Fentanyl 2.0: More Potent Opioids on the Streets?

When a drug becomes the leading cause of death for adults ages 18 to 45, it can prompt government officials to create an awareness day dedicated to warning others about it, which happened in the U.S. When it is being found in more and more unsuspecting drug supplies worldwide, the culprit of such deadly statistics can only be one drug: fentanyl. But what if someone told you that fentanyl is not even the most potent and deadly opioid on the market today? Here’s what you need to know about this troubling truth.

The Comparison Method

To put these other deadly opioid drugs into perspective, it’s helpful to first put fentanyl into perspective. Fentanyl is around 20 times more potent than heroin and 50 to 100 times more potent than heroin. One reason this drug is so deadly is that it takes as little as 2 mg of the drug to be considered a lethal dose. While this drug is certainly a force to be reckoned with, one encouraging aspect includes the breakthrough drug naloxone, which can be used to treat a fentanyl overdose. This method has been used by EMT personnel and emergency room medical professionals to save thousands of lives each year.

This is not to suggest that opioids are no longer an issue for overdose and abuse statistics other than fentanyl. But it does highlight how fentanyl has the potential to drastically increase death and overdose rates as compared to less potent opioids. In fact, the U.S Department of Health and Human Services (HHS) still sees opioids as a comprehensive drug problem across the board and is beginning to focus on promoting research and alternative pain management methods to the use of opioids.

From Unknown to Known Territory

While fentanyl is dominating headlines and commanding our attention, some trends suggest this drug may already be getting dethroned. This is because fentanyl is no longer the most potent opioid on the streets. In fact, there are two key players that have been on the streets for years already. The first is known as “ISO,” known officially as isotonitazene. Unlike fentanyl, this drug has no approved medical use anywhere in the world. In the U.S., it is a Schedule I substance compared to fentanyl, which is a Schedule II. Another version of this drug with a similar chemical structure is known as etonitazene, which is called Pyro on the streets. Estimates vary between these two drugs, but they are believed to be anywhere from 10 to 100 times more potent than fentanyl. 

While the ongoing spread of these drugs into various parts of the United States is alarming, this is still not the end of the story. During the past few years, a wave of fentanyl analogs has shown up on the streets. These include varieties such as acetylfentanyl, furanylfentanyl, and carfentanil. Essentially, these drugs start with fentanyl as the base substance but modify the chemical structure to produce an even more potent result. Carfentanil is considered the most potent of all these, being 100 times as potent as fentanyl (10,000 times more potent than morphine). Reports say that most of these drugs are created in underground labs in China, mainly because their chemical and pharmaceutical industries are far less regulated and monitored compared to other countries.

These deadly drugs are often shipped internationally direct to U.S. buyers and come in volumes that represent tens of thousands of lethal doses each. Ironically, these are often labeled as “office supplies” or “research chemicals” and hidden in containers such as printer ink bottles. Authorities worldwide are beginning to find themselves staring this drug down in close proximity, but these seizures of a much more deadly version of fentanyl are only small percentages of the drug that have already made it into the illicit drug supply.

What the Future Holds

It is vital to understand how fentanyl and any of its modified cousins in the opioid collection are absolutely deadly. As more and more modifications are made to these already powerful drugs, the potential for anyone to handle their strength and effects becomes less and less likely. Theoretically, black market drug labs will continue pushing the limits until they create a drug that kills anyone who handles it.

This is why anyone dealing with opioid addiction, whether it's fentanyl, a less potent substance, or  an even more potent one, gets help at a professional drug detox center. Not only does this offer the best defense against the withdrawal symptoms that often prohibit people from experiencing a true recovery from opioid addiction, but it also robs these drug labs and dealers of customers. When — and only when — people are no longer interested in taking a risk on these drugs, the market will finally start to see a trend in the right direction from the presence of these deadly substances.

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