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A new synthetic fentanyl analog is being blamed for an increasing number of overdose deaths. Jose Luis Pelaez Inc/Getty Images
  • Warnings are being issued about a synthetic fentanyl analog called para-fluorofentanyl.
  • Officials say deaths involving the drug increased 455 percent during a recent one-year period.
  • Experts say one of the dangers of illegal products containing fentanyl is that the user can’t be sure what’s exactly in the drugs.

Overdoses from a synthetic fentanyl analog are on the rise, according to a new report from the Centers for Disease Control and Prevention (CDC).

Fentanyl is a powerful synthetic opioid used to treat pain, but illicitly manufactured fentanyl and other synthetic opioids are a primary driver of opioid deaths in the United States, accounting for two-thirds of estimated 108,174 overdose deaths from April 2021 to April 2022, the CDC report says.

Now, a synthetic fentanyl analog called para-fluorofentanyl is in the mix, with deaths involving the drug increasing 455 percent in a one-year period. There were 253 of these deaths reported between July and December 2020. That rose to 1,405 deaths between January to June 2021.

“Para-fluorofentanyl is actually an analog of fentanyl (fentanyl analogs are often called ‘fentalogs’) that’s been around for decades,” said Jonathan Watanabe, Ph.D., PharmD, an associate dean of the Pharmacy Assessment and Quality School of Pharmacy & Pharmaceutical Sciences at the University of California at Irvine.

“There are actually many different analogs of fentanyl now being observed (ortho-, meta-, etc.), but para-fluorofentanyl has recently been the predominant isomer on the rise,” Watanabe told Healthline. “In general, manufacturing of fentanyl and fentalogs is much cheaper compared to traditional opioids harvested from poppy farms, so you’re seeing an explosion in synthetic fentanyl in a variety of ways.”

Most para-fluorofentanyl is found mixed with illegally manufactured fentanyl, making it difficult to determine the dangers of this particular fentanyl variant.

“Para-fluorofentanyl has a reported potency similar to fentanyl, both of which are about 100 times more potent than morphine. I’ve seen some news articles reporting that para-fluorofentanyl has greater potency than fentanyl, but this is not backed up in scientific journals,” Dr. Bruce Bassi, an addiction psychiatrist, told Healthline. “Over the past several years, numerous synthetic opioid adulterants have been mixed with heroin to lower the production cost. As with all synthetic opioids, the main danger is the extremely low lethal dose, giving a user an extremely narrow window to safely achieve a high before they develop respiratory depression and death.”

New combinations of fentanyl and analogs are common, with federal agents recently warning about the emergence of colorful “rainbow fentanyl.”

However, the most significant danger is not knowing which illegal drugs contain fentanyl or their analogs.

“Street drugs can be essentially anything, regardless of what they are sold as,” Dr. Ruddy Rose, the director of the Virginia Poison Control Center at VCU Health in Richmond, Virginia, told Healthline. “Mixing in these unknown compounds (analogs) just increases the uncertainty of what you are taking and its potency. And in most cases, these analogs are not detected by hospital laboratories.”

Aside from staying away from using illegal opioids, there are other actions you can take to help stem the rise of opioid deaths, experts say.

“If you are worried or concerned about a friend or a loved one, you can get trained in the use of Narcan, a medication that can be used to reverse opioid poisoning if your loved one is unresponsive, appears very sleepy, or has breathing problems,” said Marissa Abram, Ph.D., an assistant professor and director of the Psychiatric Nurse Practitioner Program in Adelphi University’s College of Nursing and Public Health Recovery in New York.

“Recovery is possible. With support, treatment, and medications like buprenorphine (suboxone) to reduce cravings, a person can recover from opioid use disorders,” she told Healthline.

If you know someone with an opioid use disorder, resources include the federal Substance Abuse and Mental Health Service Administration’s (SAMHSA) National Helpline, 1-800-662-HELP (4357), also known as the Treatment Referral Routing Service.

They can also access resources online using SAMHSA’s treatment locator.