In 2016, synthetic opioids surpassed prescription opioids as the most common drugs in overdose deaths. At 100 times the potency of morphine, fentanyl is a strong synthetic prescription opioid that is also illegally manufactured in clandestine labs in China and Mexico and sold online or transported across the Southern U.S. border. 

In fact, illicit or street fentanyl is at the center of today’s national opioid crisis. It’s sold as a stand-alone drug and laced into heroin and other drugs, making detection and treatment more challenging for first responders, medical personnel and criminal justice professionals.

A more potent alternative to heroin

In the 1980s, methylfentanyl sold as heroin became a popular street drug called China White. Fast forward nearly 40 years and illegal labs are making street fentanyl from scratch and selling it as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. Last year, 34 people were prosecuted in New York for selling furanyl fentanyl, aka China White.

For the illegal drug trade, fentanyl and fentanyl analogs provide an enormous bottom-line business boost. It is stronger and cheaper than heroin, plus, the potency of fentanyl gives users a more intense high and makes it much more addictive, both of which are good for dealers but bad for consumers. In fact, many users don’t know their drugs contain fentanyl until they overdose.

Ever-changing formulas make fentanyl difficult to detect

As quickly as the U.S. Drug Enforcement Agency can classify a fentanyl analog as a Schedule I illegal drug, savvy chemists in clandestine labs tweak the chemical makeup of illegally produced fentanyl. These fentanyl analogs, which mimic the effects of fentanyl, are more difficult to detect in lab tests and make it easier for producers to skirt the law. 

Complicating today’s drug testing even further is the fact that other versions of fentanyl are also being used, like carfentanil, which is used to tranquilize large animals. Carfentanil has been found cut into heroin as well as into fentanyl itself. It is 50 times more potent than heroin, and 100 times more potent than fentanyl.

Testing for illicit fentanyl

Because illegal producers are constantly modifying the pharmacology of illicit fentanyl, toxicology professionals are constantly adjusting lab tests to catch all known versions, as well as all known analogs. About the time labs can develop standards and a new test, the illicit labs change the makeup of the drug and the cycle starts over. Keeping up requires constant vigilance.

Today there are 22 known fentanyl analogs, and we’re still learning about them. Some are seeing an increase in use today. For many analogs, their effects on humans just aren’t well known. For example, Butyrlfentanyl’s blood levels and metabolism in humans is still unknown, making it difficult to develop accurate testing. 

Today, averhealth works with medical examiners to identify fentanyl analogs and develop tests capable of accurately detecting street fentanyl.

Contact averhealth today to learn more or get started by downloading our e-book on drug testing best practices.