CT – The powerful synthetic opioid carfentanil has made its way to the area and was part of a drug cocktail that claimed its first victim, a man who died in Norwalk CT.

Officials last year said there was no clear indication the opioid, which the Drug Enforcement Agency says is often used as an elephant tranquilizer, was in the state. The opioid is 100 times stronger than the drug fentanyl, which caused three fatal overdoses in New Haven last June.

But the state of CT Office of the Chief Medical Examiner confirmed a man in Norwalk died on April 17 from an overdose involving carfentanil and other fentanyl analogues. The ME’s office said the man’s death, ruled accidental because it was an overdose, was caused by acute intoxication due to combined effects of carfentanil, fentanyl, acetyl fentanyl, butyryl fentanyl, heroin, Etizolam, methadone and alprazolam, an anxiety medication.

The DEA says carfentanil is about 10,000 time stronger than morphine, which is often used in medical settings as a painkiller. Carfentanil’s potential presence in the state last year prompted the state’s Health Department to dispense a DEA fact sheet to hundreds of medical emergency service providers last fall. The opioid’s toxicity poses a threat not only to users, but responders who may come in contact.

It’s unclear how widespread the drug has become nationwide, though its presence in New England has been known for several months.

A trail of death

Carfentanil has been involved in at least six overdose deaths in New Hampshire since April, according to New Hampshire Public Radio. The Portland Press Herald reported the opioid claimed its first victim in Maine in April.

The Massachusetts State Police said three samples tested this week by their crime lab tested positive for carfentanil. It marked the first time the opioid had been identified in Massachusetts, but state police there said in the release they were not aware of any carfentanil overdose deaths in that state.

“Members of the general public and first responders are urged to be aware of the extreme lethality of carfentanil,” Massachusetts State Police said in a release. “Carfentanil can come in many forms, and can be mixed with other drugs or disguised as heroin.”

In New Haven, the drug’s presence has prompted the Yale School of Medicine’s Community Health Care Van to train local drug users to test their opioids using a test strip to detect the presence of carfentanyl, according to van director Dr. Frederick L. Altice.

Altice said they’re advising clients not to use opioids alone and are providing more access to naloxone, the overdose antidote medication.

“More broadly, we are alerting all of our clients about this new information and training them that in the absence of wanting to use the test strips that they use smaller quantities as a ‘test’ to see if their ‘opioid’ is extraordinarily potent,” Altice said in an emailed response. “This information is disturbing and we remain majorly concerned but we are trying to be proactive.”

Last year, 917 people died from accidental drug overdoses in Connecticut. Fentanyl was found in 483 of those overdoses.

Fair Haven Community Health Center Vice President of Clinical Affairs Dr. Doug Olson said the public should be more informed about carfentanil.

“My personal experience is that there is not a great amount of knowledge, in at least the community that we serve, about carfentanil,” Olson said.

Olson’s clinic primarily serves low-income patients. While patients at the Fair Haven clinic haven’t said they’ve been using carfentanil, Olson said the clinic has made an effort to inform users about its potential danger.

It starts with photograph: Personnel at the clinic have been using an image showing how much of three kinds of opioids is needed to kill a person. The image includes heroin, fentanyl and carfentanil. Olson said it’s been shown to opioid users and cocaine users.

The visually-striking image, “really hammers the point home,” Olson said.

“Most people have not heard of it, don’t know that it can taint their substances,” Olson said. “They’re ill-informed. We try to inform them with the ultimate goal of helping them stop using it altogether or help them use less.”