Drug cartels turn to a synthetic opioid 100 times stronger than fentanyl, 'killing hundreds of unsuspecting drug users'

The chemical makeup of carfentanil. The drug is legally used to  
anesthetize large animals such as elephants and rhinoceroses. 

Carfentanil is a deadly "weapons-grade" synthetic opioid that illicit drug makers are adding to other drugs as a potent substitute for fentanyl. The drug, which authorities say is "10,000 times more potent than morphine and 100 times stronger than fentanyl, has seen a drastic resurgence across the U.S., killing hundreds of unsuspecting drug users," report Hallie Golden and Jim Mustian of The Associated Press.

Carfentanil's presence in illegal drugs sold in the U.S. has surged since the Chinese government's more recent "crackdown on the sale of precursors used to make fentanyl," AP reports. "Those regulations are likely prompting traffickers in Mexico to use carfentanil to boost the potency of a weakened version of fentanyl."

The sheer potency of carfentanil is what makes it so dangerous for anyone who takes drugs not prescribed by their doctor. Frank Tarentino, the U.S. Drug Enforcement Administration chief of operations for its northeast region, which stretches from Maine to Virginia, told AP, "You’re talking about not even a grain of salt that could be potentially lethal. This presents an extremely frightening proposition."

While some Mexican drug cartels may be making carfentanil in their own labs, others are purchasing it from darknet marketplaces. Regardless of where it originates, it's making its way onto American streets. Golden and Mustian write, "In 2025, DEA labs identified carfentanil 1,400 times in U.S. drug seizures, compared with 145 in 2023 and only 54 in 2022."

Russia used an aerosol form of carfentanil as a chemical weapon to subdue Chechen separatists in 2002, AP reports. It is legally used to anesthetize large animals, such as elephants.

Michael King Jr., founder of the Opioid Awareness Foundation, told AP, “It’s like a biological weapon. If the world thinks we had a problem with fentanyl, that’s minute compared to what we’re going to be dealing with with carfentanil.”

Policy experts say 10 rural hospitals in Virginia are 'at risk' of closure. What does that mean?

A rural hospital can be listed as 'at risk' and never close.
(Canva photo via Cardinal News)

As rural hospitals across the U.S. grapple with fewer federal Medicaid reimbursement dollars, some, including 10 in Virginia, have been flagged as "at risk" of closure, reports Emily Schabacker of Cardinal News. But the formulas used by policy centers to determine financially strained hospitals can't predict which hospitals will close.

For instance, the Public Citizen, a non-profit that tends to lean left, released an analysis that looked specifically at "Medicaid policy changes tied to the federal funding bill," Schabacker explains. Based on their focus, Public Citizen policy experts "identified 10 Virginia hospitals as at risk of closure," including six in Southwest and Southside Virginia:

• Buchanan General Hospital, Grundy
• Carilion Tazewell Community Hospital, Tazewell
• Twin County Regional Hospital, Galax
• Dickenson Community Hospital, Clintwood
• Sentara Halifax Regional Hospital, South Boston
• Centra Southside Community Hospital, Farmville
• VCU Health Tappahannock Hospital, Tappahannock
• Bon Secours Southern Virginia Regional Medical Center, Emporia
• Sentara Northern Virginia Medical Center, Woodbridge
• VCU Health Community Memorial Hospital, South Hill

While not all policy centers will focus on Medicaid payment changes to determine a hospital's future financial difficulties, most centers will consider past financial standing, operating margins, and whether the hospital was already operating at a deficit before the Medicaid cuts were announced. 

According to Michael Shepherd, an assistant professor with the Department of Health Management and Policy at the University of Michigan, "Each research group uses slightly different methods to evaluate hospital finances," Schabacker reports.

Shepherd said he’s "concerned that reports like the one from Public Citizen border on being alarmist," Schabacker adds, "signaling with too high a degree of certainty that hospitals with negative operating margins will close as Medicaid changes take shape."

Financial vulnerability doesn't mean that "the hospital is going to close tomorrow, but it could over the next few years," Shepherd told Cardinal News. "There is some uncertainty there. Not every hospital that’s at risk of closing will close. The truth is somewhere in the middle.”

Commentary: Why one journalist traded covering national news for a small-town newspaper in Big Sky Country

After he left a national media career to become editor of the Glasgow Courier in Glasgow, Montana, this journalist began to see his writing and the news differently, writes Skylar Baker-Jordan, reflecting in The Daily Yonder on his journey to a new career in the "middle of nowhere."

"Within my first few hours of being in Valley County, I learned people are hungry for local news. A new face in Glasgow, a town of 3,202 people, folks immediately asked what brought me, a born and bred Appalachian, to the high plains of Montana," Baker-Jordan writes.

Once Glasgow residents learned Baker-Jordan was the Courier's new editor, he was inundated with town gossip, juicy conflicts and events the paper needed to investigate. He writes, "That thirst for local news is not unique to Glasgow, but it is increasingly difficult to quench. . . More than 130 local papers ceased publication in the past year alone."

As smaller newspapers close, fewer towns can rely on local reporting, which the "middle of nowhere" towns need more than most. Baker-Jordan adds, "Moving here was my chance to use my talents in the service of a community that needed an editor to help its local paper avoid this fate."

Baker-Jordan didn't decide to switch careers in an instant, but over time, while he was working as an editor at 100 Days in Appalachia, a nonprofit newsroom managed by and for Appalachians. He writes, "Suddenly, I was writing about and reporting on regional matters I’d long overlooked, and the response was overwhelming. In my entire career, the most gratitude I received from readers – the highest volume of responses – was to stories I wrote about local and regional matters."

He began to think about his past journalistic efforts differently. Baker-Jordan explains, "The sheer vitriol of the partisan press began to make my screeds feel less like a righteous contribution to public discourse and more like the very thing eroding trust in media and our civic institutions writ large."

Baker-Jordan doesn't see his new editing gig or his town as lesser than his career in the bigger national news arena. He writes, "Small towns deserve to see themselves reflected and taken seriously every bit as much as large urban areas or Congress and Wall Street. They deserve reporters and editors who are dedicated to telling their stories, to establishing a public record of their history and people."

Live, virtual panel discussion on the link between agricultural sprays and cancer cases in the Midwest, May 7

Are chemical crop treatments causing cancer in the communities where they are used?

A live virtual panel event on May 7 from 11 a.m. to noon. will explore what current data and reporting reveal about potential links between agricultural sprays and cancer diagnoses. The conversation will cover what research indicates, clinical insights and lived experience. The event is free. You can register here.

The discussion panel includes journalists, researchers, a physician and a cancer survivor who will discuss the growing body of data examining the potential link between pesticide use and cancer outcomes.

The panel will flesh out what's known about the possible connection, present what remains unclear, and examine how chemical crop treatments and severe health conditions often play out in rural communities.

The conversation will connect data, policy and personal impact to better understand what’s driving cancer risks in farm belts across the U.S. Time for a Q&A with the audience also will be included.

Current panel lineup:

• Dr. Richard Deming, MercyOne Cancer Center
• Kerri Johannsen, Iowa Environmental Council
• Amanda Starbuck, Food & Water Watch
• Carey Gillam, The New Lede
• Lisa Lawler, Iowa cancer survivor
• Ben Felder, Investigate Midwest (moderator)

“We selected these panelists to help better understand what the latest data and reporting are showing and where we go next,” said Lauren Cross, assistant editor for the event's sponsor, Investigate Midwest.

Quick hits: USDA plans fertilizer production in U.S.; farmers' 'stops' that aren't seasonal; curiosity builds community

Brooke Rollins

The Department of Agriculture plans to use tariff dollars and trade renegotiation resources to help fertilizer production in the United States. Agriculture Secretary Brooke Rollins said the "USDA is focused on helping move fertilizer supplies more quickly, but cautioned it will take time for crop nutrient prices to begin falling," reports Kim Chipman of AgriPulse. "Rollins said she hosted a meeting with executives of four top fertilizer companies and Commerce Secretary Howard Lutnick, U.S. Trade Representative Jamieson Greer and National Economic Council Director Kevin Hassett." The Trump administration hopes to roll out its full plan to move fertilizer production back to the U.S. sometime this week.

The University of Maine's Fort Kent campus will provide dorms,
 a lounge and a cafeteria for recovering teens. (UofM photo)

Just like some adults, preteens and adolescents can end up with severe drug and alcohol addictions that can end in an overdose or many failed recovery attempts. Recovery advocates in the tiny town of Fort Kent, Maine, will "use new funding to try a novel solution to the problem: a public boarding school for high schoolers in recovery," writes Lanan Cohen for The Hechinger Report. The new approach will "focus on abstinence and mental health to help students overcome their substance abuse problems." Educators hope the boarding school structure will allow students time to solidify new choices and coping strategies while remaining in school.

Graphic by A. Dixon, Offrange

It's not a farmers market. It's a farmers "stop," and it's open all year long. Farming advocates hope the concept continues to catch on. "The Argus Farm Stop model is built on a consignment basis with a 70/30 split: Farmers set their own prices and keep 70% of every sale, while Argus retains 30% to cover operating costs," reports Heidi Roth for Offrange. "A café inside each location accounts for roughly a third of sales but about half the profit, effectively subsidizing higher farmer payouts while creating a community hub where farmers can gather, and customers can meet producers." Not all farmer stops have the same elements, but all aim to support local farmers while fostering community spirit.

Musical talent from far-flung places often took center stage at the Big Ears festival in Knoxville, Tennessee. "The festival is rich with rural tradition, pulling in rural musicians from across the states and every continent except Antarctica (as far as I know)," reports Phillip Norman of The Daily Yonder. "I caught an ambient country jam by Setting in the backroom of Boyd’s Jig and Reel Scottish Pub, and hit the Knoxville Art Museum to witness the electric saxophone wizardry of Sam Gendel. . . . Big Ears is a festival for music nerds who are interested not only in how a concert sounds, but also how it reflects the lived experiences of the people making the music."

Beth Howard (Illustration by N. Nichols)

As an activist and community organizer for Appalachia and the broader South, Beth Howard hopes her memoir, Song for a Hard-Hit People: A Memoir of Anti-Racist Solidarity From a Coal Miner’s Daughter, helps readers see Southern differences through a lens of curiosity that they can apply to their daily interactions with other people, writes Nhatt Nichols of Rural Assembly. Howard said, "I think one of the biggest lessons for me when I was learning to organize is the importance of listening and asking really good, open-ended questions." Nichols adds, "Howard advocates for getting out into your community and finding other people who are doing organizing work that resonates with you, and offering to lend a hand, to learn more about your community without centering your own ideas."