Carfentanil, one of the strongest opioid drugs on the market, is an even more potent chemical analogue of another synthetic opioid painkiller—fentanyl. It is marketed under the brand name Wildnil as a veterinary anesthetic for larger animals, such as elephants.1 Carfentanil is about 10,000 times stronger than the prescription opioid, morphine, and 100 times more potent than fentanyl.1,2 Because of its potency, this synthetic opioid poses a serious risk of overdose for humans.2 Illicit carfentanil is often encountered as a white powder that resembles heroin or cocaine. Drug dealers may add it to heroin to increase heroin’s potency.2
Like many other synthetic opioids, carfentanil is abused because of its euphoric high.3 Regular use can lead to the development of dependence and, eventually, opioid addiction. Because of the potential for significant physical dependence and the resulting extremely uncomfortable withdrawal syndrome, opioid users may find it very hard to stop without professional help.4
Chronic carfentanil abuse can lead to dependence, which is the body’s natural adaptation to the presence of the opioid. Once someone has grown accustomed to a certain amount of carfentanil, suddenly quitting or reducing use can lead to the emergence of withdrawal symptoms. Carfentanil withdrawal symptoms vary in duration, time of onset, and severity, depending on the purity of the substance, the dose, frequency of use, duration of use, and method of administration. Some of the symptoms of opioid withdrawal are quite the opposite of the acute effects experienced during intoxication.5
Carfentanil withdrawal symptoms include:4,5
As stated before, the manifestation of withdrawal symptoms varies from person to person, and the timeline may depend on a number of different factors, such as individual health difference and any concurrent consumption of alcohol or other drugs.
The timing of the onset of opioid withdrawal symptoms depends on several elements, including the type of opioid, route of administration, average dose taken, and half-life of the drug. It may also be influenced by an individual user’s physical and mental health status. On average, opioid withdrawal symptoms can emerge anywhere from 6 hours after last dose to 4 days later. In the case of short-acting opioids like carfentanil, withdrawal symptoms may be seen 6–12 hours after the last dose.4
Some symptoms can persist for weeks or even months even after acute withdrawal has resolved. These lasting withdrawal symptoms may include:4
As with other types of opioid withdrawal, carfentanil detox is seldom immediately dangerous, but there are a number of complications that could occur throughout the process.
Carfentanil and other opioid withdrawal symptoms can be very uncomfortable. Although usually not life-threatening, these symptoms can make it difficult to quit without detox or treatment.7
Some of the common withdrawal complications include:5
Formal detox treatment can help ease the symptoms of opioid withdrawal significantly and reduce the risk of relapse.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends 24-hour detoxification services for opioid withdrawal as it can prevent unnecessary patient suffering.5 Detox is the healthy way for carfentanil and other opioid users to quit. There are many different settings in which detox treatment can take place, including:
Carfentanil detox may include the following medications or treatments, depending upon the user’s withdrawal manifestation:5
Detoxification is the first step to treating carfentanil dependence or addiction. Because acute opioid withdrawal is followed by a longer period of withdrawal that can last for months or even years and include symptoms like depression, anxiety, strong cravings for opioids, and insomnia, and relapse is a common part of recovery, it is essential that patients receive follow-up substance abuse treatment. A professional addiction treatment program can equip a patient with the skills needed to avoid relapse, make healthier choices, and remain clean and sober.