The widespread opioid drug fentanyl, already the leading cause of death among Americans under 50, could be used by terrorists as a chemical weapon, a new study warns, urging governments to maintain adequate stockpiles of the antidote.
Fifty times stronger than heroin, fentanyl was developed as a pain reliever, but is now widely used to adulterate heroin in drug markets.
Inhalation or ingestion of a few thousandths of a gram can cause death from cardiac and pulmonary depression.
“Before fentanyl came along, the only substances that could be used for mass poisoning were rare and hard-to-find agents like cyanide or neurotoxins,” said Lewis Nelson of Rutgers University in New Jersey.
“Fentanyl can be just as deadly if it is dispersed effectively, and it is ubiquitous. Highly motivated people could easily procure enough to poison even hundreds of people. Amount which, in unadulterated form, would easily fit in a teaspoon.’
Terrorists without special technical knowledge could inject lethal amounts into building ventilation systems, food or water tanks, Nelson’s team warns in a study published in the journal Frontiers of Public Health titled “Public health and medical preparedness for mass casualties from the deliberate release of synthetic opioids“.
The only upside is that fentanyl probably wouldn’t be effective in large-scale attacks like poisoning water supply reservoirs, the researcher explained.
“For many poisons we don’t have effective antidotes, but we do have an antidote for fentanyl poisoning,” Nelson noted.
This is naloxone, which is given by injection or as an inhaled drug to drug users who have overdosed.
“Due to the high incidence of unintentional fentanyl overdose, we now have large stockpiles of the antidote in health facilities and pharmacies,” Nelson said.
As the study suggests, authorities should be ready to move antidote stocks to where they are needed in the event of a terrorist attack.
As Nelson said, “in general, fentanyl does not kill as quickly as other poisons such as cyanide, but it still requires quick action to prevent casualties.”
