‘Super Mario’ street drug with harmful substance found in US

A recent street drug known as “Super Mario” has emerged in New York, containing a synthetic opioid that is 100 times more potent than fentanyl.

The state’s health department issued a public health alert on Friday after testing two samples from the “Super Mario” bags which were found to contain a combination of fentanyl, xylazine (a veterinary sedative), and trace amounts of heroin and carfentanil, a tranquilizing drug used for large animals like elephants.

Carfentanil, a synthetic opioid, is reported to be 10,000 times more potent than morphine and 100 times more potent than fentanyl, according to the Drug Enforcement Administration. The Department of Veterans Affairs states that just 2 milligrams of carfentanil is enough to incapacitate an average-sized elephant, which poses a lethal risk to humans as well. In comparison, a fatal dose of fentanyl is around 2 milligrams.

Carfentanil is classified as a Schedule II substance under the Controlled Substances Act due to its high potential for abuse and the risk of severe physical or psychological dependence, as stated by the National Library of Medicine. Unlike fentanyl, carfentanil has no legitimate medical uses and is no longer recommended for veterinary use due to its extreme danger.

The “Super Mario” samples containing carfentanil, collected on May 20, were associated with individuals requiring emergency care for severe injuries within two to three weeks of use. The health alert also noted changes in the drug’s composition in recent weeks, causing intense sedation among users.

The New York State Department of Health warns that the combination of substances in “Super Mario” raises the risk of adverse effects such as overdose, prolonged sedation, respiratory suppression, and potential skin damage, urging individuals to remain cautious.

The state health department’s Drug Checking Program partner, ACR Health, is conducting further tests on the “Super Mario” drug while advising drug users to adopt harm reduction practices such as substance testing and having naloxone (Narcan) available for opioid overdose reversal.

However, the presence of xylazine in “Super Mario” poses additional risks for users, as Narcan is ineffective against its effects. Xylazine, also known as “Tranq,” is a veterinary drug that can lead to dangerous drops in breathing, heart rate, and blood pressure, as well as skin complications with repeated use, according to the National Institute on Drug Abuse.

In response to the rising threat of fentanyl mixed with xylazine, the White House introduced a National Response Plan in July 2023, following DEA seizures of these mixtures across 48 states. CDC studies showed a significant increase in deaths involving illicit fentanyl and xylazine from 3% in January 2019 to 11% in June 2022.