
Deadly opioid carfentanil reemerges in Michigan, linked to 11 deaths in 2025
Carfentanil is a synthetic opioid, typically used by veterinarians to tranquilize large animals, like elephants, and is not approved for use in humans.
State health officials say that so far this year, 11 deaths involving carfentanil have been identified. None of those individuals tested positive for carfentanil alone. Ten of those who died also tested for cocaine, and fentanyl was found in eight of those deaths. The deaths occurred in Ingham, Livingston, Eaton, Genesee, Oakland and Wayne counties.
The synthetic drug is a small, white, powdery substance that looks like cocaine or heroin, but officials with the Drug Enforcement Administration say that using even a small amount could kill.
"Imagine like a speck of baby powder; that's how much could be a lethal dosage of carfentanil," said Brian McNeal, public information officer with the DEA's Detroit division. "It is a Schedule II drug, meaning it does have medical use, but it is not approved for human use, and it has found its way into the illicit drug supply."
Carfentanil is 100 times more potent than fentanyl and about 10,000 times more potent than morphine, according to the Michigan Department of Health and Human Services.
"Carfentanil is an extremely potent and deadly drug," said Dr. Natasha Bagdasarian, Chief Medical Executive for the State of Michigan. "We're urging people who use unregulated drugs – and their loved ones – to carry naloxone, an easy to administer nasal spray that can reverse opioid overdoses and save lives. Awareness and quick action can help save lives."
The DEA says some users mix carfentanil with other drugs like OxyContin or Xanax.
"Whether it's heroin, marijuana, or cocaine, it follows the same routes up from our southwest border into distribution hub, like any other business, and then into smaller communities and neighborhood, but the precursor chemicals mainly come from Asia, from China, India into Mexico, where drug cartels are putting these chemicals into the illicit drug supply," McNeal said.
Carfentanil was previously seen in the state in 2016 and 2017, with the drug contributing to 107 deaths in 2016 and 111 deaths in 2017. Deaths associated with the drug fell in recent years, dropping to a handful a year in 2018, 2019 and 2020, and then to zero in 2021 and 2022.
Health officials say the drug can rapidly cause central nervous system depression, which can lead to quick death, and that because an increasing number of overdose deaths associated with carfentanil also include cocaine, methamphetamine and other stimulants, users may not know those drugs contain carfentanil.
Treating a carfentanil overdose can also be extremely difficult, and officials say reversing an overdose may require several doses of naloxone.
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Lembke: We're all now kind of on the spectrum of compulsive overconsumption, moving toward addiction, which is resetting our hedonic threshold –– or joy set point. We need more and more of these reinforcers to feel any pleasure at all, and when we're not using, we're dysphoric, we're irritable, we can't sleep. CNN: What kinds of things risk putting us into dopamine deficit? Lembke: A lot of different things release dopamine in the reward pathway, including things that are good for us, like learning or spending time with friends. It's not that dopamine is the villain here, that dopamine release is bad –– not at all. The problem is that we've now engineered old-fashioned drugs to be more potent than ever before, and we've also created drugs that never existed before, like digital media, like 'drugified' foods. We've even taken healthy behaviors like exercise and drugified them by (tracking) ourselves and ranking ourselves and adding in social media and social comparisons. 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We know that the easier it is to access a reinforcing substance or behavior, the more likely people are to use it and hence get addicted to it. We now live in this world of very easy, frictionless access to a lot of rewarding substances and behaviors. Digital media in particular is a 24/7 mobile access — anytime, anywhere, to an almost infinite source. The other thing that makes something addictive is the quantity and frequency of exposure. The more dopamine hits the brain gets, the more likely it is to change and adapt in a way that can create a disease of addiction. (Social media algorithms are) actually engineered to overcome tolerance and create novelty, to encourage people to keep searching for the same or similar rewards as what they've already viewed but hopefully a little bit better. The criteria for diagnosing addiction are pretty much the same across different definitions. You're looking for the four C's: out-of-control use, compulsive use, craving and consequences — especially continued use despite consequences — as well as the physiologic criteria that indicate biological dependence. Those would be tolerance, needing more (or more potent forms) over time to get the same effect, and withdrawal when you try to stop using. CNN: What can we do to address dopamine deficit? Lembke: What I recommend is a 30-day abstinence trial, colloquially called a 'dopamine fast,' from the drug of choice. Not from all rewards but just from the problematic substance or behavior to see how difficult it is to stop — and also to see if you feel better after four weeks. Why four weeks? Because that's, on average, the amount of time it takes to reset reward pathways, at least phenomenologically. I always warn people, they're going to feel worse before they feel better. But if they get through the first 10 to 14 days, often they will feel much better. After the abstinence trial, when people want to go back to using, they just need to be very specific about what they're going to use, how much, how often, in what circumstances, how they're going to track it, and what their red flags will be for slipping back into old habits. Then they can reevaluate whether they can really use in moderation. When it comes to food, obviously, people can't abstain, and nor should they try. But they can abstain from sugar. They can abstain from ultraprocessed foods. How do we engage in pleasurable things but stop before we get to dopamine deficit? Lembke: It's not about not having pleasure in life; it is about resetting the balance so that simple pleasures are rewarding again. That is not going to happen if people are constantly indulging in these frictionless, high-potency rewards. I talk a lot about 'self-binding' and making sure we don't constantly surround ourselves with easy access to these high-potency, cheap pleasures so we don't get into that problem in the first place. But it takes intentionality because we live in a world where we're constantly being invited to consume, and we're told that the more we consume, the happier we'll be. So, it does take planning and intentionality to create barriers between ourselves and the many drugs out there. Self-binding can mean physical barriers. If the issue is food, not having ultraprocessed food or sugary food in the house. If it's cannabis, not having pot in the house, not having alcohol. Now, if it's some form of digital media, you can use time as a self-binding strategy: 'I'm only going to use on these days for this amount of time with these people.' Other people are a very important form of self-binding. We tend to do what those around us are doing, so try to hang out with people who are using substances and behaviors in a way that you want to use them. Sign up for CNN's Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it.