers for 2016 are not yet available. Suffolk County registered 276 deaths related to opioid overdoses in 2016 so far, a record number up from 242 in 2015 and a figure that could still rise after 120 pending cases are resolved, records show. Of those 276 deaths, 153 were attributed to fentanyl and heroin deaths totaled 107, according to the Suffolk County medical examiner’s office.
In Nassau County, there were 146 opioid-related deaths as of November, according to the Nassau County medical examiner’s office. Of those, 47 fatalities were linked to fentanyl and 43 to heroin. The numbers do not include the final two months of 2016, officials said.
Local officials are monitoring carfentanil. Last month, Nassau County Executive Edward Mangano issued a public warning about the opioid, joining a growing list of concerned public officials.
Acting Nassau Police Commissioner Thomas Krumpter said investigators are monitoring the situation “to ensure we’re not caught behind the eight ball if it makes its way to Long Island.”
Krumpter said police are going over every toxicology report on every overdose victim to determine if carfentanil was involved. “The alarms will go off very quickly, almost as quickly as these overdoses start to manifest themselves,” the commissioner said.
Suffolk Police Commissioner Timothy Sini said officers are raising awareness in the communities about the dangers of carfentanil.
“We’re always concerned when we see a new drug on the market that can endanger the lives of our residents,” Sini said. “We would certainly target any dealers who are peddling carfentanil, just like we do with the Long Island Heroin Task Force, where we target drug dealers who are causing overdoses.”
Because of carfentanil’s potential health hazards, first responders in Nassau and Suffolk have been warned to be careful when handling patients who have potentially overdosed from the narcotic.
Police officers in both counties will receive training on how to deal with the drug.
“We don’t want cops to have any contact, direct or indirect,” Krumpter said.
Sini said the Suffolk department is increasing the doses of Narcan — an antidote used to treat overdose patients — police officers are carrying with them to control the potent opioid.
“We’re training our officers about carfentanil in particular, telling them what it is, what it looks like and the dangers they pose,” Sini said.
Health officials are also seeking effective antidotes.
Dr. Michael Caplan, chief medical examiner for Suffolk County, warned that even though Narcan may be available, it may not be enough to save a carfentanil overdose victim because the narcotic is too strong.
“While it’s possible, it’s highly improbable,” Caplan said. “You would have to have such a strong dose, and get there quickly to the time of the carfentanil use and in repeated doses, to even have a chance to avert a catastrophe.”
Joseph Avella, chief forensic toxicologist for the Nassau County medical examiner’s office, said his staff is setting new protocols for carfentanil detection.
Avella says part of the problem is the small dosage could be hard to detect. Toxicologists plan to identify the drug by molecular weight.
“When you have very small amounts, it’s like looking for the proverbial needle in a haystack. Is it a signal or is it another piece of hay?” Avella said.
Dealers order carfentanil in bulk off encrypted websites, federal officials said. The drug is then sent from China in powder form to dealers, who either mix it with heroin or press the powder into pill form, DEA officials said. Dealers can buy a kilogram of fentanyl and carfentanil for about $3,500, officials said.
So far, there is no evidence of the drug in New York, officials said. However, overdoses related to carfentanil have been found in both Pennsylvania and New Jersey, an indication that the drug could be on its way, officials said.
“If fentanyl alone is a problem, and now heroin is being mixed with something 100 times more powerful, the sky’s the limit,” said James Hunt, Drug Enforcement Administration special agent in charge of operations in New York.