A new street drug named "Super Mario," which includes a synthetic opioid 100 times more potent than fentanyl, has surfaced in New York, Scripps News reports. The state's health department issued a public health alert after two samples from the "Super Mario" bags tested positive for a combination of fentanyl, a veterinary sedative called xylazine, and trace amounts of heroin and carfentanil, another a veterinary tranquilizing drug used for elephants and other large mammals. Carfentanil is a synthetic opioid that the Drug Enforcement Administration says is 10,000 times more potent than morphine and 100 times more potent than fentanyl. The Department of Veterans Affairs says only 2 milligrams is needed to knock out an average-sized elephant, while the same amount is enough to kill about 50 humans. Unlike fentanyl, which can be used to relieve severe pain in health care settings, carfentanil has no legitimate medical use, and New York state officials said it's no longer marketed for veterinary use because it's so dangerous.
The state reported drug checking program participants noticed a "change in the supply" within the last two weeks, and that individuals described the substance "knocking them out." The mixing of these substances heightens the chances of individuals facing negative effects like overdose, extended sedation, respiratory issues, and potential skin lesions, according to a New York State Department of Health public health alert. The state health department's Drug Checking Program community partner, ACR Health, is conducting a third sample test on the "Super Mario" drug while it urges people who use drugs to practice harm reduction strategies, like testing substances before use and having opioid reversal agent naloxone, or Narcan, available. However, another ingredient in the "Super Mario" bags makes the mixture an even larger risk for users to suffer fatal drug poisoning even with Narcan: Xylazine, also known as "Tranq," isn't an opioid, so Narcan won't reverse its effects.