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More opioids?
Cousins of deadly drug showing up in New Hampshire

12/01/16



 Fentanyl is the deadliest drug in the state right now, but close relatives of the chemical are starting to show up in crime lab test results, and some fear its even deadlier cousin, carfentanil, may be close behind.

 
By the numbers
Fentanyl is an opioid that has a sedating and painkilling effect similar to that of heroin, but it’s 50 times more potent. And unlike heroin, which is made from poppy plants, fentanyl can be created in a lab. Drug cartels are producing fentanyl in places like Mexico and China and shipping it across our borders.
According to the state Medical Examiner’s office, fentanyl, without any other drugs mixed in, killed 41 percent of overdose victims this year and 37 percent the year before — a plurality in both cases. Taken as a whole, fentanyl has been involved in a majority of drug-related deaths, about 70 percent (214) of deaths so far this year and 64 percent (283) in 2015. 
Heroin’s involvement has dwindled. Heroin was involved in 20 percent of overdose deaths in 2015 overall and that’s gone down to 5 percent as of Nov. 8. Similarly, deaths involving heroin alone went from 7 percent last year to 0.06 percent so far this year.
That’s made fentanyl public enemy No. 1 in the Granite State. And now, in just the past year, fentanyl spinoffs known as analogues have arrived. They’re nearly identical to fentanyl, chemically speaking, and they come with names like furanyl fentanyl, fluoro fentanyl and acetyl fentanyl.
“Especially, we’re seeing more and more acetyl fentanyl mixed in with the fentanyl, and we didn’t see that originally,” said Tim Pifer, the director of the state police crime lab.
The ME’s office reported that of fentanyl-related drug deaths this year, one involved furanyl fentanyl, one involved fluoro fentanyl and 26 had the presence of acetyl fentanyl. 
 
What are they?
Pifer said furanyl and acetyl fentanyl are both about six times less potent than fentanyl. 
Less is known about fluoro fentanyl. Some preliminary science suggests it’s slightly more potent than fentanyl. 
Only one sample tested by the crime lab was entirely composed of furanyl fentanyl along with cutting agents to dilute it. The other analogues are universally found mixed in with regular fentanyl.
For the most part, the sudden appearance of the compounds is a mystery, but Pifer and his colleagues believe the illicit drug manufacturers are not creating them on purpose.
“We’re wondering why we’re starting to see that and the hypothesis is that the starting material [used to make] the clandestinely made fentanyl is basically impure to the point where it has some other compounds that maybe aren’t being synthesized fully to fentanyl,” Pifer said.
What changed is subject to speculation. Drug manufacturers could be growing more careless or perhaps they started to purchase the starting ingredients from new suppliers who don’t guarantee the same level of purity. 
 
Elephant tranquilizer
Another fentanyl analogue that has officials like Pifer worried, but hasn’t yet arrived in the state, is carfentanil. 
Unlike the analogues that have shown up so far, this is not an accidental byproduct of fentanyl. Carfentanil is a purpose-made analgesic 100 times more potent than fentanyl and is used to tranquilize large animals like elephants. It’s 10,000 times more potent than morphine.
Like its less potent cousins, it’s a controlled substance, but the Drug Enforcement Administration released a warning in September that it’s surfaced around the country and has caused a significant number of deaths.





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