Terry DeMio

tdemio@enquirer.com

Beware of a new deadly drug, an analgesic used for elephants, which has been spotted in Greater Cincinnati:

The Hamilton County Heroin Coalition warned Friday of the powerful opioid carfentanil, which has been identified in local supplies of heroin.

The synthetic opioid is 100 times stronger than fentanyl, the analgesic blamed for increasing overdose deaths and 10,000 times stronger than morphine on the streets.

Carfentanil, like fentanyl, is a synthetic opiate, but this drug is used by veterinarians who care for large wildlife animals including elephants. It's being blamed for a recent spate of overdoses in Akron and Columbus.

On Thursday, the Greater Cincinnati Fusion Center issued a warning that carfentanil was present in street drugs in Hamilton County as well as in the Akron and Columbus regions.

Akron police reported 25 overdoses, four of which were fatal, in a recent three-day period, and Columbus reported 10 overdoses in a nine-hour period, two of which were fatal.

"This discovery is ominous for those with the disease of addiction, as well as for first responders, hospital teams, law enforcement and those striving to reverse overdoses," Hamilton County Health Commissioner Tim Ingram said in a news release.

The health department warned emergency workers, first responders, nurses and clinical staff of the appearance of the drug in the local supply of heroin. He said it is also "crucial" to get the word out to heroin users.

Veterinarians who are licensed to use it cover their hands, arms and faces when doing so and keep an antidote close by when they use it on animals.

Addiction experts warn that the use of carfentanil and other opioids in street heroin or as its substitute and sold to unwitting users could be a sign of a shift in drug sales during the nationwide heroin and opioid epidemic:

"This might be the new epidemic as heroin is pushed out of the market," said Dr. Adam Bisaga, a research scientist at the New York State Psychiatric Institute and professor of psychiatry at Columbia University Medical Center.

Addiction experts cautioned of the drug's danger and the possibility that it's been mixed in or substituted for heroin that's sold on the streets. That's what has happened with fentanyl. Hamilton, Butler and Clermont counties, along with Northern Kentucky, are among numerous areas that in 2014, 2015 and continuing into the first part of this year have been seeing fentanyl deaths rising.

"Carfentanil is one of the most potent opioids known, as an anesthetic agent by veterinarians for large animals, not used for humans," said Dr. Marc Fishman, an addiction psychiatrist and a member of the faculty of the department of psychiatry and behavioral scientists at the Johns Hopkins University School of Medicine.

"I'm not sure whether the street drug is diverted from veterinary supplies or whether it is synthesized in illicit labs like most of the street supply of fentanyl," Fishman said. "Pretty scary stuff in the hands of someone with addiction."

The appearance of carfentinal could be a "sign of more problems to come," Bisaga said.

"Need for cheap, easily distributable opioids, need for replacing the licensed pain medicines that are being less prescribed in a form of impostor or forged pills containing other opioids," Bisaga said. "I suspect that many painkillers people take and believe they are real medicines are the fake ones."

Bisaga said there appears to be a "never-ending" source of designer or synthetic opioids coming from China.

Closer to home, Newtown Police Chief Tom Synan, who oversees the Hamilton County Heroin Task Force, said police do not know what quantities of the opioid or manufacturing methods are being used by heroin dealers, "We must use extreme caution in the field and in treatment facilities," Synan said. He cautioned all law enforcement and other first responders to halt field testing of drugs, for the time being.

Dr. Lakshmi Sammarco, the Hamilton County coroner, was emphatic that people use care and inform heroin users of carfentanil.

"Our community is devastated by heroin and fentanyl abuse," she said in a statement. "The fact that there is a new lethal drug that has been found on the streets in Hamilton County is devastating."