‘Elephant tranquilizer’ deaths rise in CT; fentanyl deaths are down

Over two dozen overdose deaths in the state since 2017 have involved synthetic opioids stronger than fentanyl, complicating the fight against the opioid crisis at a time that local officials are deciding what to do with millions of dollars in opioid settlement funds.

The detection of increasingly potent opioids is alarming officials, given how the number of deaths caused by fentanyl rose dramatically over the years. Ten years ago in 2014, fentanyl was found in 75 overdose deaths in Connecticut. Last year, it was found in over 1,100 deaths, data from the state’s Office of the Chief Medical Examiner shows.

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The data shows: There were 1,464 confirmed overdose deaths for 2022. Based on preliminary data there are 1,342 overdose deaths in calendar year 2023 subject to change), “representing a decrease of 122 deaths (8.3%) compared to 2022.”

In recent years though, new synthetic opioids have been detected in overdose deaths, particularly carfentanil and nitazenes, according to the most recent monthly drug overdose reports from the Connecticut Department of Health.

Carfentanil is an opioid 100 times more potent than fentanyl, typically used as a tranquilizer on elephants and other large mammals, that has taken the lives of 18 people in Connecticut since 2017, data shows. In most years since then, the opioid wasn’t detected in any deaths at all or it was found in two deaths at most. But in 2023, the tranquilizer was the culprit in seven deaths, a number not seen in six years.

And no more than four months into this year, one person has already died from it.

The elephant tranquilizer differs from another animal tranquilizer, xylazine, that’s also been found in an increasing number of opioid overdoses. Xylazine is a non-opioid sedative often used on horses, which proves problematic when trying to reverse its effects with naloxone such as Narcan.

The other synthetic opioids found in recent deaths are nitazenes, which can be more potent than fentanyl and have been detected globally. In 2021 and 2022, nitazenes were found in three deaths in the state, but in 2023 alone, nitazenes were found in 10 deaths. This year through the second week of April, nitazenes have been found in four overdose deaths.

So in an apparent overdose, would naloxone, an opioid-reversing medication sometimes known by its brand name Narcan, still be useful if the potency of the opioids is higher? Potentially, but higher doses of naloxone may be needed. In a health alert a few years ago, the U.S. Centers for Disease Control and Prevention advised health care providers that patients should be told that multiple doses of naloxone “may be needed for a single overdose event because of the potency of illicitly manufactured fentanyl and fentanyl analogs.”

As of early last year, some towns in Connecticut were using opioid settlement funds to buy naloxone while others are still deciding what to do with the funds.

José Luis Martínez is a reporter for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.