By R Carter.
A new analogue of Fentanyl, Acrylfentanyl a Schedule I drug by the DEA, has recently contributed to three deaths in western Pennsylvania. The suspected source for the substance is China. The new analogue has sent shockwaves through public health and law enforcement because of it’s resistant to Narcan, a first line of defense for first responders when an opioid overdose is suspected.
Analytical Toxicology reports on three overdose cases where Acrylfentanyl was detected from drug paraphilia and confirmed by blood toxicology. In case #1 the deceased revealed acrylfentanyl concentrations of 0.3 ng/mL in blood serum. A nanogram is 1 million times less than a milligram (mg). Medical grade Fentanyl is 100x more potent than morphine, a typical patient dose is 100mcg or microgram, a microgram is 1000x less than a milligram.
For medical grade Fentanyl an OD can occur with blood concentration higher than 15 ng/ml making a blood concentration for acrylfentanyl of 0.3ng/ml 50x more potent than medical grade fentanyl.
Another frightening fact about acrylfentanyl is it’s resistance to Narcan, the only drug available to first responders and emergency room physicians when treating opioid overdose victims. It’s not known at this time what gives acrylfentanyl this resistance. Potency alone can’t account for this as multiple doses of Narcan seemed to have little effect.
One theory which has been proposed is that acrylfentanyl has a greater affinity for opioid receptor sites in the brain and spinal cord, so much so that in sufficient quantities, the acrylfentanyl molecules can’t be displaced from the receptor sites by the Narcan molecules.
Acrylfentanyl poses a new threat for law enforcement and healthcare. Simply looking at the white powder, it’s indistinguishable from other Fentanyl analogous or Chinese made heroin. With a potency 1000x that of medical grade Fentanyl, smaller quantities can be smuggle through our borders undetected and it’s resistance to Narcan suggests that illegal opioid overdose deaths are likely to continue rising.