Bay Area county reports first death from carfentanil, a drug 100 times more potent than fentanyl

San Francisco Chronicle​

03-05-2025

Santa Clara County has confirmed its first fatal overdose linked to carfentanil, a synthetic opioid that experts say is up to 100 times more potent than fentanyl and 10,000 times stronger than morphine.
The Office of the Medical Examiner reported last week that a 39-year-old man was found deceased with M30 pills, counterfeit tablets made to resemble prescription oxycodone, that tested positive for carfentanil.
The incident marks a grim milestone in the region's opioid crisis and raises new concerns over the spread of ultrapotent fentanyl analogs in street drugs.
'Fake pills look real, but they can be deadly,' said Dr. Michelle Jorden, Santa Clara County's chief medical examiner. 'People should not take any pill that they did not buy from the pharmacy.'
Carfentanil, once used to tranquilize elephants, is not approved for human use and is considered lethal even in minute quantities. Public health officials warn that drugs sold on the street — often disguised as oxycodone, Xanax or Norco — may contain carfentanil or related compounds.
'We believe that every life matters and no one should die of an overdose,' said Dr. Akanksha Vaidya, assistant health officer for the county's harm reduction program. 'That's why we offer evidence-based harm reduction services proven to reduce the risks of overdose.'
Officials are urging residents to carry naloxone (Narcan), an opioid-reversal drug, and to use fentanyl test strips when possible.
Santa Clara County is offering free naloxone kits by mail and access to treatment programs through the Behavioral Health Call Center at 800-704-0900 or the 988 mental health crisis line.
What to know about carfentanil
What is carfentanil?
Carfentanil is a synthetic opioid originally developed in the 1970s for use as a tranquilizer for elephants and other large mammals. It is not approved for human consumption. The drug is estimated to be 100 times more potent than fentanyl and approximately 10,000 times more powerful than morphine.
How does carfentanil end up in street drugs?
Carfentanil is often mixed with other drugs or pressed into counterfeit pills that mimic prescription opioids like oxycodone (often stamped as M30), Xanax or Norco. Users typically have no way of knowing whether their drugs contain carfentanil, which greatly increases the risk of overdose and death.
Why is carfentanil so dangerous?
Even microscopic amounts of carfentanil can cause fatal respiratory depression. Its extreme potency means it can kill even opioid-tolerant individuals, and exposure through skin contact or accidental inhalation is a risk for first responders and users alike, according to the U.S. Drug Enforcement Administration. The drug can appear in many forms — powder, blotter paper, tablets, patches or spray — and may resemble substances like cocaine or heroin.
Can an overdose from carfentanil be reversed?
Yes, but it often requires multiple, high-dose administrations of naloxone (Narcan), an opioid antagonist. In overdose situations, naloxone should be given every 2–3 minutes until the person is breathing on their own or emergency services arrive.
What should I do in an overdose emergency?
Call 911 immediately. If naloxone is available, administer it right away. Stay with the person and monitor their breathing until help arrives.
What are the signs of opioid overdose?
Signs include slowed or stopped breathing, extreme drowsiness or unresponsiveness, pinpoint pupils, blue lips or fingertips and cold, clammy skin.
How can people protect themselves?
Handling suspected carfentanil requires extreme caution. Only specially trained law enforcement professionals should manage these substances. If you encounter a suspicious powder or pill — especially something resembling cocaine, heroin or prescription opioids — do not touch or disturb it. Instead, secure the area and contact the appropriate authorities. Approved procedures for transportation and analysis are essential to prevent accidental poisonings.