Acetylfentanyl (acetyl fentanyl) is an opioidanalgesic drug that is an analog of fentanyl. Studies have estimated acetylfentanyl is between five to fifteen times more potent than heroin. Additionally it is reported as being 80 times more potent than morphine, and 15 times less potent than fentanyl. It has never been licensed for medical use and has only been sold illegally as a designer drug. Acetylfentanyl was discovered at the same time as fentanyl itself and had rarely been encountered on the illicit market in the late 1980s, but was never commonly used. However in 2013, Canadian police discovered a group distributing over 3 kilograms and 12,400 pills of desmethyl fentanyl equal to 117,400 doses. As a μ-opioid receptor agonist, acetylfentanyl may serve as a direct substitute for heroin or other μ-opioid receptor agonist substances in opioid dependent individuals. Side effects include itching, nausea, and respiratory depression, which can be potentially life-threatening.
The Centers for Disease Control and Prevention (CDC) issued a health alert to report that between March 2013 and May 2013, 14 overdose deaths related to injected acetylfentanyl had occurred among intravenous drug users (ages between 19 and 57 years) in Rhode Island. After confirming five overdoses in one county, including a fatality, Pennsylvania asked coroners and medical examiners across the state to screen for acetylfentanyl. This request led to 50 confirmed fatalities and five non-fatal overdoses statewide in 2013. Another 5 deaths were reported in Jefferson Parish, New Orleans, along with three more in North Carolina.
The drug is currently operating in a legal grey area. As an analog of fentanyl, selling acetlyfentanyl intentionally for human consumption is prosecutable by the United States Department of Justice as a DEA Schedule I controlled substance. However, as the drug itself is not classified on the DEA's schedule list if the drug is labelled "not for human consumption" it may be legal to distribute, much like bath salts have been in the past.
The illegality of the drug has been supported by the charges against individuals for distribution of acetylfentanyl and possession with the intent to distribute acetylfentanyl. The individual was sentenced to 3 years in prison by a federal court.
Overdoses on Acetyl Fentanyl have been reported to look exceedingly similar to those of heroin and may not be detected unless using gas chromatography. Additionally, while naloxone (Narcan) is effective in treating Acetyl Fentanyl overdose, larger than normal quantities may need to be administered in order for someone to recover from an overdose.
^Ruangyuttikarn, W; Law, MY; Rollins, DE; Moody, DE (1990). "Detection of fentanyl and its analogs by enzyme-linked immunosorbent assay". Journal of analytical toxicology14 (3): 160–4. doi:10.1093/jat/14.3.160. PMID2374405.